This paper argues that there is a class of terms, orusesof terms, that are best accounted for by ... more This paper argues that there is a class of terms, orusesof terms, that are best accounted for by an expressivist account. We put forward two sets of criteria to distinguish between expressive and factual (uses of) terms. The first set relies on the action-guiding nature of expressive language. The second set relies on the difference between one's evidence for making an expressive vs. factual statement. We then put those criteria to work to show, first, that the basic evaluative adjectives such as ‘good’ have expressive as well as factual uses and, second, that many adjectives whose primary meanings are factual, such as ‘powerful’, also have expressive uses.
PURPOSE: Guidelines emphasize appropriate empiric antibiotic selection in the management of pneum... more PURPOSE: Guidelines emphasize appropriate empiric antibiotic selection in the management of pneumonia; nevertheless, health-systems have been slow to adopt these recommendations. Our aim was to determine guideline-adherence rates among CAP, HCAP, HAP, and VAP patients at our institution. METHODS: Data were retrospectively collected from the medical charts for patients admitted to the intensive care unit at University Health System from Jan 2002-Dec 2006. All patients had clinically-confirmed pneumonia. Baseline demographics, co-morbidities, presenting signs and symptoms, antibiotics, complications, and health outcomes were collected. CAP, HCAP, HAP, and VAP patients were divided into 2 sub-groups based on the receipt of guideline-adherent antibiotic therapy. Yearly adherence rates were assessed for trend using regression models. Two sensitivity analyses were performed: 1) CAP and HCAP patients who received an antipseudomonal beta-lactam (APBL) were added to the CAP and HCAP guidelin...
International journal of pharmaceutical compounding
Prior studies demonstrated improved menopausal symptom relief following treatment with compounded... more Prior studies demonstrated improved menopausal symptom relief following treatment with compounded bioidentical hormone replacement therapy; however, clinical effectiveness studies evaluating different routes of bioidentical hormone replacement therapy administration are lacking. The objective of this study was to determine the effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy for the treatment of vasomotor, mood, and other quality-of-life symptoms in post-menopausal women. This was a prospective, observational cohort study of women > or = 18 years of age who received a compounded sublingual or topical bioidentical hormone replacement therapy preparation between January 1, 2003 and October 1, 2010 in a community pharmacy. Data collection included patient demographics, comorbidities, hormone regimens, and therapeutic outcomes. Patients rated their vasomotor, mood, and quality-of-life symptoms as absent, mild, moderate, or severe at baseline...
Este caso tiene el objetivo de guiar al lector en el proceso de innovación incremental de un prod... more Este caso tiene el objetivo de guiar al lector en el proceso de innovación incremental de un producto. La guía hacia la innovación comienza con la revisión de tendencias de diseño y finaliza con la elaboración de un brief de diseño. El caso toma el ejemplo de la empresa Gesta Diseño® como medio para guiar un proceso de innovación que permita a la empresa apoyar la representación de su marca. En el marco de la innovación incremental, Gesta Diseño® supone una innovación pequeña pero constante que, apoyada en su imagen de marca, permita a la empresa obtener una ventaja competitiva en el mercado. La principal recomendación del caso es usar la estrategia de innovación incremental como herramienta para el fortalecimiento de marca de una pequeña empresa.
Journal of the American Pharmacists Association, 2010
Objectives: To quantify influenza vaccination rates and determine perceived barriers to influenza... more Objectives: To quantify influenza vaccination rates and determine perceived barriers to influenza vaccination among U.S. pharmacists from various practice settings. Design: Prospective study. Setting: United States in 2008. Participants: 1,028 respondents, including 895 pharmacists. Intervention: A survey request was distributed manually at the 2008 National Community Pharmacists Association annual meeting, and an initial e-mail was sent with two follow-up e-mails to all pharmacists who receive e-mails via Pharmacist e-link. Main outcome measures: Vaccination rates and barriers to vaccination among pharmacists. Results: Pharmacists reported an influenza vaccination rate of 78%, with coverage varying across practice settings: hospital (88%), academia (86%), clinic (83%), and community (75%). Employers infrequently required the influenza vaccine as a condition of employment (7%), and slightly more than one-half (58%) compensated pharmacists for being vaccinated; both of these were significantly associated with higher influenza vaccination rates (P < 0.001 for both). One-quarter of pharmacists (26%) expressed at least one issue regarding the influenza vaccine. Pharmacists were significantly less likely to be vaccinated if they expressed a concern (91% vs. 43%, P < 0.0001). Community pharmacists were significantly less likely to be compensated for receiving the influenza vaccination and significantly more likely to express one or more concerns than pharmacists from any other practice setting. Conclusion: Pharmacists reported high influenza vaccination rates overall, with slight variability among practice settings. Although employers infrequently required influenza vaccination, approximately one-half of employers compensated their pharmacists for being vaccinated. Employer incentives and pharmacist attitudes were highly correlated with influenza vaccination.
Background Bioidentical Hormone Replacement Therapy (BHRT) is believed it to be a safer and equal... more Background Bioidentical Hormone Replacement Therapy (BHRT) is believed it to be a safer and equally effective alternative to Conventional Hormone Therapy for the relief of menopausal symptoms; however, data are needed to support these claims. The objective of this study is to evaluate the effectiveness of compounded BHRT provided in six community pharmacies. Methods This was an observational cohort study of women between the ages of 18-89 who received a compounded BHRT product from January 1, 2003 to April 30, 2010 in six community pharmacies. Data included patient demographics, comorbidities, therapeutic outcomes, and hormone therapies. Women self-rated menopausal symptoms as absent, mild, moderate, or severe. Descriptive statistics were used to characterize the patient population, BHRT use, and adverse events. Patient symptom severity was compared at baseline and 3 to 6 months follow-up using the Wilcoxon signed-rank test. Results Women (n = 296) receiving BHRT at Oakdell Pharmacy...
Background: Six hospitals instituted a voluntary, system-wide, pathway for community acquired pne... more Background: Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost. Methods: Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750 mg monotherapy or ceftriaxone 1000 mg plus azithromycin 500 mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost. Results: Overall, 792 patients met study criteria. Of these, 505 (64%) received pathway antibiotics and 287 (36%) received non-pathway antibiotics. Adjusted means and p-values were derived from Least Squares regression models that included Pneumonia Severity Index risk class, patient age, heart failure, chronic obstructive pulmonary disease, and admitting hospital as covariates. After adjustment, patients who received pathway antibiotics experienced lower adjusted 90-day mortality (p = 0.02), shorter mean hospital LOS (3.9 vs. 5.0 days, p < 0.
This paper argues that there is a class of terms, orusesof terms, that are best accounted for by ... more This paper argues that there is a class of terms, orusesof terms, that are best accounted for by an expressivist account. We put forward two sets of criteria to distinguish between expressive and factual (uses of) terms. The first set relies on the action-guiding nature of expressive language. The second set relies on the difference between one's evidence for making an expressive vs. factual statement. We then put those criteria to work to show, first, that the basic evaluative adjectives such as ‘good’ have expressive as well as factual uses and, second, that many adjectives whose primary meanings are factual, such as ‘powerful’, also have expressive uses.
PURPOSE: Guidelines emphasize appropriate empiric antibiotic selection in the management of pneum... more PURPOSE: Guidelines emphasize appropriate empiric antibiotic selection in the management of pneumonia; nevertheless, health-systems have been slow to adopt these recommendations. Our aim was to determine guideline-adherence rates among CAP, HCAP, HAP, and VAP patients at our institution. METHODS: Data were retrospectively collected from the medical charts for patients admitted to the intensive care unit at University Health System from Jan 2002-Dec 2006. All patients had clinically-confirmed pneumonia. Baseline demographics, co-morbidities, presenting signs and symptoms, antibiotics, complications, and health outcomes were collected. CAP, HCAP, HAP, and VAP patients were divided into 2 sub-groups based on the receipt of guideline-adherent antibiotic therapy. Yearly adherence rates were assessed for trend using regression models. Two sensitivity analyses were performed: 1) CAP and HCAP patients who received an antipseudomonal beta-lactam (APBL) were added to the CAP and HCAP guidelin...
International journal of pharmaceutical compounding
Prior studies demonstrated improved menopausal symptom relief following treatment with compounded... more Prior studies demonstrated improved menopausal symptom relief following treatment with compounded bioidentical hormone replacement therapy; however, clinical effectiveness studies evaluating different routes of bioidentical hormone replacement therapy administration are lacking. The objective of this study was to determine the effectiveness of sublingual and topical compounded bioidentical hormone replacement therapy for the treatment of vasomotor, mood, and other quality-of-life symptoms in post-menopausal women. This was a prospective, observational cohort study of women > or = 18 years of age who received a compounded sublingual or topical bioidentical hormone replacement therapy preparation between January 1, 2003 and October 1, 2010 in a community pharmacy. Data collection included patient demographics, comorbidities, hormone regimens, and therapeutic outcomes. Patients rated their vasomotor, mood, and quality-of-life symptoms as absent, mild, moderate, or severe at baseline...
Este caso tiene el objetivo de guiar al lector en el proceso de innovación incremental de un prod... more Este caso tiene el objetivo de guiar al lector en el proceso de innovación incremental de un producto. La guía hacia la innovación comienza con la revisión de tendencias de diseño y finaliza con la elaboración de un brief de diseño. El caso toma el ejemplo de la empresa Gesta Diseño® como medio para guiar un proceso de innovación que permita a la empresa apoyar la representación de su marca. En el marco de la innovación incremental, Gesta Diseño® supone una innovación pequeña pero constante que, apoyada en su imagen de marca, permita a la empresa obtener una ventaja competitiva en el mercado. La principal recomendación del caso es usar la estrategia de innovación incremental como herramienta para el fortalecimiento de marca de una pequeña empresa.
Journal of the American Pharmacists Association, 2010
Objectives: To quantify influenza vaccination rates and determine perceived barriers to influenza... more Objectives: To quantify influenza vaccination rates and determine perceived barriers to influenza vaccination among U.S. pharmacists from various practice settings. Design: Prospective study. Setting: United States in 2008. Participants: 1,028 respondents, including 895 pharmacists. Intervention: A survey request was distributed manually at the 2008 National Community Pharmacists Association annual meeting, and an initial e-mail was sent with two follow-up e-mails to all pharmacists who receive e-mails via Pharmacist e-link. Main outcome measures: Vaccination rates and barriers to vaccination among pharmacists. Results: Pharmacists reported an influenza vaccination rate of 78%, with coverage varying across practice settings: hospital (88%), academia (86%), clinic (83%), and community (75%). Employers infrequently required the influenza vaccine as a condition of employment (7%), and slightly more than one-half (58%) compensated pharmacists for being vaccinated; both of these were significantly associated with higher influenza vaccination rates (P < 0.001 for both). One-quarter of pharmacists (26%) expressed at least one issue regarding the influenza vaccine. Pharmacists were significantly less likely to be vaccinated if they expressed a concern (91% vs. 43%, P < 0.0001). Community pharmacists were significantly less likely to be compensated for receiving the influenza vaccination and significantly more likely to express one or more concerns than pharmacists from any other practice setting. Conclusion: Pharmacists reported high influenza vaccination rates overall, with slight variability among practice settings. Although employers infrequently required influenza vaccination, approximately one-half of employers compensated their pharmacists for being vaccinated. Employer incentives and pharmacist attitudes were highly correlated with influenza vaccination.
Background Bioidentical Hormone Replacement Therapy (BHRT) is believed it to be a safer and equal... more Background Bioidentical Hormone Replacement Therapy (BHRT) is believed it to be a safer and equally effective alternative to Conventional Hormone Therapy for the relief of menopausal symptoms; however, data are needed to support these claims. The objective of this study is to evaluate the effectiveness of compounded BHRT provided in six community pharmacies. Methods This was an observational cohort study of women between the ages of 18-89 who received a compounded BHRT product from January 1, 2003 to April 30, 2010 in six community pharmacies. Data included patient demographics, comorbidities, therapeutic outcomes, and hormone therapies. Women self-rated menopausal symptoms as absent, mild, moderate, or severe. Descriptive statistics were used to characterize the patient population, BHRT use, and adverse events. Patient symptom severity was compared at baseline and 3 to 6 months follow-up using the Wilcoxon signed-rank test. Results Women (n = 296) receiving BHRT at Oakdell Pharmacy...
Background: Six hospitals instituted a voluntary, system-wide, pathway for community acquired pne... more Background: Six hospitals instituted a voluntary, system-wide, pathway for community acquired pneumonia (CAP). We proposed this study to determine the impact of pathway antibiotics on patient survival, hospital length of stay (LOS), and total hospital cost. Methods: Data were collected for adults from six U.S. hospitals with a principal CAP discharge diagnosis code, a chest infiltrate, and medical notes indicative of CAP from 2005-2007. Pathway and non-pathway cohorts were assigned according to antibiotics received within 48 hours of admission. Pathway antibiotics included levofloxacin 750 mg monotherapy or ceftriaxone 1000 mg plus azithromycin 500 mg daily. Multivariable regression models assessed 90-day mortality, hospital LOS, total hospital cost, and total pharmacy cost. Results: Overall, 792 patients met study criteria. Of these, 505 (64%) received pathway antibiotics and 287 (36%) received non-pathway antibiotics. Adjusted means and p-values were derived from Least Squares regression models that included Pneumonia Severity Index risk class, patient age, heart failure, chronic obstructive pulmonary disease, and admitting hospital as covariates. After adjustment, patients who received pathway antibiotics experienced lower adjusted 90-day mortality (p = 0.02), shorter mean hospital LOS (3.9 vs. 5.0 days, p < 0.
Uploads
Papers by Andres Ruiz