scholarly journals Treatment patterns and appropriateness of antipsychotic prescriptions in patients with schizophrenia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Verónica Gamón ◽  
Isabel Hurtado ◽  
José Salazar-Fraile ◽  
Gabriel Sanfélix-Gimeno

AbstractSchizophrenia is a chronic mental condition presenting a wide range of symptoms. Although it has a low prevalence compared to other mental conditions, it has a negative impact on social and occupational functions. This study aimed to assess the appropriateness of antipsychotic medications administered to schizophrenic patients and describe current treatment patterns for schizophrenia. A retrospective cohort study was conducted in all patients over the age of 15 with an active diagnosis of schizophrenia and treated with antipsychotics between 2008 and 2013 in the Valencia region. A total of 19,718 patients were eligible for inclusion. The main outcome assessed was inappropriateness of the pharmacotherapeutic management, including polypharmacy use. Altogether, 30.4% of patients received antipsychotic polypharmacy, and 6.8% were prescribed three or more antipsychotics. Overdosage affected 318 individuals (1.6%), and 21.5% used concomitant psychotropics without an associated psychiatric diagnosis. Women and people with a comorbid condition like anxiety or depression were less likely to receive antipsychotic polypharmacy. In contrast, increased polypharmacy was associated with concomitant treatment with other psychoactive drugs, and only in user on maintenance therapy, with more visits to the mental health hospital. Overall, we observed a high level of inappropriateness in antipsychotic prescriptions. Greater adherence to guidelines could maximize the benefits of antipsychotic medications while minimizing risk of adverse effects.

2021 ◽  
Author(s):  
Verónica Gamón ◽  
Isabel Hurtado ◽  
José Salazar-Fraile ◽  
Gabriel Sanfélix-Gimeno

Abstract Schizophrenia is a chronic mental condition presenting a wide range of symptoms. Although this mental disorder has a low prevalence in comparison to other mental conditions, it has a negative impact on social and occupational functioning. This study is aimed to assess the inappropriateness of antipsychotic medication among schizophrenic patients and describe current patterns in the treatment of schizophrenia. A retrospective cohort study was conducted including all patients over the age of 15 with an active diagnosis of schizophrenia and treated with antipsychotics between 2008 and 2013 in the Valencia region. 19,718 patients with a diagnosis of schizophrenia and treated with antipsychotic medication were identified. The main outcome was inappropriateness of the pharmacotherapeutic management, including polypharmacy use: 30.4% of patients received antipsychotic polypharmacy (6.8% were prescribed 3 or more antipsychotics); overdosage: a total of 318 individuals (1.6%) exceeded the maximum daily doses; and use of concomitant psychotropics without an associated diagnosis: 21.5% of patients received psychotropic drugs concomitantly without associated psychiatric diagnoses. Overall, females and those who had a comorbid condition, such as anxiety or depression, were less likely to receive antipsychotic polypharmacy. In contrast, concomitant treatment with other psychoactive drugs, such as antiparkinson drugs, anxiolytics and hypnotics and more visits to mental health hospital increased the risk of polypharmacy use. In conclusion, a high level of inappropriateness has been detected among antipsychotic prescriptions. Practitioners should follow guidelines recommendations whenever possible in order to obtain the maximum benefit of antipsychotic medications without an increased risk of adverse effects in patients.


Insects ◽  
2021 ◽  
Vol 12 (6) ◽  
pp. 518
Author(s):  
Bronwyn Egan ◽  
Zwannda Nethavhani ◽  
Barbara van Asch

Macrotermes termites play important ecological roles and are consumed by many communities as a delicacy and dietary complement throughout Africa. However, lack of reliable morphological characters has hampered studies of Macrotermes diversity in a wide range of scientific fields including ecology, phylogenetics and food science. In order to place our preliminary assessment of the diversity of Macrotermes in South Africa in context, we analysed a comprehensive dataset of COI sequences for African species including new and publicly available data. Phylogenetic reconstruction and estimates of genetic divergence showed a high level of incongruity between species names and genetic groups, as well as several instances of cryptic diversity. We identified three main clades and 17 genetic groups in the dataset. We propose that this structure be used as a background for future surveys of Macrotermes diversity in Africa, thus mitigating the negative impact of the present taxonomic uncertainties in the genus. The new specimens collected in Limpopo fell into four distinct genetic groups, suggesting that the region harbours remarkable Macrotermes diversity relative to other African regions surveyed in previous studies. This work shows that African Macrotermes have been understudied across the continent, and that the genus contains cryptic diversity undetectable by classic taxonomy. Furthermore, these results may inform future taxonomic revisions in Macrotermes, thus contributing to advances in termitology.


2016 ◽  
Vol 10 (4-5) ◽  
pp. 77-83
Author(s):  
Zoltán Kovács

A wide range of empirical experiences shows that the performance of Hungarian producer organizations (aka TÉSZ) significantly falls behind the activity observed in the developed Western European countries. Regarding this issue, the present study examines how moral hazard - as one of the possible reasons - influences the producers’ activities in cooperative organizations. Information for the research was collected with the help of a questionnaire survey among the members of PaprikaKert TÉSZ Ltd. A statistical path model has been developed for the research, which assumed that - in addition to a direct effect - moral hazard also affects collaborative activity by eroding trust. The statistical model has been tested both in member-member and members-management relations. The experiences from the survey clearly show that moral hazard exists in the producer organization. According to my results, though its measure cannot be regarded numerically considerable, its negative effect on cooperative activity can be proved with statistical examinations. Its effect can be divided into two aspects: besides a direct effect, an indirect one can also be detected, which means that moral hazard is able to reduce producers’ willingness to cooperate by eroding trust. Moreover, our results have clearly pointed out that moral hazard has a negative impact on member-member and members-management relations to varying degrees and through different mechanisms. In addition to the above tests, the empirical testing of another model called Sholtes trust model has been carried out, too. The validating was successful, so the model - which attributes trust to the faith in the partner’s loyalty and capability - is basically acceptable. The argument says that high-level trust can be observed among partners only when faith both in loyalty and capability is strong enough. The research, however, revealed that the above-mentioned two factors determine it in a different way: regarding trust between members, the faith in capability is more important; while trust towards the management is more determined by faith in loyalty. JEL code: Q12, Q13


2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Luke Nelson ◽  
Henry Pollard ◽  
Rick Ames ◽  
Brett Jarosz ◽  
Pete Garbutt ◽  
...  

Abstract Background This paper describes the education and case management profile of sports chiropractors with the Federation of International Sports Chiropractors (FICS) postgraduate qualification: International Chiropractic Sport Science Practitioner (ICSSP). The ICSSP is the predominant international sports chiropractic qualification. Methods A cross-sectional survey, carried out between 22/10/2014 and 22/12/2014,was utilized with a 39-item web-based survey examining practitioner, practice and clinical management characteristics, and was distributed via email to all sports chiropractors who held an ICSSP qualification (n = 240) in 2014. Results The survey response rate was 64% (n = 154). 36% of chiropractors were aged between 31 and 40 years, just over three quarters were male, and 27% had been in practice for 5–10 years. The majority of respondents were based in North America. All sports chiropractors surveyed reported treating neuromusculoskeletal conditions outside of the spine. 91% utilized a multimodal approach in most of their treatments, prescribing rehabilitative exercises in 76% of consultations. Almost 64% of respondents reported current treatment of professional athletes, and 78% reported current treatment of semi-professional athletes, whilst the vast majority of those surveyed endorsed past treatment of professional (91%) and semi-professional (95%) athletes. All respondents reported referring to a range of conventional and allied health providers. Conclusions This study of ICSSP-qualified sports chiropractors describes a small but well-educated workforce treating high-level athletes, managing a wide range of spine and non-spinal neuromusculoskeletal conditions, utilising multimodal approaches (including active and passive strategies), and referring to and co-managing with other health practitioners.


2021 ◽  
Vol 13 (12) ◽  
pp. 6665
Author(s):  
Mohammed Albattah ◽  
Daniel Efurosibina Attoye

Sustainability in architecture engages a wide range of considerations in the light of the significant negative impact of buildings on the environment. One aspect of research in this parlance engages the technological and the social dimensions of building innovation, which promote the use of renewable technology as a mitigation strategy. The challenge, however, is that the end-users or building clients do not always have sufficient awareness and information regarding these technologies to guide their decision to accept it. Consequently, the diffusion of said innovations is slow, and the environmental or building problems they were invented to solve persist at the expense of both humanity and the environment. This study, therefore, focuses on a quantitative investigation to ascertain the level of awareness and interest of residents in the United Arab Emirates (UAE) on Building Integrated Photovoltaics (BIPV) as an example of renewable energy-based building technology. In this study, 289 residents participated, following the distribution of a questionnaire to demographically distinct individuals. This distinction was used in the analysis to highlight different groups such as, gender, generations, and occupational background of the respondents. The findings of the study show, firstly, that there is a high level of awareness of BIPV in the sample. The study also shows that comparing awareness with each of these demographic variables produced a second layer of findings. For example, the statistical analysis showed that there is no significant difference between the level of awareness and any of the demographic characteristics of the study participants. However, there is a significant statistical difference (p = 0.000) between awareness and interest in BIPV. In concluding this study, recommendations for further research that elaborates other statistical variables and tests, as well as a follow-up qualitative investigation are planned and outlined for future studies. The findings of this investigation may be of benefit to researchers, policy makers, as well as energy companies and marketing agencies within and outside the region.


Author(s):  
V. Dodokhov ◽  
N. Pavlova ◽  
T. Rumyantseva ◽  
L. Kalashnikova

The article presents the genetic characteristic of the Chukchi reindeer breed. The object of the study was of the Chukchi reindeer. In recent years, the number of reindeer of the Chukchi breed has declined sharply. Reduced reindeer numbers could lead to biodiversity loss. The Chukchi breed of deer has good meat qualities, has high germination viability and is adapted in adverse tundra conditions of Yakutia. Herding of the Chukchi breed of deer in Yakutia are engaged only in the Nizhnekolymsky district. There are four generic communities and the largest of which is the agricultural production cooperative of nomadic tribal community «Turvaurgin», which was chosen to assess the genetic processes of breed using microsatellite markers: Rt6, BMS1788, Rt 30, Rt1, Rt9, FCB193, Rt7, BMS745, C 143, Rt24, OheQ, C217, C32, NVHRT16, T40, C276. It was found that microsatellite markers have a wide range of alleles and generally have a high informative value for identifying of genetic differences between animals and groups of animal. The number of identified alleles is one of the indicators of the genetic diversity of the population. The total number of detected alleles was 127. The Chukchi breed of deer is characterized by a high level of heterozygosity, and the random crossing system prevails over inbreeding in the population. On average, there were 7.9 alleles (Na) per locus, and the mean number of effective alleles (Ne) was 4.1. The index of fixation averaged 0.001. The polymorphism index (PIC) ranged from 0.217 to 0.946, with an average of 0.695.


2020 ◽  
Author(s):  
Sina Faizollahzadeh Ardabili ◽  
Amir Mosavi ◽  
Pedram Ghamisi ◽  
Filip Ferdinand ◽  
Annamaria R. Varkonyi-Koczy ◽  
...  

Several outbreak prediction models for COVID-19 are being used by officials around the world to make informed-decisions and enforce relevant control measures. Among the standard models for COVID-19 global pandemic prediction, simple epidemiological and statistical models have received more attention by authorities, and they are popular in the media. Due to a high level of uncertainty and lack of essential data, standard models have shown low accuracy for long-term prediction. Although the literature includes several attempts to address this issue, the essential generalization and robustness abilities of existing models needs to be improved. This paper presents a comparative analysis of machine learning and soft computing models to predict the COVID-19 outbreak as an alternative to SIR and SEIR models. Among a wide range of machine learning models investigated, two models showed promising results (i.e., multi-layered perceptron, MLP, and adaptive network-based fuzzy inference system, ANFIS). Based on the results reported here, and due to the highly complex nature of the COVID-19 outbreak and variation in its behavior from nation-to-nation, this study suggests machine learning as an effective tool to model the outbreak. This paper provides an initial benchmarking to demonstrate the potential of machine learning for future research. Paper further suggests that real novelty in outbreak prediction can be realized through integrating machine learning and SEIR models.


Author(s):  
Сергей Иванович Вележев ◽  
Антон Михайлович Седогин

В представленной статье авторами рассматриваются вопросы уголовно-правовой охраны топливно-энергетического комплекса Российской Федерации от преступных проявлений, в том числе от коррупционной противоправной деятельности должностных лиц. Такие действия причиняют значительный ущерб нормальному функционированию предприятий топливно-энергетического комплекса. Авторами приводятся результаты исследования некоторых криминологических характеристик должностных лиц, совершивших преступления коррупционного характера. Дан анализ причин и условий, способствующих совершению вышеуказанных противоправных действий. Определена типовая модель преступника для данной категории преступлений и его характеристики: в первую очередь, это высокий уровень компетентности, специальное образование и т. д. Авторами отмечается высокий уровень латентной преступности в данной отрасли. Предложены некоторые пути профилактики данной категории правонарушений. Исследование проводилось на основе анализа конкретных уголовных дел, возбужденных следственными органами по результатам оперативно-розыскной деятельности правоохранительных органов. In the article the authors consider the issues of criminal and legal protection of the fuel and energy complex of the Russian Federation from criminal activity including corrupt illegal practices of officials. The authors cite the results of some criminological characteristics study of the fuel and energy complex staff committed corruption crimes. As a result of these illegal actions significant damage is caused to the normal functioning of the fuel and energy enterprises. Such officials` actions determine not only a wide range of other illegal activities, but also lead to public outcry and discredit the industry as a whole. The analysis of the reasons and conditions contributing to the above illegal actions commission is given. A typical model of a criminal for a given crime category and its characteristics are determined. First of all it is a high level competence, special education, etc. A high level of latent crime in this industry is shown. The study results are presented on the example of specific criminal cases initiated by the investigating authorities based on the results of the operation detection activities of law enforcement agencies. Some ways of preventing this category of offenses are proposed.


1970 ◽  
Vol 19 (1-2) ◽  
pp. 264-267 ◽  
Author(s):  
F.H. Reuling ◽  
J.T. Schwartz

In the late 1950's and early 1960's, it became evident that some glaucoma patients developed elevations of intraocular pressure, which were difficult to control, following prolonged use of systemic or ocular medications containing corticosteroids (Chandler, 1955, Alfano, 1963; Armaly, 1963). In addition, some patients without glaucoma, when treated with steroids for long periods of time, developed clinical signs of chronic simple glaucoma (McLean, 1950; François, 1954; Covell, 1958; Linner, 1959; Goldman, 1962). Fortunately, the elevation of intraocular pressure was reversible if the drug was discontinued.Over the past decade, extensive investigation of the “steroid response” has been undertaken. For this presentation, the steroid response may be considered as a gradual elevation of intraocular pressure, occurring over several weeks, in an eye being medicated with corticosteroid drops several times a day. The elevation in pressure is usually accompanied by a reduction in the facility of aqueous outflow. When relatively large numbers of subjects were tested with topical steroids, so that a wide range of responsiveness could be observed, a variation in individual sensitivity was demonstrated. Frequency distributions of intraocular pressure or change in pressure following steroids showed a skew toward the high side. On the basis of trimodal characteristics which they observed in such frequency distributions, Becker and Hahn (1964), Becker (1965) and Armaly (1965, 1966) considered the possible existence of several genetically determined subpopulations. These investigators distinguished three subpopulations on the basis of low, intermediate, and high levels of pressure response. It was hypothesized that these levels of response characterized three phenotypes, corresponding to the three possible genotypes of an allele pair, wherein one member of the pair determined a low level of response, and the other member determined a high level of response (Armaly, 1967).


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