scholarly journals To Treat or Not to Treat? Polish Physicians’ Opinions about the Clinical Aspects of Cannabinoids—An Online Survey

2022 ◽  
Vol 11 (1) ◽  
pp. 236
Author(s):  
Martyna Joanna Hordowicz ◽  
Jerzy Jarosz ◽  
Anna Klimkiewicz ◽  
Małgorzata Czaplińska ◽  
Agnieszka Leonhard ◽  
...  
Keyword(s):  
Safety Profile ◽  
Online Survey ◽  
Clinical Aspects ◽  
Similar Proportion ◽  
Routine Practice ◽  
Age Group ◽  
Specialist Training ◽  
Medical Cannabis ◽  
Treatment Side Effects ◽  
Insight Into

Introduction: Medical cannabis’ importance in Poland increased dramatically following its legalization as the 12th country in Europe in 2017. However, no studies have been published to give insight into Polish physicians’ opinions about medical cannabis. Objectives: To investigate physician’s opinions about cannabinoids’ utility in clinical practice, concerns regarding their safety profile, and their clinical experience with cannabinoids. Methods: The survey using a self-developed tool was conducted online; participants were physicians with or without specialist training. Participation was voluntary. Physicians were recruited through personal networks, palliative care courses, and Medical Chambers. Results: From June to October 2020, we recruited 173 physicians from 15/16 voivodeships. The largest age group (43.9%; n = 76) was 30–39 year-olds. A similar proportion declared they never used cannabis and did not receive any training regarding cannabinoids (60% for both). Only 15 (8%) ever prescribed medical cannabis, although about 50% declared knowing suitable patients for such therapy, and 53.8% had at least one patient proactively asking for such treatment in the last 6 mo. The most common indication chosen was pain: chronic cancer-related (n = 128), chronic non-cancer (n = 77), and neuropathic (n = 60). Other commonly chosen conditions were alleviation of cancer treatment side-effects (n = 56) and cachexia (n = 57). The overall safety profile of THC was assessed as similar to most commonly used medications, including opioids; NSAIDs and benzodiazepines were, however, perceived as safer. Conclusions: Polish physicians favored the legalization of medical cannabis. However, it is of concern that a limited number have any experience with prescribing cannabis. The creation of clear guidelines to advise physicians in their routine practice and education about pain management and the risks related to the consumption of recreational cannabis for medical conditions are needed.

scholarly journals Connecting and Communicating Effectively with Teens – An Online Survey of Teen Communication Styles

2010 ◽  
Vol 5 (2) ◽  
pp. 83-89
Author(s):  
Laura Bovitz
Keyword(s):  
Online Survey ◽  
Communication Styles ◽  
Adult Educators ◽  
Age Group ◽  
Insight Into

The lives of most teens are rapidly changing and involve methods of communication that are unfamiliar to many adults. An online teen communication survey was developed to assess how and why teens communicate in order to assist adult educators in developing more effective methods of communication with this audience. The survey was completed by 148 teens ranging in age from 13 to 19. The results of the survey provide insight into teen viewpoints on their preferred methods of communication and provides valuable lessons for adults who work with this age group.

Prescribing trends of antidiabetic drugs in diabetic and hypertensive diabetic patients in an urban tertiary care hospital of Bangladesh

2017 ◽  
Vol 3 (3) ◽  
pp. 338-343
Author(s):  
Mohammad Didar Khan ◽  
Md. Ibrahim ◽  
Md. Mizanur Rahman Moghal ◽  
Dipti debnath ◽  
Asma Kabir ◽  
...  
Keyword(s):  
Urban Areas ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Age Group ◽  
Microsoft Excel ◽  
Patient Profile ◽  
Prescribing Trends ◽  
Medical University ◽  
Insight Into

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.

scholarly journals Are telephone consultations here to stay in rheumatology?

2020 ◽  
Author(s):  
Sabrina R Raizada ◽  
Natasha Cleaton ◽  
James Bateman ◽  
Diarmuid M Mulherin ◽  
Nick Barkham
Keyword(s):  
Older Patients ◽  
Online Survey ◽  
Vulnerable Groups ◽  
Age Group ◽  
Telephone Consultation ◽  
Survey Tool ◽  
Face To Face ◽  
Vulnerable Patients ◽  
Number Of Patients

Abstract Objectives During the COVID-19 pandemic, face-to-face rheumatology follow-up appointments were mostly replaced with telephone or virtual consultations in order to protect vulnerable patients. We aimed to investigate the perspectives of rheumatology patients on the use of telephone consultations compared with the traditional face-to-face consultation. Methods We carried out a retrospective survey of all rheumatology follow-up patients at the Royal Wolverhampton Trust who had received a telephone consultation from a rheumatology consultant during a 4-week period via an online survey tool. Results Surveys were distributed to 1213 patients, of whom 336 (27.7%) responded, and 306 (91.1%) patients completed all components of the survey. Overall, an equal number of patients would prefer telephone clinics or face-to-face consultations for their next routine appointment. When divided by age group, the majority who preferred the telephone clinics were <50 years old [χ2 (d.f. = 3) = 10.075, P = 0.018]. Prevalence of a smartphone was higher among younger patients (<50 years old: 46 of 47, 97.9%) than among older patients (≥50 years old: 209 of 259, 80.7%) [χ2 (d.f. = 3) = 20.919, P < 0.001]. More patients reported that they would prefer a telephone call for urgent advice (168, 54.9%). Conclusion Most patients interviewed were happy with their routine face-to-face appointment being switched to a telephone consultation. Of those interviewed, patients >50 years old were less likely than their younger counterparts to want telephone consultations in place of face-to-face appointments. Most patients in our study would prefer a telephone consultation for urgent advice. We must ensure that older patients and those in vulnerable groups who value in-person contact are not excluded. Telephone clinics in some form are here to stay in rheumatology for the foreseeable future.

scholarly journals Disrupted prevention: condom and contraception access and use among young adults during the initial months of the COVID-19 pandemic. An online survey

2021 ◽  
pp. bmjsrh-2020-200975
Author(s):  
Ruth Lewis ◽  
Carolyn Blake ◽  
Michal Shimonovich ◽  
Nicky Coia ◽  
Johann Duffy ◽  
...  
Keyword(s):  
Young People ◽  
Online Survey ◽  
Unmet Need ◽  
Initial Response ◽  
Mitigation Measures ◽  
Routine Practice ◽  
Sexual Risk Taking ◽  
Transmitted Infection ◽  
Convenience Sample ◽  
Preventive Practices

BackgroundThe initial response to COVID-19 in the UK involved a rapid contraction of face-to-face sexual and reproductive health (SRH) services and widespread use of remote workarounds. This study sought to illuminate young people’s experiences of accessing and using condoms and contraception in the early months of the pandemic.MethodsWe analysed data, including open-text responses, from an online survey conducted in June–July 2020 with a convenience sample of 2005 16–24-year-olds living in Scotland.ResultsAmong those who used condoms and contraception, one quarter reported that COVID-19 mitigation measures had made a difference to their access or use. Open-text responses revealed a landscape of disrupted prevention, including changes to sexual risk-taking and preventive practices, unwanted contraceptive pathways, unmet need for sexually transmitted infection (STI) testing, and switches from freely provided to commercially sold condoms and contraception. Pandemic-related barriers to accessing free condoms and contraception included: (1) uncertainty about the legitimacy of accessing SRH care and self-censorship of need; (2) confusion about differences between SRH care and advice received from healthcare professionals during the pandemic compared with routine practice; and (3) exacerbation of existing access barriers, alongside reduced social support and resources to navigate SRH care.ConclusionsEmerging barriers to STI and pregnancy prevention within the context of COVID-19 have the potential to undermine positive SRH practices, and widen inequalities, among young people. As SRH services are restored amid evolving pandemic restrictions, messaging to support navigation of condom and contraception services should be co-created with young people.

scholarly journals Atypical Outcomes of Nasal and Lip Appearance After Unilateral Cleft Lip Repair: Judgment by Professionals, Patients, and Laypeople

2021 ◽  
pp. 105566562098280
Author(s):  
Robin A. Tan ◽  
Frans J. Mulder ◽  
Roderic M. F. Schwirtz ◽  
David G. M. Mosmuller ◽  
Henrica C. W. De Vet ◽  
...  
Keyword(s):  
Analysis Of Variance ◽  
Online Survey ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Old Patients ◽  
Rank Score ◽  
Cleft Lip Repair ◽  
Typical Appearance ◽  
Unilateral Cleft Lip Repair ◽  
Insight Into

Objective: To gain more insight into the assessment of “atypical” nasal and lip appearance outcomes compared to “typical” appearance outcomes after unilateral cleft lip and palate (UCLP) repair, when judged by professionals, patients with repaired UCLP, and laypeople. Design: An online survey containing 3 series of photographs with various degrees of “typical” and “atypical” nasal and lip appearance outcomes after UCLP repair was sent to 30 professionals, 30 patients with repaired UCLP, and 50 laypeople in 2 countries. Participants were instructed to rank the photographs from excellent to poor based on overall appearance. Mean rank positions of photographs were analyzed and differences in mean rank score between “typical” and “atypical” results were assessed using a T-test. Agreement of ranking between the 3 groups was assessed with an analysis of variance analysis. Setting: Amsterdam UMC, location VUmc, Netherlands and Boston Children’s Hospital, Boston, USA. Patients: Photographs of 6- to 18-year-old patients with repaired UCLP. Results: “Atypical” appearance outcomes were ranked significantly less favorably (small nostril: P = 0.00; low vermillion border: P = 0.02; whistling deformity: P = 0.00) compared to “typical” outcomes. Difference between professionals, patients and laypeople in rank positioning the photographs was not statistically significant ( P = 0.89). Conclusions: Noses with a smaller nostril and lips containing a whistling deformity were perceived as poorer outcome compared to the “typical” results. Professionals, patients, and laypeople are in agreement when assessing these outcomes.

A Systematic Review of Assessments and Interventions for Chronic Pain in Young Children With or at High Risk for Cerebral Palsy

2021 ◽  
pp. 088307382199691
Author(s):  
Lisa Letzkus ◽  
Darcy Fehlings ◽  
Lauren Ayala ◽  
Rachel Byrne ◽  
Alison Gehred ◽  
...  
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Cerebral Palsy ◽  
High Risk ◽  
Online Survey ◽  
Botulinum Toxin Type A ◽  
Botulinum Toxin Type ◽  
Parent Report ◽  
Medical Cannabis ◽  
Nonpharmacologic Intervention

Background: Pain is common in children with cerebral palsy. The purpose of this systematic review was to evaluate the evidence regarding assessments and interventions for chronic pain in children aged ≤2 years with or at high risk for cerebral palsy. Methods: A comprehensive literature search was performed. Included articles were screened using PRISMA guidelines and quality of evidence was reviewed using best-evidence tools by independent reviewers. Using social media channels, an online survey was conducted to elicit parent preferences. Results: Six articles met criteria. Parent perception was an assessment option. Three pharmacologic interventions (gabapentin, medical cannabis, botulinum toxin type A) and 1 nonpharmacologic intervention were identified. Parent survey report parent-comfort and other nonpharmacologic interventions ranked as most preferable. Conclusion: A conditional GRADE recommendation was in favor of parent report for pain assessment. Clinical trials are sorely needed because of the lack of evidence for safety and efficacy of pharmacologic interventions.

scholarly journals Investigating Relationships Between Alcohol and Cannabis Use in an Online Survey of Cannabis Users: A Focus on Cannabinoid Content and Cannabis for Medical Purposes

2020 ◽  
Vol 11 ◽  
Author(s):  
Hollis C. Karoly ◽  
Raeghan L. Mueller ◽  
Chrysta C. Andrade ◽  
Kent E. Hutchison
Keyword(s):  
Alcohol Consumption ◽  
Survey Data ◽  
Online Survey ◽  
Medical Condition ◽  
Cannabis Use ◽  
Medical Cannabis ◽  
Drinking Frequency ◽  
The Relationship ◽  
Drinking Occasion

Cannabis is commonly used among people who drink alcohol, but findings are mixed regarding the direction of this relationship. The type of cannabis used [high-cannabidiol (CBD) vs. high-delta-9tetrahydrocannabinol (THC)] and motives for use (i.e., whether cannabis is used to treat a medical condition) may influence the relationship between cannabis and drinking. Specifically, CBD has shown preclinical promise in reducing alcohol consumption, and medical cannabis users report using cannabis to reduce drinking. This study leverages survey data from cannabis users who drink alcohol (N = 533). Respondents were categorized as using cannabis to treat (CTT) a medical condition or as individuals whose cannabis use is not intended to treat (NCTT) a medical condition and grouped based on the THC/CBD ratio of the flower or edible cannabis they typically use (e.g., “High-THC/CBD,” “Medium-THC/CBD” and “Low-THC/CBD”). The CTT group (n = 412) reported drinking significantly less frequently than the NCTT group (n = 121). Cannabinoid content of flower cannabis was associated with alcohol consumed on cannabis-use days, such that individuals in the High-THC/CBD group drink more on cannabis-use days compared to the Medium-THC/CBD group. Cannabinoid content of edible cannabis was associated with drinks per drinking occasion, such that the High-THC/CBD group consumed the most drinks and the Low-THC/CBD group consumed the fewest. For both edible and flower groupings, higher-THC/CBD cannabis was associated with more frequent co-use than lower-THC/CBD cannabis. Results suggest that whether someone uses cannabis to treat a medical condition may impact their drinking frequency, and the cannabinoid content in flower and edible cannabis impacts alcohol consumption.

scholarly journals Online survey into developing a model for a legal cannabis market in the United Kingdom

2021 ◽  
Vol 7 ◽  
pp. 205032452110349
Author(s):  
Edward James ◽  
Thomas L Robertshaw ◽  
Michael J Pascoe ◽  
Fiona M Chapman ◽  
Andrew D Westwell ◽  
...  
Keyword(s):  
United Kingdom ◽  
Online Survey ◽  
Medical Condition ◽  
Population Sample ◽  
Regulatory System ◽  
Supporting Evidence ◽  
Medical Conditions ◽  
Medical Cannabis ◽  
Individual Liberty ◽  
The United Kingdom

Background Despite rescheduling of cannabis to Schedule 2 and amendments to the law permitting legal availability of cannabis for the treatment of medical conditions, access to cannabis for medical use remains challenging for patients in the United Kingdom (UK). Recreational use is widespread despite laws stating users can be sentenced to prison for up to 5 years for possession. Objective The aim of the study was to develop a model for a legal cannabis market in the UK building upon the results of a preceding study in which a UK population sample determined that pharmacies are the most suitable primary legal vendor of cannabis as opposed to regulated shops or the black market. Methods An online survey was developed using Qualtrics software and advertised via the Multidisciplinary Association for Psychedelic Studies’ Facebook, Twitter and Instagram social media accounts and monthly newsletter. Results Three hundred and ninety seven individuals, a majority having used cannabis at least once, consented to participate in the study. The participants concluded that there is enough evidence for cannabis to be prescribed to treat a range of medical conditions. In addition to pharmacies providing cannabis to patients with a prescription, a majority of participants supported cannabis being sold in pharmacies for harm reduction purposes and allowing access to medicinal cannabis in cases where supporting evidence is insufficient to merit a prescription. Participants supported greater integration between dispensing pharmacies and mental health services. Overall, the participants did not oppose a consultation or screening for potential cannabis users prior to obtaining access from licensed vendors. UK participants were supportive of the concept of a cannabis card, which users can present to licensed vendors such as pharmacies, with specific recommendations (such as strains relevant to a patient’s medical condition) being coded into the card. A majority of participants supported the existence of shisha-type bars for the purchase and onsite consumption of cannabis and determined that such vendors should not be part of a pharmacy chain of stores or regulated by pharmacy regulators. The participants generally preferred that laws regarding public consumption are in line with existing smoking legislation. Participants determined that it should be legally permitted to grow cannabis at home for personal medical and non-medical purposes but not to sell for profit. Conclusion The results are suggestive of a regulatory system that medical and non-medical cannabis users can use which aims to maximise therapeutic applications, minimise harms and respect individual liberty.

The Occurrence of High Levels of Acute Behavioral Distress in Children and Adolescents Undergoing Routine Venipunctures

PEDIATRICS ◽  
1992 ◽  
Vol 90 (1) ◽  
pp. 87-91 ◽  
Author(s):  
G. Bennett Humphrey ◽  
Chris M. J. Boon ◽  
G. F. E. Chiquit van Linden van den Heuvell ◽  
Harry B. M. van de Wiel
Keyword(s):  
Children And Adolescents ◽  
Age Group ◽  
Loss Of Control ◽  
Strong Relation ◽  
And Gender ◽  
Trained Observers ◽  
Distress Scale ◽  
Insight Into

While there is no question that children dislike needles, there are very little data available on the occurrence of high levels of distress experienced by children undergoing routine venipunctures. To provide some insight into this problem, trained observers evaluated distress in 223 different children and adolescents undergoing this procedure. An observational distress scale of 1 to 5 was developed; 1 = calm, 2 = timid/nervous, 3 = serious distress, but still under control, 4 = serious distress with loss of control, and 5 = panic. We observed a strong relation between distress and age but not between distress and gender. During the actual venipuncture. half the subjects (113/223) were scored as having high levels of distress (3 or more). Our subjects were also grouped into three age ranges: toddlers; 2½ to 6 years, N = 70; preadolescents; 7 to 12 years, N = 55; and adolescents; 12 years and older, N = 98. The percent of subjects experiencing high levels of distress for each age group were: 83%, 51%, and 28%, respectively. We conclude that for venipunctures: 1) high levels of distress are common, and 2) age and not gender correlates with distress. Other correlations are discussed. Toddlers and pre-adolescents should be the targets for new interventions to reduce distress.

Taxing Disability: A Critical Look into the Medical Cannabis Regime under the New Cannabis Act, 2018

2021 ◽  
Vol 55 (2) ◽  
pp. 436-457
Author(s):  
Rachel Rohr
Keyword(s):  
Medical Marijuana ◽  
People With Disabilities ◽  
Sales Tax ◽  
Medical Cannabis ◽  
Access To Medicine ◽  
Excise Tax ◽  
Insight Into ◽  
Medical Regime ◽  
Taxation Scheme

Medical marijuana users represent many people with disabilities in Canada. Recent legislative attempts have allowed people with disabilities to access cannabis as medicine, however the landscape is ever changing. The Cannabis Act was recently introduced, legalizing marijuana for all; however, people with disabilities have not been accounted for when it comes to the issue of access to medicine. Those who rely on cannabis as medicine and those who enjoy it recreationally are now part of the same system, for better or worse. The new medical marijuana regime, under the new Cannabis Act, boasts a “two-stream” process, and it claims that it will be maintaining and improving the old medical regime alongside the new recreational regime. The applicable taxes tell a different story. Medical marijuana has always been subject to sales tax despite being effectively prescribed by doctors to manage and treat many disabilities and illnesses. Now, with the enactment of the Cannabis Act, medical marijuana is subject to an excise tax too—colloquially known as the “sin tax.” Recreational and medical marijuana are subject to the same taxation scheme, making any notion of a “two-stream” process nonsensical and blatantly unfair. The purpose of this article is to provide insight into the varying faults concerning the medical marijuana regime in Canada, with specific emphasis on the issue of taxation. In the simplest terms, taxing medical marijuana is taxing medicine and effectively taxing people with disabilities. Broken down into five parts, this article discusses the underlying reasons for the taxes surrounding medical marijuana, provides a case study of the most important tax case for medical marijuana users, scrutinizes the lack of recognition of medical marijuana as a proper prescription, outlines the ways to improve legislation, and, finally, explores a potential Charter challenge that can be effectively brought against this taxation.

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