Drug–Drug Interactions in Vestibular Diseases, Clinical Problems, and Medico-Legal Implications

Peripheral vestibular disease can be treated with several approaches (e.g., maneuvers, surgery, or medical approach). Comorbidity is common in elderly patients, so polytherapy is used, but it can generate the development of drug–drug interactions (DDIs) that play a role in both adverse drug reactions and reduced adherence. For this reason, they need a complex kind of approach, considering all their individual characteristics. Physicians must be able to prescribe and deprescribe drugs based on a solid knowledge of pharmacokinetics, pharmacodynamics, and clinical indications. Moreover, full information is required to reach a real therapeutic alliance, to improve the safety of care and reduce possible malpractice claims related to drug–drug interactions. In this review, using PubMed, Embase, and Cochrane library, we searched articles published until 30 August 2021, and described both pharmacokinetic and pharmacodynamic DDIs in patients with vestibular disorders, focusing the interest on their clinical implications and on risk management strategies.

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The Legal Implications of Obstacle Racing and Suggested Risk Management Strategies

Journal of Legal Aspects of Sport ◽

10.1123/jlas.2014-0002 ◽

2014 ◽

Vol 24 (2) ◽

pp. 78-95 ◽

Cited By ~ 2

Author(s):

Margaret C. Keiper ◽

Sarah Young ◽

Gil Fried ◽

Todd Seidler

Keyword(s):

Risk Management ◽

Management Strategies ◽

Legal Implications ◽

Risk Management Strategies

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Medicolegal Issues in Pediatrics

10.1542/9781581107012 ◽

2005 ◽

Author(s):

Keyword(s):

Risk Management ◽

Management Strategies ◽

Medical Liability ◽

Specific Risk ◽

Malpractice Claims ◽

Wide Range ◽

Risk Management Strategies ◽

Medicolegal Issues

Medical liability continues to be a fact of life for pediatricians. One third of pediatricians will be sued for medical liability over the course of their careers. Pediatricians need to be aware of this fact and take steps to reduce the likelihood of being sued. Medicolegal Issues in Pediatrics, offers a wide range of medicolegal topics that affect the practice of pediatrics from residency through retirement. It provides pediatricians with detailed information on common pediatric malpractice claims and specific risk management strategies to reduce the threat of being sued and make it easier to defend a claim.

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Helping supervisees learn ethically based risk management strategies

PsycEXTRA Dataset ◽

10.1037/e500672008-001 ◽

2008 ◽

Author(s):

Samuel Knapp

Keyword(s):

Risk Management ◽

Management Strategies ◽

Risk Management Strategies

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The management of risk in a dryland environment

Proceedings of the New Zealand Grassland Association ◽

10.33584/jnzg.2011.73.2835 ◽

2011 ◽

pp. 13-21

Author(s):

D.I. Gray ◽

J.I. Reid ◽

D.J. Horne

Keyword(s):

Risk Management ◽

Service Providers ◽

Management Strategies ◽

Subterranean Clover ◽

Farming Systems ◽

Market Risk ◽

Farm Size ◽

Forage Crops ◽

Risk Management Strategies ◽

Upside Risk

A group of 24 Hawke's Bay hill country farmers are working with service providers to improve the resilience of their farming systems. An important step in the process was to undertake an inventory of their risk management strategies. Farmers were interviewed about their farming systems and risk management strategies and the data was analysed using descriptive statistics. There was considerable variation in the strategies adopted by the farmers to cope with a dryland environment. Importantly, these strategies had to cope with three types of drought and also upside risk (better than expected conditions), and so flexibility was critical. Infra-structure was important in managing a dryland environment. Farmers chose between increased scale (increasing farm size) and geographic dispersion (owning a second property in another location) through to intensification (investing in subdivision, drainage, capital fertiliser, new pasture species). The study identified that there may be scope for further investment in infra-structural elements such as drainage, deeper rooting alternative pasture species and water harvesting, along with improved management of subterranean clover to improve flexibility. Many of the farmers used forage crops and idling capacity (reduced stocking rate) to improve flexibility; others argued that maintaining pasture quality and managing upside risk was a better strategy in a dryland environment. Supplementary feed was an important strategy for some farmers, but its use was limited by contour and machinery constraints. A surprisingly large proportion of farmers run breeding cows, a policy that is much less flexible than trading stock. However, several farmers had improved their flexibility by running a high proportion of trading cattle and buffer mobs of ewe hoggets and trade lambs. To manage market risk, the majority of farmers are selling a large proportion of their lambs prime. Similarly, cattle are either sold prime or store onto the grass market when prices are at a premium. However, market risk associated with the purchase of supplements and grazing was poorly managed.

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Review of Prelabor Rupture of the Membranes: Pathophysiologic Concepts and Novel Therapeutic Strategies

Current Women s Health Reviews ◽

10.2174/1573404816999201026223954 ◽

2020 ◽

Vol 16 ◽

Author(s):

Saadia Ghafoor

Keyword(s):

Management Strategies ◽

Signs And Symptoms ◽

Cochrane Library ◽

Main Body ◽

Scientific Publications ◽

Timely Diagnosis ◽

Narrative Literature Review ◽

Contemporary Management ◽

Online Library ◽

Novel Therapeutic Strategies

Background:: Prelabor rupture of membrane (PROM) refers to the breakage of fetal membranes before the onset of labor, resulting in the leakage of amniotic fluid. PROM affects approximately 3% and 8% of preterm and term pregnancies. Because of associated high maternal and perinatal mortality, correct and timely diagnosis together with effective management is highly recommended to prevent adverse fetal and maternal outcomes. Objective:: To provide an overview of the novel concepts in the understanding of PROM including etiology, pathophysiology, risk factors, complications, assessment, diagnostic modalities, and contemporary management strategies for PROM at preterm and term. Methodology:: This narrative literature review was conducted through a literature search using the Cochrane library and electronic databases including PubMed, Web of Science, Medline, Scopus, Crossref, Google Scholar, Wiley online library, ScienceDirect with specific search terms in scientific publications published from March 1980 to March 2020. Main Body:: Preterm PROM has the potential to cause prenatal morbidity and mortality. It is imperative to monitor the signs and symptoms of an impending infection due to the risk of infectious morbidity with PROM at preterm and preterm. PROM at preterm and term requires prompt diagnosis followed by an appropriate management strategy. Conclusion:: The correct and timely diagnosis of PROM is essential for efficacious management. Furthermore, it can reduce avoidable emergent health care visits and related costs in a clinical setting subjected to pregnancy with suspected PROM. Further studies are needed to fill the gaps in identifying better diagnostic predictive tools in high- risk pregnancies.

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The Effects of Decision Aid Orientation on Risk Factor Identification and Audit Test Planning

Auditing A Journal of Practice & Theory ◽

10.2308/aud.2002.21.2.39 ◽

2002 ◽

Vol 21 (2) ◽

pp. 39-56 ◽

Cited By ~ 29

Author(s):

Jean C. Bedard ◽

Lynford E. Graham

Keyword(s):

Risk Factors ◽

Risk Management ◽

Decision Aid ◽

Decision Aids ◽

Management Strategies ◽

Risk Identification ◽

Matched Pair ◽

Audit Planning ◽

Audit Firms ◽

Risk Management Strategies

In auditing, risk management involves identifying client facts or issues that may affect engagement risk, and planning evidence-gathering strategies accordingly. The purpose of this paper is to examine whether auditors' identification of risk factors and planning of audit tests is affected by decision aid orientation, i.e., a “negative” focus wherein client risk and its consequences are emphasized, or a “positive” focus where such factors are not emphasized. Specifically, we expect that auditors will identify more risk factors using a negatively oriented risk identification decision aid, but only when engagement risk is relatively high. We address this issue in the context of auditors' knowledge of actual clients, manipulating decision aid orientation as negative or positive in a matched-pair design. Results show that auditors using the negative decision aid orientation identify more risk factors than do those using a positive orientation, for their higher-risk clients. We also find that decisions to apply substantive tests are more directly linked to specific risk factors identified than to direct risk assessments. Further, our results show that auditors with repeat engagement experience with the client identify more risk factors. The findings of this study imply that audit firms may improve their risk management strategies through simple changes in the design of decision aids used to support audit planning.

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Evaluation of Physical Risk during Necropsy and Morgue Activities as Risk Management Strategy

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18168266 ◽

2021 ◽

Vol 18 (16) ◽

pp. 8266

Author(s):

Zoe Del Fante ◽

Nicola Di Fazio ◽

Adriano Papale ◽

Paola Tomao ◽

Fabio Del Duca ◽

...

Keyword(s):

Risk Factors ◽

Risk Management ◽

Management Strategies ◽

Risk Management Strategy ◽

Work Related ◽

Activity Measurements ◽

Risk Management Strategies ◽

Physical Risk ◽

Critical Issues ◽

Load Handling

Physical risk assessments allow us to understand work-related critical issues, thus representing a useful tool in risk management strategies. In particular, our study focuses on the identification of already known and emerging physical risks related to necropsy and morgue activities, as well as crime scene investigations. The aim of our study is, therefore, to identify objective elements in order to quantify exposure to such risk factors among healthcare professionals and working personnel. For the research of potentially at-risk activities, data from the Morgue of Policlinico Umberto I Hospital in Rome were used. The scientific literature has been reviewed in order to assess the risks associated with morgue activity. Measurements were performed on previously scheduled days, in collaboration with the activities of different research units. The identified areas of risk were: microclimate; exposure to noise and vibrations; postural and biomechanical aspects of necropsy activities. The obtained results make it possible to detect interindividual variability in exposure to many of the aforementioned risk factors. In particular, the assessment of microclimate did not show significant results. On the contrary, exposure to vibrations and biomechanical aspects of load handling have shown potential risk profiles. For this reason, both profiles have been identified as possible action targets for risk management strategies.

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Persistence and Potential Lethality in Intimate Partner Violence: Evaluating the Concurrent and Predictive Validity of a Dual Risk Assessment Protocol

Violence Against Women ◽

10.1177/1077801220988347 ◽

2021 ◽

pp. 107780122098834

Author(s):

Kirk R. Williams ◽

Richard Stansfield ◽

Jacquelyn Campbell

Keyword(s):

Risk Assessment ◽

Intimate Partner Violence ◽

Predictive Validity ◽

Race And Ethnicity ◽

Partner Violence ◽

Management Strategies ◽

Intimate Partner ◽

Assessment Protocol ◽

Risk Management Strategies ◽

Domestic Violence Screening

This study seeks to determine the concurrent and predictive validity of a dual risk assessment protocol. It combines the risk of persistence in intimate partner violence (IPV) measured via the Domestic Violence Screening Instrument–Revised (DVSI-R) with supplemental items from the Danger Risk Assessment (DRA) bearing on the risk of potential lethality. We further test whether this assessment protocol reproduces disparities by race and ethnicity found in the larger population. Using a sample of 4,665 IPV male defendants with a female victim, analyses support both types of criterion validity. The DRA risk score is associated with felony charges, incarceration at the initial arrest, and the frequency of subsequent dangerous behavior. Results also suggest minimal predictive bias or disparate impact by race and ethnicity. Incorporating supplemental items bearing on potential lethality risk adds important information concerning the risk management strategies of those involved in IPV.

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Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis

RMD Open ◽

10.1136/rmdopen-2021-001647 ◽

2021 ◽

Vol 7 (2) ◽

pp. e001647

Author(s):

Andréa Marques ◽

Eduardo Santos ◽

Elena Nikiphorou ◽

Ailsa Bosworth ◽

Loreto Carmona

Keyword(s):

Systematic Review ◽

Full Text ◽

Inflammatory Arthritis ◽

Data Extraction ◽

Management Strategies ◽

Psychosocial Interventions ◽

Behavioural Therapy ◽

Self Management ◽

Cochrane Library ◽

Management Interventions

ObjectiveTo perform a systematic review (SR) on the effectiveness of self-management interventions, in order to inform the European League Against Rheumatism Recommendations for its implementation in patients with inflammatory arthritis (IA).MethodsThe SR was conducted according to the Cochrane Handbook and included adults (≥18 years) with IA. The search strategy was run in Medline through PubMed, Embase, Cochrane Library, CINAHL Plus with Full Text, and PEDro. The assessment of risk of bias, data extraction and synthesis were performed by two reviewers independently. A narrative Summary of Findings was provided according to the Grading of Recommendations, Assessment, Development and Evaluation.ResultsFrom a total 1577 references, 57 were selected for a full-text review, and 32 studies fulfilled the inclusion criteria (19 randomised controlled trials (RCTs) and 13 SRs). The most studied self-management components were specific interactive disease education in ten RCTs, problem solving in nine RCTs, cognitive–behavioural therapy in eight RCTs, goal setting in six RCTs, patient education in five RCTs and response training in two RCTs. The most studied interventions were multicomponent or single exercise/physical activity in six SRs, psychosocial interventions in five SRs and education in two SRs. Overall, all these specific components and interventions of self-management have beneficial effects on IAs-related outcomes.ConclusionsThe findings confirm the beneficial effect of the self-management interventions in IA and the importance of their implementation. Further research should focus on the understanding that self-management is a complex intervention to allow the isolation of the effectiveness of its different components.

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