Interventional pain treatment – overview of available procedures

Ból ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 1-14
Author(s):  
Michał But ◽  
Andrzej Król ◽  
Teodor Goroszeniuk ◽  
Elwira Góraj ◽  
Kamil Starczewski ◽  
...  
Keyword(s):  
Subjective Experience ◽  
Pain Treatment ◽  
Hospital Setting ◽  
Anatomical Location ◽  
Heavy Burden ◽  
The Right ◽  
Fee Schedule ◽  
Interventional Pain Treatment ◽  
Based Medicine

Chronic pain has become dominant problem in recent years affecting not only patient quality of life but having economic impact and heavy burden on the health systems. The first line in pain management would be patient education, physical rehabilitation and pharmacotherapy. Unfortunately aforementioned treatment often appears incomplete and specialised, targeted pain interventions are warranted. With significant progress in pain medicine, the number of available and effective interventional procedures and techniques have increased. In this manuscript authors have carried out an up to date review of modern interventional techniques with emphasize of anatomy, level of advancement and complexity. Authors classified procedures according to anatomical location: head and neck, spine, upper and lower limb, trunk as well as pathophysiology: interventions in neuropathic pain, cancer pain including neuromodulation techniques. Whenever possible authors relied on evidence based medicine (EBM) but with emphasize of its limitation, especially in assessment of pain relief which remains patient subjective experience. In summary, reimbursement of up to date pain procedures, in the outpatient and hospital setting has been shown. It hopefully guide pain specialists to choose the right intervention and facilitate renumeration within NFZ fee schedule.

scholarly journals Mental Disorder or Creative Gift?

1970 ◽  
Vol 20 (1) ◽  
pp. 73-98
Author(s):  
Józef Bremer
Keyword(s):  
Mental Disorder ◽  
Experimental Research ◽  
Subjective Experience ◽  
Sense Modality ◽  
The Senses ◽  
Neurological Research ◽  
The Right

In cases where one sense-modality is stimulated by another, we speak of synesthesia, i.e., of a subjective experience of multiple distinct sensations as being quite literally conjoined. The term “synesthesia” is derived indirectly from the Greek words “syn,” meaning “together,” and “aisthesis,” meaning “sensation.” This article focuses on the question of whether synesthesia is in fact a mental disorder or a creative gift. Both the commonsense views that have emerged in recent times, and neurological research, demonstrate that our knowledge of this relatively uncommon phenomenon is slowly but constantly expanding. Proper experimental research conducted with the right sorts of synesthete, and philosophically and scientifically nuanced conceptual studies of synesthesia, can all be helpful when seeking answers to the question posed above, while also confirming general claims about the extent to which our perceptions are really subjective. Most synesthetes see themselves as gifted, and claim that this “conjoining of the senses” enriches the quality of their lives.

scholarly journals Guidelines and evidence based medicine. The importance of stakeholder involvement.

2014 ◽  
Vol 5 (3) ◽  
pp. 109-115
Author(s):  
Francesco Massoni ◽  
Pasquale Ricci ◽  
Serafino Ricci
Keyword(s):  
Assessment Tool ◽  
Stakeholder Involvement ◽  
Professional Conduct ◽  
Criminal Cases ◽  
Right To Life ◽  
Validated Questionnaire ◽  
The Right ◽  
Based Medicine ◽  
Elaboration Process

With the depenalization of professional conduct of the physician in case of adherence to the guidelines proposed by L. 189/2012 the discussion on the quality of the available guidelines in the literature has led the authors to a review with particular regard to stakeholder involvement in the elaboration process. Evident critical points arise in the accessible studies that have used as an assessment tool a scientifically validated questionnaire (Appraisal of Guidelines for Research and Evaluation – AGREE). As a result the solution of the legislature, although useful to contain the phenomenon of defensive medicine, may be useless and ineffective in criminal cases where fundamental and absolute rights, as the right to life and health of patients, are involved.

scholarly journals Partnerships and Collaborations: The Right Alliances for Clinical Trials in Africa

2020 ◽  
pp. 954-958
Author(s):  
Olusola Solarin ◽  
Sulma I. Mohammed ◽  
Ntokozo Ndlovu ◽  
Verna Vanderpuye ◽  
Victoria Olaiya
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
New Therapies ◽  
Racial Profile ◽  
Research Organizations ◽  
Heavy Burden ◽  
Empiric Data ◽  
The Right ◽  
Global Population

Africa attracts < 1% of all trials conducted around the world. The implication is that proof of safety and efficacy in Africans is lacking for a lot of new therapies. The sizeable proportion of approximately 20% of the global population that Africa represents largely does not have empiric data to support use of new therapies in a population with a distinct genetic and racial profile. Beyond the imperative of evidence-based interventions, Africans carry a disproportionately heavy burden of certain diseases, including prostate cancer, sickle cell anemia, and malaria. It therefore provides opportunity for efficient recruitment of participants for trials for such diseases. However, this advantage has not convinced sponsors to carry out clinical trials in Africa. India and China each have roughly the same population size as Africa, but each presents just one regulatory jurisdiction for clinical trials. Africa has 54 countries, and a sponsor would theoretically need to file 54 different applications to cover the entire continent. Collaboration and partnership among all stakeholders in the clinical trial ecosystem will reduce the burden on sponsors and make Africa competitive as a destination for clinical trials. Collaboration among national regulatory agencies will enable Africa to be treated as one regulatory jurisdiction and reduce administrative burden. Sites and researchers can partner to improve quality, attain necessary certifications, and increase overall efficiency. Central to all of these are clinical research organizations that can coordinate and work across borders to make clinical trial projects seamless. Ultimately, patients will benefit as quality of clinical practice improves and access to new therapies is enhanced.

ANALYSIS OF REGULATIONS REGARDING THE SETTLEMENT OF ISSUES ON THE REMOVAL AND RECOVERY OF PLANTATIONS IN THE RIGHT-OF-WAY OF PUBLIC ROADS

2020 ◽  
pp. 55-60
Author(s):  
Nataliia Kharytonova ◽  
Olha Mykolaienko ◽  
Tetyana Lozova
Keyword(s):  
Traffic Safety ◽  
Climatic Factors ◽  
Visual Orientation ◽  
Right Of Way ◽  
Adverse Weather ◽  
Overhead Power Lines ◽  
The Right ◽  
Neck Diameter ◽  
Proper Operation

Greening of roads contributes to the protection of roads and their elements from influence of adverse weather and climatic factors; it includes the measures for improvement and landscaping of roads, ensures the protection of roadside areas from transport pollution, provides visual orientation of drivers. The solution of these issues will ensure creation and maintenance of safe and comfortable conditions for travelers. Green plantings in the right-of-way road area include woody, bushy, flower and grass vegetation of natural and artificial origin. For proper operation of public roads and satisfaction of other needs of the industry, there may be the need in removing the greenery. The reason for the removal of greenery in the right-of-way road area may be due to the following factors: construction of the architectural object, widening of the motor road, repair works in the security zone of overhead power lines, water supply, drainage, heating, telecommunications facilities, cutting of hazardous, dry and fautal trees, as well as self-grown and brushwood trees with a root neck diameter not exceeding 5 cm, elimination of the consequences of natural disasters and emergencies. The removal of plantations in the right-of-way area is executed in order to ensure traffic safety conditions and to improve the quality of plantations composition and their protective properties. Nowadays, in Ukraine there is no clear procedure for issuing permits for removing of such plantations. In order to resolve this issue, there is a need in determining the list of regulations in the area of forest resources of Ukraine and, if needed, the list of regulatory acts that have to be improved; to prepare a draft of the regulatory legal act that would establish the procedure of plantations cutting, the methodology of their condition determination, recovery costs determination, the features of cutting. Keywords: plantations, cutting, right-of-way, woodcutting permit, order.

Key facts on moderate to severe acute pain combined treatment with tramadol and dexketoprofen at fixed doses

2020 ◽  
Vol 13 (3) ◽  
pp. 304-310
Author(s):  
Jarosław Woroń
Keyword(s):  
Quality Of Life ◽  
Treatment Adherence ◽  
Acute Pain ◽  
Pain Treatment ◽  
Combined Treatment ◽  
Physiological Changes ◽  
Physiological Mechanisms ◽  
Pain Mechanisms ◽  
Proven Efficacy

The development of pain is associated with numerous physiological mechanisms. Improper acute pain treatment significantly reduces the quality of life and leads to a number of physiological changes that adversely affect the general condition of the patient. In many cases, inadequate analgesic therapy results in the transition from acute to chronic pain. For this reason, it is extremely important to use drugs that synergistically affect various pain mechanisms. Combined preparations, including the combination of tramadol and dexketoprofen, are very effective. This combination has many advantages, including proven efficacy and tolerability, ensures better treatment adherence and is easy to administer.

Modifikasi Model Pembelajaran Problem Based Learning (PBL) dengan Strategi Pembelajaran Tugas dan Paksa

2019 ◽  
Vol 2 ◽  
Author(s):  
Tita Mila Mustofani ◽  
Ita Hartinah
Keyword(s):  
Critical Thinking ◽  
Learning Strategies ◽  
Student Motivation ◽  
Problem Based Learning ◽  
Learning Model ◽  
Learning Material ◽  
Task Strategies ◽  
The Right ◽  
Increasing Student Learning

This writing aims to help teachers to increase motivation, activity, creativity, and critical thinking of students in solving problems in class. The way to increase student motivation in learning in class is to choose the right learning model with ongoing learning material. One learning model that increases students' creativity and critical thinking in problem solving is a Problem Based Learning (PBL) learning model. To improve students' insights in order to easily solve problems there is a need to do tasks, if students do not do the task then they must accept the agreed upon consequences when making learning contracts, thus modifying the Problem Based Learning (PBL) learning model with task strategies and forced. The results of the modification of learning with the Problem Based Learning (PBL) learning model through forced and forced strategies are expected to improve the learning process so that students become more disciplined and do not waste time doing assignments. The advantages of modifying the Problem Based Learning (PBL) learning model with task and forced learning strategies are increasing student learning motivation, improving the quality of learning, training students' understanding by giving assignments continuously, teaching discipline to students in order to be accountable for tasks assigned, and reducing laziness in students.

THE VALUE OF LOVE IN THE SYSTEM OF FORMATION OF THE PROFESSIONAL MATURITY OF THE EDUCATOR

2020 ◽  
Vol 1 (10(79)) ◽  
pp. 12-18
Author(s):  
G. Bubyreva
Keyword(s):  
Russian Federation ◽  
The State ◽  
Educational Process ◽  
Wide Range ◽  
The Family ◽  
The Russian Federation ◽  
The Government ◽  
The Individual ◽  
The Right

The existing legislation determines the education as "an integral and focused process of teaching and upbringing, which represents a socially important value and shall be implemented so as to meet the interests of the individual, the family, the society and the state". However, even in this part, the meaning of the notion ‘socially significant benefit is not specified and allows for a wide range of interpretation [2]. Yet the more inconcrete is the answer to the question – "who and how should determine the interests of the individual, the family and even the state?" The national doctrine of education in the Russian Federation, which determined the goals of teaching and upbringing, the ways to attain them by means of the state policy regulating the field of education, the target achievements of the development of the educational system for the period up to 2025, approved by the Decree of the Government of the Russian Federation of October 4, 2000 #751, was abrogated by the Decree of the Government of the Russian Federation of March 29, 2014 #245 [7]. The new doctrine has not been developed so far. The RAE Academician A.B. Khutorsky believes that the absence of the national doctrine of education presents a threat to national security and a violation of the right of citizens to quality education. Accordingly, the teacher has to solve the problem of achieving the harmony of interests of the individual, the family, the society and the government on their own, which, however, judging by the officially published results, is the task that exceeds the abilities of the participants of the educational process.  The particular concern about the results of the patriotic upbringing served as a basis for the legislative initiative of the RF President V. V. Putin, who introduced the project of an amendment to the Law of RF "About Education of the Russian Federation" to the State Duma in 2020, regarding the quality of patriotic upbringing [3]. Patriotism, considered by the President of RF V. V. Putin as the only possible idea to unite the nation is "THE FEELING OF LOVE OF THE MOTHERLAND" and the readiness for every sacrifice and heroic deed for the sake of the interests of your Motherland. However, the practicing educators experience shortfalls in efficient methodologies of patriotic upbringing, which should let them bring up citizens, loving their Motherland more than themselves. The article is dedicated to solution to this problem based on the Value-sense paradigm of upbringing educational dynasty of the Kurbatovs [15].

Evaluation of staff in Healthcare Companies

2020 ◽  
Author(s):  
Troncone Raffaella ◽  
Coda Marco
Keyword(s):  
Social Context ◽  
Evaluation System ◽  
Daily Life ◽  
Good Health ◽  
Rehabilitation Services ◽  
Individual Contribution ◽  
Personnel Evaluation ◽  
Good Evaluation ◽  
The Right

Evaluation is at the basis of any social context where all individuals are simultaneously "evaluated" and "evaluators" in all areas of daily life. The goal of a good evaluation system is to encourage staff to do "Good Health" through the provision of quality prevention, diagnosis, treatment and rehabilitation services. The main reasons that lead to the evaluation of the personnel lie in the inevitable and primary importance of the human resource in achieving the corporate objectives, and by the pressing need for the quality of the service provided to the citizen, as well as the legitimate need of the employee to differentiate, clarifying its specificities and its own individual contribution to the general objectives of the company. In the working context, the "personnel evaluation" assumes a fundamental importance, if managed with the right criteria, in order to make the employee not a simple pawn to move and manage for use and consumption of the organization, but an integral part of the organization itself.

Current Regulatory Standpoint on Evaluating the Bioequivalence of Different Classes of Generic Drugs - Is the Evaluation in the Right Direction?

2019 ◽  
Vol 20 (10) ◽  
pp. 835-844 ◽  
Author(s):  
Francis Micheal ◽  
Mohanlal Sayana ◽  
Balamurali Musuvathi Motial
Keyword(s):  
Generic Drugs ◽  
Bibliographic Databases ◽  
Eligibility Criteria ◽  
Individual Bioequivalence ◽  
Population Bioequivalence ◽  
Standard Tool ◽  
Review Question ◽  
Guidance Documents ◽  
The Right

Background: The concept of evaluating bioequivalence has changed over a period of time. Currently, the Average Bioequivalence approach (ABE) is the gold standard tool for the evaluation of generics. Of late, many debates had arisen about employing ABE approach for the appraisal of all drug categories. This review aims to examine the limitations of ABE approach and the significances of Population Bioequivalence (PBE) and Individual Bioequivalence (IBE) approach, current regulatory thinking for assessing different categories of the drug, whether they are adequately assessed, and the evaluation is in the right direction. Methods: We carried out an organized search of bibliographic databases for peer-reviewed research literatures, regulatory recommendations, guidance documents using a focused review question and eligibility criteria. The standard tools were used to appraise the quality of retrieved documents and to make sure the authenticity of the data. Results: In total 73 references were used in the review, the majority of the references (guidance documents) were from the different regulatory agencies and product-specific guidance. There were 29 product-specific guidance from USFDA and EMA. The limitations of the ABE approach were discussed in detail along with the significances of Population Bioequivalence (PBE) approach and Individual Bioequivalence (IBE) approaches. Conclusion: It is apparent from the review that IBE approach is a precise method for evaluating the drugs as it answers drug interchangeability (prescribability and switchability). IBE approach is followed by PBE approach and ABE approach for the evaluation of different categories of drugs in terms of precision.

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