scholarly journals Terapia del dolore: nuove norme e aspetti pratici per l’uso degli analgesici

2005 ◽  
Vol 6 (1) ◽  
pp. 77-83
Author(s):  
Lorenzo Pradelli
Keyword(s):  
Health Professionals ◽  
Pain Therapy ◽  
Drug Prescription ◽  
Legal Framework ◽  
Cultural Barriers ◽  
Industrialized Countries ◽  
Opioid Use ◽  
Important Indicator ◽  
Modern Approach ◽  
Care Giving

Until recently, pain therapy in Italy was conducted with largely sub-optimal standards, as revealed by one of the lowest mean morphine consumption values, an important indicator of pain therapy quality according to the WHO, among industrialized countries. The recognition of such a negative situation has led to an important effort to improvement, carried out by the law-maker, institutions and health professionals. As suggested by the WHO, these efforts aimed at three main objectives: reducing the cultural barriers to appropriate opioid use through targeted education and information, easing of analgesic drug prescription and availability, and improvement of the integration among hospital-based and domiciliar pain management and care-giving. In this article, the new legal framework concerning the prescription and administration of analgesics - regulatory innovations started in February 2001 - is presented and its practical implications for health professionals are discussed. Alongside the new laws, some regulatory interventions recently adopted by the Italian Drug Agency (AIFA) are presented and discussed, as they share the proposition of simplifying pain therapy and permit the prescription of more analgesics paid for by the National Health Service. In the last years, the premises for a more rational and modern approach to pain therapy in Italy have been created, which will need to be followed by cultural, organizing and clinical practice adaptations in order to warrant effective and efficient management of algic patients.

Sexual and gender-based violence in migration context: Needs, gaps and good practices

2021 ◽  
Vol 7 (1) ◽  
pp. 64-81
Author(s):  
María Aranda López ◽  
David Moreno Molina ◽  
Teresa Fernández Contreras ◽  
Juana María Morcillo Martínez ◽  
Marta García Domingo ◽  
...  
Keyword(s):  
Third Sector ◽  
Essential Element ◽  
Legal Framework ◽  
Cultural Barriers ◽  
Gender Based Violence ◽  
Good Practices ◽  
Cultural Mediators ◽  
Use Of Services ◽  
Gender Based ◽  
And Gender

The first goal of the present work was to identity needs and gaps in interventions for migrant and refugee victims of sexual and gender-based violence (SGBV) in Spain. The second goal was to develop a guide for itineraries, resources and good practices to address the gaps detected. To produce data pertaining to the first purpose, we used a qualitative approach and focus groups (FGs) with institutional operators and representatives of the Third Sector. In total, six FGs were conducted with 35 key informants. The results of the study showed that existing services and resources are, in general, sufficient to cover the needs of the target group. However, some issues, such as excessive bureaucracy, re-victimization, difficulties regarding legal regularization, cultural barriers and the scant presence of cultural mediators were revealed. Regarding the second goal, a guide was created on the legal framework, itineraries and resources for migrant and refugee victims of SGBV, to ensure good practices and incorporate cultural mediation as an essential element to guarantee optimal use of services.

scholarly journals The state of regulatory legal framework for the classification of biological threats

2016 ◽  
Vol 21 (4) ◽  
pp. 188-195
Author(s):  
Tatyana G. Suranova ◽  
V. V Nikiforov
Keyword(s):  
Health Professionals ◽  
Legal Framework ◽  
The State ◽  
Biological Hazard ◽  
The Creation

Recognition of the globality of biological hazard problems put forward a new task for health professionals - the creation of a system ofprotection based on the continuous comprehensive monitoring of real and potential biological threats. The article is devoted to the classification of biological threats.

Health Technology Assessment

2011 ◽  
pp. 26-41
Author(s):  
Lise Lund Haheim ◽  
Berit Morland
Keyword(s):  
Information Flow ◽  
Health Professionals ◽  
Rapid Development ◽  
New Drugs ◽  
Treatment Modalities ◽  
Industrialized Countries ◽  
Scientific Publications ◽  
The Public ◽  
Health Technologies ◽  
Health Authorities

Scientific publications in medical fields are rapidly increasing and are overwhelming in numbers. This poses a challenge to health authorities, and health professionals who need knowledge to make informed decisions in finding the best evidence for treatment and practice in the health provision to the public. They need an accessible system that handle the information flow using a systematic approach. This applies to developing and industrialized countries alike. The rapid development of health technologies with the introduction of new drugs, devices, and complex treatment modalities to achieve better health outcomes increases the need for evaluation of the treatment effect. This chapter illustrates how the health service handles the information flow utilizing information technology, and the great benefit that is gained by this methodology.

scholarly journals Avoiding Difficult Conversations in the Australian Health Sector

2020 ◽  
Vol 6 ◽  
pp. 237796082094197
Author(s):  
Christine King ◽  
Tanya Edlington ◽  
Brett Williams
Keyword(s):  
Health Professionals ◽  
Health Care Professionals ◽  
Health Sector ◽  
Educational Opportunities ◽  
Cultural Barriers ◽  
Communication Style ◽  
Negative Consequences ◽  
Clinical Supervisors ◽  
Australian Health ◽  
Difficult Conversations

Background Health professionals avoiding difficult conversations with each other can lead to serious negative consequences for patients. Clinical supervisors are in the unique position of interacting both with students as well as colleagues and peers. This study explores the avoidance of difficult conversations from the perspective of clinical supervisors in order to better understand why health professionals avoid difficult conversations. Objective This study aimed to identify the reasons why difficult conversations are avoided between health-care professionals and to gain deeper insight into the phenomenon of avoiding difficult conversations in general. Methods Convergent interviewing was used with 20 clinical supervisors to explore the following question: Why do you think that people in your workplace avoid difficult conversations? Results Major reasons for avoiding difficult conversations included the fear of negative consequences, a general distaste for confrontation, and a lack of confidence in their skills to have such conversations. Additional factors included individual qualities such as personality type and communication style, available time, size of the workplace, and a range of perceived cultural barriers standing in the way of having difficult conversations. Conclusion There is a need to encourage clinical supervisors and other health professionals to embrace difficult conversations to reduce adverse events and enhance patient outcomes. This requires additional training and educational opportunities to enhance knowledge, skills, and confidence to plan and engage in difficult conversations. Some types of difficult conversations require more skills than others.

scholarly journals Biased Opioid Antagonists as Modulators of Opioid Dependence: Opportunities to Improve Pain Therapy and Opioid Use Management

Molecules ◽  
2020 ◽  
Vol 25 (18) ◽  
pp. 4163 ◽  
Author(s):  
Wolfgang Sadee ◽  
John Oberdick ◽  
Zaijie Wang
Keyword(s):  
Opioid Dependence ◽  
Pain Therapy ◽  
Active Form ◽  
Opioid Analgesics ◽  
Opioid Antagonist ◽  
Opioid Antagonists ◽  
Opioid Use ◽  
Opioid Agonist ◽  
Opposing Effects

Opioid analgesics are effective pain therapeutics but they cause various adverse effects and addiction. For safer pain therapy, biased opioid agonists selectively target distinct μ opioid receptor (MOR) conformations, while the potential of biased opioid antagonists has been neglected. Agonists convert a dormant receptor form (MOR-μ) to a ligand-free active form (MOR-μ*), which mediates MOR signaling. Moreover, MOR-μ converts spontaneously to MOR-μ* (basal signaling). Persistent upregulation of MOR-μ* has been invoked as a hallmark of opioid dependence. Contrasting interactions with both MOR-μ and MOR-μ* can account for distinct pharmacological characteristics of inverse agonists (naltrexone), neutral antagonists (6β-naltrexol), and mixed opioid agonist-antagonists (buprenorphine). Upon binding to MOR-μ*, naltrexone but not 6β-naltrexol suppresses MOR-μ*signaling. Naltrexone blocks opioid analgesia non-competitively at MOR-μ*with high potency, whereas 6β-naltrexol must compete with agonists at MOR-μ, accounting for ~100-fold lower in vivo potency. Buprenorphine’s bell-shaped dose–response curve may also result from opposing effects on MOR-μ and MOR-μ*. In contrast, we find that 6β-naltrexol potently prevents dependence, below doses affecting analgesia or causing withdrawal, possibly binding to MOR conformations relevant to opioid dependence. We propose that 6β-naltrexol is a biased opioid antagonist modulating opioid dependence at low doses, opening novel avenues for opioid pain therapy and use management.

Knowledge of and Attitudes towards Prostate Cancer among Italo-Australian Men

2001 ◽  
Vol 7 (3) ◽  
pp. 9 ◽  
Author(s):  
Murray J. N. Drummond ◽  
Tom A. Laws ◽  
Jelena Poljak-Fligic
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Health Professionals ◽  
Treatment Options ◽  
Medical Science ◽  
Cultural Barriers ◽  
Health Issues ◽  
Cancer Awareness ◽  
Health Laws ◽  
Insight Into

Information surrounding the treatment of prostate cancer is not clearly defined by medical science. Consequently, health professionals are divided with respect to the most appropriate method of screening and detection. The assumption that if health professionals are not clear, what are the perceptions of Australian males in terms of prostate cancer detection and treatment options? Further, what does it mean to men from non-Australian cultures with language and cultural barriers impacting on choices and decisions relating to health? (Laws et al., 2000). This paper provides insight into the lives of 20 Italo-Australian men. It attempts to draw on their perceptions and understandings of prostate cancer and prostate cancer awareness from their unique perspectives. It will highlight some of the significant issues with respect to being an Italian born man living in Australia and how this impacts on health issues, and specifically prostate cancer awareness. The intention of this paper is to provide in-depth qualitative data to emphasise Italo-Australian men?s health perspectives and experiences.

scholarly journals Correction: Rate of opioid use disorder in adults who received prescription opioid pain therapy—A secondary data analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (1) ◽  
pp. e0246146
Author(s):  
Johannes M. Just ◽  
Norbert Scherbaum ◽  
Michael Specka ◽  
Marie-Therese Puth ◽  
Klaus Weckbecker
Keyword(s):  
Data Analysis ◽  
Pain Therapy ◽  
Secondary Data ◽  
Opioid Use Disorder ◽  
Secondary Data Analysis ◽  
Prescription Opioid ◽  
Opioid Use ◽  
Correction Rate

scholarly journals Daily Opioid Use Is Common in Adults with Sickle Cell Disease Presenting to an Acute Care Unit for Treatment of Vaso-Occlusive Pain

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 4587-4587
Author(s):  
Fuad El Rassi ◽  
Neli Stoyanova ◽  
Eldrida Randall ◽  
Morgan L. McLemore ◽  
Claudia R. Morris
Keyword(s):  
Clinical Trial ◽  
Acute Care ◽  
Sickle Cell ◽  
Clinical Characteristics ◽  
Pain Therapy ◽  
Admission Rate ◽  
Cell Disease ◽  
Opioid Use ◽  
Chronic Opioid Use ◽  
Acute Care Unit

Abstract Background: Pain is the hallmark of sickle cell disease (SCD), and the most common reason for emergency department (ED) visits and hospitalizations in adults and children with SCD. The Emory University Sickle Cell Center at Grady Memorial Hospital has been providing specialized services for adult SCD patients for 30 years. In addition to daily sickle cell specialized clinics, the center is set up with a 24/7 acute care unit (ACU) that is staffed by specialized SCD providers and manages vaso-occlusive episodes (VOE). The patients are started on intravenous narcotics, fluids and antibiotics within 30 minutes of presenting to the ACU. After eight hours of management, the patient is then either discharged home if the VOE is controlled or admitted to the hospital for continued management. Annually, around 3000 ACU visits are recorded with 17% hospital admission rate (over the last 5 years). Little information is known about the clinical characteristics of adults with SCD and chronic opioid use in the setting of VOE pain. Methods: Clinical data from adult SCD patient visits for VOE presenting to the ACU was prospectively collected over a 4-month period (March 1, 2015- July 1 2015) as part of a screening process of an ongoing clinical trial. Results: 214 patients were evaluated for VOE requiring parenteral opioids, with an admission rate of 18%. Mean age was 31+/-14 years, 53% were male and the majority (80%) had hemoglobin (Hb) SS. See Table 1 for clinical characteristics. Over 80% of patients treated in the ACU were ultimately discharged home. Interestingly, the rate of chronic opioid use was around 50% in both admitted and discharged patients from the ACU. Conclusions: The admission rate for VOE in adults with SCD is low at our center through the utilization of the ACU. 51% of patients requiring admission for continued pain therapy were on daily opioids and most of these patients had Hb-SS. 50% of the patients discharged from the ACU were also on daily opioids which represents a significant finding when trying to recruit opioid-na•ve patients on clinical trials to manage VOE. Additionally, this high percentage of daily opioid users reflects a group of patients with possibly more severe disease, who are at risk of tolerance, hyperanalgesia and difficulty in managing VOE in the outpatient setting. This information is valuable for clinical trial design, as chronicopioid use is often an exclusion criterion for enrollment into novel pain therapy trials in SCD. More research is needed on this important topic. Table 1. Clinical Characteristics of Adults with SCD and VOE presenting to Grady Acute Care Center Characteristics Total(N=214) Admitted(N=38) Discharged (N=176) Patient Visits (%) 100% 18% 82% Male n (%) 114 (53%) 19 (50%) 95 (54%) Female n (%) 100 (47%) 19 (50%) 81 (46%) Age ± SD 31±14 29±10 31±9 Hb SS 170 (80%) 34 (89%) 136 (77%) Hb SC 37 (17%) 4 (11%) 33 (19%) Hb S beta+ thalassemia 7 (3%) 0 7 (4%) Chronic Opioids n (%) 108 (51%) 19 (50%) 89 (51%) Disclosures No relevant conflicts of interest to declare.

Sign in / Sign up

Export Citation Format

Share Document