scholarly journals Treatment preferences of opiate-dependent patients

2004 ◽  
Vol 28 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Jason Luty
Keyword(s):  
Substance Misuse ◽  
Treatment Options ◽  
Treatment Preferences ◽  
Clinical Implications ◽  
Card Sorting ◽  
Heroin Use ◽  
Injectable Drugs ◽  
Oral Methadone ◽  
Sorting Technique ◽  
Drug Free

Aims and MethodTo assess the preferences of people attending a substance misuse facility towards the treatment options available for opiate dependency. Interviews were conducted using a card sorting technique.ResultsThe majority (60%) of the 101 participants believed that detoxification was superior to maintenance in preventing illicit heroin use. The preferred treatment options were oral methadone, buprenorphine, drug-free rehabilitation, in-patient detoxification and prescription of injectable drugs.Clinical ImplicationsBoth pharmacological and psychosocial options, including in-patient detoxification and rehabilitation, are among the treatments preferred by clients of substance misuse services. There is also a significant demand for both injectable drugs and dihydrocodeine.

scholarly journals Setting up a methadone maintenance clinic in a hostel in London's West End

2006 ◽  
Vol 30 (9) ◽  
pp. 337-339
Author(s):  
John Dunn ◽  
David Robertson ◽  
Paul Davis ◽  
Babak Khosrawan ◽  
Suneel Christian
Keyword(s):  
Treatment Outcomes ◽  
Substance Misuse ◽  
Methadone Maintenance ◽  
Homeless People ◽  
Clinical Implications ◽  
Original Cohort ◽  
Heroin Use ◽  
The Past ◽  
Outreach Clinic ◽  
Set Up

Aims and MethodA satellite methadone prescribing service was set up in a hostel in London's West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile.ResultsAt 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days, P<0.001) and in the frequency of injecting (from 25.9 to 15.9 days, P<0.001).Clinical ImplicationsThis outreach clinic offers a model for developing services to homeless people with substance misuse problems.

The impact of a physician’s recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation

2020 ◽  
Author(s):  
Marie Eggeling ◽  
Anna Meinhardt ◽  
Ulrike Cress ◽  
Joachim Kimmerle ◽  
Martina Bientzle
Keyword(s):  
Decision Making ◽  
Cruciate Ligament ◽  
Treatment Options ◽  
General Information ◽  
Treatment Preference ◽  
Controlled Study ◽  
Treatment Preferences ◽  
Hypothetical Scenario ◽  
And Gender ◽  
The Impact

Objective: This study examined the influence of physicians’ recommendations and gender on the decision-making process in a preference-sensitive situation. Methods: N = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs. physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision, and attitude toward the treatment options. Then participants watched a video that differed regarding physician’s recommendation (surgery vs. physiotherapy) and physician’s gender (female vs. male voice and picture). Afterward, they indicated again their treatment preference, certainty, satisfaction, and attitude, as well as the physician’s professional and social competence.Results: Participants changed their treatment preferences in the direction of the physician’s recommendation (P&lt;.001). Decision certainty (P&lt;.001) and satisfaction (P&lt;.001) increased more strongly if the physician’s recommendation was congruent with the participant’s prior attitude than if the recommendation was contrary to the participant’s prior attitude. Finally, participants’ attitudes toward the recommended treatment became more positive (surgery recommendation: P&lt;.001; physiotherapy recommendation: P&lt;.001). We found no influence of the physician’s gender on participants’ decisions, attitudes, or competence assessments.Conclusion: This research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient’s preferences.

scholarly journals Variation in treatment preferences of pulmonary exacerbations among Australian and New Zealand cystic fibrosis physicians

2021 ◽  
Vol 8 (1) ◽  
pp. e000956
Author(s):  
Grace Currie ◽  
Anna Tai ◽  
Tom Snelling ◽  
André Schultz
Keyword(s):  
Cystic Fibrosis ◽  
Clinical Trials ◽  
New Zealand ◽  
Treatment Options ◽  
Early Response ◽  
Treatment Preferences ◽  
Dornase Alfa ◽  
Clinical Scenarios ◽  
Professional Opinion ◽  
Pulmonary Exacerbations

BackgroundDespite advances in cystic fibrosis (CF) management and survival, the optimal treatment of pulmonary exacerbations remains unclear. Understanding the variability in treatment approaches among physicians might help prioritise clinical uncertainties to address through clinical trials.MethodsPhysicians from Australia and New Zealand who care for people with CF were invited to participate in a web survey of treatment preferences for CF pulmonary exacerbations. Six typical clinical scenarios were presented; three to paediatric and another three to adult physicians. For each scenario, physicians were asked to choose treatment options and provide reasons for their choices.ResultsForty-nine CF physicians (31 paediatric and 18 adult medicine) participated; more than half reported 10+ years of experience. There was considerable variation in primary antibiotic selection; none was preferred by more than half of respondents in any scenario. For secondary antibiotic therapy, respondents consistently preferred intravenous tobramycin and a third antibiotic was rarely prescribed, except in one scenario describing an adult patient. Hypertonic saline nebulisation and twice daily chest physiotherapy was preferred in most scenarios while dornase alfa use was more variable. Most CF physicians (>80%) preferred to change therapy if there was no early response. Professional opinion was the most common reason for antibiotic choice.ConclusionsVariation exists among CF physicians in their preferred choice of primary antibiotic and use of dornase alfa. These preferences are driven by professional opinion, possibly reflecting a lack of evidence to base policy recommendations. Evidence from high-quality clinical trials is needed to inform physician decision making.

scholarly journals Symposium report: breast cancer in India—trends, environmental exposures and clinical implications

2021 ◽  
Vol 32 (6) ◽  
pp. 567-575
Author(s):  
Jasmine A. McDonald ◽  
Roshni Rao ◽  
Marley Gibbons ◽  
Rajiv Janardhanan ◽  
Surinder Jaswal ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Scientific Evidence ◽  
Treatment Options ◽  
Environmental Exposures ◽  
Population Based ◽  
Clinical Implications ◽  
Think Tank ◽  
Case Control Studies ◽  
Short Term

Abstract Purpose Incidence of breast cancer (BC), particularly in young women, are rising in India. Without population-based mammography screening, rising rates cannot be attributed to screening. Investigations are needed to understand the potential drivers of this trend. Methods An international team of experts convened to discuss the trends, environmental exposures, and clinical implications associated with BC in India and outlined recommendations for its management. Results Panels were structured across three major BC themes (n = 10 presentations). The symposium concluded with a semi-structured Think Tank designed to elicit short-term and long-term goals that could address the challenges of BC in India. Conclusion There was consensus that the prevalence of late-stage BC and the high BC mortality rates are associated with the practice of detection, which is primarily through clinical and self-breast exams, as opposed to mammography. Triple-Negative BC (TNBC) was extensively discussed, including TNBC etiology and potential risk factors, the limited treatment options, and if reported TNBC rates are supported by rigorous scientific evidence. The Think Tank session yielded long-term and short-term goals to further BC reduction in India and included more regional etiological studies on environmental exposures using existing India-based cohorts and case–control studies, standardization for molecular subtyping of BC cases, and improving the public’s awareness of breast health.

Mapping the landscape of computer-assisted language learning: an inventory of research

2013 ◽  
Vol 10 (4) ◽  
pp. 252-269 ◽  
Author(s):  
Antigoni Parmaxi ◽  
Panayiotis Zaphiris ◽  
Salomi Papadima-Sophocleous ◽  
Andri Ioannou
Keyword(s):  
Language Learning ◽  
Research Work ◽  
Computer Assisted ◽  
Computer Assisted Language Learning ◽  
Card Sorting ◽  
Holistic View ◽  
Content Type ◽  
Coding Scheme ◽  
Sorting Technique ◽  
Version 2.0

Purpose – The purpose of this study is to chart the development in computer-assisted language learning (CALL), by building a map of existing research work in the field. Based on a corpus of 163 manuscripts, published between January 2009 and September 2010 in four major journals devoted to CALL, it sets out to describe the range of topics covered under the umbrella of CALL and provide a holistic view of the field. Design/methodology/approach – The approach adopted in this research includes: development of the 2009-2010 CALL corpus; literature overview and initial coding scheme development; refinement of the initial coding scheme with the help of a focus group and construction of the CALL map version 1.0; refinement of the CALL map version 1.0 following a systematic approach of content analysis and development of the CALL map version 2.0; evaluation of the proposed structure and inclusiveness of all categories in the CALL map version 2.0 using card sorting technique; and finally development of the CALL map version 3.0. Findings – The research trends in the categories of the CALL map are discussed, as well as possible future directions in the field. Originality/value – This paper provides a holistic view of the field of CALL guiding both junior CALL researchers to place themselves in the field, and policy and decision makers who attempt to evaluate the current and future scholar activity in the field. Finally, it caters for more experienced researchers to focus on certain underinvestigated domains.

scholarly journals Opiate dependence and pregnancy: 20-year follow-up study

2007 ◽  
Vol 31 (12) ◽  
pp. 450-453 ◽  
Author(s):  
Marie Whitty ◽  
John O'Connor
Keyword(s):  
Psychosocial Functioning ◽  
Substance Misuse ◽  
Opiate Dependence ◽  
Drug Misuse ◽  
Clinical Implications ◽  
Follow Up Study ◽  
Treatment Centre ◽  
Long Term Follow Up

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

scholarly journals POS1097 TREATMENT KNOWLEDGE AND PREFERENCES FOR BLACK PEOPLE WITH HIP AND KNEE OSTEOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW AND META-ANALYSIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 828.2-829
Author(s):  
C. Brantner ◽  
D. Pearce-Fisher ◽  
C. Moezinia ◽  
H. Tornberg ◽  
J. Fitzgerald ◽  
...  
Keyword(s):  
Knee Osteoarthritis ◽  
Racial Differences ◽  
Black People ◽  
Meta Analysis ◽  
Treatment Options ◽  
Cochrane Library ◽  
Treatment Preferences ◽  
White People ◽  
Narcotic Analgesics ◽  
Accessible Information

Background:Black people are less likely to undergo total joint arthroplasties, despite reporting more severe symptoms. (1) While racial disparities exist in treatment utilization for osteoarthritis, comprehensive studies of the treatment preferences of Black people have not been conducted.Objectives:The purpose of this manuscript is to systematically review the literature and identify Black osteoarthritis patients’ treatment preferences to understand how they may contribute to racial differences in the utilization of different treatment options.Methods:Searches ran on April 8, 2019 and April 7, 2020 in the following databases: Ovid MEDLINE (ALL - 1946 to Present); Ovid EMBASE (1974 to present); and The Cochrane Library (Wiley). Using the Patient/Population-Intervention-Comparison/Comparator-Outcome (PICO) format, our population of interest was Black people with hip and/or knee osteoarthritis, our intervention was preferences and opinions about treatment options for osteoarthritis, our comparator was white people with hip and/or knee osteoarthritis, and our outcome was preferences of osteoarthritis therapies. The protocol was registered under the PROSPERO international register, and the Preferred Reporting Items of Systematic reviews and Meta-Analyses (PRISMA) guidelines were followed.Results:Searches across the chosen databases retrieved 10,894 studies after de-duplication, 182 full text, and 31 selected for inclusion in this review. Black people were less likely to use NSAIDs or narcotic analgesics compared to white people. (Figure 1) Black people were more likely than white people to use spirituality and prayer, as well as topical treatments. Utilization of meditation, supplement/vitamin use, and hot/cold treatments was not significantly different between groups. Black people were less willing than white people to consider or undergo joint replacements, even if the procedure was needed and recommended by a physician.Conclusion:Racial differences persist in OA care across the spectrum of options. Future interventions should focus on providing accessible information surrounding treatment options and targeting perceptions of the importance of joint health.References:[1]Suarez-Almazor ME, Souchek J, Kelly PA, et al. Ethnic Variation in Knee Replacement: Patient Preferences or Uninformed Disparity? Arch Intern Med. 2005;165(10):1117-1124. doi:10.1001/archinte.165.10.1117Figure 1.Meta-analysis describing the odds ratios of Black people using NSAIDs and Narcotic Analgesics compared to white peopleDisclosure of Interests:Collin Brantner: None declared, Diyu Pearce-Fisher: None declared, Carine Moezinia: None declared, Haley Tornberg: None declared, John FitzGerald: None declared, Michael Parks Consultant of: Zimmer Biomet, Peter Sculco Consultant of: EOS Imaging, Intellijoint Surgical, DePuy Synthes, Lima Corporate, Cynthia Kahlenberg: None declared, Curtis Mensah: None declared, Ajay Premkuar: None declared, Nicholas Williams: None declared, Michelle Demetres: None declared, Susan Goodman Consultant of: UCB, Grant/research support from: Novartis, Horizon Therapeutics.

Treatment options for deciduous molar hypomineralization: a report of three cases

Dental Update ◽  
2019 ◽  
Vol 46 (6) ◽  
pp. 546-553
Author(s):  
Yasmy Quintero ◽  
Manuel Restrepo ◽  
Jenny Angélica Saldarriaga ◽  
Alexandra Saldarriaga ◽  
Lourdes Santos-Pinto
Keyword(s):  
Differential Diagnosis ◽  
Early Diagnosis ◽  
Treatment Options ◽  
Clinical Implications ◽  
Therapeutic Approaches ◽  
Enamel Defect ◽  
Delayed Treatment ◽  
Molar Incisor Hypomineralization ◽  
Permanent Molars ◽  
Deciduous Molar

Deciduous molar hypomineralization (DMH) is an enamel defect of systemic and multifactorial origin that affects the second deciduous molar. Currently, its treatment is based on guidelines for Molar Incisor Hypomineralization (MIH), a disturbance that affects permanent molars and may or may not be associated with permanent incisors. To date, there are no guidelines for DMH. Therefore, three different therapeutic approaches are presented to treat DMH, emphasizing the relevance of early diagnosis, differential diagnosis and treatment options, and tailored to take into account each patient's and parents' specific needs, as well as the involved tooth, severity of DMH, patients' symptoms and behaviour. CPD/Clinical Relevance: To understand the clinical implications of DMH since the diagnosis and delayed treatment of this enamel alteration could have important complications in both the primary and permanent dentition.

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