Pragmatic Side Effects

International audienceIn the quest to give a formal compositional semantics to natural languages, semanticists have started turning their attention to phenomena that have been also considered as parts of pragmatics (e.g., discourse anaphora andpresupposition projection). To account for these phenomena, the very kinds of meanings assigned to words and phrases are often revisited. To be more specific, in the prevalent paradigm of modeling natural languagedenotations using the simply-typed lambda calculus (higher-order logic) this means revisiting the types of denotations assigned to individual parts of speech. However, the lambda calculus also serves as a fundamental theory of computation, and in the study of computation, similar type shifts have been employed to give a meaning to side effects. Side effects in programming anguages correspond to actions that go beyond the lexical scope of an expression (a thrown exception might propagate throughout a program, a variable modified at one point might later be read at an another) or even beyond the scope of the program itself (a program might interact with the outside world by e.g., printing documents, making sounds, operating robotic limbs\ldots)

Effectiveness of second generation antipsychotics: A systematic review of randomized trials

<p>Abstract</p> <p>Background</p> <p>Systematic reviews based on efficacy trials are inconclusive about which second generation antipsychotic drug (SGA) should be preferred in normal clinical practice, and studies with longer duration and more pragmatic designs are called for. Effectiveness studies, also known as naturalistic, pragmatic, practical or real life studies, adhere to these principles as they aim to mimic daily clinical practice and have longer follow-up.</p> <p>Objective</p> <p>To review the head-to-head effectiveness of SGAs in the domains of global outcomes, symptoms of disease, and tolerability.</p> <p>Methods</p> <p>Searches were made in Embase, PubMED, and the Cochrane central register of controlled trials for effectiveness studies published from 1980 to 2008, week 1. Different combinations of the keywords <it>antipsychotic*, neuroleptic* AND open, pragmatic, practical, naturalistic, real life, effectiveness, side effect*, unwanted effect*, tolera* AND compar* AND random* </it>were used.</p> <p>Results</p> <p>Sixteen different reports of randomized head-to-head comparisons of SGA effectiveness were located. There were differences regarding sample sizes, inclusion criteria and follow-up periods, as well as sources of financial sponsorship. In acute-phase and first-episode patients no differences between the SGAs were disclosed regarding alleviating symptoms of disease. Olanzapine was associated with more weight gain and adverse effects on serum lipids. In the chronic phase patients olanzapine groups had longer time to discontinuation of treatment and better treatment adherence compared to other SGAs. The majority of studies found no differences between the SGAs in alleviating symptoms of psychosis in chronically ill patients. Olanzapine was associated with more metabolic adverse effects compared to the others SGAs. There were surprisingly few between-drug differences regarding side effects. First generation antipsychotics were associated with lower total mental health care costs in 2 of 3 studies on chronically ill patients, but were also associated with more extrapyramidal side effects compared to the SGAs in several studies.</p> <p>Conclusion</p> <p>In chronically ill patients olanzapine may have an advantage over other SGAs regarding longer time to treatment discontinuation and better drug adherence, but the drug is also associated with more metabolic side effects. More effectiveness studies on first-episode psychosis are needed.</p

ADVANTAGES OF COLLABORATIVE ACUPUNCTURE OR ACUPRESSURE REGARDING THE SIDE EFFECTS OF MEDICATIONS/THERAPIES

This bibliography extracted recently from the international literature should have pragmatic influence for all health professionals as well as pharmaceutical companies. So many patients terminate their use of prescription medications of all kinds because of side effects. Now, the international literature contains clinical reports wirh a common theme demonstrating that different forms of acupuncture are useful to minimize or even eliminate side effects of many medications. Physicians utilizing clinical wisdom (collaborating with an acupuncture colleague) to avoid masking important warning signs, now can prescribe medications knowing that many more patients will get the benefits of their prescriptions. At times, the reader will need to look at the entire article to capture the details of this theme. The articles do not focus on acupuncture as a substitute for allopathic medication but, insread, address acupuncture facilitating the use of a much smaller dose of medication andlor dealing pragmatically with side effects of the allopathies

A multicenter randomized clinical trial investigating the cost-effectiveness of treatment strategies with or without antibiotics for uncomplicated acute diverticulitis (DIABOLO trial)

Background. Conservative treatment of uncomplicated or mild diverticulitis usually includes antibiotic therapy. It is, however, uncertain whether patients with acute diverticulitis indeed benefit from antibiotics. In most guidelines issued by professional organizations antibiotics are considered mandatory in the treatment of mild diverticulitis. This advice lacks evidence and is merely based on experts' opinion. Adverse effects of the use of antibiotics are well known, including allergic reactions, development of bacterial resistance to antibiotics and other side-effects. Methods. A randomized multicenter pragmatic clinical trial comparin

Adjunctive misoprostol for prevention of post-partum haemorrhage: a pragmatic strategy of selective sequential administration

Background: To evaluate the effect of adjunctive misoprostol in preventing postpartum haemorrhage (PPH) by selective administration above threshold bleeding in order to reduce its side effects in comparison with primary prevention with oxytocin alone.Methods: It was a prospective observational cohort study conducted at Government medical College of central India. Population included 500 low risk women delivering vaginally. After having received oxytocin as primary prevention, women were monitored for bleeding by quantitative assessment of blood loss (QBL) using an innovative drape (kept prepared at the point of care) and once bleeding crossed 350 ml mark, alternate women were given 800 µg misoprostol sublingually as an adjuvant (study group) and compared with those who did not receive adjuvant misoprostol (control group). Main outcome measure: Comparing the incidence of PPH and side effects between study and control group.Results: 150 women had blood loss >350 ml which constituted 76 women in study and control group each. Incidence of PPH was significantly less in the study group (10.52 versus 22.36%, p<0.05, RR 0.470 95% CI= 0.216-1.024). Though side effects were more (38.15%) in study group but these were mild in nature and when the number was extrapolated to all recruited women, the incidence came down to 11.6%.Conclusions: Sequential adjuvant misoprostol at 350 ml blood loss after primary prevention with oxytocin is an effective and pragmatic strategy for preventing PPH when compared to oxytocin alone but with reduced overall side effects owing to less number of women receiving misoprostol

Patients' motives for choosing a physician: comparison between conventional and complementary medicine in Swiss primary care

<p>Abstract</p> <p>Background</p> <p>The study is part of a nationwide evaluation of complementary and alternative medicine (CAM) in primary care in Switzerland. The Objective was to identify patients' expectations and reasons governing the choice of complementary medicine compared with conventional primary care (CONV).</p> <p>Methods</p> <p>The data were derived from the PEK study (Programm Evaluation Komplementärmedizin), which was conducted in 2002–2003 with 7879 adult patients and parents of 1291 underage patients, seeking either complementary (CAM) or conventional (CONV) primary care. The study was performed as a cross-sectional survey. The respondents were asked to document their (or their children's) self-perceived health status, reasons governing their choice, and treatment expectations. Physicians were practicing conventional medicine and/or complementary methods (homeopathy, anthroposophic medicine, neural therapy, and traditional Chinese medicine). Reasons governing the choice of physician were evaluated on the basis of a three-part classification (physician-related, procedure-related, and pragmatic/other reasons)</p> <p>Results and Discussion</p> <p>Patients seeing CAM physicians tend to be younger and more often female. CAM patients referred to procedure-related reasons more frequently, whereas pragmatic reasons dominated among CONV patients. CAM respondents expected fewer adverse side effects compared to conventional care patients.</p> <p>Conclusion</p> <p>The majority of alternative medicine users appear to have chosen CAM mainly because they wish to undergo a certain procedure; additional reasons include desire for more comprehensive treatment, and expectation of fewer side-effects.</p

A study of gamification effectiveness

Studies have shown that gamification increases motivation and user experience when it comes to a certain behavior or completing a process. Gamification is often deeply associated with naïve animations and stylized text. This paper addresses the effect that visual representation has on the motivation of a subject by measuring their motivation after completing a mundane process, with entertaining gamification elements as well as gamification elements presented in plain text. For the purposes of this study a within subject design was used to gather data. Participants completed a mundane task three times, once without any gamification elements, once with pragmatic feedback and once with entertaining feedback. After completion the participants filled out the same Likert scale survey. The results were evaluated using the Wilcoxon Signed-Ranks test method, indicated that there was not a significant difference in user motivation between the visually stylized and plain text feedback. If conducted on a larger scale, this discovery could lead to a reduction time and cost for gamification development

Brandom's deontic scorekeeping model and the assertive family

This paper deals with what, from a speech-act theoretical point of view, can be considered to be the \u201cillocutionary\u201d side of Robert Brandom\u2019s pragmatist framework, which regards the pragmatic significance of linguistic performances (specifically, assertional performances) characterized in terms of their effects on the normative statuses of the participants in a discursive practice. In Brandom\u2019s deontic scorekeeping model of discursive practice (which consists of ascribing, undertaking and acknowledging commitments and entitlements), all speech acts are alleged to have pragmatic significance because of their relationship with the act of asserting: here, I investigate whether the same model can be used to account for the pragmatic significance of other assertive speech acts which differ from assertion in terms of their varying degrees and modes of commitment, and I argue that it simply lacks the resources to do so. I conclude by making some general suggestions (with examples) of how an Austin-inspired conception of illocutionary force (to some extent compatible with Brandom\u2019s analysis) could be used as a basis to account for the varying degrees and modes of commitment of assertive speech acts in terms of variations in their force

Amoxicillin mit Clavulansäure Standardantibiotikum im allgemeinzahnärztlichen Alltag

This script gives a pragmatic advice for general dentists on accurate use of amoxicillin with clavulanic acid considering current literature at acute inflammatory disease. In absence of contraindications a twice daily formulation of 1g amoxicillin with clavulanic acid is the first choice for concomitant therapy after treating the cause of inflammation or prophylaxis. Compared to clindamycin the concentration of amoxicillin in teeth and bone (Hallig 2014) is higher and has less gastrointestinal side-effects (Bax 2007). Furthermore it is prescribable during pregnancy and lactation. With these advantages amoxicillin with clavulanic acid is the first choice of antibiotics in general dental medicine