Psychiatric drugs and common factors: An evaluation of risks and benefits for clinical practice.

2010 ◽  
pp. 199-235 ◽  
Author(s):  
Jacqueline A. Sparks ◽  
Barry L. Duncan ◽  
David Cohen ◽  
David O. Antonuccio
Keyword(s):  
Clinical Practice ◽  
Common Factors ◽  
Risks And Benefits ◽  
Psychiatric Drugs

Venous Thromboembolism: Genetics and Thrombophilias

2021 ◽  
Vol 42 (02) ◽  
pp. 271-283
Author(s):  
Manila Gaddh ◽  
Rachel P. Rosovsky
Keyword(s):  
Clinical Practice ◽  
Venous Thromboembolism ◽  
Family History ◽  
Morbidity And Mortality ◽  
Inherited Thrombophilia ◽  
Risks And Benefits ◽  
Hereditary Thrombophilia ◽  
The World ◽  
The Future ◽  
History Of

AbstractVenous thromboembolism (VTE) is a major cause of morbidity and mortality throughout the world. Up to one half of patients who present with VTE will have an underlying thrombophilic defect. This knowledge has led to a widespread practice of testing for such defects in patients who develop VTE. However, identifying a hereditary thrombophilia by itself does not necessarily change outcomes or dictate therapy. Furthermore, family history of VTE by itself can increase an asymptomatic person's VTE risk several-fold, independent of detecting a known inherited thrombophilia. In this article, we will describe the current validated hereditary thrombophilias including their history, prevalence, and association with VTE. With a focus on evaluating both risks and benefits of testing, we will also explore the controversies of why, who, and when to test as well as discuss contemporary societal guidelines. Lastly, we will share how these tests have been integrated into clinical practice and how to best utilize them in the future.

‘Quit while you are ahead – and smell the roses!’ A survey of retired Fellows of the Australian and New Zealand College of Anaesthetists

2021 ◽  
pp. 0310057X2110057
Author(s):  
Diana Strange Khursandi ◽  
Victoria Eley
Keyword(s):  
Clinical Practice ◽  
New Zealand ◽  
Standard Deviation ◽  
Response Rate ◽  
Common Factors ◽  
Published Data ◽  
Factors Affecting ◽  
Retirement Decisions ◽  
Zealand College ◽  
The Mean

There are no published data on the age of retirement of anaesthetists in Australia and New Zealand. We surveyed 622 retired Fellows of the Australian and New Zealand College of Anaesthetists to determine their ages of complete retirement from clinical practice, demographics, and whether they had retired at the age they had intended to retire. We also aimed to explore factors affecting the decision to retire, the practice of ‘winding down’, common post-retirement activities, and the arrangement of personal and professional affairs. Responses were received from 371 specialists (response rate 60%). The mean (standard deviation) age of retirement was 65.2 (6.9) years. The mean (standard deviation) retirement ages ranged from 62.0 (7.1) years (those who retired earlier than planned) to 68.0 (4.3) years (those who retired later than they had intended). The mean (standard deviation) age of retirement of the male respondents was 66.0 (6.5) years, and for female respondents was 62.7 (7.7) years. Two hundred and thirty-three respondents (63%) reported winding down their practice prior to retirement, and 360 (97%) had made a will. Poor health and loss of confidence were the two most common factors in the retirement decisions of those who retired earlier than they had planned. Our results may assist current practitioners plan for retirement, and suggest strategies to help health services, departments and private groups accommodate individuals in winding down their practice.

Engaging older people in decisions about their healthcare: the case for shared decision making

2012 ◽  
Vol 22 (2) ◽  
pp. 99-107 ◽  
Author(s):  
Joanne Lally ◽  
Ellen Tullo
Keyword(s):  
Atrial Fibrillation ◽  
Decision Making ◽  
Clinical Practice ◽  
Healthcare Professional ◽  
Older People ◽  
Shared Decision Making ◽  
Clinical Condition ◽  
Decision Making Process ◽  
Shared Decision ◽  
Risks And Benefits

SummaryShared decision making in clinical practice involves both the healthcare professional, an expert in the clinical condition and the patient who is an expert in what is important to them. A consultation involving shared decision making enables an examination of the options available, consideration of the risks and benefits whilst incorporating the values of the patient into the decision making process. A decision is aimed at, which is both clinically appropriate and is congruent with the patient's values.Older people have been shown to value involvement, to varying degrees, in decisions about their care and treatment. The case of atrial fibrillation shows the opportunities for, and benefits of, sharing with older people decision making about their healthcare.

Physicians' attitudes towards accelerated access to medicines

2019 ◽  
pp. 1-16
Author(s):  
Jessica Pace ◽  
Ian Kerridge ◽  
Sallie Pearson ◽  
Wendy Lipworth
Keyword(s):  
Clinical Practice ◽  
Access To Medicines ◽  
Policy Formation ◽  
Third Parties ◽  
Limited Time ◽  
Patient Access ◽  
Structured Interviews ◽  
Know How ◽  
Risks And Benefits ◽  
Potential Risks

Abstract In recent years, a variety of ‘accelerated access’ schemes have been introduced by pharmaceutical regulators and funders globally. These schemes aim to overcome perceived regulatory and reimbursement barriers to accessing medicines – particularly for patients with limited time or therapeutic options. However, patient access to approved medicines is mediated by a number of third parties including regulators and payers, and physicians who act both as gatekeepers and guides to prescribed medications. It is therefore essential to know how physicians think about accelerated access as they are responsible for advising patients on and prescribing medicines made available via these pathways. We conducted semi-structured interviews with 18 Australian physicians focusing on their attitudes towards accelerated access. We identified three ‘archetypes’ of physicians: ‘confident accelerators’, ‘cautious accelerators’, and ‘decelerators’. Although all acknowledged the potential risks and benefits of accelerated access, they disagreed on their magnitude and extent and how they should be balanced in both policy formation and clinical practice. Overall, our results illustrate the diversity of clinical opinions in this area and the importance of monitoring both the prescribing and clinical outcomes that result from accelerated access programmes to ensure that these are both clinically and morally acceptable.

scholarly journals Consumption of psychiatric drugs by patients of medical and surgical clinics in a general hospital

2013 ◽  
Vol 21 (4) ◽  
pp. 948-955 ◽  
Author(s):  
Flavio Hiroshi Shirama ◽  
Adriana Inocenti Miasso
Keyword(s):  
Clinical Practice ◽  
Quantitative Analysis ◽  
General Hospital ◽  
Health Professionals ◽  
Common Mental Disorders ◽  
Roman Catholicism ◽  
Structured Interviews ◽  
Psychiatric Drugs ◽  
High Prevalence ◽  
Benzodiazepine Drugs

PURPOSES: to identify the prevalence of the use of psychiatric drugs among patients admitted to medical and surgical clinics of a general hospital, and also the factors related to the consumption of this type of medication. METHOD: this is a transversal, descriptive, correlational study with quantitative analysis. For the collection of data, there was use of structured interviews and also reference to medical files. RESULTS: there was confirmation of a high prevalence of users of psychiatric drugs, which was associated to the female sex, to people who do not practice Roman Catholicism, and admittance to the clinic not covered by the Single Health System (Sistema Único de Saúde - SUS), as well as the presence of common mental disorders. Benzodiazepine drugs were the most commonly used psychiatric drugs. Among the total number of users, there has been the identification of patients who were not aware that they were receiving such medication. Doctors who are not psychiatrists were responsible for most prescriptions of psychiatric drugs. CONCLUSIONS: this signals the need to prepare health professionals to deal with psychological and social problems commonly found in clinical practice, in order to promote the rational use of psychiatric drugs.

Risks and benefits of research on children: developing an ethical framework to meet children's needs

Clinical Risk ◽  
2008 ◽  
Vol 14 (6) ◽  
pp. 215-217 ◽  
Author(s):  
James Appleyard
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Dosage Forms ◽  
Essential Medicines ◽  
Ethical Framework ◽  
Everyday Clinical Practice ◽  
Safety And Efficacy ◽  
Risks And Benefits ◽  
The World

Children are put at unnecessary risk in everyday clinical practice by being given medicines whose safety and efficacy have not been adequately researched. The lack of appropriate dosage forms for many ‘essential medicines’ for the main five treatable conditions causing the deaths of 10 million children worldwide under the age of 5 years are a major reason why countries are not achieving their millennium developmental goals. There has been understandable reluctance to undertake the necessary research on children. The reasons for this are reviewed. The existing levels of protection for child subjects worldwide are insufficient. Key principles are suggested both to encourage clinical research and to ensure adequate protection for children around the world.

scholarly journals Attributed Contribution of Therapist’s Emotional Variables to Psychotherapeutic Effectiveness: A Preliminary Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Antonio Romero-Moreno ◽  
Alberto Paramio ◽  
Serafín Cruces-Montes ◽  
Antonio Zayas ◽  
Rocío Guil
Keyword(s):  
Clinical Practice ◽  
Ad Hoc ◽  
Training Programs ◽  
Therapeutic Process ◽  
Common Factors ◽  
Extensive Literature ◽  
Emotional Skills ◽  
Psychotherapeutic Research ◽  
Preliminary Study ◽  
Common Factors In Psychotherapy

BackgroundThe aim of this manuscript is to analyze the degrees of responsibility for healing that psychotherapists attribute to a set of emotional variables of the therapist involved in the therapeutic process. Such variables, framed within the well-known common factors in psychotherapy, have been proven to be essential in making the therapeutic process effective, as has been shown by research in psychotherapy in recent decades.Materials and MethodsBased on an extensive literature review, the responses from a sample of 69 psychotherapists to a tool created ad hoc are analyzed to verify whether their attributions are in line with the results of said review.ResultsThe therapists have doubts about the factors responsible for psychotherapeutic effectiveness, as well as about the value of common variables, including those of an emotional nature, not valuing them above those of a specific type. They also argue against the similar effectiveness of different psychotherapeutic models.ConclusionDiscrepancies have thus been found between the conclusions reached by research on therapeutic processes and the statements made by the therapists studied, which could indicate an insufficient impact of psychotherapeutic research on clinical practice. We also propose courses of action such as establishing training programs for the acquisition and development of emotional skills for therapists that could increase the effectiveness of their interventions.

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