28 research outputs found
Surface-Initiated Polymer Brushes in the Biomedical Field: Applications in Membrane Science, Biosensing, Cell Culture, Regenerative Medicine and Antibacterial Coatings
Cigarette smoking, nicotine dependence and anxiety disorders : a systematic review of population-based, epidemiological studies
Background Multiple studies have demonstrated that rates of smoking and nicotine dependence are increased in individuals with anxiety disorders. However, significant variability exists in the epidemiological literature exploring this relationship, including study design (cross-sectional versus prospective), the population assessed (random sample versus clinical population) and diagnostic instrument utilized.Methods We undertook a systematic review of population-based observational studies that utilized recognized structured clinical diagnostic criteria (Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD)) for anxiety disorder diagnosis to investigate the relationship between cigarette smoking, nicotine dependence and anxiety disorders.Results In total, 47 studies met the predefined inclusion criteria, with 12 studies providing prospective information and 5 studies providing quasiprospective information. The available evidence suggests that some baseline anxiety disorders are a risk factor for initiation of smoking and nicotine dependence, although the evidence is heterogeneous and many studies did not control for the effect of comorbid substance use disorders. The identified evidence however appeared to more consistently support cigarette smoking and nicotine dependence as being a risk factor for development of some anxiety disorders (for example, panic disorder, generalized anxiety disorder), although these findings were not replicated in all studies. A number of inconsistencies in the literature were identified.Conclusions Although many studies have demonstrated increased rates of smoking and nicotine dependence in individuals with anxiety disorders, there is a limited and heterogeneous literature that has prospectively examined this relationship in population studies using validated diagnostic criteria. The most consistent evidence supports smoking and nicotine dependence as increasing the risk of panic disorder and generalized anxiety disorder. The literature assessing anxiety disorders increasing smoking and nicotine dependence is inconsistent. Potential issues with the current literature are discussed and directions for future research are suggested
Politics ahead of patients: The battle between medical and chiropractic professional associations over the inclusion of chiropractic in the American Medicare System
Health care professions struggling for legitimacy, recognition, and market share can become disoriented to their priorities. Health care practitioners are expected to put the interests of patients first. Professional associations represent the interests of their members. So when a professional association is composed of health care practitioners, its interests may differ from those of patients, creating a conflict for members. In addition, sometimes practitionersâ perspectives may be altered by indoctrination in a belief system, or misinformation, so that a practitioner could be confused about the reality of patient needs. Politicians, in attempting to find an expedient compromise, can value a âwinâ in the legislative arena over the effects of that legislation. These forces all figure into the events that led to the acceptance of chiropractic into the American Medicare system. Two health care systems in a political fight lost sight of their main purpose: to provide care to patients without doing harm.
Dans leur recherche de lĂ©gitimitĂ©, de reconnaissance et dâune juste part sur le marchĂ© de la santĂ©, les professionnels de la santĂ© peuvent perdre de vue leurs prioritĂ©s. Ces praticiens doivent donner prĂ©sĂ©ance aux intĂ©rĂȘts des patients tandis que les associations professionnelles reprĂ©sentent ceux de leurs membres. Lorsquâune association professionnelle regroupe des praticiens de la santĂ© cependant, ses intĂ©rĂȘts sâopposent parfois Ă ceux des patients, crĂ©ant ainsi un conflit pour les membres. De plus, les praticiens peuvent ĂȘtre endoctrinĂ©s par un systĂšme de valeurs ou mal informĂ©s, au point de se tromper dans lâĂ©valuation des besoins rĂ©els des patients. De leur cĂŽtĂ©, les politiciens peuvent prĂ©fĂ©rer une « victoire » dans lâarĂšne lĂ©gislative Ă une juste apprĂ©ciation des impacts dâune loi. Ces forces ont toutes participĂ© aux Ă©vĂšnements qui ont menĂ© Ă lâacceptation de la chiropraxie par le systĂšme amĂ©ricain Medicare. Dans cette bataille politique, deux systĂšmes de santĂ© ont nĂ©gligĂ© leur principal objectif : soigner des patients sans leur nuire
Symptom Dimensions of Attention Deficit Hyperactivity Disorder and Nicotine Withdrawal Symptoms
Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines
Purpose: The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral mucositis (OM). Methods: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention in each cancer treatment setting was assigned an evidence level. The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible. Results: A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines. Conclusions: The evidence supports the use of multi-agent combination oral care protocols in the specific populations listed above. Additional well-designed research is needed on the other BOC interventions prior to guideline formulation
A NEW DEFENSE POLICY FOR COSTA RICA: CONSTRUCTING REALITY AND THE POLICY AGENDA
This paper examine5 the policymaking progress in Costa Rica, specifically the creation of a new item for the governmental agenda. This new agenda challenges the traditional Itno army" policy of Costa Kica. Following a brief historical overview of the traditional policy, the paper considers the role of specific factors that promote structural conduciveness for the new "defense" policy and the attendant transformation of political symbols and definitions. The impact of the definitional and organizational changes on the implementation stage of policy is explored. This article suggests the importance of studying the role of hegemony in the construction and transformation of political and cultural definitions, an explication of deci- sionmaking as well as nondecisionmaking processes, and the influence of external and internal threats on nation-state dependency. Copyright 1985 by The Policy Studies Organization.
Boundary violations in professionalâclient relationships: Overview and guidelines for prevention
MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy
Background: Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for the management of mucositis. Methods: The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and in each treatment setting was assigned a level of evidence based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. Results: The guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions. Conclusions: The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help with the management of mucositis in patients who have cancer