Delirium and Acute Anxiety

2019 ◽  
pp. 46-52
Author(s):  
Kevin Bezanson ◽  
Stephanie Rogers
Keyword(s):  
Management Strategies ◽  
Psychosocial Care ◽  
Health Conditions ◽  
Pharmacological Interventions ◽  
Humanitarian Crises ◽  
Acute Confusion ◽  
Relationship Of ◽  
Personal Trauma ◽  
Distinguishing Features ◽  
Acute Anxiety

This chapter reviews the assessment and management of patients presenting with acute confusion and agitation in humanitarian crises. The first section focuses on delirium, its distinguishing characteristics, and its diagnosis. The chapter then describes a contextually appropriate process for identifying and treating potentially reversible causes. Finally, it recommends management strategies for associated distressing symptoms with a priority on behavioral over pharmacological interventions. The second section addresses acute anxiety in the context of collective and personal trauma. Distinguishing features and manifestations are described. Approaches to management emphasizing behavioral and psychosocial care, with a limited role for pharmacological support, are outlined. The potential relationship of acute anxiety to other mental health conditions is also referenced.

scholarly journals Management Strategies for Antipsychotic-Related Sexual Dysfunction: A Clinical Approach

2021 ◽  
Vol 10 (2) ◽  
pp. 308
Author(s):  
Angel L. Montejo ◽  
Rubén de Alarcón ◽  
Nieves Prieto ◽  
José Mª Acosta ◽  
Bárbara Buch ◽  
...  
Keyword(s):  
Sexual Dysfunction ◽  
Management Strategies ◽  
Drop Out ◽  
Adjunctive Treatment ◽  
Psychotic Symptoms ◽  
Clinical Approach ◽  
Clinical Perspective ◽  
Pharmacological Interventions ◽  
Dopaminergic Agonist ◽  
Low Rate

Antipsychotic medication can be often associated with sexual dysfunction (SD). Given its intimate nature, treatment emergent sexual dysfunction (TESD) remains underestimated in clinical practice. However, psychotic patients consider sexual issues as important as first rank psychotic symptoms, and their disenchantment with TESD can lead to important patient distress and treatment drop-out. In this paper, we detail some management strategies for TESD from a clinical perspective, ranging from prevention (carefully choosing an antipsychotic with a low rate of TESD) to possible pharmacological interventions aimed at improving patients’ tolerability when TESD is present. The suggested recommendations include the following: prescribing either aripiprazole or another dopaminergic agonist as a first option antipsychotic or switching to it whenever possible. Whenever this is not possible, adjunctive treatment with aripiprazole seems to also be beneficial for reducing TESD. Some antipsychotics, like olanzapine, quetiapine, or ziprasidone, have less impact on sexual function than others, so they are an optimal second choice. Finally, a variety of useful strategies (such as the addition of sildenafil) are also described where the previous ones cannot be applied, although they may not yield as optimal results.

Virus Vector Relationship of Yellow Mosaic Virus and Whitefly, Bemisia tabaci (Gennadius) in Soybean

2021 ◽  
Author(s):  
M. Swathi ◽  
Neeta Gaur ◽  
Kamendra Singh
Keyword(s):  
Mosaic Virus ◽  
Virus Disease ◽  
Management Strategies ◽  
Virus Transmission ◽  
Virus Vector ◽  
Yellow Mosaic Virus ◽  
Starvation Period ◽  
Mungbean Yellow Mosaic Virus ◽  
Biological Relationship ◽  
Relationship Of

Background: Whitefly is one of the most destructive sucking pest in the tropical and subtropical regions of the world and causing significant crop losses directly by sucking sap from the plants and indirectly through the transmission of viral diseases specifically caused by the genus Begomovirus. The Begomovirus species viz., Mungbean yellow mosaic India virus (MYMIV) and Mungbean yellow mosaic virus (MYMV) are causing yellow mosaic virus disease in soybean, which is transmitted by whiteflies. The disease accounts to 30-70 per cent yield loss and increases up to 80 - 100 per cent during severe incidence. Hence, there is a need for development of integrated pest management strategies against disease and whiteflies, for this the knowledge on virus-vector relationship is required. But, the studies on biological relationship of yellow mosaic virus disease and whitefly in soybean are scarce. At this juncture, considering the importance of disease in soybean, the present investigation was carried out to know the virus -vector relationship of the YMV and whitefly in soybean.Methods: The experiment on virus-vector relationship of yellow mosaic virus and whitefly in soybean was conducted at Department of Entomology, College of Agriculture, G. B. Pant University of Agriculture and Technology, Pantnagar, Uttarakhand during 2016-17. The data on number of whiteflies per plant, acquisition and inoculation access feeding period and pre and post starvation period required for effective transmission of virus was recorded.Result: A single viruliferous whitefly was able to transmit virus and ten viruliferous whiteflies per plant were required for cent per cent transmission of virus. The minimum acquisition access and inoculation access feeding periods required for virus transmission was 0.25h (15 min) each; while the 100 per cent virus transmission was recorded with acquisition and inoculation period of 12h, each. The per cent transmission was increased with the increase of acquisition and inoculation periods. The rate of transmission was positively correlated with pre-acquisition starvation period and negatively correlated with post- acquisition starvation period.

scholarly journals The Relationship of Maternal Health Conditions on the Utilization of Maternity Waiting Homes for Maternity Motherhood

2020 ◽  
Vol 2 (1) ◽  
pp. 220-230
Author(s):  
Zufrizal ◽  
Ida Yustina ◽  
Asfriyati
Keyword(s):  
Maternal Health ◽  
Health Conditions ◽  
Regional Government ◽  
Cross Sectional ◽  
Government Program ◽  
Maternity Waiting Homes ◽  
Cross Sectional Design ◽  
Relationship Of ◽  
The Relationship ◽  
North Sumatra

Maternity Waiting Homes is a regional government program that aims to reduce maternal mortality. But in reality, there are still many people who do not utilize this facility. The purpose of this study is to determine the relationship of maternal health conditions on the utilization of maternity waiting homes for maternity motherhood. This research is an explanatory survey research with cross sectional design. The study was conducted in Langkat Regency, North Sumatra. The results showed that there was a relationship between maternal health conditions and the utilization of the maternity waiting house for maternity motherhood in Langkat Regency (p = 0.027).

scholarly journals Integrated and consumer-directed care: a necessary paradigm shift for rural chronic ill health

2016 ◽  
Vol 22 (3) ◽  
pp. 176 ◽  
Author(s):  
Nicole E. Ranson ◽  
Daniel R. Terry ◽  
Kristen Glenister ◽  
Bill R. Adam ◽  
Julian Wright
Keyword(s):  
Rural Communities ◽  
Clinical Outcomes ◽  
Management Strategies ◽  
Global Scale ◽  
Health Conditions ◽  
Urban Experience ◽  
Rural And Urban ◽  
Important Health ◽  
Access To Medical Care ◽  
Important Health Issue

Chronic ill health has recently emerged as the most important health issue on a global scale. Rural communities are disproportionally affected by chronic ill health. Many health systems are centred on the management of acute conditions and are often poorly equipped to deal with chronic ill health. Cardiovascular disease (CVD) is one of the most prominent chronic ill health conditions and the principal cause of mortality worldwide. In this paper, CVD is used as an example to demonstrate the disparity between rural and urban experience of chronic ill health, access to medical care and clinical outcomes. Advances have been made to address chronic ill health through improving self-management strategies, health literacy and access to medical services. However, given the higher incidence of chronic health conditions and poorer clinical outcomes in rural communities, it is imperative that integrated health care emphasises greater collaboration between services. It is also vital that rural GPs are better supported to work with their patients, and that they use consumer-directed approaches to empower patients to direct and coordinate their own care.

scholarly journals The Examination of non-pharmacologic treatment of pain after spinal cord injury

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
J. A. Piatt ◽  
L. Eldridge ◽  
J. M. Baker
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Chronic Pain ◽  
Pain Management ◽  
Psychological Health ◽  
Management Strategies ◽  
Pharmacological Intervention ◽  
Pharmacological Interventions ◽  
Convenience Sample ◽  
Cord Injury

Background: One of the primary debilitating secondary health conditions experienced by individuals living with a spinal cord injury (SCI) is chronic pain. Approximately, over 30% of SCI patients endure chronic pain after sustaining the injury, and engage in opioid pharmacotherapy as the first form of treatment. The increase in use and misuse of prescribed opioids for chronic pain can lead to both physical and psychological health risks. This danger is exacerbated by the notion that a large percentage of the SCI population have a pre-existing condition of drug and alcohol abuse and addiction. This study will examine how pain is actually being addressed through non-pharmaceutical methods among the SCI adult population.  Experimental Design: Employing a cross-sectional web survey design with a convenience sample of adults with a SCI. A Qualtrics survey is currently being administered to known individuals with SCIs via email. The survey questions will illuminate what pain management strategies are being implemented in the SCI population within the US.   Anticipated Results: The results from the data will provide insight on what non-pharmacological interventions can be employed in place of or in combination with the pharmacological management. This will allow community-based rehabilitation therapies to incorporate appropriate pain management strategies.   Potential Impact: Non-pharmacological interventions may hold the answer in treating chronic pain in the SCI population by limiting or eliminating the use of opioids. This study will help develop the most appropriate non-pharmacological intervention to test in quasi-experimental clinical trials, and ultimately minimize the use of opioids for chronic pain.

Rathke cleft cysts: a review of clinical and surgical management

2011 ◽  
Vol 31 (1) ◽  
pp. E1 ◽  
Author(s):  
Gabriel Zada
Keyword(s):  
Cyst Wall ◽  
Clinical Symptoms ◽  
Management Strategies ◽  
Field Testing ◽  
Csf Leak ◽  
Recurrence Rates ◽  
Alcohol Injection ◽  
Nonsurgical Management ◽  
Relationship Of ◽  
Sellar Floor

The aim of this paper is to provide a comprehensive review of clinical, imaging, and histopathological features, as well as operative and nonoperative management strategies in patients with Rathke cleft cysts (RCCs). A literature review was performed to identify previous articles that reported surgical and nonsurgical management of RCCs. Rathke cleft cysts are often incidental lesions found in the sellar and suprasellar regions and do not require surgical intervention in the majority of cases. In symptomatic RCCs, the typical clinical presentation includes headache, visual loss, and/or endocrine dysfunction. Visual field testing and endocrine laboratory studies may reveal more subtle deficiencies associated with RCCs. When indicated, the transsphenoidal approach typically offers the least invasive and safest method for treating these lesions. Various surgical strategies including cyst wall resection, intralesional alcohol injection, and sellar floor reconstruction are discussed. Although headache and visual symptoms frequently improve after surgical drainage of RCCs, hypopituitarism and diabetes insipidus are less likely to do so. A subset of more aggressive, atypical RCCs associated with pronounced clinical symptoms and higher recurrence rates is discussed, as well as the possible relationship of these lesions to craniopharyngiomas. Rathke cleft cysts are typically benign, asymptomatic lesions that can be monitored. In selected patients, transsphenoidal surgery provides excellent rates of improvement in clinical symptoms and long-term cyst resolution. Complete cyst wall resection, intraoperative alcohol cauterization, and sellar floor reconstruction in the absence of a CSF leak are not routinely recommended.

scholarly journals Relationship of External Knowledge Management and Performance of Chinese Manufacturing Firms: The Mediating Role of Talent Management

2017 ◽  
Vol 10 (6) ◽  
pp. 248 ◽  
Author(s):  
Muhammad Ali ◽  
SHEN Lei ◽  
Syed Talib Hussain
Keyword(s):  
Knowledge Management ◽  
Management Strategies ◽  
Talent Management ◽  
Manufacturing Firms ◽  
Point Of View ◽  
Mediation Effects ◽  
External Knowledge ◽  
Mediating Role ◽  
And Performance ◽  
Relationship Of

For the competitive market, both talent management and knowledge management of employees are key primary resources in organizations. While it is well known that in today's emerging economy, intangible resources like knowledge and human capital seem as the soul of survival; few studies have examined the effect of external knowledge management and talent management strategies in Chinese manufacturing firms. This study tries to bridge this gap by examining the importance of external knowledge management and talent management, Moreover, how this consequence can affect in particular industry for the economic growth of China? Total 249 responses were collected through structured questionnaire from manufacturing organizations located in Shanghai and Suzhou, China. PLS-SEM techniques via Smart-PLS (3.2.4) software has been used to test and validate proposed model and the relationships among the hypothesized constructs. The findings of this study show that external knowledge management (E-KM) and talent management both contributes positively to the performance of manufacturing firms. Moreover, talent management as mechanism demonstrated strong mediation effects between E-KM and performance. In researchers' point of view and results revealed the evidence by linking E-KM with TM-OP and TM as a mechanism between E-KM and OP. Such insights may helpful for managers to target sustainable current and future growth of the organizations and also, to overcome the shortage of talented and qualified worker’s issues in fast-growing emerging economies.

scholarly journals Hospitalized Children Continue to Report Undertreated and Preventable Pain

2014 ◽  
Vol 19 (4) ◽  
pp. 198-204 ◽  
Author(s):  
Kathryn A Birnie ◽  
Christine T Chambers ◽  
Conrad V Fernandez ◽  
Paula A Forgeron ◽  
Margot A Latimer ◽  
...  
Keyword(s):  
Pain Assessment ◽  
Pain Treatment ◽  
Management Strategies ◽  
Pharmacological Interventions ◽  
Hospital Units ◽  
Significant Pain ◽  
Experienced Pain ◽  
Treatment Thresholds ◽  
Pediatric Inpatient ◽  
Clinically Significant

BACKGROUND: Published reports of substantial rates of moderate to severe pediatric inpatient pain tend to overlook lower-intensity pain that may be clinically significant.OBJECTIVE: To document the prevalence of clinically significant pain in pediatric inpatients by considering the pain threshold at which each child desires intervention, and to assess sources of pain, pain assessment and intervention, and relationships among demographic and medical variables to reported pain.METHODS: Inpatients or their parents on four hospital units during four nonconsecutive days were eligible for inclusion. Interviews (76 parents; 31 patients) captured experiences of 107 inpatients (three weeks to 18 years of age) including current, worst and usual pain, pain treatment thresholds, sources of pain and help received during the previous 24 h. A chart review provided data regarding demographic and medical variables, and pain assessment and management.RESULTS: In total, 94% of patients experienced pain. The prevalence of clinically significant pain was 8% (current), 62% (worst) and 24% (usual). Current and worst pain was primarily procedural, and usual pain was primarily disease related. On average, patients had 4.03 documented pain assessments over 24 h. Caregiver responses (eg, reassurance) and nonpharmacological interventions were frequently reported (>90%) but infrequently documented (<50%); 66% of patients received pharmacological interventions. Younger patients received fewer pain assessments and opioids. Patients with clinically significant usual pain were more likely to have undergone surgery, and receive more pain assessments and interventions.CONCLUSIONS: While recent studies suggest reduced pain in pediatric inpatients, the present findings reveal a continued high frequency of undertreated pain. High rates of procedural pain are preventable and should be targeted given the underutilization of pain management strategies.

scholarly journals Diet and companionship modulate pain via a serotonergic mechanism

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Huy Tran ◽  
Varun Sagi ◽  
Sarita Jarrett ◽  
Elise F. Palzer ◽  
Rajendra D. Badgaiyan ◽  
...  
Keyword(s):  
Management Strategies ◽  
Thermal Hyperalgesia ◽  
Optimal Dose ◽  
Response Modulation ◽  
Opioid Use ◽  
Pharmacological Interventions ◽  
Analgesic Effects ◽  
Pain Pathway ◽  
Ventromedial Medulla ◽  
Norepinephrine Reuptake Inhibitor

AbstractTreatment of severe chronic and acute pain in sickle cell disease (SCD) remains challenging due to the interdependence of pain and psychosocial modulation. We examined whether modulation of the descending pain pathway through an enriched diet and companionship could alleviate pain in transgenic sickle mice. Mechanical and thermal hyperalgesia were reduced significantly with enriched diet and/or companionship. Upon withdrawal of both conditions, analgesic effects observed prior to withdrawal were diminished. Serotonin (5-hydroxytryptamine, 5-HT) was found to be increased in the spinal cords of mice provided both treatments. Additionally, 5-HT production improved at the rostral ventromedial medulla and 5-HT accumulated at the dorsal horn of the spinal cord of sickle mice, suggesting the involvement of the descending pain pathway in the analgesic response. Modulation of 5-HT and its effect on hyperalgesia was also investigated through pharmaceutical approaches. Duloxetine, a serotonin-norepinephrine reuptake inhibitor, showed a similar anti-nociceptive effect as the combination of diet and companionship. Depletion of 5-HT through p-chlorophenylalanine attenuated the anti-hyperalgesic effect of enriched diet and companionship. More significantly, improved diet and companionship enhanced the efficacy of a sub-optimal dose of morphine for analgesia in sickle mice. These findings offer the potential to reduce opioid use without pharmacological interventions to develop effective pain management strategies.

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