scholarly journals Clinical Applications of System Regulation Medicine

2019 ◽  
Vol 7 (18) ◽  
pp. 3053-3060
Author(s):  
Massimo Fioranelli ◽  
Alireza Sepehri ◽  
Maria Grazia Roccia ◽  
Cota Linda ◽  
Chiara Rossi ◽  
...  
Keyword(s):  
Drug Use ◽  
Biological Networks ◽  
Paradigm Shift ◽  
Pathological Process ◽  
Clinical Applications ◽  
High Quality Research ◽  
Axiom A ◽  
Preclinical Phase ◽  
The Usa ◽  
Shared Networks

Increasing incidence and poor outcome of chronic non-communicable diseases in western population would require a paradigm shift in the treatments. Guidelines-based medical approaches continue to be the standard rule in clinical practice, although only less than 15% of them are based on high-quality research. For each person who benefits from the 10 best-selling drugs in the USA, a number between 4 and 25 has no one beneficial effect. The reductionist linear medicine method does not offer solutions in the non-manifest preclinical stage of the disease when it would still be possible to reverse the pathological progression and the axiom "a drug, a target, a symptom" are still inconclusive. Needs additional tools to address these challenges. System Medicine considers the disease as a dysregulation of the biological networks that changes throughout the evolution of the pathological process and with the comorbidities development. The strength of the networks indicates their ability to withstand dysregulations during the perturbation phases, returning to the state of stability. The treatment of dysregulated networks before the symptomatological manifestation emerges offers the possibility of treating and preventing pathologies in the preclinical phase and potentially reversing the pathological process, stopping it or preventing comorbidities. Furthermore, treating shared networks instead of individual phenotypic symptoms can reduce drug use, offering a solution to the problem of ineffective drug use.

scholarly journals Review of Drug Utilization Studies in Neonatal Units: A Global Perspective

2020 ◽  
Vol 17 (16) ◽  
pp. 5669 ◽  
Author(s):  
Asma Al-Turkait ◽  
Lisa Szatkowski ◽  
Imti Choonara ◽  
Shalini Ojha
Keyword(s):  
Drug Use ◽  
Drug Utilization ◽  
Antibiotic Use ◽  
Global Perspective ◽  
Use Patterns ◽  
Rational Prescribing ◽  
Drug Use Patterns ◽  
General Drug ◽  
The Usa ◽  
Drug Utilization Studies

Rational prescribing is challenging in neonatology. Drug utilization studies help identify and define the problem. We performed a review of the literature on drug use in neonatal units and describe global variations. We searched databases (EMBASE, CINAHL and Medline) from inception to July 2020, screened studies and extracted relevant data (two reviewers). The search revealed 573 studies of which 84 were included. India (n = 14) and the USA (n = 13) reported the most. Data collection was prospective (n = 56) and retrospective (n = 26), mostly (n = 52) from one center only. Sixty studies described general drug use in 34 to 450,386 infants (median (IQR) 190 (91–767)) over a median (IQR) of 6 (3–18) months. Of the participants, 20–87% were preterm. The mean number of drugs per infant (range 11.1 to 1.7, pooled mean (SD) 4 (2.4)) was high with some reporting very high burden (≥30 drugs per infant in 8 studies). This was not associated with the proportion of preterm infants included. Antibiotics were the most frequently used drug. Drug use patterns were generally uniform with some variation in antibiotic use and more use of phenobarbitone in Asia. This study provides a global perspective on drug utilization in neonates and highlights the need for better quality information to assess rational prescribing.

scholarly journals B-PO03-115 ANTIARRHYTHMIC MEDICATION FOR ATRIAL FIBRILLATION (AIM-AF) STUDY: A PHYSICIAN SURVEY OF ABLATION AND ANTIARRHYTHMIC DRUG USE IN THE USA AND EUROPE

Heart Rhythm ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. S235
Author(s):  
Sanjeev Saksena ◽  
Carina Blomström-Lundqvist ◽  
Jose L. Merino ◽  
Andreas Goette ◽  
Giuseppe Boriani ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Drug Use ◽  
Antiarrhythmic Drug ◽  
Physician Survey ◽  
The Usa ◽  
Antiarrhythmic Medication

scholarly journals The system of personalized instruction in school education: problems of implementation and adaptation

2020 ◽  
pp. 142-152
Author(s):  
Polina O. Kraynova ◽  
Alexey S. Obukhov
Keyword(s):  
General Education ◽  
Personal Characteristics ◽  
Personalized Learning ◽  
Educational Process ◽  
Learning System ◽  
High Quality Research ◽  
Global Trends ◽  
Learning Platform ◽  
The Usa ◽  
The Individual

In the context of global trends in the humanization of education, issues of differentiation, individualization and personalization of education are actively discussed. At the same time, the key question remains – how to preserve the individual capabilities, interests and needs of each student while maintaining collective learning formats? How to take into account the personal characteristics and capabilities of each when passing and mastering general education programs? One such solution was the PCBL personalized learning platform developed in the USA. Currently, the Khoroshevskaya school is introducing and adapting this platform to the Russian conditions of education. The article examines the specific case of implementing a system of personalized competency-based education in a separate school – what problems, barriers and difficulties are encountered in its implementation. The study is built in the logic of qualitative research on the basis of high-quality research interviews with the main participants in the educational process in the context of introducing a personalized learning system.

scholarly journals HIV in UK Prisons: A Review of Seroprevalence, Transmission and Patterns of Risk

1995 ◽  
Vol 6 (6) ◽  
pp. 387-391 ◽  
Author(s):  
Simon P Curtis ◽  
Anne Edwards
Keyword(s):  
Drug Use ◽  
Risk Behaviour ◽  
Current Data ◽  
Focused Attention ◽  
Intravenous Drug Use ◽  
Penal Institutions ◽  
The Usa ◽  
Partner Change ◽  
The Uk ◽  
Low Prevalence

Summary: Prisons contain individuals at high risk of HIV infection, notably through intravenous drug use. For complex political, social and legal reasons penal institutions in the UK are unable to provide condoms and clean needles. The outbreak of HIV and hepatitis B that occurred in a Scottish prison in 1993 focused attention on the potential problems. Debate about the issue is hampered by a lack of useful information. Current data about risk behaviour and seroprevalence is reviewed, and compared with experience in other countries. Injecting drug use in prison appears to be common, and the majority who inject in prison share equipment, which can be used many times. Sexual activity may be a smaller risk factor, but does occur between men in prison. In addition, prisoners appear to have high rates of partner change between sentences. The true prevalence of HIV in UK prisons is difficult to assess, but the available data suggest it is between 0.1 and 4.5%, lower than in Southern Europe and the USA. A window of opportunity still exists to prevent further outbreaks of HIV in UK penal institutions and to maintain these low prevalence rates. Strenuous, and possibly unpalatable measures are needed now.

scholarly journals Declines in prevalence of adolescent substance use disorders and delinquent behaviors in the USA: a unitary trend?

2017 ◽  
Vol 48 (9) ◽  
pp. 1494-1503 ◽  
Author(s):  
R. A. Grucza ◽  
R. F. Krueger ◽  
Arpana Agrawal ◽  
A. D. Plunk ◽  
M. J. Krauss ◽  
...  
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Risk Behaviors ◽  
Substance Use Disorders ◽  
Adolescent Substance ◽  
Delinquent Behaviors ◽  
Adolescent Risk ◽  
The Usa ◽  
Item Response Theory Models ◽  
Adolescent Risk Behaviors

AbstractBackgroundDownward trends in a number of adolescent risk behaviors including violence, crime, and drug use have been observed in the USA in recent years. It is unknown whether these are separate trends or whether they might relate to a general reduction in propensity to engage in such behaviors. Our objectives were to quantify trends in substance use disorders (SUDs) and delinquent behaviors over the 2003–2014 period and to determine whether they might reflect a single trend in an Externalizing-like trait.MethodsWe analyzed data from 12 to 17 year old participants from the National Survey on Drug Use and Health, a representative survey of the household dwelling population of the USA, across the 2003–2014 period (N = 210 599). Outcomes included past-year prevalence of six categories of substance use disorder and six categories of delinquent behavior.ResultsTrend analysis suggested a net decline of 49% in mean number of SUDs and a 34% decline in delinquent behaviors over the 12-year period. Item Response Theory models were consistent with the interpretation that declines in each set of outcomes could be attributed to changes in mean levels of a latent, Externalizing-like trait.ConclusionsOur findings suggest that declines in SUDs and some delinquent behaviors reflect a single trend related to an Externalizing-like trait. Identifying the factors contributing to this trend may facilitate continued improvement across a spectrum of adolescent risk behaviors.

Relationship between marijuana and other illicit drug use and depression/suicidal thoughts among late middle-aged and older adults

2015 ◽  
Vol 28 (4) ◽  
pp. 577-589 ◽  
Author(s):  
Namkee G. Choi ◽  
Diana M. DiNitto ◽  
C. Nathan Marti ◽  
Bryan Y. Choi
Keyword(s):  
Older Adults ◽  
Drug Use ◽  
Drug Users ◽  
Illicit Drugs ◽  
Illicit Drug ◽  
Service Providers ◽  
Illicit Drug Use ◽  
Middle Aged ◽  
Suicidal Thoughts ◽  
The Usa

ABSTRACTBackground:Despite growing numbers of older-adult illicit drug users, research on this topic is rare. This study examined the relationship between marijuana and/or other illicit drug use and major depressive episode (MDE) and serious suicidal thoughts among those aged 50+ years in the USA.Methods:The public use files of the 2008 to 2012 US National Survey on Drug Use and Health (NSDUH) provided data on 29,634 individuals aged 50+ years. Logistic regression analysis was used to test hypothesized associations between past-year marijuana and/or other illicit drug use and MDE and serious suicidal thoughts.Results:Nearly 6% of the 50+ years age group reported past-year marijuana and/or other illicit drug use. Compared to non-users of any illicit drug, the odds of past-year MDE among those who used marijuana only, other illicit drugs only, and marijuana and other illicit drugs were 1.54 (95% CI = 1.17–2.03), 2.75 (95% CI = 1.75–4.33), and 2.12 (95% CI = 1.45–3.09), respectively. Those who used marijuana and other drugs also had higher odds (2.44, 95% CI = 1.58–3.77) of suicidal thoughts than non-users of any illicit drug. However, among users of any illicit drug, no difference was found among users of marijuana only, marijuana and other illicit drugs, and other illicit drugs only. Among marijuana users, marijuana use frequency was a significant correlate of suicidal thoughts only among those with MDE.Conclusions:Health and mental health (MH) service providers should pay close attention to the potential reciprocal effects of marijuana and other illicit drug use and MDE and suicidal thoughts among late middle-aged and older adults.

scholarly journals Economic decline, incarceration, and mortality from drug use disorders in the USA between 1983 and 2014: an observational analysis

2019 ◽  
Vol 4 (7) ◽  
pp. e326-e333 ◽  
Author(s):  
Elias Nosrati ◽  
Jacob Kang-Brown ◽  
Michael Ash ◽  
Martin McKee ◽  
Michael Marmot ◽  
...  
Keyword(s):  
Drug Use ◽  
Economic Decline ◽  
Observational Analysis ◽  
Drug Use Disorders ◽  
The Usa

scholarly journals Fatal attraction: A narrative of early opioid addiction

2019 ◽  
Vol 36 (5) ◽  
pp. 470-481 ◽  
Author(s):  
Willy Pedersen
Keyword(s):  
Drug Abuse ◽  
Drug Use ◽  
Healthcare System ◽  
Drug Users ◽  
New Wave ◽  
Opioid Misuse ◽  
Depth Interview ◽  
Morphine Addiction ◽  
Fatal Attraction ◽  
The Usa

Norway’s first clinic to treat drug abuse was established in 1961. Most patients had been initiated into drug use through the healthcare system, i.e., in an iatrogenic manner. However, we know little about the drug users from this period. Here, we present an in-depth interview with a woman born into a wealthy family in the early 1920s who developed a heavy morphine addiction. In the course of the interview, she gradually reveals how her husband, who was a physician, as well as two other physicians, who were also erotically attracted to her, had key roles in this development. The narrative illustrates and elaborates how females from the upper strata of society with close links to male physicians may have been at particular risk of opioid misuse in the period before 1960. We now witness a new wave of iatrogenic drug abuse, particularly in the USA. We suggest that experiences from this period may again be relevant.

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