scholarly journals The medication discrepancy detection service: A cost-effective multidisciplinary clinical approach

2021 ◽  
Vol 53 (1) ◽  
pp. 43-50
Author(s):  
Ainhoa Oñatibia-Astibia ◽  
Amaia Malet-Larrea ◽  
Amaia Mendizabal ◽  
Elena Valverde ◽  
Belen Larrañaga ◽  
...  
2014 ◽  
Vol 6 (3) ◽  
pp. 195 ◽  
Author(s):  
Janet Titchener

INTRODUCTION: Patient-centred care has proven to be cost-effective, with a positive impact on health outcomes. A patient-centred approach is recognised as a desirable component of diabetes care. AIM: The aim of this audit was to determine if the specific patient-centred intervention offered by a clinical service (GPSI Diabetes service) improves diabetes care, as measured by changes in glycosylated haemoglobin (HbA1c). METHODS: The GPSI Diabetes service is a community-based service, run by a general practitioner with a specific interest (GPSI) in diabetes, and a practice nurse. Adults with diabetes are referred to the service by their general practitioner (GP) and care is provided using a set of loosely structured diabetes-specific patient-centred approaches. Following a series of visits, patients are discharged back to their GP. Baseline HbA1c was recorded at intake and for two years after discharge from the service. Patient and GP satisfaction questionnaires were also completed. RESULTS: New Zealand (NZ) Europeans and Maori with Type 2 diabetes and Type 1 diabetes experienced immediate and sustained (two-year) improvements in HbA1c. At intake, baseline HbA1c for Maori was higher than that of NZ Europeans. However, following this patient-centred intervention, this difference was reduced. None of the returned GP or patient questionnaires contained negative feedback, although the patient response rate was low. DISCUSSION: A patient-centred clinical approach to diabetes can contribute to significant and sustained reductions in HbA1c. This clinical approach is potentially reproducible in other clinical settings and could also be applied to the management of other chronic conditions. KEYWORDS: Chronic disease; clinical audit; diabetes mellitus; patient-centered care; self-management


Author(s):  
Behnaz Mirza Ahmadi ◽  
Mahmood Talkhabi ◽  
Sarah Rajabi

Introduction: Skeletal muscles account for about 40% of the total body weight. Every year, hundreds of people lose at least part of their muscle tissue due to illness, war, and accidents. This can lead to disruption of activities such as breathing, movement, and social life. To this end, various therapeutic strategies such as medication therapy, cell therapy and tissue transplantation have been used or studied in muscle regeneration. However, there is no effective and well-defined clinical approach for treatment of muscle injuries and the severity of muscle injuries increase with age in most cases. Therefore, investigation for finding new and effective clinical approach for muscle regeneration is one of the most important issues in basic and clinical researches. Tissue engineering is considered as one of the promising and newest approach for skeletal muscle tissue regeneration and provides an appropriate model for personalized medicine and basic researches that can be used in personalized medicine and basic research. Besides biomaterials and cells, inducing factors are another element of tissue engineering. These factors influence epigenetic mechanisms and signaling pathway, thereby inducing proliferation, differentiation, and migration of cells used in muscle tissue engineering, and accelerates muscle formation in vitro. Recently, small molecules have been used as alternatives to growth factors or along with other inducing factors in muscle tissue engineering. Since they do not induce an immune reaction, penetrate easily to the cells and have a specific molecular target, therefore they have attracted much attention as the cost-effective inducing factors in tissue engineering. Conclusion:  Taken together, the effective small molecules in muscle tissue engineering can be used with different biomaterial conditions (e.g. hydrogel, decellularized tissue, and synthetic scaffolds) in both in vivo and in vitro, resulting to production of cost effective and highly efficient engineered muscle tissues that help to achieve therapeutical goals of muscle tissue engineering. Herein, we describe tissue engineering and review the small molecules used in skeletal muscle tissue engineering.


Author(s):  
Qi Li ◽  
Stephen Andrew Spooner ◽  
Megan Kaiser ◽  
Nataline Lingren ◽  
Jessica Robbins ◽  
...  

Author(s):  
David A. Jobes ◽  
Samantha A. Chalker

While the existence of mental illness has been documented for centuries, the understanding and treatment of such illnesses has evolved considerably over time. Ritual exorcisms and locking mentally ill patients in asylums have been fundamentally replaced by the use of psychotropic medications and evidence-based psychological practices. Yet the historic roots of mental health management and care has left a certain legacy. With regard to suicidal risk, the authors argue that suicidal patients are by definition seen as mentally ill and out of control, which demands hospitalization and the treatment of the mental disorder (often using a medication-only approach). Notably, however, the evidence for inpatient care and a medication-only approach for suicidal risk is either limited or totally lacking. Thus, the “one-size-fits-all” approach to treating suicidal risk needs to be re-considered in lieu of the evolving evidence base. To this end, the authors highlight a series of evidence-based considerations for suicide-focused clinical care, culminating in a stepped care public health model for optimal clinical of suicidal risk that is cost-effective, least-restrictive, and evidence-based.


2012 ◽  
Vol 97 (9) ◽  
pp. 2957-2968 ◽  
Author(s):  
D. Lynn Loriaux

Hirsutism is a common endocrinological complaint. The causes of this complaint can vary from dissatisfaction with a normal pattern of hair growth on the one hand, to the first clinical manifestation of androgen overproduction by an adrenal adenocarcinoma on the other. The purpose of this short review is to reexamine the physiology of hair growth in normal women, identify the common abnormal patterns, and explore the differential diagnosis associated with each. An approach to working through the differential diagnosis will be described, and the commonly available treatment modalities for the various forms of hirsutism will be examined in terms of risk and benefit. The review is written from the point of view of the physician and the most efficient, cost effective, and safe clinical approach to the patient with the problem.


Author(s):  
Lawrence M. Roth

The female reproductive tract may be the site of a wide variety of benign and malignant tumors, as well as non-neoplastic tumor-like conditions, most of which can be diagnosed by light microscopic examination including special stains and more recently immunoperoxidase techniques. Nevertheless there are situations where ultrastructural examination can contribute substantially to an accurate and specific diagnosis. It is my opinion that electron microscopy can be of greatest benefit and is most cost effective when applied in conjunction with other methodologies. Thus, I have developed an approach which has proved useful for me and may have benefit for others. In cases where it is deemed of potential value, glutaraldehyde-fixed material is obtained at the time of frozen section or otherwise at operation. Coordination with the gynecologic oncologist is required in the latter situation. This material is processed and blocked and is available if a future need arises.


Author(s):  
James F. Mancuso

IBM PC compatible computers are widely used in microscopy for applications ranging from control to image acquisition and analysis. The choice of IBM-PC based systems over competing computer platforms can be based on technical merit alone or on a number of factors relating to economics, availability of peripherals, management dictum, or simple personal preference.IBM-PC got a strong “head start” by first dominating clerical, document processing and financial applications. The use of these computers spilled into the laboratory where the DOS based IBM-PC replaced mini-computers. Compared to minicomputer, the PC provided a more for cost-effective platform for applications in numerical analysis, engineering and design, instrument control, image acquisition and image processing. In addition, the sitewide use of a common PC platform could reduce the cost of training and support services relative to cases where many different computer platforms were used. This could be especially true for the microscopists who must use computers in both the laboratory and the office.


2012 ◽  
Vol 21 (2) ◽  
pp. 60-71 ◽  
Author(s):  
Ashley Alliano ◽  
Kimberly Herriger ◽  
Anthony D. Koutsoftas ◽  
Theresa E. Bartolotta

Abstract Using the iPad tablet for Augmentative and Alternative Communication (AAC) purposes can facilitate many communicative needs, is cost-effective, and is socially acceptable. Many individuals with communication difficulties can use iPad applications (apps) to augment communication, provide an alternative form of communication, or target receptive and expressive language goals. In this paper, we will review a collection of iPad apps that can be used to address a variety of receptive and expressive communication needs. Based on recommendations from Gosnell, Costello, and Shane (2011), we describe the features of 21 apps that can serve as a reference guide for speech-language pathologists. We systematically identified 21 apps that use symbols only, symbols and text-to-speech, and text-to-speech only. We provide descriptions of the purpose of each app, along with the following feature descriptions: speech settings, representation, display, feedback features, rate enhancement, access, motor competencies, and cost. In this review, we describe these apps and how individuals with complex communication needs can use them for a variety of communication purposes and to target a variety of treatment goals. We present information in a user-friendly table format that clinicians can use as a reference guide.


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