scholarly journals The opioid epidemic: helping rheumatologists prevent a crisis

RMD Open ◽  
2019 ◽  
Vol 5 (2) ◽  
pp. e001029 ◽  
Author(s):  
Anne-Priscille Trouvin ◽  
Francis Berenbaum ◽  
Serge Perrot
Keyword(s):  
Developed Countries ◽  
European Federation ◽  
French Society ◽  
Risk Of Death ◽  
Number Of Patients ◽  
Opioid Intoxication ◽  
The Usa ◽  
American Society ◽  
Strong Opioids

An endemic increase in the number of deaths attributable to prescribed opioids is found in all developed countries. In 2016 in the USA, more than 46 people died each day from overdoses involving prescription opioids. European data show that the number of patients receiving strong opioids is increasing. In addition, there is an upsurge in hospitalisations for opioid intoxication, opioid abuse and deaths in some European countries. This class of analgesic is increasingly used in many rheumatological pathologies. Cohort studies, in various chronic non-cancer pain (CNCP) (osteoarthritis, chronic low back pain, rheumatoid arthritis, etc), show that between 2% and 8% of patients are treated with strong opioids. In order to help rheumatologists prescribe strong opioids under optimal conditions and to prevent the risk of death, abuse and misuse, recommendations have recently been published (in France in 2016, the recommendations of the French Society of Study and Treatment of Pain, in 2017, the European recommendations of the European Federation of IASP Chapters and the American Society of International Pain Physicians). They agree on the same general principles: opioids may be of interest in situations of CNCP, but their prescription must follow essential rules. It is necessary to make an accurate assessment of the pain and its origin, to formulate therapeutic objectives (pain, function and/or quality of life), to evaluate beforehand the risk of abuse and to get a specialised opinion beyond a certain dose or duration of prescription.

scholarly journals The American press about the soviet industrialization in 1920-1930s

2016 ◽  
Vol 5 (2) ◽  
pp. 115-120
Author(s):  
Olga Olegovna Rezanenko
Keyword(s):  
Quality Of Life ◽  
Quality Management ◽  
Foreign Affairs ◽  
Soviet Regime ◽  
Press Releases ◽  
Information Selection ◽  
American Press ◽  
The Usa ◽  
American Society

Press releases nature about the soviet industrialization, business and political circles and intellectuals reaction to the changes in the USSR during the 1920-1930s and deciding factors of the five-year plans perception by the Americans are determined and analyzed in this work. American periodicals, diplomatic correspondence of the Peoples Commissariat for Foreign Affairs (NKID) as well as materials of soviet propaganda are of particular importance for this research. On the basis of these sources the following conclusions were drawn: the American public had different views on the Soviet industrialization. Positive estimations were based on the real progress (new plants construction, improvement of the quality of life). Negative - on disparities between Soviet and American standards of labor productivity and quality, management, discipline, etc. Authors personal sympathies to the Soviet regime, artificial information selection by soviet censorship, political, social and economic environment in the USA influenced on the American public opinion. Soviet propaganda methods in order to form proper views in American society in that period were not substantial.

Objectives and outcomes of clinical ethics services: a Delphi study

2019 ◽  
Vol 45 (12) ◽  
pp. 761-769
Author(s):  
Leah McClimans ◽  
Geah Pressgrove ◽  
Emmaling Campbell
Keyword(s):  
Delphi Study ◽  
Clinical Ethics ◽  
Moral Distress ◽  
Medical College ◽  
Ethics Support ◽  
Starting Point ◽  
The Usa ◽  
American Society ◽  
Level Of Agreement

ObjectivesTo explore the objectives and outcomes most appropriate for evaluating clinical ethics support services (CESs) in the USA.MethodsA three-round e-Delphi was sent to two professional medical ethics listservs (Medical College of Wisconsin-Bioethics and American Society for Bioethics and Humanities) as well as 19 individual experts. The survey originally contained 15 objectives and 9 outcomes. In round 1, participants were asked to validate the content of these lists. In round 2, we had 17 objectives and 10 outcomes, and participants were asked to rank them for appropriateness in a top 10 list of objectives and a top 5 list of outcomes.ResultsParticipants came to a high(at least 70%) level of agreement on seven objectives: mediate, educate, develop policy, improve the moral quality of a decision or action, counsel, create a moral space and manage moral distress. Participants came to a moderate (at least 51%) level of agreement on three objectives: empower, awareness of ethics and preventative ethics. Participants also came to a moderate (at least 51%) level of agreement on five outcomes: ethical justification, transformation of institution, improvement of quality of life, principled consensus and satisfaction with the expertise of a CES.ConclusionThis e-Delphi identified 10 objectives and 5 outcomes that are a good starting point for developing outcome measures to evaluate CESs in the USA, while reminding us of the diversity of perspectives still evident in the field.

scholarly journals Tafamidis and quality of life in people with transthyretin amyloid cardiomyopathy in the study ATTR-ACT: A plain language summary

2021 ◽  
Author(s):  
Mazen Hanna ◽  
Thibaud Damy ◽  
Martha Grogan ◽  
Michelle Stewart ◽  
Balarama Gundapaneni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
General Health ◽  
Oral Treatment ◽  
Plain Language ◽  
Clinical Trial Registration ◽  
Risk Of Death ◽  
The Usa ◽  
Amyloid Cardiomyopathy

This plain language summary describes the results of a study called ATTR-ACT, which was published in the American Journal of Cardiology. In ATTR-ACT, researchers looked at the effects of tafamidis treatment in people with transthyretin amyloid cardiomyopathy (called ATTR-CM for short). Tafamidis is currently available in the USA and other countries as an oral treatment for adults with ATTR-CM. In ATTR-ACT, 441 people with ATTR-CM from 13 different countries took either tafamidis or placebo by mouth for 30 months. First, researchers looked at the effects of tafamidis on the risk of death and hospitalization due to heart problems between the start and the end of the study; they found that these risks were about one-third lower with tafamidis compared with placebo. As described in this summary, researchers also looked at the effects of tafamidis on people’s heart failure symptoms, quality of life, and general health over the 30-month study. People who took part in ATTR-ACT rated these effects using questionnaires filled out before, during, and after the study. More people who took tafamidis saw improvement or no change in their heart failure symptoms and quality of life than people who took placebo. In addition, compared with people taking placebo, people taking tafamidis had less worsening of their general health during the study. These results show the benefits of tafamidis in reducing the declines in quality of life and health that often occur with this debilitating disease. To read the full Plain Language Summary of this article, click on the View Article button above and download the PDF. Clinical Trial Registration: NCT01994889 ( ClinicalTrials.gov )

The quality of care in outpatient primary care in public and private sectors in Malaysia

2019 ◽  
Author(s):  
May Chien Chin ◽  
Sheamini Sivasampu ◽  
Nilmini Wijemunige ◽  
Ravindra P Rannan-Eliya ◽  
Rifat Atun
Keyword(s):  
Primary Care ◽  
Public Sector ◽  
Private Sector ◽  
Clinical Care ◽  
Developed Countries ◽  
Prescribing Practices ◽  
Public And Private ◽  
The Public ◽  
The Usa

Abstract In Malaysia, first-contact, primary care is provided by parallel public and private sectors, which are completely separate in organization, financing and governance. As the country considers new approaches to financing, including using public schemes to pay for private care, it is crucial to examine the quality of clinical care in the two sectors to make informed decisions on public policy. This study intends to measure and compare the quality of clinical care between public and private primary care services in Malaysia and, to the extent possible, assess quality with the developed economies that Malaysia aspires to join. We carried out a retrospective analysis of the National Medical Care Survey 2014, a nationally representative survey of doctor–patient encounters in Malaysia. We assessed clinical quality for 27 587 patient encounters using data on 66 internationally validated quality indicators. Aggregate scores were constructed, and comparisons made between the public and private sectors. Overall, patients received the recommended care just over half the time (56.5%). The public sector performed better than the private sector, especially in the treatment of acute conditions, chronic conditions and in prescribing practices. Both sectors performed poorly in the indicators that are most resource intensive, suggesting that resource constraints limit overall quality. A comparison with 2003 data from the USA, suggests that performance in Malaysia was similar to that a decade earlier in the USA for common indicators. The public sector showed better performance in clinical care than the private sector, contrary to common perceptions in Malaysia and despite providing worse consumer quality. The overall quality of outpatient clinical care in Malaysia appears comparable to other developed countries, yet there are gaps in quality, such as in the management of hypertension, which should be tackled to improve overall health outcomes.

Effect of country image and materialism on the quality evaluation of Korean products

2019 ◽  
Vol 32 (2) ◽  
pp. 386-405 ◽  
Author(s):  
Byoungho Ellie Jin ◽  
Naeun Lauren Kim ◽  
Heesoon Yang ◽  
Minji Jung
Keyword(s):  
Product Quality ◽  
Online Survey ◽  
Quality Evaluation ◽  
Developed Countries ◽  
Country Image ◽  
Content Type ◽  
The Usa ◽  
Managerial Implications ◽  
The Impact

Purpose It is critical to understand how global consumers evaluate the quality of Asian products while marketing Asian products in the global marketplaces. The purpose of this paper is to examine the impact of Korea’s macro and micro country image and global consumers’ materialism level on the quality evaluation of Korean cosmetics among consumers in four countries. Design/methodology/approach Data from 900 participants were collected from consumers aged 20 or older living in economically developed countries (the USA and France) and economically developing countries (China and Vietnam) via professional online survey firms. Multiple regression analyses were used to analyze the data. Findings Along with the direct effect of macro and micro country image and materialism on product quality evaluation, a moderating effect of materialism and the respective country was discovered. Subsequently, the effect of macro country image on quality evaluation was found to be only significant in the USA and France and not in China and Vietnam. In contrast, the impact of micro country image was robust across all four countries. Furthermore, the effect of materialism on product quality was significant only in Vietnam. This implies that materialistic consumers in emerging markets might have favorable perceptions regarding the quality of Korean cosmetics. Originality/value This study advances country image research by providing new theoretical and managerial implications for countries whose image is less distinctive with respect to the effective marketing of products by the destination countries’ development status and consumers’ familiarity.

scholarly journals Current status and potential perspectives in classical radiotherapy technology

2004 ◽  
Vol 57 (5-6) ◽  
pp. 241-248
Author(s):  
Kata Dabic-Stankovic ◽  
Jovan Stankovic ◽  
Ljiljana Radosevic-Jelic
Keyword(s):  
Radiation Therapy ◽  
Developed Countries ◽  
Current Status ◽  
Growing Up ◽  
Record System ◽  
Radiation Technology ◽  
The Usa ◽  
Ct And Mri

Introduction and potentials of classical radiotherapy After purchase of radiotherapy equipment in 2003, classic radiation therapy in Serbia will reach the highest world level. In order to define the highest standards in radiation technology, we analyzed the current status and potential perspectives of radiation therapy. Technological levels of radiotherapy in developed countries An analysis of present situation in the USA, assumed as the most developed in the world, was done. Available data, collected in the last 3 years (equipment assortment, therapy modalities, workload and manpower) for 284 radiotherapy centers, out of potential 2050, were analyzed. Results were presented as crude percentage and mached to point current status. Results of analysis and discussion The analysis showed that CLINAC accelerators are the most popular (82.7%), as well as, ADAC (43.7%) and Focus (CMS) (27.4%) systems for therapy planning. Movement towards virtual simulation is evident (59.3%), although classic ?simulation? is not fully eliminated from the radiotherapy chain. The most popular brachytherapy afterloader is Microselectron HDR (71%). About 64.4% centers use IMPAC communication/verification/record system that seems more open than Varis. All centers practice modern radiotherapy modalities and techniques (CFRT, IMRT, SRS/SRT, TBI, IORT, IVBHRT, HDR BHRT, etc.). CT and MRI availability is out of question, but PET is available in 3% of centers, however this percentage is rapidly growing. Up to 350 new patients per year are treated by one accelerator (about 35 pts. a day). Centers are relatively small and utilize 2-3 accelerators on average. Average FTE staffing norm is 4 radiation oncologists, 2-3 medical radiotherapy physicists, about 3 certified medical dosimetrists and about 6 radiotherapy technologists. Technological aspects and conclusion In the past 5 years relative stagnation in classic radiotherapy has been observed. In spite of substantial investments in technology and consequent improvements, as well as wide introduction of computers in radiotherapy, radiotherapy results have not changed significantly. Vendor development strategies do not point that this trend will change in the next 5 years. On the other hand, wide introduction of the PET in each radiotherapy chain ring (diagnostics, planning, follow-up), could improve results (local and regional control, as well as quality of patients' life).

scholarly journals The value of motherhood: paid maternity leave discourse in major U.S. media outlets in the years 2014-2018

2021 ◽  
Vol 12 (1) ◽  
pp. 68-85
Author(s):  
Aleksandra Rabenda
Keyword(s):  
Labour Market ◽  
Maternity Leave ◽  
Negative Attitude ◽  
Developed Countries ◽  
The United States ◽  
Family Values ◽  
Business Culture ◽  
American Media ◽  
The Usa ◽  
American Society

Aim. This article’s goal is to present the discourse concerning paid maternity leaves in the USA in major American media outlets between the years 2014 and 2018. It is an attempt to answer the question whether maternity, caregiving work or family values are contradictory to American work ethic and regulations of the labour market. Methodology. The work is devoted to content analysis of the four most popular American online media, both liberal and conservative. Their content search engines are used to find information and articles on paid maternity leaves and to group them into different categories. Results. Three main categories are distinguished in terms of the content of 302 articles, namely articles with a positive attitude towards paid maternity leaves (248 articles – 82.10%), articles with a negative attitude (20 articles – 6.60%), and neutral articles (34 – 11.30%). In general, Americans see the long-term benefits of paid maternity leaves, but they differ when it comes to the methods of their introduction. Conclusions. There is a conflict between maternity, family values, American work culture, and regulations of the labour market. In American society, individualism, competition, and masculinity of the business culture do not support the values of nurturing and caregiving. Originality. Except for the USA, there is no other country among OECD states which does not provide paid parental leaves for working mothers. Because of the fact that the United States is known to be one of the most developed countries in the world, this information may be considered worth-studying.

scholarly journals THE INFLUENCE OF THE CULTURE IN THE STYLE OF LEADERSHIP

10.26458/1716 ◽  
2017 ◽  
Vol 17 (1) ◽  
pp. 73
Author(s):  
Madalina Gheta
Keyword(s):  
Cultural Revolution ◽  
Chinese Communist Party ◽  
Developed Countries ◽  
The State ◽  
Cultural Tradition ◽  
The Social ◽  
Fast Development ◽  
The Usa ◽  
Definition Of

The level of development of a country is defined based on indicators such as population size, GDP and contry area. Although it’s easy to identify countries like the USA, France and Spain that are part of developed countries and countries such as Senegal, Gabon Greece or China ranked as emerging countries, there is no universally accepted definition of developing contries. The “emerging contries” are often listed in terms of their differentiation from the developed contries; A comun problem is that some organizations dont’t take into consideration all the variables, a country located on a higher position in terms of GDP is possible to not have the same position at the social development or quality of life. For the last 25 years China has known continuous economic expansion, it’s forecasted that in the next 20 years it will become one of the world’s superpower. China encountered a relatively fast development after the deployment of the “cultural revolution”.In China, the long standing cultural tradition influences till today the economic area, more than other countries encounter from this category. The youth’s mentality is to learn and to work very well with the solely interest to serve the country completely. This desire of the Chinese people is positively influenced by the state - the Chinese Communist Party encourages the state of raising the development of education and the level of life.

scholarly journals Fighting Nosocomial Infection Rates in the General Surgery Department of the Teaching Hospital Gabriel Toure in Bamako, Mali

2010 ◽  
Vol 3 (1) ◽  
pp. 87-91 ◽  
Author(s):  
Togo A. ◽  
Traore A. ◽  
Kante L. ◽  
Coulibaly Y. ◽  
Diango D. ◽  
...  
Keyword(s):  
Risk Factors ◽  
Nosocomial Infections ◽  
Surgical Site Infections ◽  
Cost Of Care ◽  
The Usa ◽  
American Society ◽  
Tract Infections ◽  
Surgery Department ◽  
Hospital Acquired

Nosocomial infections (NI) or hospital-acquired diseases are indicators of the quality of care. This study conducted in Mali aimed to determine the frequency of nosocomial infections, to recognize the risk factors, to identify the pathogens and their sensitivity to antibiotics and to determine the additional cost of care. The study lasted 6 months from January to June 2007, and the diagnosis of nosocomial infections was based on criteria from the USA C.D.C (Center for Disease Control). We identified 460 patients and 44 among them (9.6%) were affected by nosocomial infections, which included 31 cases of surgical site infections (57.4%), 9 cases of infections on burns (16.7%), 7 cases of lung infections (13%), and 7 cases of urinary tract infections (13%). The most frequently isolated bacteria were Escherichia coli (44%). All isolated bacteria were resistant to amoxicillin and 46% were sensitive to ciprofloxacin. The risk factors for infection were emergency surgery, ASA (American Society of Anaesthesiology) class and the type of surgery defined by Altemeir. The preoperative preparation of the patients, the strict respect of hygiene and asepsis to the operating room can reduce the frequency of NI in our country.

SIP: Smart Insulin Pump

2013 ◽  
Vol 464 ◽  
pp. 123-128
Author(s):  
Ali Faraji ◽  
Mina Kasiri
Keyword(s):  
Interaction Design ◽  
Diabetes Complications ◽  
Healthcare Professionals ◽  
Insulin Pump ◽  
Design Strategy ◽  
Developed Countries ◽  
High Price ◽  
Number Of Patients ◽  
The World

Diabetes, due to its growing prevalence and heavy medical costs and complications has become one of the major focuses of healthcare professionals in developed countries. The acceleration of diabetes prevalence in developing countries such as Iran is so fast and by absence of health insurances protection, many families are faced with serious problems. Manufacturing an insulin pump, which is the ultimate solution for diabetes in the world, can be very beneficial. There is only one model of insulin pump available in the country with a high price that very few patients can afford its expenses and learn how to use it. The production and localization of these devises can help a significant number of patients to use this vital device and besides enhancing their quality of life, the heavy costs of diabetes complications will be reduced to a great extent. By making use of interaction design strategy, this research is the result of a project which targeted to find the most effective ways for controlling blood sugar and at the same time to pleasant the user experience with improving performance, interaction and aesthetics features based on needs of the Iranian user. Established upon the extensive library and field researches and several evaluations, the design criteria for the best answer to this problem are proposed.

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