Attitudes to antipsychotics: a multi-site survey of Canadian psychiatry residents

2018 ◽  
Vol 13 (6) ◽  
pp. 318-338
Author(s):  
Anees Bahji ◽  
Neeraj Bajaj
Keyword(s):  
First Generation ◽  
Treatment Options ◽  
Similar Efficacy ◽  
Psychiatry Residents ◽  
Training Experience ◽  
Content Type ◽  
Electronic Survey ◽  
Site Survey ◽  
Long Acting ◽  
The University

Purpose The purpose of this paper is to identify the training needs of the next generation of psychiatrists, and barriers in prescribing first-generation antipsychotics (FGAs), long-acting injectable (LAIs) antipsychotics and clozapine. Design/methodology/approach An electronic survey was sent to psychiatry residents (N= 75/288, 26 percent) at four Canadian residency programs in late December 2017. The survey was based on an instrument originally developed at the University of Cambridge and consisted of 31 questions in 10 content domains. Findings Nearly 80 percent of residents were aware that FGAs and second-generation antipsychotics (SGAs) have similar efficacy. However, extra-pyramidal symptoms and lack of training experience were the leading concerns associated with the prescribing of FGAs. Although over 90 percent of residents felt confident about initiating an oral SGA as a regular medication, only 40 percent did so with FGAs. Confidence with initiating LAIs and clozapine was 60 and 61 percent, respectively. Practical implications The survey highlights the need for better training in the use of FGAs, clozapine and LAIs. These medications can be effectively used in providing patients with the most appropriate evidence-based treatment options to improve treatment outcomes, while ensuring that these resources are not lost to the future generations of psychiatrists. Originality/value The survey may be the first of its kind to assess antipsychotic prescribing attitudes in Canadian psychiatry residents in multiple sites.

Prison psychiatry: is the training experience safe?

2018 ◽  
Vol 13 (4) ◽  
pp. 219-227
Author(s):  
Ruairi Page ◽  
Matthew Tovey ◽  
Fiona Hynes
Keyword(s):  
Forensic Psychiatry ◽  
General Medical Council ◽  
Training Programme ◽  
Medical Council ◽  
Training Experience ◽  
Content Type ◽  
Electronic Survey ◽  
Mental Health Settings ◽  
Review Protocol ◽  
Training Programme Director

Purpose Training in the prison settings is a mandatory part of higher training in forensic psychiatry. Violence in prisons is a recognised issue, which can impact on trainee safety and overall training experience. The Royal College of Psychiatrists have produced guidelines regarding the safety of the environment in inpatient mental health settings, but there is currently no such guidance regarding the prison setting. The purpose of this paper is to report on a survey of UK-based ST4-6 trainees in forensic psychiatry regarding their training experience in prisons, focusing on supervision and safety. Design/methodology/approach The authors constructed an electronic survey which comprised of 18 items. This was sent to each UK training programme director in forensic psychiatry, who were asked to distribute the survey to trainees in their region. Findings There were 36 unique responses, out of an approximate total of 100 trainees. The questions fell into two broad categories: trainee safety and trainee supervision. The main themes that arose were that the majority of trainees (59 per cent) reported that they had not received a formal induction at their prison and had not received training in using the Assessment, Care in Custody and Teamwork framework (58 per cent) and serious incident review protocol (83 per cent). The vast majority (76 per cent) reported not being allocated a personal safety alarm, and 27 per cent reported having received a direct threat from a patient in prison. Responses with regards to consultant supervision were varied. The majority indicated that they received weekly supervision (62 per cent). Originality/value The findings indicate that there are a number of areas where both safety and supervision within the prison environment may be improved. This is concerning given the standards outlined by Promoting Excellence (General Medical Council), which highlights the importance of a safe and supported learning environment, and suggests the need for further analysis locally of training opportunities within prisons.

scholarly journals First-generation antipsychotics: not gone but forgotten

2016 ◽  
Vol 40 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Claire R. M. Dibben ◽  
Golam M. Khandaker ◽  
Benjamin R. Underwood ◽  
Christopher O'Loughlin ◽  
Catherine Keep ◽  
...  
Keyword(s):  
Side Effects ◽  
First Generation ◽  
Similar Efficacy ◽  
Dose Titration ◽  
Similar Proportion ◽  
High Dose ◽  
Training Experience ◽  
East Anglia ◽  
Regular Medication ◽  
First And Second Generation

Aims and methodTo identify training needs of the next generation of psychiatrists and barriers in prescribing first-generation antipsychotics (FGAs). We have surveyed psychiatry trainees in East Anglia with regard to their training experience, knowledge and attitudes to the use of oral FGAs as regular medication.ResultsTwo-thirds of trainees were aware that first- and second-generation antipsychotics (SGAs) have similar efficacy, and a similar proportion perceived the older drugs to have more or ‘stronger’ side-effects. Lack of training experience was noted as the second leading concern for prescribing FGAs. A quarter of trainees received no training exposure to the older drugs and two-thirds had never initiated these drugs themselves. Although nearly 90% of trainees felt confident about initiating an oral SGA as a regular medication, only about 40% felt confident with FGAs (P<0.001).Clinical implicationsThe survey highlights worrying gaps in training. FGAs can be used effectively, minimising side-effects, by careful dose titration, avoiding antipsychotic polypharmacy, high-dose, and high-potency drugs, thus ensuring they are not lost to future generations of psychiatrists.

Coda: Ten Questions on Globality

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
The Editors ◽  
Dipesh Chakrabarty
Keyword(s):  
South Asian ◽  
The State ◽  
University Of Chicago ◽  
Subaltern Studies ◽  
Content Type ◽  
Human Understanding ◽  
The University ◽  
Asian Languages

Abstract Dipesh Chakrabarty is Lawrence A. Kimpton Distinguished Service Professor in History and South Asian Languages and Civilizations at the University of Chicago. He is the author of several books, including The Crises of Civilization (2018) and Provincializing Europe (2000); and was one of the principal founders of the editorial collective of Subaltern Studies. In this discussion he ruminates upon the state of globality; its relationship to the planet Earth; the scope and possible duration of the Anthropocene; and some of globalization's consequences for humanity and human understanding. The interview was conducted by managing editor, Kenneth Weisbrode.

scholarly journals Why Do Our Cancer Patients Sleep So Badly? Sleep Disorders in Cancer Patients: A Frequent Symptom with Multiple Causes

2021 ◽  
pp. 1-7
Author(s):  
Herwig Strik ◽  
Werner Cassel ◽  
Michael Teepker ◽  
Thomas Schulte ◽  
Jorge Riera-Knorrenschild ◽  
...  
Keyword(s):  
Sleep Disorders ◽  
Cancer Patients ◽  
Treatment Options ◽  
Ethics Committee ◽  
Breathing Disorders ◽  
The One ◽  
Diagnosis Therapy ◽  
The University ◽  
Insomnia Symptoms

<b><i>Introduction:</i></b> On the one hand, sleep disorders in cancer patients are reported in 30–50% of cancer patients. On the other hand, specific causes for these sleep disorders are little known. This study was done to evaluate factors which may affect sleep of cancer patients. To our knowledge, this is the first study which includes return to work as one factor of sleep disturbance. <b><i>Methods:</i></b> 107 patients with various types of cancer treated in 2 hospitals were interviewed with a battery of questionnaires after having given informed consent. The questionnaires intended to detect abnormalities of sleep and related pain, breathing disorders, restless legs syndrome, depression, rumination, medication, and psychosocial distress. The study was approved by the ethics committee of the University of Marburg. <b><i>Results:</i></b> The analysis of the 6 sleep-related questionnaires indicated a sleep disorder of any kind in 68% of all patients. Insomnia symptoms were present in 48 patients (44.9%). Pain, depression, anxiety, and worries about the workplace were significantly related to sleep disorders. <b><i>Conclusion:</i></b> Sleep disorders are common in cancer patients. The causes are manifold and should be considered by caregivers during diagnosis, therapy, and aftercare of cancer patients. Tumour patients should actively be asked about sleep disorders. If these are present, they should be addressed, and as they have a large impact on quality of life, treatment options should be offered in cooperation with sleep specialists.

Graduates giving back – a mentoring program for MBA students

2015 ◽  
Vol 4 (3) ◽  
pp. 200-212 ◽  
Author(s):  
Ann Darwin
Keyword(s):  
Higher Education ◽  
South Australia ◽  
Value Added ◽  
Master Of Business Administration ◽  
Mentoring Program ◽  
Education Students ◽  
Content Type ◽  
Mba Students ◽  
A Value ◽  
The University

Purpose – The purpose of this paper is to discuss the challenges and obstacles encountered in the implementation of a mentoring program for Master of Business Administration (MBA) students at the University of South Australia (UniSA) Business School. The paper starts with an exploration into the need for a mentoring program, the trial and subsequent four years of implementation. The paper also explores the network model of mentoring and the reasons why this, rather than a more traditional model, was chosen for the program’s implementation. Design/methodology/approach – This exploratory case study uses data from over 600 students and their alumni mentors over a five-year period to evaluate and improve the program as well as cultivating a critical community of adult learners. Findings – Feedback from students indicates that the mentoring program is regarded by most as a value-added feature of their early learning as it offers support, if and when it is required, from those who have been there before. Research limitations/implications – Results are limited to one institution. However, as research into mentoring for higher education students is thin on the ground, this study contributes to our understanding of the positive impacts of mentoring on student success. Practical implications – This paper emphasizes the importance of business leaders giving back to their alma mater through mentoring current MBA students. It shows how mentoring can support learning and management development. Originality/value – This is an original study which explores ways to increase the learning of higher education students for positive social outcomes.

scholarly journals 1578. Treatments for complicated urinary tract infections (cUTI) caused by multidrug resistant (MDR) Gram-negative (GN) pathogens- a systematic review and network meta-analysis (NMA)

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S787-S787
Author(s):  
Tim Reason ◽  
Karan Gill ◽  
Christopher Longshaw ◽  
Rachael McCool ◽  
Katy Wilson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Health Economics ◽  
Meta Analysis ◽  
Treatment Options ◽  
Final Analysis ◽  
Similar Efficacy ◽  
Global Public Health ◽  
Efficacy And Safety ◽  
Support Unit ◽  
Tract Infections

Abstract Background Antimicrobial resistance is a major and growing threat to global public health. Cefiderocol (CFDC) is a new siderophore-cephalosporin with a wide activity spectrum covering all aerobic GN pathogens including all WHO critical priority pathogens, that was recently approved by FDA for the treatment of GN cUTI in susceptible organisms. We aim to understand the relative efficacy and safety of current treatment options for cUTI caused by MDR GN pathogens. Methods We conducted a systematic review to identify all relevant trials that investigated the efficacy and safety of antimicrobial regimens, for the treatment of GN pathogens in cUTI. Outcomes of interest included clinical cure and microbiological eradication (ME) at time of cure (TOC) and sustained follow up (SFU), and safety. Evidence networks were constructed using data for outcomes of interest and analyses were conducted in a frequentist framework using NMA methods outlined by the NICE decision support unit using the netmeta package in R. Results A total of 5 studies, 6 interventions and 2,349 randomised patients were included in the final analysis. Interventions included CFDC, imipenem-cilastatin (IPM-CIL), ceftazidime-avibactam (CAZ/AVI), doripenem (DOR), levofloxacin and ceftolozane-tazobactam (CEF/TAZ). Trials included predominantly Enterobacterales, and Pseudomonas aeruginosa and very few Acinetobacter baumannii. The patient population presented some clinical differences across trials, which were not adjusted for the NMA. Overall, there were numerical differences (especially in endpoints at SFU favouring CFDC), but all treatments showed similar efficacy and safety, with exception of higher ME rate at TOC for CFDC vs IPM, Table 1, also observed at SFU, consistent with the data from the individual clinical trial. Table 1- Results for microbiological eradication Table 1- Results for microbiological eradication Conclusion This NMA, showed superiority of CFDC vs IPM-CIL in ME at TOC and SFU and similar efficacy and safety vs all other comparators, with numeric differences favouring CFDC for outcomes at SFU. These traditional methodologies for NMA, are only valid within a similar pathogens pool and population across the trials, and may not reflect the full value of breadth of coverage that new therapeutic options bring for the treatment of MDR GN pathogens. Disclosures Tim Reason, PhD, Shionogi (Consultant) Karan Gill, MSc, Shionogi BV (Employee) Christopher Longshaw, PhD, Shionogi B.V. (Employee) Rachael McCool, PhD, York Health Economics Consortium (Employee, YHEC was commissioned by Shionogi to conduct the systematic review) Katy Wilson, PhD, York Health Economics Consortium (Employee, Shionogi commissioned YHEC to conduct the systematic review) Sara Lopes, PharmD, Shionogi BV (Employee)

First steps for a library publisher

2015 ◽  
Vol 31 (2) ◽  
pp. 76-86 ◽  
Author(s):  
Somaly Kim Wu ◽  
Heather McCullough
Keyword(s):  
Open Access ◽  
Electronic Publishing ◽  
Academic Library ◽  
Lessons Learned ◽  
Content Type ◽  
Journal Publishing ◽  
Digital Scholarship ◽  
Publishing Services ◽  
Communication Policies ◽  
The University

Purpose – The purpose of this paper is to presents the very recent development of e-journal publishing services at the University of North Carolina (UNC) at Charlotte. In 2011, the J. Murrey Atkins Library at UNC Charlotte created a new unit in the library, the Digital Scholarship Lab (DSL), which partners with faculty and graduate students in the use of digital and networked research tools to create, disseminate and store new knowledge. E-journal publishing and hosting are among the suite of services offered by the DSL, and we currently publish three journals (https://journals.uncc.edu/). Design/methodology/approach – This report provides an overview of the context of our library’s decision to begin publishing journals, including a discussion of our university’s becoming more research-intensive, our university system mandating increased efficiencies and sharing research with the state citizens, and the library’s own goals of raising awareness of and supporting open access. Also outlined are the technical and procedural choices made, important activities undertaken to develop, define and publicize the new services, campus response to the service and next steps. Findings – This report provides detailed accounting of how a large academic library implemented an electronic publishing service to support open access scholarship. Important activities such as marketing communication, policies development and technical/procedural activities are defined and results described. The report provides observation and lessons learned for academic libraries in development and support of electronic journals. Originality/value – Library as the publisher is a new concept. This report will be of interest to many libraries who are considering offering publishing services and to libraries that currently offer publishing services.

Which journal ranking list? A case study in business and economics

2020 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Rayana Jaafar ◽  
Vijay Pereira ◽  
Samer S. Saab ◽  
Abdul-Nasser El-Kassar
Keyword(s):  
Research Output ◽  
Citation Count ◽  
Google Scholar ◽  
Journal Ranking ◽  
Content Type ◽  
Journal Quality ◽  
Hard Time ◽  
Yearly Average ◽  
The University

PurposeWith over 3,000 academic journals in the fields of Business and Economics, most academics face a hard time selecting an adequate journal to submit their work to. In today's demanding academic environment and with the presence of different journal ranking lists (JRLs), the selection becomes more difficult when considering employment, promotion and funding. The purpose of this paper is to explore key differences among multiple JRLs pertinent to the latter common objectives. An extensive analysis is conducted to compare the content of journals in the Australian Business Deans Council (ABDC) Journal Quality list, Scopus and Web of Science (WoS) in the fields of Business and Economics. Then, a case of a university with medium research output is considered where scholarly performance evaluation is based on the ABDC Journal Quality List.Design/methodology/approachAfter ranking journals in the fields of Business and Economics based on SCImago Journal Rank (SJR) indicator, JCR's Journal Impact Factor (JIF) and JCR's Eigenfactor (EF), a methodology is proposed to categorize journals in the three JRLs into the same categorization adopted by ABDC. The latter establishes a way to compare the four JRLs under consideration and serves as a basis to compare and analyze the content of journals in the ABDC Journal Quality list, Scopus and WoS. As a proxy impact metric, a normalized citation count is associated with each article based on Google Scholar. The publications of the considered university are then evaluated from the perspective of the four JRLs in terms of citation-based impact and quality while considering the exposure to popular world university ranking tables.FindingsFor journals classified under fourth tier by ABDC, over 53 and 59% are not indexed by Scopus and WoS, respectively. In this case study, over 42% of the publications appear in journals that are not listed in JCR despite the fact that over 94% of them are listed by the SJR list. Generally, publications that appear in journals listed by JCR achieve, on a yearly average, significantly higher citation rates when compared to those that appear in journals listed in ABDC and SJR Lists.Originality/valueA four-tier mapping is proposed for consistent comparison among JRLs. Normalized citation count associated with each article based on Google Scholar is employed for evaluation. The findings provide recommendations for scholars, administrators and global universities, including Euro-Med Universities, on which JRL can be more influential for both faculty development and positioning of the university.

scholarly journals ZN148 Is a Modular Synthetic Metallo-β-Lactamase Inhibitor That Reverses Carbapenem Resistance in Gram-Negative Pathogens In Vivo

2020 ◽  
Vol 64 (6) ◽  
Author(s):  
Ørjan Samuelsen ◽  
Ove Alexander Høgmoen Åstrand ◽  
Christopher Fröhlich ◽  
Adam Heikal ◽  
Susann Skagseth ◽  
...  
Keyword(s):  
Active Site ◽  
Therapeutic Potential ◽  
Treatment Options ◽  
Carbapenem Resistance ◽  
Functional Space ◽  
Bactericidal Effect ◽  
Gram Negative ◽  
Content Type

ABSTRACT Carbapenem-resistant Gram-negative pathogens are a critical public health threat and there is an urgent need for new treatments. Carbapenemases (β-lactamases able to inactivate carbapenems) have been identified in both serine β-lactamase (SBL) and metallo-β-lactamase (MBL) families. The recent introduction of SBL carbapenemase inhibitors has provided alternative therapeutic options. Unfortunately, there are no approved inhibitors of MBL-mediated carbapenem-resistance and treatment options for infections caused by MBL-producing Gram-negatives are limited. Here, we present ZN148, a zinc-chelating MBL-inhibitor capable of restoring the bactericidal effect of meropenem and in vitro clinical susceptibility to carbapenems in >98% of a large international collection of MBL-producing clinical Enterobacterales strains (n = 234). Moreover, ZN148 was able to potentiate the effect of meropenem against NDM-1-producing Klebsiella pneumoniae in a murine neutropenic peritonitis model. ZN148 showed no inhibition of the human zinc-containing enzyme glyoxylase II at 500 μM, and no acute toxicity was observed in an in vivo mouse model with cumulative dosages up to 128 mg/kg. Biochemical analysis showed a time-dependent inhibition of MBLs by ZN148 and removal of zinc ions from the active site. Addition of exogenous zinc after ZN148 exposure only restored MBL activity by ∼30%, suggesting an irreversible mechanism of inhibition. Mass-spectrometry and molecular modeling indicated potential oxidation of the active site Cys221 residue. Overall, these results demonstrate the therapeutic potential of a ZN148-carbapenem combination against MBL-producing Gram-negative pathogens and that ZN148 is a highly promising MBL inhibitor that is capable of operating in a functional space not presently filled by any clinically approved compound.

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