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PubMed2002

Pharmaceutical education in the wake of genomic technologies for drug development and personalized medicine.

The development of safe and effective new therapeutics is a long, difficult, and expensive process. Over the last 20-30 years, recombinant DNA (rDNA) technology has provided a multiple of new methods, molecular targets and DNA-based diagnostics to pharmaceutical research that can be utilized in assays for screening and developing potential biopharmaceutical drugs. In parallel, new innovative approaches to drug delivery systems were discovered and reached the market. Pharmaceutical biotechnology, pharmacogenomics, combinatorial chemistry, in close relation to high-throughput screening technologies, and bioinformatics are major advances that give a new direction to pharmaceutical sciences. To meet with the needs of this new dynamic era of pharmaceutical research and health care environment, pharmaceutical education has to set new priorities to keep pace with the challenges related to genomic technologies. The development of new initiative education programs, for both undergraduate and graduate curricula, in pharmacy has to be focused on preparing pharmacists oriented for both pharmacy practice and drug research and development. This can be achieved by providing future pharmacists with knowledge, skills and attitudes to be more competitive in the health care system, pharmacy practice-related fields, pharmaceutical industry and drug research and development areas, or finally in academia. Educators and pharmacy school members have the responsibility of deciding how, to what extent, by which methods, and/or in which way these changes and new directions in the education programs should be developed.

Animals↗
PubMed1983

Prevention of adolescent substance abuse through the development of personal and social competence.

The initiation of substance use typically begins during adolescence and appears to be the result of the complex interplay of social, personality, cognitive, attitudinal, behavioral, and developmental factors. Traditional smoking, alcohol, and drug education programs have attempted to increase students' knowledge of the risks associated with using these substances in the hope that this would deter use. Other programs have attempted to enrich the personal and social development of students through what has been referred to as "affective" education. Unfortunately, the inescapable conclusion to be drawn from the substance abuse prevention literature is that few of these programs have demonstrated any degree of success in terms of the actual prevention of substance use/abuse. Traditional educational approaches to substance abuse prevention appear to be inadequate because they are based on faulty assumptions and are too narrow in their focus. The "affective" education approaches, on the other hand, appear to have placed too little emphasis on the acquisition of the kind of skills that are likely to increase general personal competence and enable students to cope with the various interpersonal and intrapersonal pressures to begin using tobacco, alcohol, or drugs. From the perspective of social learning theory (Bandura 1977) and problem behavior theory (Jessor and Jessor 1977), substance use is conceptualized as a socially learned, purposive, and functional behavior which is the result of the interplay of social (environmental) and personal factors. One potentially effective approach to substance abuse prevention might involve enhancing general personal competence and teaching adolescents the kind of problem-specific skills and knowledge which will increase their ability to resist the various forms of pro-substance-use social pressure. Brief reviews of the social skills training literature and the literature related to techniques for coping with anxiety not only provide evidence for the feasibility of teaching these kinds of skills, but also provide guidelines concerning the most effective approaches to use. Similarly, several of the most successful smoking prevention programs have included components designed to increase adolescents' ability to resist the various pro-use social pressures, particularly pressure from their peers. Our own research has involved testing a broad-spectrum prevention strategy which focuses both on the enhancement of personal competence through the development of basic "life skills" and the acquisition of problem-specific skills and knowledge designed to increase adolescents' ability to resist the various forms of social pressure to engage in the use of one or more substances.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗
PubMed2003

Continuing professional development (CPD): GPs' perceptions of post-graduate education-approved (PGEA) meetings and personal professional development plans (PDPs).

BACKGROUND: Conventional post-graduate meetings-typically 'lunchtime' meetings outside practices-have been heavily criticized. Revalidation is also impending, and there has been associated pressure for the widespread introduction of personal development plans (PDPs). However, there is very little empirical evidence about the usefulness to GPs of different kinds of educational meeting or of PDPs. OBJECTIVES: Our aim was to assess the utility to GPs of different types of post-graduate meeting and PDPs. METHODS: A postal questionnaire was sent to 921 GP principals in three health authorities, who were asked to recall their most recent post-graduate education-approved (PGEA) meetings (practice-based and 'outside') and the latest major learning 'undertaken' in their PDP. RESULTS: A total of 698 GPs (76%) returned questionnaires. A substantial minority (208; 30%) had a PDP. Most had undertaken education recently [median time elapsed (weeks): meeting 'outside' practice, 4; 'practice-based', 5; PDP, 3]. Education had not changed clinical practice for many GPs ('practice-based' 39% reported no change; 'outside' meetings 50% and PDPs 57%). A change in practice after a practice meeting was related to relevance to everyday practice [disagree/neutral, agree, strongly agree odds ratios: 1.00, 4.22 (95% CI 2.1-8.6) and 5.9 (2.6-13.3), respectively], to lecturer factors (enthusiasm, summarizing important points, handouts) and to social enjoyment. PDPs were less likely to be perceived relevant to practice (practice-based meeting, 'outside' meeting, PDPs: 89, 87 and 72%, respectively), as a break from practice (54,72 and 18%), good socially (63, 72 and 15%), good for professional networking (54, 70 and 19%) and glad to have done it (84, 86 and 44%). Being glad to use a PDP was more likely if the learning was clinically relevant, a break from practice, and incorporated professional networking. CONCLUSION: Changes in practice after post-graduate meetings are not only related to clinical relevance and lecturer factors, but also to professional and social factors. PDPs may not be providing better learning opportunities or enjoyment than traditional meetings, although GPs who are glad to use PDPs incorporate clinical relevance, a break from practice and networking. Post-graduate tutors should probably continue to support and monitor the lecturer quality and clinical relevance of a balanced portfolio of both practice-based and 'outside' meetings.

Adult↗
PubMed1983

[Personality disorders in adolescents].

The aim of the study was the investigation of symptoms and origin of the disturbances in personality development of adolescents. The group of 50 patients (22 girls and 28 boys aged from 14 to 20 years) of the Young People's Unit and Outpatient Clinic of the Department of Child and Youth Psychiatry of the Institute of Mother and Child in Warsaw were examined. The study consists of the psychiatric, psychological and sociological types of investigation. The following methods were used in the study: the standard methods of the clinical investigation, Wechsler-Bellevue Intelligence Scale, R. B. Cattell, M. Choynowski and M. Nowakowska 's 16 PF; A. Roe and M. Siegelman 's "My Father" and "My Mother" questionnaires; E. S. Schaefer and R. Q. Bell's Parental Attitude Research Instrument and E. Kobia łka's Family Environmental Questionnaire. The control group was formed in the method of pairs and was investigated in the same way as patients. After the detailed analysis of the data, the final conclusions were formed. They are as follows: In the clinical picture of disturbances of the development of patients personality, the conduct disorders prevailed. The suicidal and parasuicidal behaviour occurred in 1/3 of the patients. Also the depressive and other neurotic symptoms took place. The intelligence level was average and dull normal. The following personality features were established: emotional instability, guilt proness , low self- sentiment , high ergic tension (both sexes); protension ( suspection jealous ), shrewdness (girls) and threat sensitive (boys). Patients attitudes toward both parents were disturbed and unfavourable for normal personality development. The declared mothers attitudes toward patients were also unfavourable for development of mature personality. The general family environment (also living standard) was significantly worse in the criterion group. It should be stressed in conclusion, that the results of the study showed among others that the disturbed family hinder the development of adjustment mechanisms, mainly of the adjustment to the small group, which are essential for the normal personality functioning.

Adolescent↗
PubMed1984

Estimation of personal exposure to tobacco smoke with a newly developed nicotine personal monitor.

To evaluate the actual level of exposure of nonsmokers to tobacco smoke in their living environments, a convenient personal monitor of nicotine specific for tobacco smoke has been developed. The nicotine personal monitor consists of a sampler tube containing 450 mg of Uniport-S coated with silicon OV-17 and a portable sampling pump with a mechanical counter for obtaining total sampling volume. Using the personal monitor attached to a nonsmoker, ambient nicotine was collected in the sampler tube by drawing environmental air at a constant flow rate for a maximum period of 8 hr. The collected nicotine was desorbed by heating and directly transferred onto a GC column with a carrier gas. The amounts of nicotine inhaled by passive smoking in various living environments were estimated to be in the range of 0.9-40 micrograms/hr. These levels are equivalent to those from the active smoking of about 0.001-0.044 ordinary cigarettes in 1 hr.

Equipment and Supplies↗
PubMed2001

The contribution of temperament, childhood neglect, and abuse to the development of personality dysfunction: a comparison of three models.

We examined the contribution of temperament, childhood neglect, and abuse to the development of personality dysfunction as postulated in three different but correlated models of personality: the psychobiological, Vaillant's psychoanalytic, and DSM psychopathology models. Character, defense style, and personality disorder symptomatology (the dependent variables), and temperament, childhood neglect, and abuse (the independent variables) were assessed in 168 depressed outpatients. High harm avoidance (temperament) tended to be the strongest and most consistent risk factor across the three models. Deficient parental care predicted personality dysfunction, however low care was not consistently predictive across all three models. Emotional/psychological abuse and actual physical abuse were risk factors for increasing personality disorder symptomatology only. Childhood sexual abuse was not as predictive of personality dysfunction as might be expected, thereby raising questions as to the importance placed on child sexual abuse as a general risk factor for personality psychopathology.

Adult↗
PubMed2000

[Personality disorders in adolescence. A pilot study on classification and early course].

72 case histories of former adolescent psychiatric inpatients diagnosed on discharge as suffering from a personality disorder were evaluated. It was possible to re-examine 33 (46%) of them. The discharge diagnosis was made according to ICD 9, the follow-up diagnosis according to ICD 10 and DSM-III-R. Depending on the instrument and criterion, 40% to 87.9% of the discharge diagnoses made could be confirmed after an average follow-up period of 3.4 years. Only in 12.1% of the cases there was no personality disorder established. There was no indication of any change of diagnosis to other psychiatric disorders. The re-diagnosis rates obtained are thus similar to those for adults. The classifications of ICD 10 and DSM-III-R corresponded much better than those of ICD 9 to clinical reality. The classification systems and assessment instruments that have normally been verified only for adults thus also seem suitable for use among adolescents. In both adolescents and adults the avoidant personality disorder is a particularly frequent subtype. However, the current study was unable to resolve the question of what the decisive criteria should be in the case of competing definitions such as puberty crisis, personality development disorder, personality disorder and emotional or affective disorder. This issue requires further investigation.

Adolescent↗
PubMed2001

The Masterson Approach with play therapy: a parallel process between mother and child.

This paper discusses a case in which the Masterson Approach was used with play therapy to treat a child with a developing personality disorder. It describes the parallel progression of the child and mother in adjunct therapy throughout a six-year period. The unique value of the Masterson Approach is that it provides the therapist with a framework and tool to diagnose and treat a child during the dynamic process of play. The case describes the mother-child dyad throughout therapy. It traces their parallel processes that involve separation, individuation, rapprochement, and the recovery of real self-capacities. Each stage of treatment is described, including verbal interventions. The child's internal affective state and intrapsychic structure during the various stages of treatment are illustrated by representative pictures.

Child↗
PubMed1993

[Forensic psychiatric diagnoses and assessment of abnormal psychosocial development].

Introduction of the concept of severely abnormal personality development in the legal code in the former GDR in 1968 (section 16, para 1) made acquittal of criminals possible where abnormal psychosocial development was proved. So far, however, statistically based criteria for the classification of this legal decision were lacking. The authors compared, using statistical methods, severely pathological abnormal personality development and a group of subject homogenized on the basis of substantial parameters. Mainly due to multivariance methods they were able to visualize different syndromes which are characterized by the given criteria of severely abnormal personality development.

Forensic Psychiatry↗