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Biomedical subjects

M D Shepherd

Publications and source records attributed to M D Shepherd.

45 records · Page 3Linked to original sources
PubMedDate not supplied

Outpatient prescription drug use by children enrolled in five drug benefit plans.

This study examined prescription drug use among ambulatory children younger than 18 years of age enrolled in five drug benefit plans. Data for this study were obtained from the pharmacy benefit manager who administers the drug benefit plans. During the study period of December 29, 1992, through December 28, 1993, 3144 children younger than 18 years of age (34.0% of the total plan enrollment) were enrolled in the five drug benefit plans. A total of 8547 prescription drugs were dispensed to the study population. The mean prescription price was $16.38, and the mean duration of therapy was 11.7 days. The mean prescription price was $1.56 more for boys than for girls. The most frequently dispensed drugs were antibiotics (42.0%), followed by cold preparations (15.9%). The annual prevalence rate of prescription drug use was 59.1 cases per 100 children. The study population-based annual frequency rate was 3.2 prescriptions per child, and the drug user-based annual frequency rate was 5.5 prescriptions per child. The annual expenditures were $51.85 per child and $90.39 per drug users, with the out-of-pocket expenditures being $19.09 and $33.04, respectively. The prevalence rate varied little by sex. However, both frequency and expenditure rates differed by sex and decreased with age. Higher levels of cost sharing per prescription were associated with higher prevalence, frequency, and expenditure rates. Larger cost-sharing differentials between generic and brand name drugs were associated with higher rates of generic drug use but were not always associated with lower expenditure rates.

Adolescent↗
PubMedDate not supplied

Pharmaceutical products declared by US residents on returning to the United States from Mexico.

The overall objective of this research project was to measure the types and amounts of Mexican drug products being purchased and declared to US Customs by US residents crossing the border in Laredo, Texas. Data for this study were obtained from the US Customs Declaration Form, which each person completes as he or she reenters the United States. Data included demographic information as well as the types and quantities of medications purchased. Data were collected from a randomly selected sample of 84 days between July 1994 and June 1995. A total of 5624 declaration forms were analyzed. The average age of people who declared medications was 34.5 years. Only 9.3% of the people were 50 years of age or older. Fourteen of the top 15 drug products declared are classified in the United States as "controlled" substances. In examining the quantities of medications being declared, on average 11,057 diazepam tablets were declared each day, which is equivalent to 4,035,842 diazepam tablets per year. On average 4033 tablets of flunitrazepam were declared each day, which is equivalent to 1,472,045 tablets a year declared at one US port of entry. On average, there were 2.48 drug products listed on each declaration form. The majority of the drug products were controlled substances and, based on the types and quantities of products being declared, many questions can be raised with regard to US policies on the control and safety of Mexican drugs coming into the United States.

Adult↗
PubMedDate not supplied

Does the in-hospital BMET face obsolescence?

Changes in electronic technology, increased BMET manpower costs, and changes in hospital purchasing procedures are reducing the hospital's need for an in-hospital, bench technician. A new technologist will probably evolve. As repairs decline, greater emphasis will be placed on device-operator education, the device-patient interface, performance assurance and safety inspections, and coordination of device safety and functional problems. In-hospital BMET's should recognize these changes and prepare themselves for this new role. Certification commissions must establish curriculum and procedural requirements that are responsive to rapid technological change.

Biomedical Engineering↗
PubMedDate not supplied

The etiology of loosened connections in hospital-grade plugs.

The loosening of terminal connections over time in wired, hospital-grade plugs has been reported. This study was performed to determine the extent of the problem and the cause(s) of the loosening connections. Of 45 hospitals responding to the survey, 15 reported a total of 25 melted plugs. Terminal torques were measured on the plugs of ninety-nine randoMly selected medical devices; 21% of the inspected torques measured zero in-lbs. Static mechanical tests were performed on the plug terminals of five manufacturers. A maximum decrease in torque of 18% was noted over a 6-month period. The combined affects of current cycling and cold flow on the terminal torques were also noted to be about 43% over a six-month period. Loosening torques appear to be more frequently associated with appliances requiring high currents and those that are frequently inserted and withdrawn from receptacles. It is concluded that a serious problem exists with loosened terminals in hospital-grade plugs. Until a design change can correct this screw loosening, maintenance groups have a responsibility to assure adequately low wire-to-terminal resistances. A semi-annual torquing of the plug connections of critical function medical devices should be considered.

California↗