The effect of disease outbreaks on shrimp aquaculture and the role of cooperatives in the Mekong Delta

Disease outbreaks are considered the root of drug overuse and the main reason for crop failure in the Mekong Delta. Shrimp cooperatives appear to be a promising solution to struggle with the problem because the cooperative model has been proven to be successful in many sectors such as agriculture, industry, and services. This study examines the effectiveness of a shrimp cooperative in terms of information sharing and price reduction. We employ the propensity score matching method (PSM) to do the analysis, based on the data collected from 256 households in nine communes in the Phu Tan district, Ca Mau province for 2016 and 2017. The study finds limited benefits for farmers who participate in shrimp cooperatives. It further explains why many farmers withdrew after a time. Although shrimp cooperatives have a significant effect on exchanging information related to prohibited substances, shrimp cooperative participants withhold shrimp prices. In addition, we find that the probability of participating in a shrimp cooperative is higher in households with older age or more educated household heads. Moreover, if the farmer has undergone training, the probability of participating in a shrimp cooperative increases.

Therapeutic Management: When and What

Migraine is a widespread brain disease that is classified as the second most disabling condition and has the third highest prevalence of all medical conditions. Despite its non-emergent or life-threatening nature, migraine can progress to chronic type, a subform associated with significant morbidity and drug overuse. In the management of migraine, it is important therefore to introduce early prophylactic treatment in order to limit migraine chronification. In this chapter, we will go through all the treatment options, both acute and preventive, pharmaceutical and non-pharmaceutical following this flowchart: 1. Introduction; 2. General principles; 2.1 Symptomatic therapy; 2.2 Prophylactic management; 3. Pharmaceutical therapies; 3.1 Symptomatic; 3.1.1 Disease-specific; 3.1.2 No disease-specific; 3.2 Prophylactic; 3.2.1 Disease-specific; 3.2.2 No disease-specific; 3.3 Non-Pharmaceutical therapies; 3.4 Neuromodulation; 3.4.1 Invasive; 3.4.5 Non-invasive; 3.5 Nutrient (nutraceuticals); 3.6 Dietary interventions; 3.7 Acupuncture; 3.8 Physical therapy; 4. Cognitive behavioral therapies; 5. Patient centricity and patient education.

Medication Overuse Withdrawal in Children and Adolescents does not Always Improve Headache: A Cross-Sectional Study

Background. MOH can be diagnosed in subjects with headache occurring 15 days/month in association with a regular medication overuse, but its existence is not universally accepted. ICHD-3 redefined criteria for MOH, removing the criterion associating drug suspension with headache course. Aim of our study was to compare the rate of patients diagnosed with medication overuse headache (MOH) according to ICHD-2 and ICHD-3 criteria, to verify the degree of concordance. Secondary aim was to verify if drug withdrawal was really associated with pain relief.Methods. In this cross-sectional study, we retrospectively analyzed a sample of 400 patients followed for primary chronic headache at the Headache Center of Bambino Gesù Children’s Hospital. We then selected those presenting with a history of medication overuse, and we applied both ICHD-2 and ICHD-3 criteria to verify in which patients the criteria would identify a clinical diagnosis of MOH.Results. We identified 42 subjects (10.5%) with MOH; 23 of them (55%) presented a relief of headache withdrawing drug overuse. Regarding the applicability of the ICHD-2 criteria, 43% of patients (18/42) fulfilled all criteria, while all ICHD-3 diagnostic criteria were satisfied in 76% of patients (32/42). Eighteen patients (43%) satisfied both ICHD-2 and ICHD-3 criteria, while 10 patients (24%) did not satisfy either diagnostic criteria.Conclusions. Our study suggests that in children and adolescents withdrawing medication overuse is not always associated with a clinical benefit. Therefore, though allowing a MOH diagnosis in a higher rate of patients as compared to ICHD-2, the application of ICHD-3 criteria does not guarantee a true a causal relationship between medication overuse and headache worsening.

ALCOHOL, DRUG AND SEXUAL BACKPACKERS’ LICENTIOUSNESS IN THE LIGHT OF INTERNATIONAL COMPARATIVE RESEARCH

Purpose. Among the variety of backpaker’s behaviour, the excessive use of alcohol, drugs and sexual promiscuity are considered to be potentially dangerous for their physical and mental health. According to many researchers, this behavior is the result of backpakers’ loss of control in new social and cultural situations while travelling abroad. The aim of this study was to determine the role of drugs and sexual promiscuity in the backpackers’ travels and to find the reason for their behavior becoming less controlled. Method. In this paper, the results of field research on a group of 290 backpackers from Poland and other countries, conducted within the years 2014-2016 in 5 countries (Australia, Indonesia, Thailand, United Arab Emirates and Poland) are described. Findings. The obtained results enable us to indicate a new function of drugs in backpakers daily life and the relationship between drug overuse and backpackers’ experience in novel cultural conditions as well as their financial stance. Research and conclusion limitations. The article does not present a comprehensive study on the behaviour of backpackers, which is too complex, but primarily focuses on their uncontrolled drug consumption and sexual promiscuity. Practical implications. The data presented in this paper can be particularly important for individuals and institutions responsible for the development of local tourism. It is important to understand the attitudes and behaviour of backpackers, the emancipatory functions of sexual stimulants and sexual promiscuity. It is also necessary to continue this kind of research and to supplement the existing knowledge with the new contexts of the changes in the backpackers’ behaviour, also in case of the experience of Polish backpackers. Originality. This is the first paper prepared in Poland to describe and analyze the uncontrolled consumption of alcohol, drugs and sexual promiscuity among backpackers. Type of paper. The article presents the results of empirical research.

OP45 Study On Effects Of Community-acquired Pneumonia Clinical Pathway On Antibiotics’ Utilization

INTRODUCTION:Drug overuse in healthcare settings is common in China. Clinical pathways are tools that provide the link between the best available evidence and clinical practice. This study aimed to determine if the clinical pathway of community-acquired pneumonia (CAP) had effects on the antibiotic use in patients with CAP.METHODS:The study was conducted in Shanghai, Hubei Province, and Gansu Province to represent high, middle, and low levels of socioeconomic status in 2015. In each region, three public tertiary general hospitals and three public secondary general hospitals were selected for chart review of antibiotics’ utilization in the patients with CAP during 2014. A multilevel logistic regression model was used in the study, with a dependent variable of appropriate utilization of antibiotics (right time, right type, and right combined use) and independent variables of hospital adoption of clinical pathway and patient characteristics (sex, age, severity of disease, and number of comorbidities).RESULTS:Twelve surveyed hospitals (66.67 percent) adopted CAP clinical pathways and 354 cases (66.29 percent) were from these twelve hospitals (CP group). Among the total utilization of antibiotics (796 times) in eighteen types of antibiotics used in patients with CAP, the five recommended types of antibiotics accounted for 82.16 percent.The percentages of cases that got initial antibiotics in time were 90.60 percent in the CP group and 76.11 percent in the non-CP group. The compliance rate for appropriate types of antibiotic utilization was 88.36 percent in CP group, much higher than that in non-CP group (70.22 percent). For 244 cases that used combined antibiotics, the compliance rate for the recommended combinations of antibiotics was 20.12 percent in the CP group, but 1.25 percent in the non-CP group. After controlling patients’ characteristics, the patients in the CP group got more appropriate antibiotics than those in the non-CP group.CONCLUSIONS:Adoption of the CAP clinical pathway in hospitals can improve antibiotics' utilization.

Rhode Island Board of Medical Licensure and Discipline: Illustration of the disciplinary process as it pertains to cases involving opioid prescribing

Prescription-drug overuse/overdose and misuse is an important and pivotal issue to state medical boards. This is an illustration of how some cases involving overprescribing of opioids have been addressed by the Rhode Island Board of Medical Licensure and Discipline.