Regular medication use by active scuba divers with a declared comorbid medical condition and victims of scuba and snorkelling-related fatalities

2021 ◽  
Vol 51 (3) ◽  
pp. 264-270
Author(s):  
Simone E Taylor ◽  
◽  
David McD Taylor ◽  
Daisy Pisasale ◽  
Kyle Booth ◽  
...  
Keyword(s):  
Medical Condition ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Asia Pacific ◽  
Psychological Conditions ◽  
Scuba Divers ◽  
Australian State ◽  
Psychiatric Conditions ◽  
Medical Examinations ◽  
Comorbid Medical Condition

Introduction: The aim of this study was to describe the nature of regular medications taken by active comorbid scuba divers (having a declared medical comorbidity) and scuba divers and snorkellers who died following a diving incident. Methods: We undertook a retrospective, observational study from July to October, 2020. Data on 268 active comorbid divers were obtained through a 2013 survey of Divers Alert Network Asia-Pacific members. Data on 126 deceased scuba divers and 175 deceased snorkellers were obtained predominantly from 2001–2013 reports to Australian State Coronial Services. Results: The active comorbid divers were significantly older, less likely to be male, and more likely to be taking one or more medications than the two deceased subject groups (P < 0.001). Cardiovascular, endocrine and psychotropic medications accounted for 53.4%, 9.9% and 6.4% of all medications taken, respectively. Almost one tenth of the deceased divers took at least one psychotropic medication, a proportion significantly greater than the other groups (P = 0.01). Conclusions: Medication use among active comorbid divers is common which likely reflects their declared medical condition. Nevertheless, they appear to be diving relatively safely, often with conditions once thought to be absolute contradictions to scuba diving. The deceased divers took significantly more psychotropic medications. It is possible that their underlying psychological/psychiatric conditions rendered them more at risk of a diving incident. Increased vigilance for psychological conditions may need to be considered during diving medical examinations.

scholarly journals Appropriateness of psychotropic medication use in a cohort of adolescents with intellectual disability in Queensland, Australia

BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Menghuan Song ◽  
Robert S. Ware ◽  
Tan N. Doan ◽  
Lyn McPherson ◽  
Julian N. Trollor ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Clinical Decision Making ◽  
Medical Condition ◽  
Inappropriate Prescribing ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Off Label ◽  
Inappropriate Use ◽  
Challenging Behaviours

Background Psychotropic medications are sometimes used off-label and inappropriately. This may cause harm to adolescents with intellectual disability. However, few studies have analysed off-label or inappropriate prescribing to this group. Aims To examine the appropriateness of psychotropic prescribing to adolescents with intellectual disability living in the community in south-east Queensland, Australia. Method Off-label medication use was determined based on whether the recorded medical condition treated was approved by the Australian Therapeutic Goods Administration. Clinical appropriateness of medication use was determined based on published guidelines and clinical opinion of two authors who specialise in developmental disability medicine (J.N.T. and D.H.). Results We followed 429 adolescents for a median of 4.2 years. A total of 107 participants (24.9%) were prescribed psychotropic medications on at least one occasion. Of these, 88 (82.2%) were prescribed their medication off-label or inappropriately at least once. Off-label or inappropriate use were most commonly associated with challenging behaviours. Conclusions Off-label or inappropriate use of psychotropic medications was common, especially for the management of challenging behaviours. Clinical decision-making accounts for individual patient factors and is made based on clinical experience as well as scientific evidence, whereas label indications are developed for regulatory purposes and, although appropriate at a population level, cannot encompass the foregoing considerations. Education for clinicians and other staff caring for people with intellectual disability, and a patient-centred approach to prescribing with involvement of families should encourage appropriate prescribing. The effect of the National Disability Insurance Scheme on the appropriateness of psychotropic medication prescribing should be investigated.

Parent-Reported Medication Use in a Head Start Population

2008 ◽  
Vol 24 (5) ◽  
pp. 319-325
Author(s):  
Tara M. Brinkman ◽  
John S. Carlson
Keyword(s):  
Head Start ◽  
Low Income ◽  
Medication Use ◽  
School Nurses ◽  
Psychotropic Medications ◽  
Hispanic Children ◽  
Raising Awareness ◽  
Head Start Children ◽  
Different Types ◽  
Reported Data

This study investigates the prevalence of medication use within a Head Start population. Parent-reported data ( N = 1,397) from initial enrollment information indicated 6.8% of children were taking 34 different types of medication. More than two thirds (69%) of those on medication were prescribed more than one medication, and more than one third (37%) were taking three or more medications. The majority of children were reported to be taking medications that were asthma (88%) or allergy (17%) related. Psychotropic medications accounted for 4% of the medications, indicating a prevalence of less than 0.3%. African American and Hispanic children were overrepresented in those taking medicines. School nurses can work with parents and caregivers of Head Start children by raising awareness of (1) the benefits and side effects of medications commonly taken within this population, (2) the significant role that asthma medications play in low-income areas, and (3) the issues and challenges associated with polypharmacy practices.

scholarly journals An Updated Narrative Review on Ergometric Systems Applied to Date in Assessing Divers’ Fitness

Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 1044
Author(s):  
Sven Dreyer ◽  
Johannes Schneppendahl ◽  
Fabian Moeller ◽  
Andreas Koch ◽  
Thomas Muth ◽  
...  
Keyword(s):  
Physical Performance ◽  
Bicycle Ergometry ◽  
Vast Number ◽  
Scuba Divers ◽  
Underwater Environment ◽  
Alternative Systems ◽  
Scale Down ◽  
Medical Examinations ◽  
Current Screening ◽  
Performance Diagnostics

Many recreational divers suffer medical conditions, potentially jeopardizing their safety. To scale down risks, medical examinations are mandatory and overwhelmingly performed using bicycle ergometry, which overlooks some important aspects of diving. Searching ergometric systems that better address the underwater environment, a systematic literature search was conducted using the keywords ‘diving’, ‘fitness’, ‘ergometry’, and ‘exertion’. All presented alternative systems found convincingly describe a greatly reduced underwater physical performance. Thus, if a diver’s workload in air should already be limited, he/she will suffer early from fatigue, risking a diving incident. How to assess fitness? Performance diagnostics in sports is always specific for a modality or movement. Therefore, professional scuba divers should be tested when fin-swimming underwater. For the vast number of recreational divers, the current screening can likely not be replaced. However, to prevent accidents, divers need to understand and be able to improve factors that limit their physical performance underwater. Other systems, presented here, will continue to be important tools in underwater research.

Changes in authenticity

2018 ◽  
pp. 312-323
Author(s):  
Erez C. Miller ◽  
Amos Fleischmann
Keyword(s):  
Social Media ◽  
Medical Condition ◽  
Medication Use ◽  
Sense Of Control ◽  
Online Forums ◽  
Hyperactivity Disorder ◽  
Internet Forums ◽  
The Cost ◽  
Adhd Medications ◽  
Medical Perspective

The use of medications for attention deficit hyperactivity disorder (ADHD) has been strongly debated because medications may alter the individual’s sense of authenticity. This chapter examines online forums that include young people’s experiences with ADHD medications, their sense of control over medication use, and the drugs’ effects on their sense of authenticity. It discusses the analysis of four Internet forums dedicated to ADHD issues using an ethnographic-discursive approach, and demonstrates that the results suggest there are two types of competing narratives—those of the young people, who express doubts about taking medications due to their effect on various psychological characteristics and especially on their sense of authenticity, and those of professionals, who uphold the medical perspective that regardless of the medications’ effects they are still the best option for treating ADHD. It covers how the clash between these two competing narratives resonates a more general struggle of people with disabilities for their rights. Finally, it discusses how social media echoes the struggle between individuals with disabilities and the establishment’s view of ADHD as a medical condition which should be treated accordingly, even at the cost of losing the individual’s authenticity.

Historical Insights in Psychopharmacology

2018 ◽  
pp. 508-511
Author(s):  
S. Nassir Ghaemi
Keyword(s):  
20Th Century ◽  
Psychiatric Illness ◽  
Depressive Illness ◽  
Psychotropic Medications ◽  
Dementia Praecox ◽  
Manic Depressive Illness ◽  
Relevant Today ◽  
Manic Depressive ◽  
Basic Distinction ◽  
Psychiatric Conditions

The writings of two classic thinkers in psychiatry in the 19th and 20th centuries, Emil Kraepelin and Aubrey Lewis, are provided and examined for insights they provided into continuing problems in the diagnostic and treatment of psychiatric conditions today. Kraepelin was the famed great late 19th-century psychiatric leader from Germany who identified the basic distinction between schizophrenia (dementia praecox) and manic-depressive illness. He laid the foundations of much of psychiatric diagnosis that remains relevant today, and he was a committed defender of the biological approach to psychiatry, although he was conservative with the use of drugs, which were ineffective in his day. Lewis (1900–1975) was the most prominent figure in British psychiatry through most of the 20th century. He was the leader of the Institute of Psychiatry at the Maudsley Hospital for much of the middle of the 20th century. That institution in London was the most influential educational center for psychiatry in the nation. Through his leadership there, Lewis was extremely influential. He tended to be skeptical about the use of psychotropic medications, and emphasized social aspects of psychiatric illness.

scholarly journals Medication Use, Substance Use, and Psychological Conditions of Female Inmates in Canadian Federal Prisons

2013 ◽  
Vol 51 (1-2) ◽  
pp. 23-37 ◽  
Author(s):  
Chantal Plourde ◽  
Natasha Dufour ◽  
Serge Brochu ◽  
Annie Gendron
Keyword(s):  
Substance Use ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Female Inmates ◽  
Illicit Substance ◽  
Psychological Conditions ◽  
Use Patterns ◽  
Federal Prisons ◽  
Illicit Substance Use ◽  
Significant Relationships

SummaryThis study provides data on substance use patterns, including medications, among female inmates in Canadian federal prisons. The participants were interviewed regarding their substance use and their psychological condition before and during incarceration. Their medication cards were also analyzed. The results show that a large proportion (66.9 %) of these incarcerated women reported substance abuse prior to incarceration and exhibited psychological disorders. In prison, if the illicit substance use remained low, most subjects had prescriptions for more than one medication. Furthermore, women with psychotropic medication prescriptions in their file had, on average, prescriptions for two different psychotropic medications. Significant relationships were found between substance misuse before incarceration and illicit substance use or and psychotropic medication use during incarceration. These results support the need to develop integrated services for both addiction and mental health for female offenders during incarceration.

scholarly journals Safety of psychotropic medications in people with COVID-19: evidence review and practical recommendations

BMC Medicine ◽  
2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Giovanni Ostuzzi ◽  
Davide Papola ◽  
Chiara Gastaldon ◽  
Georgios Schoretsanitis ◽  
Federico Bertolini ◽  
...  
Keyword(s):  
Working Group ◽  
Medical Condition ◽  
Potential Interaction ◽  
Psychotropic Medications ◽  
Evidence Based ◽  
Medical Treatments ◽  
Safety Issues ◽  
Safety Risks ◽  
Novel Coronavirus ◽  
Practical Recommendations

Abstract Background The novel coronavirus pandemic calls for a rapid adaptation of conventional medical practices to meet the evolving needs of such vulnerable patients. People with coronavirus disease (COVID-19) may frequently require treatment with psychotropic medications, but are at the same time at higher risk for safety issues because of the complex underlying medical condition and the potential interaction with medical treatments. Methods In order to produce evidence-based practical recommendations on the optimal management of psychotropic medications in people with COVID-19, an international, multi-disciplinary working group was established. The methodology of the WHO Rapid Advice Guidelines in the context of a public health emergency and the principles of the AGREE statement were followed. Available evidence informing on the risk of respiratory, cardiovascular, infective, hemostatic, and consciousness alterations related to the use of psychotropic medications, and drug–drug interactions between psychotropic and medical treatments used in people with COVID-19, was reviewed and discussed by the working group. Results All classes of psychotropic medications showed potentially relevant safety risks for people with COVID-19. A set of practical recommendations was drawn in order to inform frontline clinicians on the assessment of the anticipated risk of psychotropic-related unfavorable events, and the possible actions to take in order to effectively manage this risk, such as when it is appropriate to avoid, withdraw, switch, or adjust the dose of the medication. Conclusions The present evidence-based recommendations will improve the quality of psychiatric care in people with COVID-19, allowing an appropriate management of the medical condition without worsening the psychiatric condition and vice versa.

scholarly journals Effect of Psychotropic Medications on Hammertoe Reconstruction Outcomes

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142094413
Author(s):  
Samuel D. Maidman ◽  
Amalie E. Nash ◽  
Amanda Fantry ◽  
Shay Tenenbaum ◽  
Yahya Daoud ◽  
...  
Keyword(s):  
Short Form ◽  
Medication Use ◽  
Psychotropic Medications ◽  
Activity Level ◽  
Mood Stabilizers ◽  
Level Of Evidence ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported ◽  
Before And After

Background: Hammertoe deformities can seriously affect activity level and footwear. The use of prescription, mood-altering medications is very common, with some estimates as high as 25% of the population. Mood disorders, especially depression, negatively affect the results of medical and operative treatments. This study assessed the relationship of mood-altering medication use with the outcomes and complications of operative reconstruction of hammertoes. Methods: Data were prospectively collected from 116 patients who underwent hammertoe reconstruction, including demographic information, medical history, the use of mood-altering psychotropic medications (antidepressants, anxiolytics, hypnotics, and mood stabilizers), and postoperative complications. Preoperative patient-reported outcomes were measured using the visual analog scale (VAS) for pain and Short Form Health Survey (SF-36), which were repeated at 1-year follow-up. Results: A total of 36.2% of patients were taking psychotropic medications. Medication and nonmedication groups had similar pain VAS and SF-36 Physical Component Summary (PCS) scores before and after surgery. Compared with nonmedication patients, patients on psychotropic medications had significantly lower SF-36 Mental Component Summary (MCS) scores preoperatively ( P = .001) and postoperatively ( P = .006), but no significant difference in the change in MCS (ΔMCS) from preoperative to postoperative. Psychotropic medication use was associated with superficial wound infections ( P = .048), but not other complications. Conclusions: Patients taking psychotropic medications were equally likely to benefit from forefoot reconstruction as nonmedication patients. Preoperative and postoperative PCS and VAS were not significantly different between medication and nonmedication groups. Although the medication group had lower absolute MCS, they reported the same magnitude of improvement in MCS (ΔMCS) as the nonmedication group. Level of Evidence: Level II, prospective cohort study.

scholarly journals Psychiatric conditions with relevance to fitness to drive

2000 ◽  
Vol 6 (4) ◽  
pp. 261-269 ◽  
Author(s):  
Margaret Harris
Keyword(s):  
Road Safety ◽  
Medical Condition ◽  
Fitness To Drive ◽  
Medical Unit ◽  
Driving License ◽  
Secretary Of State ◽  
Psychiatric Conditions

In the interest of road safety, driving license holders who suffer from a medical condition likely to affect fitness to drive must notify the Driver and Vehicle Licensing Agency (DVLA) and not drive. The Secretary of State for the Environment, Transport and the Regions (of the Department for the Environment, Transport and the Regions, DETR) has the responsibility, via his Medical Advisers at the Drivers Medical Unit of the DVLA, to ensure that all licence holders are fit to drive.

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