1,721,653 research outputs found
Guidelines for treating mental illness: love them, hate them. Can the SIEP-DIRECT'S Project serve in the search for a happy medium?
No full textThis paper discusses some key aspects of the debate on the difficulties of incorporating scientific evidence into the daily work of clinicians in mental health services (MHS). It highlights the topics of: the utility of guidelines in this field, the ethical principles that should guide their utilisation, their limitations, obstacles impeding the diffusion of guidelines in psychiatry, and strategies that can be useful for overcoming the barriers to guideline implementation. The SIEP-DIRECT'S ((DIscrepancy between Routine practice and Evidence in psychiatric Community Treatments on Schizophrenia) Project's potential role in fostering this advancement is discussed in detail. This Project developed a set of 103 indicators that operationalised the NICE clinical guidelines for schizophrenia recommendations and tested them in 19 MHS in Italy. A multi-step design was used to assess recommendation and indicator acceptability in the Italian context; provide an assessment of any current discrepancies between routine practice and guideline recommendations in the treatment of schizophrenia; and understand the reasons for any discrepancies that might emerge. This process, moreover, was instrumental in keeping the debate arising during conduction of this Project far from the excesses of hostility - and excesses of "bright-eyed enthusiasm" - that frequently influence discussion on topic. This Project therefore showed potential to serve in the search for a happy medium, that can facilitate the pursuit of a fundamental advancement in guideline implementation in mental health services
To which extent mental health services meet the patients’ needs and provide satisfactory care?
No full textIncreasing importance is being given to the views of mental health service users about their care. Central to this debate is the capability of mental health services to meet the needs of patients and provide satisfactory care. A remarkable improvement in the quality of research and a better understanding of the role of service satisfaction and needs for care measurements has been achieved recently. Both measurements can provide highly valuable service-specific information and useful knowledge for service planning and evaluation. It has definitely been proved that the perspectives of staff and users on needs for care do differ, that social needs are more difficult to meet than clinical needs and that needs for care might differ widely in individuals with different disorders. Service satisfaction measurement has been shown to be a sensitive method to detect differences between different approaches, and identify aspects of care, such as involvement of relatives and information provided, likely to be perceived, in the patient's perspective, as unsatisfactory in many mental heath services. A further effort is requested to establish the social, patient and service characteristics that interfere with needs for care and service satisfaction over time. © 2002 Lippincott Williams & Wilkins
[Clinical and economical evaluation of new analgesics for the management of chronic pain].
No full textThe management of chronic pain still represent a challenge for physicians. Opioids are the main stem in the treatment of chronic severe pain, not only for their potency, but as they act as central drugs. The main limit to their utilization in clinical practice is the prevalence of side effects, in particular in the gastrointestinal tract, whose constipation represents the most common. Two new formulations are nowadays available on the market: tapentadol PR (TAP PR) and oxycodone/naloxone (OXN). A recent meta-analysis showed that both drugs have a better tolerability profile than a tradizional opioid, such as oxycodone CR (OXY CR), but TAP PR reduces by 47% (RR=0.53) the percentage of patients discontinuing treatment because of side effects, compared to 24% (RR=0.76) of OXN. A similar advantage has been reported in the reduction of the risk of developing nausea and/or vomiting: TAP PR reduces the risk by 47% (RR=0.53), while OXN reduces the risk by only by 10% (RR=0.90). Both drugs red
Prevention in Mental Health: From Risk Management to Early Intervention
No full textThe book brings together into a single text the interrelated but different research efforts to translate the current evidence on risk and outcome of severe mental disorders into a preventive perspective. The book also introduces a holistic approach to prevention in mental health, by combining biological, psychological and environmental evidence that attempts to blunt the risk and reduce the number of individuals with mental health vulnerabilities who eventually progress to the manifestation of a severe mental disorder. Finally, the book wants also to highlight the possibility to overcome the single disorder-oriented preventive approach in an attempt to intercept a wider at-risk youth population and explore clinical research areas underperformed where future efforts will have to concentrate.Mental health problems have their peak of incidence during the transition from childhood to young adulthood, interesting up to 20% adolescents. Half of those eventually developing such difficulties experience clinically relevant mental distress by the age of 14. Even more importantly, the symptomatic onset is generally anticipated by non-specific warning signs of psychosocial impairment potentially evolving in any severe mental disorder. This is of crucial importance, as almost one in two health problems contributing to the global disease burden across the 0-25 age span is a mental disorder.The search for preventive strategies among youth has developed over the past 2-3 decades, invigorated by a rethinking of mental disorders’ ineluctable prodromal phase into a period where the trajectory of illness can be slowed down, blunted, or even halted. The paradigms for implementing preventing approaches in mental health have often developed independent of each other. This book aims at summarizing the available evidence and make a step towards a more mature vision of the potentialities of promotion and prevention in mental health
Comparing Tapentadol to Oxycodone/Naloxone combination: Imaging castles in the air...while building sandcastles! Re: Flaminia Coluzzi, Matteo Ruggeri. Clinical and economic evaluation of tapentadol extended release and oxycodone/naloxone extended release in comparison with controlled release oxycodone in musculoskeletal pain. Curr Med Res Opin 2014; 30 (6): 1139-1151.
No full textNumerical analysis of the Landau-Lifshitz-Gilbert equation with inertial effects
Full text linkWe consider the numerical approximation of the inertial Landau-Lifshitz-Gilbert equation (iLLG), which describes the dynamics of the magnetisation in ferromagnetic materials at subpicosecond time scales. We propose and analyse two fully discrete numerical schemes: The first method is based on a reformulation of the problem as a linear constrained variational formulation for the linear velocity. The second method exploits a reformulation of the problem as a first order system in time for the magnetisation and the angular momentum. Both schemes are implicit, based on first-order finite elements, and generate approximations satisfying the unit-length constraint of iLLG at the vertices of the underlying mesh. For both methods, we prove convergence of the approximations towards a weak solution of the problem. Numerical experiments validate the theoretical results and show the applicability of the methods for the simulation of ultrafast magnetic processes
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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