(13)C mixed triglyceride breath testing using infrared spectrometry: comparison of two devices in early infancy.

BACKGROUND/OBJECTIVES: The (13)C mixed triglyceride (MTG) breath test has been proposed for the non-invasive assessment of fat digestion and absorption. To evaluate whether reference values for the adequacy of fat absorption, set in the non-dispersive infrared spectrometry (NDIRS) system software proposed for healthy children and adults using the (13)C MTG breath test, are also applicable to infants of <5 months of age. SUBJECTS/METHODS: (13)C MTG breath testing with the NDIRS technique was performed in 54 healthy infants <5 months of age (38 breast-fed, 16 formula-fed) and six infants diagnosed with cystic fibrosis (CF) using two NDIRS devices, IRIS and FANci2. RESULTS: The IRIS results were slightly higher compared with those assessed by the FANci2 device. The minimum cutoff value for pancreatic sufficiency (PS) is set as a cumulative percentage dose of (13)C recovered (cPDR) after 5 h of 13.0%. Pancreatic function status of six CF infants, three with PS and three with pancreatic insufficiency (PI), according to the 72 h-faecal fat balance test could be correctly determined with the (13)C MTG breath test using two NDIRS techniques. However, if these reference values had been used to determine pancreatic function status in healthy infants, 26 out of 54 infants would have been misclassified as pancreatic insufficient. CONCLUSIONS: Although the (13)C MTG breath test with the MS technique has the potential to be a suitable assessment of fat absorption in infants, the technique of NDIRS appears too insensitive in an infant population group.

STEP sisters, sex, and STDs: a process evaluation of the recruitment of lay health advisors.

Individual interviews, field observations, and group debriefings were used in this qualitative study that assessed the accuracy of the recruitment strategy used to identify natural helpers to assist African American women, aged 18-34, to prevent and seek care for sexually transmitted diseases (STDs). The study indicates that the recruitment strategy is effective when a list of natural helpers is generated by advisory groups from the same geographic community. Screening protocols used to interview potential natural helpers appear to reduce later barriers to advising on sensitive topics like STDs. The data suggest the importance of using community members to identify natural helpers and the importance of addressing sensitive topics early in the recruitment process.

Practitioners' assessment of the externship experience: a retrospective analysis. Part I.

This study examines the externship experience of participants in the first four years of Illinois' mandatory externship program. A questionnaire was developed and mailed to a sample of 300 pharmacists resulting in a 60 percent response rate. Analysis of the data suggest a generally positive attitude toward externship and this was especially true for more recent graduates. It was also found that preceptors were perceived as positive role models, that externship had only slightly positive impact on preparing the respondents for practice and their perceived development of self confidence, and had virtually no influence on their ultimate choice of practice environment. These findings hold important implications for future refinements of externship programs.

Practitioners' assessment of the externship experience: a retrospective analysis. Part II.

This study further examines the externship of participants in the first four years of Illinois' mandatory externship program utilizing a mail survey as described in an earlier report. This presentation focuses on the accomplishment of specific objectives during the externship and assesses their importance in current pharmacy practice. The data revealed that, on average, these objectives were perceived to have been only slightly to moderately accomplished yet were rated between moderate and high importance to current practice. Females rated the objective statements pertaining to patient contact and drug monitoring skills more favorably than males, but reported lower ratings for both the accomplishment and importance of administrative skills when compared to male respondents. Several significant differences were found based on externship environment and further emphasize the need for multi-environmental experiences in practice based programs.

Implementing clinical pathways in a small agency: surviving IPS and preparing for PPS.

A rural health department-based home health agency's financial status was jeopardized by the BBA's per-beneficiary and reduced per-visit cost limits. This article describes the process used and the benefits gained from reorganizing operations and traditional practice patterns. These strategies are helping position the agency for PPS later this year.