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At least 973 records · Page 54Linked to original sources
PubMed2004

Prevalence and appropriateness of psychotropic drug use in old age: results from the Berlin Aging Study (BASE).

BACKGROUND: The aim of this epidemiological study is to examine the prevalence and correlates of psychotropic drug use in the very old and to evaluate the appropriateness of psychotropic drug use in very old age. METHODS: Data from the Berlin Aging Study (BASE), a multidisciplinary study of an age- and gender-stratified, randomly selected sample of elderly people living in Berlin are presented. Over-sampling, especially very old men, allows for powerful analyses of this population. All participants went through extensive psychiatric and somatic examinations. Medication intake was assessed by different data sources (interviewing patients and their family physicians, drug inspection at home). Results were brought together in a consensus-conference and research physicians gave operationalized ratings of medication appropriateness. RESULTS: The prevalence of elderly people who were taking at least one psychotropic medication within the 14 days immediately preceding investigation was 29.8%. Of these medications, 68.4% had been taken for longer than one year. There was no effect of age or gender on the scope of psychotropic drug use. Benzodiazepines were taken by 19.8% of the elderly. Antidepressants, neuroleptics and anti-dementia drugs were taken by about 3-4% each. People taking psychotropic drugs had significantly higher levels of psychiatric morbidity, as measured by syndromes and specified diagnoses. Psychotropic drugs were significantly less often judged to be indicated than somatic medications. This is mostly due to benzodiazepines. CONCLUSIONS: Psychotropic drug use is common in old age, but there is no additional increase in usage beyond the age of 70. Intake of psychotropics is mostly oriented at symptoms or syndromes, which explains why benzodiazepines are still the most commonly prescribed psychotropics.

Aged↗
PubMedDate not supplied

Integrated decision-making in response to weapons of mass destruction incidents: development and initial evaluation of a course for healthcare professionals.

INTRODUCTION: Standardized, validated training programs for teaching administrative decision-making to healthcare professionals responding to weapons of mass destruction (WMD) incidents have not been available. Therefore, a multidisciplinary team designed, developed, and offered a four-day, functional exercise, competency-based course at a national training center. OBJECTIVE: This report provides a description of the development and initial evaluation of the course in changing participants' perceptions of their capabilities to respond to WMD events. METHODS: Course participants were healthcare professionals, including physicians, nurses, emergency medical services administrators, hospital administrators, and public health officials. Each course included three modified tabletop and/or real-time functional exercises. A total of 441 participants attended one of the eight course offerings between March and August 2003. An intervention group only, pre-post design was used to evaluate change in perceived capabilities related to administrative decision-making for WMD incidents. Paired evaluation data were available on 339 participants (81.9%). Self-ratings for each of 21 capability statements were compared before and after the course. A 19-item total scale score for each participant was calculated from the pre-course and post-course evaluations. Paired t-tests on pre- and post-course total scores were conducted separately for each course. RESULTS: There was consistent improvement in self-rated capabilities after course completion for all 21 capability statements. Paired t-tests of pre- and post-course total scale scores indicated a significant increase in mean ratings for each course (all p < 0.001). CONCLUSION: The tabletop/real-time-exercise format was effective in increasing healthcare administrators' self-rated capabilities related to WMD disaster management and response. Integrating the competencies into training interventions designed for a specific target audience and deploying them into an interactive learning environment allowed the competency-based training objectives to be accomplished.

Bioterrorism↗
PubMed2003

Sustainability science and engineering: the emergence of a new metadiscipline.

A case is made for growth of a new metadiscipline of sustainability science and engineering. This new field integrates industrial, social, and environmental processes in a global context. The skills required for this higher level discipline represent a metadisciplinary endeavor, combining information and insights across multiple disciplines and perspectives with the common goal of achieving a desired balance among economic, environmental, and societal objectives. Skills and capabilities that are required to support the new metadiscipline are summarized. Examples of integrative projects are discussed in the areas of sustainability metrics and integration of industrial, societal, and environmental impacts. It is clear that a focus on green engineering that employs pollution prevention and industrial ecology alone are not sufficient to achieve sustainability, because even systems with efficient material and energy use can overwhelm the carrying capacity of a region or lead to other socially unacceptable outcomes. To meet the educational and human resource needs required for this new discipline, the technological and environmental awareness of society must be elevated and a sufficient and diverse pool of human talent must be attracted to this discipline.

Conservation of Natural Resources↗
PubMed2005

In search of a novel anti-HIV drug: multidisciplinary coordination in the discovery of 4-[[4-[[4-[(1E)-2-cyanoethenyl]-2,6-dimethylphenyl]amino]-2- pyrimidinyl]amino]benzonitrile (R278474, rilpivirine).

Ideally, an anti-HIV drug should (1) be highly active against wild-type and mutant HIV without allowing breakthrough; (2) have high oral bioavailability and long elimination half-life, allowing once-daily oral treatment at low doses; (3) have minimal adverse effects; and (4) be easy to synthesize and formulate. R278474, a new diarylpyrimidine (DAPY) non-nucleoside reverse transcriptase inhibitor (NNRTI), appears to meet these criteria and to be suitable for high compliance oral treatment of HIV-1 infection. The discovery of R278474 was the result of a coordinated multidisciplinary effort involving medicinal chemists, virologists, crystallographers, molecular modelers, toxicologists, analytical chemists, pharmacists, and many others.

Administration, Oral↗
PubMed1999

The quarantine of philosophy in medical education: why teaching the humanities may not produce humane physicians.

Patients increasingly see physicians not as humane caregivers but as unfeeling technicians. The study of philosophy in medical school has been proposed to foster critical thinking about one's assumptions, perspectives and biases, encourage greater tolerance toward the ideas of others, and cultivate empathy. I suggest that the study of ethics and philosophy by medical students has failed to produce the humane physicians we seek because of the way the subject matter is quarantined in American medical education. First, the liberal arts are seen as the province of undergraduate education, and not medical school. Second, philosophy, when taught in medical school, is seen by students as just one subject to be mastered along with many other more important ones, and not as a way to foster critical thinking and empathy. What is needed is a new pedagogy that combines both cognitive and affective elements to implant and nourish the liberal arts in students. Removing the quarantine of philosophy from other facets of medical education is an important first step.

Education, Medical↗