Currently, an estimated 38 million Individuals 65 years or older live in the United States, and more than 11 million of these individuals are 80 years or older. Older people are at high risk of neuropathic pain becaus...
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Currently, an estimated 38 million Individuals 65 years or older live in the United States, and more than 11 million of these individuals are 80 years or older. Older people are at high risk of neuropathic pain because many diseases that cause neuropathic pain increase in incidence with age. Depending on their underlying health, older adults with neuropathic pain may have to cope with multiple coexisting diseases, polypharmacy, and Impaired functional ability. The objective of this article Is to review how aging and frailty affect the treatment of older adults with neuropathic pain. Specific topics reviewed include the complexity of treatment decisions In older patients due to aged heterogeneity, multimorbidity, and polypharmacy;selection of treatment in an effort to maximize patients' functional abilities In addition to relieving their pain;more careful dosing (usually lower) and monitoring of pharmacotherapy relative to younger patients due to age-related changes in pharmacokinetics and pharmacodynamics;and underrepresentation of older adults In clinical trials of neuropathic pain treatments, which further compromises physicians' ability to make informed treatment decisions.
Pharmacy, resembling all autonomous medical professions, has a history of male practitioners. With the rapid increase in numbers of women entering the field, evaluation of their status and projections as to the impact...
To clinically apply the inverse PSA-body mass index (BMI) correlation and enhance PSA sensitivity in obese cases, a new formula is warranted. An innovated BMI-PSA equation is designed. PSA-BMI adjusted formula (named ...
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To clinically apply the inverse PSA-body mass index (BMI) correlation and enhance PSA sensitivity in obese cases, a new formula is warranted. An innovated BMI-PSA equation is designed. PSA-BMI adjusted formula (named Hekal's equation): measured total PSA (ng ml(-1)) multiplied by age (years) and divided by BMI of the patient. The formula is applied over a randomly chosen 1000 cases of different PSA, BMI, age and trans-rectal ultrasound biopsy results, the yield of new PSA is correlated with pathology and age-specific PSA adjustment values. Among the 988 cases with complete data, obesity (BMI: 30-35 kg m(-2)) in 236 cases (23.8%) and 79 cases (7.9%) have BMI>435 kg m(-2). Mean PSA was 5.8 ng ml(-1) (s.d. +/- 8.4 ng ml(-1)). Cases stratified based on their age (every 10 years). The new equation was applied. Obesity is detected in 33.5 and 43.6% of fifth and sixth decade of life respectively (P = 0.02), with low measured PSA values (2.1, 3.8 ng ml(-1), respectively). By such PSA measurement biopsy may be omitted, missing 53.3% of malignant cases. In contrast, PSA adjusted were 4 and 9.3 ng ml(-1) within the same group of patients. With such values, the decision of a biopsy could not be missed for the targeted groups. Specificity and sensitivity of adjusted PSA values at cutoff point 4 ng ml(-1) was 41.7 and 70%, respectively. Based on our results, the new PSA-BMI adjusted formula is reproducible, easy applied formula. With such a formula the higher sensitivity of PSA in obese patients could be achieved. The misleading low PSA in obese cases in the fifth and sixth decade will be corrected. Prostate Cancer and Prostatic Diseases (2010) 13, 186-190;doi: 10.1038/pcan.2009.53;published online 22 December 2009
oThis kind of activity is an example of a great leveller.' The development of distributed leadership qualities in health and social care are cited as crucial to effective team working, staff development, collabora...
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oThis kind of activity is an example of a great leveller.' The development of distributed leadership qualities in health and social care are cited as crucial to effective team working, staff development, collaboration and partnership within an interprofessional context. We share a case study in which music and percussive activities were introduced into the social work and nursing curriculum of a Post-Qualifying Award for Practice Education and Leadership and Management. Participating students, service users and academics learned to play a complex traditional piece of Balinese Gamelan music led by an external facilitator. This provided opportunities for more innovative and creative co-produced learning experiences using arts-based methods. These approaches are recommended to improve critical reflection, collaborative teamwork and participatory leadership, transferrable to different settings in health and social care. Evaluation from the learners perspective identified key themes from these approaches relating to emotional engagement in learning, acquiring a sense of achievement and the significance of equality and co-production in learning a new skill. Using more creative pedagogies in post-qualifying education proved to be a ogreat leveller' in achieving more satisfying and effective learning relationships whilst acknowledging the dynamics and power relationships involved in the process.
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