scholarly journals Looking for the “Little Things”: A Multi-Disciplinary Approach to Medicines Monitoring for Older People Using the ADRe Resource

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 79 ◽  
Author(s):  
David Hughes ◽  
Meirion Jordan ◽  
Patricia A. Logan ◽  
Alan Willson ◽  
Sherrill Snelgrove ◽  
...  
Keyword(s):  
Medical Knowledge ◽  
Signs And Symptoms ◽  
Regulatory Regime ◽  
Team Approach ◽  
Drug Induced ◽  
The Social ◽  
Structured System ◽  
Iatrogenic Harm ◽  
Reaction Profile ◽  
Regular Review

Advances in medicines have increased the effectiveness of treatments and the social and cultural authority of doctors. However, as prescribing has become the dominant modality of treatment, the “pharmaceuticalization” of medical practice has often resulted in treatment “at a distance”, with doctors having limited contact with patients. Older and poorer people, who are socially distanced from medical prescribers, suffer more adverse drug reactions (ADRs) than the general population. A team approach to checking patients systematically for ADRs, as detailed in manufacturers’ literature, can minimise medication errors, but regular review is rare. This paper explains the benefits of medicines monitoring to protect older patients from iatrogenic harm, such as over-sedation, falls, or drug-induced Parkinsonism. We show how multidisciplinary initiatives to optimise prescribing can be supported by using a recognised resource—the adverse drug reaction profile (ADRe). The profile identifies and documents patients’ signs and symptoms of putative ADRs. Better monitoring allows professionals to adjust prescribing and respond to identified problems with agility. Implementation of systematic monitoring will require changes to the regulatory regime and better inter-professional cooperation. Providing carers, nurses and pharmacists with a structured system to monitor patients would democratise relevant medical knowledge and help address ageism and the socio-economic health divide.

scholarly journals Combatting Misinformation During the COVID-19 Pandemic Via Social Media

2021 ◽  
Vol 9 (1) ◽  
pp. 56-58
Author(s):  
Shehrbano Ali ◽  
Muhammad Murad Murtaza
Keyword(s):  
Social Media ◽  
Medical Knowledge ◽  
Signs And Symptoms ◽  
Sufficient Information ◽  
Corona Virus ◽  
The People ◽  
The Social ◽  
Virus Research ◽  
False News ◽  
Poster Presentations

Misinformation or "fake news" has existed in society for quite a while, with healthcare related misinformation being especially problematic, particularly during the COVID-19 pandemic. Due to the false news circulating on the social media, many misconceptions exist about the disease and the pandemic, leading to people reacting in extreme and unrecommended ways that cause more harm than benefit. In order to combat this, the CMH Arts and Design Society took an initiative and formed a facebook page named "Pakistan Corona Virus Research Outlook" that aimed to present well researched facts regarding COVID-19 in the form of video or poster presentations, so that they could be understood easily by the general public. We also drafted an online handbook that addressed the basic concerns regarding the signs and symptoms of the disease, and the basic principles of management, so as to equip the people without medical knowledge with sufficient information for them to be able to manage mild symptoms themselves, without burdening the healthcare system. We also formed a facebook group by the name "Corona Virus (COVID-19) Free Counselling" that aimed to provide a platform to the public to ask their queries regarding COVID-19 which were then addressed by medical professionals. A post-COVID syndrome series was also initiated on these platforms that addressed the post-COVID symptoms individually and provided a follow up plan for each, based on expert guidelines.

scholarly journals Adverse Drug Reactions, Power, Harm Reduction, Regulation and the ADRe Profiles

Pharmacy ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 102 ◽  
Author(s):  
Sue Jordan ◽  
Patricia Logan ◽  
Gerwyn Panes ◽  
Mojtaba Vaismoradi ◽  
David Hughes
Keyword(s):  
Adverse Effects ◽  
Adverse Drug Reactions ◽  
Signs And Symptoms ◽  
Drug Reactions ◽  
Drug Induced ◽  
Regulatory Systems ◽  
Regulatory Interventions ◽  
Iatrogenic Harm ◽  
The Many ◽  
The Impact

The power and influence of healthcare systems comes largely from the ability to prescribe efficacious medicine. However, medicine can sometimes cause harm rather than bring benefits. Systematically checking patients for the adverse effects of medicines, as listed in manufacturers’ literature, would protect patients from iatrogenic harm, but this is rarely undertaken. We argue for the benefits of this approach using the example of the prescription of antipsychotics to older adults. Prescribing antipsychotics to control challenging behaviours associated with dementia is a controversial matter, and regulatory intervention is under discussion. Improved regulatory systems could protect against iatrogenic harm, such as over-sedation, falls, tremor, or drug-induced Parkinsonism. However, measuring the impact and outcomes of regulatory interventions has proved difficult, not least because there are rarely systematic records of all adverse effects of medicines. We indicate how regulatory initiatives to reduce antipsychotic prescribing can be supported by systematic monitoring and documentation of patients’ signs and symptoms of putative adverse drug reactions. Monitoring documentation then provides the rationale and support for professionals’ responses to identified problems. Longitudinal monitoring records would improve understanding of the impact and outcomes of adverse drug reactions (ADRs) on health and wellbeing, and the many costs of ADRs.

Central Banks and the New Regulatory Regime for Banks

2019 ◽  
pp. 502-527
Author(s):  
David T. Llewellyn
Keyword(s):  
Central Banks ◽  
Employee Attitudes ◽  
Social Costs ◽  
Regulatory Regime ◽  
Bank Failures ◽  
The Social ◽  
Global Banking ◽  
Regulated Firms ◽  
And Behavior ◽  
Attitudes And Behavior

The most serious global banking crisis in living memory has given rise to one of the most substantial changes in the regulatory regime of banks. While not all central banks have responsibility for regulation, because they are almost universally responsible for systemic stability, they have an interest in bank regulation. Two core objectives of regulation are discussed: lowering the probability of bank failures and minimizing the social costs of failures that do occur. The underlying culture of banking creates business standards and employee attitudes and behavior. There are limits to what regulation can achieve if the underlying cultures of regulated firms are hazardous. There are limits to what can be achieved through detailed, prescriptive, and complex rules, and when, because of what is termed the endogeneity problem, rules escalation raises issues of proportionality, a case is made for banking culture to become a supervisory issue.

scholarly journals Two case reports of continued progression of chronic ocular graft-versus-host disease without concurrent systemic comorbidities treated by amniotic membrane transplantation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hideto Ikarashi ◽  
Naohiko Aketa ◽  
Eisuke Shimizu ◽  
Yoji Takano ◽  
Tetsuya Kawakita ◽  
...  
Keyword(s):  
Graft Versus Host Disease ◽  
Amniotic Membrane ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Amniotic Membrane Transplantation ◽  
Team Approach ◽  
Host Disease ◽  
Graft Versus Host ◽  
Target Organs ◽  
Conjunctival Inflammation

Abstract Background Chronic ocular graft-versus-host disease (oGVHD) is an ocular comorbidity of graft-versus-host disease (GVHD) that usually occurs concurrently with systemic manifestations. Failure to detect and treat oGVHD in its early stages may lead to progression of ocular signs and symptoms leading to oGVHD that is refractory to conventional treatment. Case presentation We report the clinical course of a 19-year-old male and a 59-year-old female with severe and progressive chronic oGVHD without concurrent systemic signs of chronic graft-versus-host disease (cGVHD). Although their systemic conditions had been stable, both suffered from severe oGVHD and were referred to our clinic. Both cases exhibited marked improvement in conjunctival inflammation and fibrotic changes after amniotic membrane transplantation (AMT). Both cases underwent keratoplasty eventually to stabilize ocular surface conditions and to improve visual function. Conclusions We reported the clinical outcomes of 2 cases of chronic oGVHD without concurrent systemic comorbidities that were treated with AMT. The clinician should be aware that cGVHD may persist in target organs even in the absence of concurrent systemic comorbidities following seemingly successful systemic treatment. A multidisciplinary team approach is essential in the early detection and therapeutic intervention for chronic oGVHD.

The Entextualization of Ayurveda as Intellectual Property

2012 ◽  
Vol 19 (3) ◽  
pp. 313-343 ◽  
Author(s):  
Matthew Wolfgram
Keyword(s):  
Intellectual Property ◽  
Global Economy ◽  
Medical Knowledge ◽  
Linguistic Anthropology ◽  
Medical Discourse ◽  
Complex Nature ◽  
Multiple Sources ◽  
The Social ◽  
Rights Discourse ◽  
The Individual

AbstractThis article documents the practices of pharmaceutical creativity in Ayurveda, focusing in particular on how practitioners appropriate multiple sources to innovate medical knowledge. Drawing on research in linguistic anthropology on the social circulation of discourse—a process calledentextualization—I describe how the ways in which Ayurveda practitioners innovate medical knowledge confounds the dichotomous logic of intellectual property (IP) rights discourse, which opposes traditional collective knowledge and modern individual innovation. While it is clear that these categories do not comprehend the complex nature of creativity in Ayurveda, I also use the concept of entextualization to describe how recent historical shifts in the circulation of discourse have caused a partial entailment of this opposition between the individual and the collectivity. Ultimately, I argue that the method exemplified in this article of tracking the social circulation of medical discourse highlights both the empirical complexity of so-called traditional creativity, and the politics of imposing the categories of IP rights discourse upon that creativity, situated as it often is, at the margins of the global economy.

scholarly journals Mental health and burden in mothers of children with congenital Zika syndrome during COVID-19 pandemic

2021 ◽  
Vol 21 (suppl 2) ◽  
pp. 481-490
Author(s):  
Gabriela Lopes Gama ◽  
Bruna Milena da Silva ◽  
Mariana Balbino da Silva ◽  
Rayssa Vieira Brandão Ferreira ◽  
Jousilene de Sales Tavares ◽  
...  
Keyword(s):  
Mental Health ◽  
Signs And Symptoms ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Symptoms Of Depression ◽  
Maternal Schooling ◽  
The Social ◽  
Burden Scale ◽  
Congenital Zika Syndrome ◽  
Health Impairments

Abstract Objectives: to evaluate burden, frequency of anxiety and signs and symptoms of depression in mothers of children with congenital Zika syndrome (CZS) during the COVID-19 pandemic and the social isolation period. Methods: this is a cross-sectional study conducted with mothers who care for their children with CZS. The data were collected by an online form with questions regarding mother's socioeconomic conditions and questions related with Zarit burden scale and Beck's inventories on depression and anxiety. Spearman’s correlation tests and multiple regression analyzes were performed to assess factors related to mothers' burden and mental health. Results: 41 mothers were evaluated, 51.2% had mild burden, 39% had minimal anxiety and 73.2% did not have signs and symptoms of depression. Negative correlations were observed between levels of burden and maternal schooling (p=0.01), presence of signs and symptoms of anxiety and receiving financial aid (p<0.04) as well as the presence of signs and symptoms of anxiety and having children with seizures history (p=0.03). Conclusion: despite the risk of their children again being victims of an epidemic virus, mothers who care for their children with CZS did not present serious mental health impairments.

scholarly journals Narratives of Starting, Using, and Stopping Methamphetamine Use

2021 ◽  
Author(s):  
◽  
John Dance
Keyword(s):  
Drug Use ◽  
Drug Users ◽  
Policy Issue ◽  
Law And Order ◽  
Drug Induced ◽  
Methamphetamine Use ◽  
Problematic Use ◽  
The Social ◽  
Cognitive Decision ◽  
Behavioural Theories

<p>Methamphetamine use has come to be seen as a significant policy issue in New Zealand and elsewhere. Panic about methamphetamine’s effects, the increasing prevalence of its use and its alleged potential to cause more harm than other drugs has been fundamental in elevating public concern and initiating a raft of law and order responses. Using the familiar tropes of addiction and drug-induced criminality, authoritative discourses conveying the nature of the ‘meth problem’ have obfuscated the social, cultural and structural forces which intersect decisions about drug use. Instead, explanations of meth-use anchored to behavioural theories about risk have emphasised drug-use is as being the product of individualised cognitive decision making. In taking a narrative approach to analyse 17 drug-users’ stories about starting, using and stopping methamphetamine use, this thesis sets out to theoretically engage with the experiential and contextual nuances of drug-taking decisions which continue to be excluded from authoritative accounts of problematic use. In doing so this thesis reveals how decisions about starting and using methamphetamine had occurred within established trajectories of problematic poly-drug taking behaviour. Collectively, the experiences of starting, using and stopping methamphetamine use storied by this sample of drug users help challenge pejorative constructions of problematic users of drugs as being wilfully self-destructive by highlighting that “risk actions are rarely the product of any one individuals’ rational decisions”(Rhodes: 1997:216).</p>

scholarly journals Pulmonary Hypertension in Pregnancy: Critical Care Management

2012 ◽  
Vol 2012 ◽  
pp. 1-9 ◽  
Author(s):  
Adel M. Bassily-Marcus ◽  
Carol Yuan ◽  
John Oropello ◽  
Anthony Manasia ◽  
Roopa Kohli-Seth ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Critical Care ◽  
Right Ventricular ◽  
Pregnant Women ◽  
Signs And Symptoms ◽  
Right Ventricular Failure ◽  
Team Approach ◽  
Ventricular Failure ◽  
Critical Care Management ◽  
New Treatments

Pulmonary hypertension is common in critical care settings and in presence of right ventricular failure is challenging to manage. Pulmonary hypertension in pregnant patients carries a high mortality rates between 30–56%. In the past decade, new treatments for pulmonary hypertension have emerged. Their application in pregnant women with pulmonary hypertension may hold promise in reducing morbidity and mortality. Signs and symptoms of pulmonary hypertension are nonspecific in pregnant women. Imaging workup may have undesirable radiation exposure. Pulmonary artery catheter remains the gold standard for diagnosing pulmonary hypertension, although its use in the intensive care unit for other conditions has slowly fallen out of favor. Goal-directed bedside echocardiogram and lung ultrasonography provide attractive alternatives. Basic principles of managing pulmonary hypertension with right ventricular failure are maintaining right ventricular function and reducing pulmonary vascular resistance. Fluid resuscitation and various vasopressors are used with caution. Pulmonary-hypertension-targeted therapies have been utilized in pregnant women with understanding of their safety profile. Mainstay therapy for pulmonary embolism is anticoagulation, and the treatment for amniotic fluid embolism remains supportive care. Multidisciplinary team approach is crucial to achieving successful outcomes in these difficult cases.

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