Teratogenic risk and contraceptive counselling in psychiatric practice: analysis of anticonvulsant therapy

<p>Background: Anticonvulsants have been used to manage psychiatric conditions for over 50 years. It is recognised that some, particularly valproate, carbamazepine and lamotrigine, are human teratogens, while others including topiramate require further investigation. We aimed to appraise the documentation of this risk by psychiatrists and review discussion around contraceptive issues.</p> <p>Methods: A retrospective review of prescribing patterns of four anticonvulsants (valproate, carbamazepine, lamotrigine and topiramate) in women of child bearing age was undertaken. Documented evidence of discussion surrounding teratogenicity and contraceptive issues was sought.</p> <p>Results: Valproate was most commonly prescribed (n=67). Evidence of teratogenic risk counselling at medication initiation was sub-optimal – 40% of individuals prescribed carbamazepine and 22% of valproate. Documentation surrounding contraceptive issues was also low- 17% of individuals prescribed carbamazepine and 13% of valproate.</p> <p>Conclusion: We found both low rates of teratogenic risk counselling and low rates of contraception advice in our cohort. Given the high rates of unplanned pregnancies combined with the relatively high risk of major congenital malformations, it is essential that a detailed appraisal of the risks and benefits associated with anticonvulsant medication occurs and is documented within patients’ psychiatric notes.</p&gt

Gender, occupation and first birth:Do 'career men' delay first birth too?

In the period following the turn of the Century European total fertility rates (TFR) dropped to well below replacement. Work examining this highlights that cohort postponement in births contributes to low TFRs. It is generally recognised that women in more advantaged occupations often postpone childbearing in contrast to those in less advantaged occupational groups. However, relatively little research has been conducted on men in similar terms. This paper contrasts the timing of first birth by occupational class between men and women using individual level data in a case study of Scotland. The data are an extract from the Scottish Longitudinal Study (SLS). This provides a 5.3% sample of the population of Scotland from the 1991 Census. The research applies the Cox proportional hazard model to estimate the speed to first birth during a period of observation between 1991 and 2006. Class is measured using NS-SEC 8 class analytic version. The model controls marital status, educational attainment, raised religion and urban-rural geography. It is found that 'career men' who occupy more advantaged occupational positions do not delay first birth in contrast to men in other occupational categories. This is in contrast to the well-known phenomenon of career women who have later childbearing. Our analysis shows that gender inequalities in how the social structure influences childbearing offer an avenue of explanation for wider patterns of social inequality

F38X 11 Skills for Customer Care

The Unit is intended for students who wish to develop knowledge and understanding of customer care. The Unit is suitable for those wishing to learn how to deliver good customer care and designed to enable the student to recognise the importance of customer care within a work environment.

F1FC 11 IT Software Word Processing and Presenting Information

This Unit is designed to introduce routine features of word processing, presentation and artwork and imaging software. The student will gain practical experience in the use of routine features in these types of software, and the selection of appropriate software for specific tasks.

Enterprise Activity

This resource is designed for educators working within a variety of subject areas, and who have an enthusiasm to support students in exploring enterprise, identifying concepts and developing strategies to embrace enterprising approaches and adopting entrepreneurial mindsets to learning, work and life.

Relevant Experiences (Excellence in Practice Series)

Excellence in Practice: If you make it more real, it would help. A lot. The practice highlighted here are of two colleges who, in different ways, make it real: - Virtual logbook in early education and childcare. Lindsay Hegarty, Lecturer and Course Tutor for NC and HNC in Early Education and Childcare, Anniesland College. - Involving young people with experience of residential care as educators in social care programmes. Ann Hotchkiss, Senior Lecturer – Scottish Institute of Residential Childcare, Langside College.

F1FG 12 PC Passport: Working with Artwork and Imaging

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F1F9 10 Introduction to the internet and online communications

This Unit is designed to enable students to develop basic skills in internet and online communications. This Unit covers conventional connection methods used to access, retrieve and exchange information from the internet or an intranet.

D9NL 10 Hospitality: Organisation of Practical Skills

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