scholarly journals APA survey finds spike in treatment demand, telehealth use

2020 ◽  
Vol 30 (45) ◽  
pp. 4-5
Author(s):  
Valerie A. Canady
Keyword(s):  
2003 ◽  
Vol 358 (1433) ◽  
pp. 927-945 ◽  
Author(s):  
Terry D. Butters ◽  
Howard R. Mellor ◽  
Keishi Narita ◽  
Raymond A. Dwek ◽  
Frances M. Platt

Glycosphingolipid (GSL) lysosomal storage disorders are a small but challenging group of human diseases to treat. Although these disorders appear to be monogenic in origin, where the catalytic activity of enzymes in GSL catabolism is impaired, the clinical presentation and severity of disease are heterogeneous. Present attitudes to treatment demand individual therapeutics designed to match the specific disease–related gene defect; this is an acceptable approach for those diseases with high frequency, but it lacks viability for extremely rare conditions. An alternative therapeutic approach termed ‘substrate deprivation’ or ‘substrate reduction therapy’ (SRT) aims to balance cellular GSL biosynthesis with the impairment in catalytic activity seen in lysosomal storage disorders. The development of N–alkylated iminosugars that have inhibitory activity against the first enzyme in the pathway for glucosylating sphingolipid in eukaryotic cells, ceramide–specific glucosyltransferase, offers a generic therapeutic for the treatment of all glucosphingolipidoses. The successful use of N–alkylated iminosugars to establish SRT as an alternative therapeutic strategy has been demonstrated in in vitro , in vivo and in clinical trials for type 1 Gaucher disease. The implications of these studies and the prospects of improvement to the design of iminosugar compounds for treating Gaucher and other GSL lysosomal storage disorders will be discussed.


2020 ◽  
Author(s):  
Nicole Boffin ◽  
Jerome Antoine ◽  
Luk Van Baelen ◽  
Sarah Moreels ◽  
Kris Doggen

Abstract BackgroundIn Belgium, the incidence of treatment episodes for substance use problems is monitored by the Network of Sentinel General Practices (SGP) and by the Treatment Demand Indicator (TDI) surveillance at higher, specialist care levels. Using both data sources, we examine 1) how patients starting specialist treatment for substance use problems on referral by their GP compare to those that were referred by non-GP caregivers; 2) how patients starting GP treatment for substance use problems without receiving specialist treatment concurrently compare to those who do.MethodsThe same European protocol with common variables was used by both surveillances. Data from 2016 and 2017 were examined using 95% confidence intervals and multivariate regression.ResultsAccording to TDI-data (n=16,543), determinants of being referred by a GP (versus by a non-GP caregiver) for specialist treatment were age ≥ median (OR 1.25; 95% CI 1.13-1.38), education ≥ secondary level (OR 1.27; 95% CI 1.15-1.41), recent employment (OR 1.71; 1.56-1.88), stable housing (3.62; 95% CI 3.08-4.26), first treatment episode (OR 1.72; 95% CI 1.57-1.87), recent daily primary substance use (OR 1.46; 95% CI 1.33-1.59) and mono substance use (OR 1.23; 95% CI 1.04-1.48). Type of substance use was a significant determinant with higher odds of using pharmaceuticals (and alcohol) (OR 1.24; 95% CI 1.04-1.48), and lower odds of using cannabis only/primarily (OR 0.73; 95% CI 0.62-0.86), with reference to street drugs minus cannabis only/primarily. According to SGP data (n=314), determinants of starting GP treatment without concurrent specialist treatment were recent employment (OR 2.58; 95% CI 1.36-4.91), first treatment episode (OR 2.78; 95% CI 1.39-5.55) and living in the Brussels or Walloon region (OR 1.97; 95% CI 1.06-3.66).ConclusionsThis study adds knowledge about the general practice population treated for substance use problems and the consistency of data from the surveillances. Both studies show a relatively favourable profile of general practice patients with substance use problems.


1999 ◽  
Vol 5 (4) ◽  
pp. 179-184 ◽  
Author(s):  
Ana Alvarez-Requejo ◽  
Josep M. Suelves ◽  
M. Teresa Brugal ◽  
J. Francisco Correa

2015 ◽  
Vol 20 (1) ◽  
pp. 23-29 ◽  
Author(s):  
Fabio Lourenço Romano ◽  
Alberto Consolaro

The use of mini-implants have made a major contribution to orthodontic treatment. Demand has aroused scientific curiosity about implant placement procedures and techniques. However, the reasons for instability have not yet been made totally clear. The aim of this article is to establish a relationship between implant placement technique and mini-implant success rates by means of examining the following hypotheses: 1) Sites of poor alveolar bone and little space between roots lead to inadequate implant placement; 2) Different sites require mini-implants of different sizes! Implant size should respect alveolar bone diameter; 3) Properly determining mini-implant placement site provides ease for implant placement and contributes to stability; 4) The more precise the lancing procedures, the better the implant placement technique; 5) Self-drilling does not mean higher pressures; 6) Knowing where implant placement should end decreases the risk of complications and mini-implant loss.


Eye ◽  
2020 ◽  
Vol 34 (10) ◽  
pp. 1825-1834 ◽  
Author(s):  
Adam H. Ross ◽  
Louise Downey ◽  
Helen Devonport ◽  
Richard P. Gale ◽  
Ajay Kotagiri ◽  
...  

Abstract Objectives This report aims to provide clear recommendations and practical guidance from a panel of UK retinal experts on an aflibercept treat-and-extend (T&E) pathway that can be implemented in clinical practice. These recommendations may help service providers across the NHS intending to implement a T&E approach, with the aim of effectively addressing the capacity and resource issues putting strain on UK neovascular age-related macular degeneration (nAMD) services while promoting patients’ best interests throughout. Methods Two structured roundtable meetings of retinal specialists were held in London, UK on 7 December 2018 and 1 March 2019. These meetings were organised and funded by Bayer. Results The panel provided recommendations for an aflibercept T&E pathway and developed specific criteria based on visual acuity, retinal morphology and optical coherence tomography imaging to guide reduction, maintenance and extension of injection intervals. They also discussed the extension of treatment intervals by 2- or 4-week adjustments to a maximum treatment interval of 16 weeks, the management of retinal fluid and the stopping of treatment. Conclusions The long-term benefits of implementing a T&E pathway may include superior visual outcomes compared with a pro re nata (PRN; as needed) protocol, and a lower treatment burden compared with a fixed protocol, which is likely to improve service capacity. Furthermore, the predictable nature of a T&E approach compared with a PRN service may aid capacity planning for the future nAMD treatment demand.


2012 ◽  
Vol 29 (4) ◽  
pp. 297-302 ◽  
Author(s):  
Helena Silveira Schuch ◽  
Marília Leão Goettems ◽  
Marcos Britto Correa ◽  
Dione Dias Torriani ◽  
Flávio Fernando Demarco

2020 ◽  
Author(s):  
Nicole Boffin ◽  
Jerome Antoine ◽  
Luk Van Baelen ◽  
Sarah Moreels ◽  
Kris Doggen

Abstract Background In Belgium, the incidence of treatment episodes for substance use problems is monitored by the Network of Sentinel General Practices (SGP) and by the Treatment Demand Indicator (TDI) surveillance at higher, specialist care levels. Using both data sources, we examine 1) how patients starting specialist treatment for substance use problems on referral by their GP compare to those that were referred by non-GP caregivers; 2) how patients starting GP treatment for substance use problems without receiving specialist treatment concurrently compare to those who do. Methods Both surveillances are based on the TDI protocol for reporting data to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) on persons starting treatment as a result of their substance use. Data from 2016 and 2017 were examined using 95% confidence intervals and multivariate logistic regression. Results According to TDI-data (n=16,543), determinants of being referred by a GP (versus by a non-GP caregiver) for specialist treatment were age ≥ median (OR 1.25; 95% CI 1.13-1.38), education ≥ secondary level (OR 1.27; 95% CI 1.15-1.41), recent employment (OR 1.71; 1.56-1.88), stable housing (3.62; 95% CI 3.08-4.26), first treatment episode (OR 1.72; 95% CI 1.57-1.87), recent daily primary substance use (OR 1.46; 95% CI 1.33-1.59) and mono substance use (OR 1.23; 95% CI 1.04-1.48). Type of substance use was a significant determinant with higher odds of using pharmaceuticals (and alcohol) (OR 1.24; 95% CI 1.04-1.48), and lower odds of using cannabis only/primarily (OR 0.73; 95% CI 0.62-0.86), with reference to street drugs minus cannabis only/primarily. According to SGP data (n=314), determinants of starting GP treatment without concurrent specialist treatment were recent employment (OR 2.58; 95% CI 1.36-4.91), first treatment episode (OR 2.78; 95% CI 1.39-5.55) and living in the Brussels or Walloon region (OR 1.97; 95% CI 1.06-3.66). Conclusions This study adds knowledge about the general practice population treated for substance use problems. It shows that both surveillances consistently found a relatively favourable profile of general practice patients with substance use problems.


Author(s):  
Dang Thi Thanh Huyen ◽  
Trinh Dinh Lai

Mekong River Delta is an important delta of Vietnam, which is located at the downstream of Mekong River. With the high urbanization and industrialization, this region has been facing more intense environmental threats. This study was conducted to assess the current wastewater management in the region. Initial survey results revealed that there was only 8 wastewater treatment plants, meeting requirement of 6.9% of treatment demand, and the sewer coverage was 69%. The low environmental protection fees can not help cover the operation cost of sewerage system and wastewater treatment plants. Sludge treatment has been neglected. Therefore, more proactive in improving the wastewater sector and protecting their environment should be implemented from local authorities for the sustainable development in the future in the region. Keywords: wastewater management; Mekong river delta; environmental protection.


2020 ◽  
Author(s):  
Nicole Boffin ◽  
Jerome Antoine ◽  
Luk Van Baelen ◽  
Sarah Moreels ◽  
Kris Doggen

Abstract Background In Belgium, the incidence of treatment episodes for substance use problems is monitored by the Network of Sentinel General Practices (SGP), and at higher, specialist care levels by the Treatment Demand Indicator (TDI) surveillance. Using both data sources, we examine 1) how patients starting specialist treatment for substance use problems on referral by their GP compare to those that were referred by non-GP caregivers; 2) how patients starting GP treatment for substance use problems without receiving concurrent specialist treatment compare to those who did. Methods Both surveillances are based on the TDI protocol for reporting data to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) on individuals starting treatment as a result of their substance use. Data from 2016 and 2017 were examined using 95% confidence intervals and multivariate logistic regression. Results According to TDI-data (n=16,543), determinants of being referred by a GP (versus by a non-GP caregiver) for specialist treatment were age ≥ median (OR 1.25; 95% CI 1.13-1.38), education ≥ secondary level (OR 1.27; 95% CI 1.15-1.41), recent employment (OR 1.71; 1.56-1.88), recent stable accommodation (3.62; 95% CI 3.08-4.26), first treatment episode (OR 1.72; 95% CI 1.57-1.87), recent daily primary substance use (OR 1.46; 95% CI 1.33-1.59) and mono substance use (OR 1.23; 95% CI 1.04-1.48). Type of substance use was a significant determinant with higher odds of using pharmaceuticals (and alcohol) (OR 1.24; 95% CI 1.04-1.48), and lower odds of using cannabis only/primarily (OR 0.73; 95% CI 0.62-0.86), with reference to street drugs minus cannabis only/primarily. According to SGP data (n=314), determinants of starting GP treatment without concurrent specialist treatment were recent employment (OR 2.58; 95% CI 1.36-4.91), first treatment episode (OR 2.78; 95% CI 1.39-5.55) and living in the Brussels or Walloon region (OR 1.97; 95% CI 1.06-3.66). Conclusions This study provides a useful insight into the general practice population treated for substance use problems. It shows that both surveillances consistently found a relatively favourable profile of general practice patients with substance use problems.


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