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Articles 1951 - 1980 of 2232
Full-Text Articles in Medicine and Health Sciences
Effects Of A Reading Inference Strategy Intervention On The Reading And Social Inference Abilities Of Adults With Asperger Syndrome, Kimberly A. Murza
Effects Of A Reading Inference Strategy Intervention On The Reading And Social Inference Abilities Of Adults With Asperger Syndrome, Kimberly A. Murza
Electronic Theses and Dissertations
The ability to generate inferences is a skill that is necessary to fully comprehend a text and understand the intentions, behaviors, and emotions of a conversational partner. Individuals with Asperger syndrome (AS) have been shown to demonstrate significant difficulty in inference generation in both social contexts and in reading comprehension. Although, the reciprocity of the four components of literacy (reading, writing, listening, and speaking) has been established in the literature (Bradley & Bryant, 1983; Catts & Kamhi, 2005; Englert & Thomas, 1987; Gillon & Dodd, 1995; Hiebert, 1980; Kroll, 1981; Ruddell & Ruddell, 1994); the relationship between inference generation in …
Nose To Brain Delivery Of Therapeutic Agents, Siva Ram Kiran Vaka
Nose To Brain Delivery Of Therapeutic Agents, Siva Ram Kiran Vaka
Electronic Theses and Dissertations
The potential treatment approaches for various disorders associated with central nervous system are invasive and do not allow frequent administration. Brain targeting of drugs by intranasal route is a safe and noninvasive method of drug delivery which allows frequent administration and is certainly more patient compliant than the currently folloinvasive methods. In this study, the plausibility of delivering neurotrophins [nerve growth factor (NGF) and brain derived neurotrophic factor (BDNF)], neurotrophinogenic agents (ex: carnosic acid) and antibiotics (ex: cefotaxime) to brain via nose-brain pathway using chitosan as barrier modulating agent was investigated. In vitro permeation studies of fluorescein isothiocyanate dextran (FD40k) …
Professional Preparation Of Secondary Health Education Teachers In Mississippi, Ensley Howell
Professional Preparation Of Secondary Health Education Teachers In Mississippi, Ensley Howell
Electronic Theses and Dissertations
The purpose of this study was to examine the professional preparation of secondary health education teachers in Mississippi. All four-year institutions of higher learning were contacted to determine the requirements for an approved program in order to obtain a supplemental endorsement in health, to compare the similarities and differences, and to determine the extent to which the approved programs reflect the ten content areas of the Mississippi Comprehensive Health Framework. This study also examined the status of secondary school health education programs in Mississippi by utilizing selected data from the U.S. Department of Health and Human Services Centers for Disease …
Photodisruption In Ocular Tissue Near And At The Boundary Between The Anterior Chamber And Crystalline Lens, Richard Ty Olmstead
Photodisruption In Ocular Tissue Near And At The Boundary Between The Anterior Chamber And Crystalline Lens, Richard Ty Olmstead
Electronic Theses and Dissertations
Lasers have been involved in Ophthalmology in the treatment of myopia and hyperopia for several years. Laser systems have transformed patients‟ quality of life, freeing them from the need for glasses, as in the case of LASIK. Ultrafast lasers have played an important role in surgery of the eye. In LASIK, they are used to cut the flap that is lifted to expose the stroma for UV Excimer laser treatment of this region. They are now being used for surgery deeper into the eye,for instance, treating the lens as part of treatments for cataract surgery. The use of ultrafast lasers …
Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients, Amma Serwaah-Bonsu
Comparative Retrospective Analysis Assessment Of Extracellular Volume Excess In Hypertensive Hemodialysis Patients, Amma Serwaah-Bonsu
Electronic Theses and Dissertations
Cardiovascular disease, including hypertension, accounts for almost 50% of the deaths in patients with end stage renal disease (ESRD) on hemodialysis (HD) yet hypertension remains very poorly controlled in this population. The purpose of this study was to retrospectively compare control of hypertension in hemodialysis (HD) patients when extracellular volume (ECV) was assessed and managed by clinical parameters and physical assessment data alone with control of hypertension when data from blood volume monitoring (BVM) technology was also used to assess and manage ECV in a freestanding outpatient hemodialysis unit. The main cause of hypertension in the ESRD population has been …
Identifying Patients At Risk For Obstructive Sleep Apnea In Primary Health Care : Can Obesity In Combination With Other High-Risk Diagnoses Be Used For Screening Purposes?, Clelia Lima
Electronic Theses and Dissertations
Obstructive sleep apnea (OSA) affects about 15 million adults in the United States, and is an independent risk factor for all-cause mortality. The under-diagnosing of OSA has been linked to the inadequate screening by primary care practitioners (PCPs). Existing screening tools are not widely used by PCPs possibly due to time constraints they experience as providers. This study demonstrates how common high-risk diagnoses (obesity, hypertension, diabetes mellitus type 2, dyslipidemia, arrhythmia, and coronary artery disease) can be used to help PCPs identify adult patients at risk for OSA. Unlike other screening tools, these diagnoses are easy to identify in a …
Factors Related To Birth Transition Success Of Late-Preterm Infants, Karen L. Wright
Factors Related To Birth Transition Success Of Late-Preterm Infants, Karen L. Wright
Electronic Theses and Dissertations
Problem: Identifying the factors effecting birth transition success of late preterm infants may improve early recognition of newborn compromise. Multiple explanatory variables may be associated with birth transition success or failure. The purpose of the study was to determine the prevalence of, and clinical-epidemiological and demographic predictive factors for birth transition success of late preterm infants. Methods: A retrospective case-control chart review was used to compare the characteristics of successful and unsuccessful birth transition of 35 and 36 week gestational age late-preterm infants delivered in a large tertiary-care center during calendar year 2007. A mixture of categorical and numeric variables …
Role Of Membrane Lipids In Modulating Protein Structure & Function, Ray Supriyo
Role Of Membrane Lipids In Modulating Protein Structure & Function, Ray Supriyo
Electronic Theses and Dissertations
A-B family of toxins consists of plant toxins such as ricin and bacterial toxins such as cholera. The A subunit is the enzymatic domain and the B subunit is the receptor binding domain. Commonly, these toxins bind to the target cell plasma membrane receptors through their B subunit followed by endocytosis and a transport to the endoplasmic reticulum (ER). Inside the ER, the A subunit dissociates from the rest of the toxin, unfolds and triggers the ER quality control mechanism of ER-associated degradation (ERAD). Most ERAD substrates are purged out of the ER into the cytosol for proteasomal degradation. However, …
Hybrid Adult Neuron Culture Systems For Use In Pharmacological Testing, Darin Keay Edwards
Hybrid Adult Neuron Culture Systems For Use In Pharmacological Testing, Darin Keay Edwards
Electronic Theses and Dissertations
Neuronal culture systems have many applications, such as basic research into neuronal structure, function, and connectivity as well as research into diseases, conditions, and injuries affecting the brain and its components. In vitro dissociated neuronal systems have typically been derived from embryonic brain tissue, most commonly from the hippocampus of E18 rats. This practice has been motivated by difficulties in supporting regeneration, functional recovery and long-term survival of adult neurons in vitro. The overall focus of this dissertation research was to develop a dissociated neuronal culture system from human and animal adult brain tissue, one more functionally and developmentally correlative …
Discovery And Optimization Of Novel Small-Molecular Inhibitors Suppressing Stat3-Dependent Tumor Process, Xiaolei Zhang
Discovery And Optimization Of Novel Small-Molecular Inhibitors Suppressing Stat3-Dependent Tumor Process, Xiaolei Zhang
Electronic Theses and Dissertations
With the critical role of aberrantly active Signal Transducer and Activator of Transcription (Stat) 3 protein in many human cancers, selective small-molecule inhibitors targeting the dimerization event which is required for stat3 activation, would be valuable as therapeutic agents. And the inhibitors will be useful chemical probes to clarify the complex biological functions of Stat3. By computational and structural analyses of the interaction between Stat3 and the lead dimerization disruptor, S3I-201, we have designed a diverse set of analogs. One of the most active analogs, S3I-201.1066 is derived to contain a cyclo-hexyl benzyl moiety on the amide nitrogen, which increases …
Genetic And Physiological Contribution Of Adrenergic Cells In Heart Development, Kingsley Osuala
Genetic And Physiological Contribution Of Adrenergic Cells In Heart Development, Kingsley Osuala
Electronic Theses and Dissertations
The adrenergic hormones norepinephrine (NE) and epinephrine (EPI) are essential for cardiovascular development as embryos lacking NE/EPI begin to die abruptly between embryonic days 10.5 and 11.5 due to apparent cardiac failure. The objective of this research aims to elucidate the mechanism of the embryonic fatality observed in the NE/EPI deficient mouse model. Here we utilized the dopamine β- hydroxylase knockout (Dbh-/-) mouse model, which lacks the gene and subsequent enzyme necessary for the conversion of dopamine to norepinephrine. Embryonic mouse hearts were extracted from Dbh+/+ (control) and Dbh-/- (experimental model) mice for mRNA transcript expression profiling. These studies were …
Genetically Modified Es Cells Enhance Cardiac Repair And Regeneration In The Infarcted Heart, Carley E. Glass
Genetically Modified Es Cells Enhance Cardiac Repair And Regeneration In The Infarcted Heart, Carley E. Glass
Electronic Theses and Dissertations
Transplanted embryonic stem (ES) cells following myocardial infarction (MI) contribute to limited cardiac repair and regeneration with improved function. Therefore novel strategies are still needed to enhance the efficacy by which ES cells differentiate into cardiac cell types and inhibit adverse remodeling in the infarcted myocardium. Our studies evaluate whether genetic manipulation of transplanted ES cells employing miR- 1, a pro-cardiac microRNA, and TIMP-1, an anti-apoptotic and anti-fibrotic protein, will enhance cardiac myocyte differentiation, inhibit native cardiac apoptosis, and reduce fibrosis in the infarcted myocardium. Furthermore, we assess levels of associated pro- (caspase-3, PTEN) and anti-(Akt) apoptotic proteins as well …
Translocation Of The Cholera Toxin A1 Subunit From The Endoplasmic Reticulum To The Cytosol, Michael Prentice Taylor
Translocation Of The Cholera Toxin A1 Subunit From The Endoplasmic Reticulum To The Cytosol, Michael Prentice Taylor
Electronic Theses and Dissertations
AB-type protein toxins such as cholera toxin (CT) consist of a catalytic A subunit and a cell-binding B subunit. CT proceeds through the secretory pathway in reverse, termed retrograde trafficking, and is delivered to the endoplasmic reticulum (ER). In order for the catalytic A1 subunit to become active it must separate from the rest of the holotoxin, and this dissociation event occurs in the ER lumen. CTA1 assumes an unfolded conformation upon dissociation from the holotoxin and is recognized by ERassociated degradation (ERAD), a quality control system that recognizes and exports misfolded proteins to the cytosol for degradation by the …
Clopidogrel Provision For Indigent Patients With St-Elevation Myocardial Infarction, Sita S. Price
Clopidogrel Provision For Indigent Patients With St-Elevation Myocardial Infarction, Sita S. Price
Electronic Theses and Dissertations
The Joint Commission in a joint effort with the Centers of Medicare and Medicaid Services (CMS) has established certain "core measures" by which hospital performance is measured. One of these is the measure for patients with ST-elevation myocardial infarction (STEMI) recommending percutaneous coronary intervention within 90 minutes of presentation to the Emergency Department in institutions that are able to provide this service. This recommendation does not take into account the long-term use of clopidogrel that is recommended by the American College of Cardiology and American Heart Association for patients that are treated with coronary stents. The purpose of this study …
Glial Differentiation Of Human Umbilical Stem Cells In 2d And 3d Environments, Hedvika Davis
Glial Differentiation Of Human Umbilical Stem Cells In 2d And 3d Environments, Hedvika Davis
Electronic Theses and Dissertations
During differentiation stem cells are exposed to a range of microenvironmental chemical and physical cues. In this study, human multipotent progenitor cells (hMLPCs) were differentiated from umbilical cord into oligodendrocytes and astrocytes. Chemical cues were represented by a novel defined differentiation medium containing the neurotransmitter norepinephrine (NE). In traditional 2 dimensional (2D) conditions, the hMLPCs differentiated into oligodendrocyte precursors, but did not progress further. However, in a constructed 3 dimensional (3D) environment, the hMLPCs differentiated into committed oligodendrocytes that expressed MBP. When co-cultured with rat embryonic hippocampal neurons (EHNs), hMLPCs developed in astrocytes or oligodendrocytes, based on presence of growth …
The Lived Experience Of Young-Onset Dementia, Debra A. Hunt
The Lived Experience Of Young-Onset Dementia, Debra A. Hunt
Electronic Theses and Dissertations
The lived experiences of dementia in older persons have been well studied, but the unique experiences of persons between ages 35 and 65 years who are living with young-onset dementia have not been closely examined. The purpose of the research was to explore the experiences of middle-aged individuals living with young-onset dementia. Van Manen‘s (1990) approach to interpretive phenomenological inquiry was used to answer the research question. Purposive sampling was used to recruit 9 people between 42 to 61 years of age who had received a formal diagnosis of mild or early-stage dementia. Participants were prescreened for the ability to …
A Comparison Of Stimuli Presentation In Advanced Theory Of Mind Tasks For Adolescents With Asperger's Syndrome (As), Juliet N. Leon
A Comparison Of Stimuli Presentation In Advanced Theory Of Mind Tasks For Adolescents With Asperger's Syndrome (As), Juliet N. Leon
Electronic Theses and Dissertations
Individuals diagnosed with Asperger‟s Syndrome (AS) have marked impairments in social interaction, including difficulty expressing and perceiving thoughts, emotions, and intentions. This deficit may be due in part to a delayed or underdeveloped Theory of Mind (ToM). The previous research investigating ToM in individuals with AS has been inconclusive. The purpose of this study was to compare three Theory of Mind (ToM) tasks, presented via three different modalities, to evaluate the recognition of complex emotions and mental states in adolescents with AS compared to typically developing adolescents. Participants in this study included twenty adolescents: 10 adolescents with AS and 10 …
Curriculum Vocabulary Acquisition Of 4th Graders Using A Language-Sensitive Teaching Approach, Joanna H. Spielvogel
Curriculum Vocabulary Acquisition Of 4th Graders Using A Language-Sensitive Teaching Approach, Joanna H. Spielvogel
Electronic Theses and Dissertations
The purpose of this pilot study was to determine if a direct, explicit method of teaching vocabulary with a Vocabulary Scenario Technique-Language Sensitive protocol (VST-LS) would yield gains in the vocabulary knowledge of 4th grade students greater than those seen in 4th grade students receiving vocabulary instruction typical to some general education classrooms. VST-LS is a detailed description of procedures intended to be used by a teacher in a general education classroom for direct vocabulary instruction. The VST-LS protocol provides for 14 word encounters involving listening, reading, writing, and speaking. Forty-one 4 th grade students consisting of 18 males and …
Perceptions Of Maternal Stress And Neonatal Patient Outcomes In A Single Private Room Versus Open Room Neonatal Intensive Care Unit Environment., Lisa M. Smithgall
Perceptions Of Maternal Stress And Neonatal Patient Outcomes In A Single Private Room Versus Open Room Neonatal Intensive Care Unit Environment., Lisa M. Smithgall
Electronic Theses and Dissertations
Limited clinical evidence exists regarding whether the single private room Neonatal Intensive Care Unit (NICU) environment of care delivery has a positive, negative, or neutral impact on health outcomes for the high risk neonate and on maternal stress as compared to the open room design. The study purpose was to examine whether a difference exists in health outcomes in the open room versus single private room NICU environment. The factors considered were weight gain, ventilator days, hospital length of stay, incidence and grade of intraventricular hemorrhage (IVH), the number of parental visits, and perceptions of maternal stress. Infants hospitalized in …
Mathematical Modeling, Simulation, And Time Series Analysis Of Seasonal Epidemics., Eric Shu Numfor
Mathematical Modeling, Simulation, And Time Series Analysis Of Seasonal Epidemics., Eric Shu Numfor
Electronic Theses and Dissertations
Seasonal and non-seasonal Susceptible-Exposed-Infective-Recovered-Susceptible (SEIRS) models are formulated and analyzed. It is proved that the disease-free steady state of the non-seasonal model is locally asymptotically stable if Rv < 1, and disease invades if Rv > 1. For the seasonal SEIRS model, it is shown that the disease-free periodic solution is locally asymptotically stable when R̅v < 1, and I(t) is persistent with sustained oscillations when R̅v > 1. Numerical simulations indicate that the orbit representing I(t) decays when R̅v < 1 < Rv. The seasonal SEIRS model with routine and pulse vaccination is simulated, and results depict an unsustained decrease …
The Effect Of Sternocleidomastoid Muscle Activation Pattern And Feedback Condition On The Vestibular Evoked Myogenic Potential., Mary Jo Davenport
The Effect Of Sternocleidomastoid Muscle Activation Pattern And Feedback Condition On The Vestibular Evoked Myogenic Potential., Mary Jo Davenport
Electronic Theses and Dissertations
The vestibular evoked myogenic potential (VEMP) has been shown to be clinically useful in providing diagnostic information regarding the function of the otolith receptors, inferior vestibular nerve, and vestibulospinal pathways. The VEMP is a biphasic response elicited by loud clicks or tone bursts and recorded from the tonically contracted sternocleidomastoid (SCM) muscle. Because the VEMP is an inhibitory response, it is important to investigate stimulus and parameter characteristics in order to determine the optimal test protocol and maximize clinical usefulness. The aims of this study were 1) to evaluate the effects of 4 different methods of SCM muscle activation and …
Our Health Matters: Promoting The Health Of Sexual Minority Women In The New Media Landscape, Brenda Kane
Our Health Matters: Promoting The Health Of Sexual Minority Women In The New Media Landscape, Brenda Kane
Electronic Theses and Dissertations
The shifts occurring in the mediascape and the field of public health offer new opportunities for promoting the health and wellness of sexual minority women. As a population that has historically been underserved by the healthcare system, sexual minority women face multiple barriers to achieving positive health outcomes. They are often less likely to access preventive healthcare services and more likely to engage in risky behaviors that are detrimental to health than heterosexual women. Despite the significant health disparities among sexual minority women, studying this population has not been a priority in health research and there is little research-based evidence …
Rural Versus Urban: Tennessee Health Administrators' Strategies On Recruitment And Retention For Allied Health Professionals., Derek Ray Slagle
Rural Versus Urban: Tennessee Health Administrators' Strategies On Recruitment And Retention For Allied Health Professionals., Derek Ray Slagle
Electronic Theses and Dissertations
There is a growing interest in understanding recruitment, retention, and turnover of allied health professionals considering employment trends and workforce mobility, an increased need to understand the healthcare delivery system, and the dynamic nature of the allied health workforce especially for rural areas. A survey was sent to allied health administrators across a variety of allied health disciplines from the state of Tennessee hospitals in order to gauge opinions on retention and recruitment strategies. Overall successful strategies for recruitment and retention of allied health professionals were reported as well as differences between urban and rural areas, differences among allied health …
Narcissism And Binge Drinking: Exploring The Role Of Overconfidence And Confidence-Based Risk-Taking., Alicia M. Wood
Narcissism And Binge Drinking: Exploring The Role Of Overconfidence And Confidence-Based Risk-Taking., Alicia M. Wood
Electronic Theses and Dissertations
Binge drinking (BD) entails excessive alcohol intake in a short time period. Despite numerous negative outcomes associated with BD and efforts to curtail it, rates remain steady. Thus, it is important to identify "who" binge drinks and "why" it occurs. Drawing from past research, I sought to replicate the link between trait narcissism and BD; moreover, I examined if overconfidence and confidence-based risk-taking assessed via the Georgia Gambling Task (GGT), explained why they did so. The results generally supported my hypotheses. As expected, narcissism related to poor GGT performance and high levels of BD; likewise, poor GGT performance related to …
Synthesis Of A Water Soluble Resveratrol Derivative As A Potential Anti-Cancer Drug., Augustine Essel
Synthesis Of A Water Soluble Resveratrol Derivative As A Potential Anti-Cancer Drug., Augustine Essel
Electronic Theses and Dissertations
Research on development of water soluble anti-cancer drugs is one of the great challenges of modern medicinal chemistry. Resveratrol (Res) is one of the many phytoalexins producing stilbenoids present in several medicinal plants, grape skin, peanuts, and red wine. It has been found to exhibit anti-cancer, anti-inflammatory, and anti-oxidant properties. Water solubility and bioavailability are some of the setbacks of this interesting compound. In view of this, effort has been made to synthesize amino acid derivative of resveratrol to improve its bioavailability and solubility in water. Methyl 4-{-[(1E)-2-(3, 5-dihydroxyphenyl)-ethenyl] - phenoxy} butyrate (7), a novel ester intermediate, has been synthesized …
The Effects Of An Actiped Pedometer Intervention Program On Body Composition And Aerobic Capacity Of Youth In A School System In East Tennessee., Kristie Russell Coleman
The Effects Of An Actiped Pedometer Intervention Program On Body Composition And Aerobic Capacity Of Youth In A School System In East Tennessee., Kristie Russell Coleman
Electronic Theses and Dissertations
The purpose of this study is to determine if the ActiPed Pedometer Intervention Program would sustain or improve aerobic capacity or body composition scores over a 12-week period for students ages 8-12 in a school system in East Tennessee. Obesity is an epidemic in Tennessee and in the United States. In fact, Tennessee has the 5th highest obesity rates for youth in the United States. National and State Legislations with physical activity and wellness mandates are being passed at an alarming rate as the need to combat the obesity epidemic is astonishing. The responsibility to decrease the obesity rates …
Trends In International Compulsory Licensing Of Pharmaceuticals Since The Institution Of The Trade-Related Aspects Of Intellectual Property Protection (Trips) Agreement, Reed F. Beall
Electronic Theses and Dissertations
The Trade-related Aspects of Intellectual Property Rights (TRIPS) Agreement went into effect for World Trade Organization (WTO) members in 1995. The agreement defines minimum standards of patent protection that must eventually be observed by all signatories. TRIPS includes "compulsory licensing", a policy that allows for states under certain conditions to permit the use of a patented innovation without the consent of the patent holder. This paper considers instances of compulsory licenses (CLs) aimed to increase access to pharmaceuticals during urgent public health scenarios. The WTO maintains no registry of CLs; therefore, this research is an effort to catalog as many …
Effects Of Patient Trauma On Hospital Staff Functioning: An Exploratory Study Of Psychological Distress Resulting From Trauma Exposure, Randy Allen Braley
Effects Of Patient Trauma On Hospital Staff Functioning: An Exploratory Study Of Psychological Distress Resulting From Trauma Exposure, Randy Allen Braley
Electronic Theses and Dissertations
The present study attempted to determine the relationship between exposure to traumatic experiences of hospitalized children and adolescents and the development of secondary traumatic stress, also known as compassion fatigue, vicarious traumatization, or burnout in clinical staff working with such patients. Hierarchical regression was used to test the hypotheses that: clinical treatment staff will experience higher levels of psychological distress following exposure to patient trauma and previous lifetime trauma events; clinical treatment staff will experience quality of patient relationships associated with the degree of exposure to patient trauma, previous lifetime or work-related trauma history, and level of supervisor support; clinical …
Assessing Adult Attitudes Toward End-Of-Life Issues And Advanced Directives After Implementing An Educational Intervention In A, Marchina Tolbert-Jones
Assessing Adult Attitudes Toward End-Of-Life Issues And Advanced Directives After Implementing An Educational Intervention In A, Marchina Tolbert-Jones
Electronic Theses and Dissertations
Purpose: There is a lack of discussion regarding end-of-life care planning which results in low advanced directive execution (AD) rates. This can lead to decision making by family, friends, and the health care team on behalf of patients whose end-of-life care wishes are unknown. The purpose of this study was to determine the effectiveness of an educational intervention in the work setting to increase end-of-life discussions and the execution of advanced directives. Methods: A descriptive design was used in an occupational workplace setting at a local bottling company after appropriate IRB approval was obtained. An educational intervention based on the …
Pharmacists' Rating Of Relevance Of Available Information In Deciding The Validity Of Opioid Medication Prescriptions, Leonardo Roberto Torres
Pharmacists' Rating Of Relevance Of Available Information In Deciding The Validity Of Opioid Medication Prescriptions, Leonardo Roberto Torres
Electronic Theses and Dissertations
Pharmacists are tasked with making decisions regarding the validity of prescriptions. Some have proposed factors that should be considered when evaluating a prescription's validity. Yet, there is little known about the decision process that pharmacists employ at the time of dispensing and what information pharmacists deem relevant in that decision-making process. Using an online survey instrument, a sample of community pharmacists were divided into three groups and presented with a prescription scenario. They were asked to rate the relevance of information, which is proposed to be appropriate and inappropriate, available at the time of dispensing. They were asked to consider …