Types Of Medical Conditions Research Articles

Reporting Requirements, Confidentiality, and Legal Immunity for Physicians Who Report Medically Impaired Drivers

Physicians play an important role in assessing patients' ability to drive. There is a dearth of peer-reviewed information on policies regarding physician reporting of medically impaired drivers. To investigate state reporting requirements and the availability of confidentiality and legal immunity for physicians who report medically impaired drivers. This cross-sectional study was conducted from November 1 to 30, 2022, in 3 rounds. First, all 50 US states' Department of Motor Vehicle (DMV) websites were systematically reviewed. Second, DMV staff from each state were surveyed via telephone. Third, each state's legal codes for driver licensing were reviewed. Outcome measures included the percentage of states with mandatory and voluntary reporting policies, reporting instructions on DMV websites, anonymous reporting options, and legal immunity for reporting physicians, in addition to characteristics of states' mandatory reporting policies (ie, types of medical conditions that require reporting) and policies surrounding the confidentiality of reports. The data were analyzed using descriptive statistics. One-third of state DMV websites (17 [34%]) lacked instructions regarding physician reporting. Six states had mandatory reporting requirements; 4 of these states only required reporting of conditions characterized by lapses of consciousness. Only 3 states (6%) accepted anonymous reports, and 7 states (14%) deemed physician reports of medically impaired drivers confidential without exception. Nearly one-third of states (15 [30%]) deemed reports by physicians confidential, with the exception that reported drivers could find out who reported them if they asked for a copy of the reporting form. Most states (37 [74%]) had statutes that protected physicians from liability related to reporting medically impaired drivers. This cross-sectional study of state reporting requirements regarding medically impaired drivers found many differences in state policies regarding mandatory reporting and the conditions that require reporting. There was also limited availability of online reporting instructions, anonymous reporting options, and legal protections for reporting physicians.

Outcomes From a Physician Health Center

This retrospective cohort study describes the population of physicians seeking medical evaluation in a dedicated physician health center and identifies factors associated with needing practice restrictions. Participants had an initial evaluation between January 1, 2016, and December 31, 2022. We report personal and professional demographics and types of medical conditions in this cohort. An ordinal logistic regression analysis was used to identify factors associated with occupational outcomes. Physicians in a wide variety of specialties from 34 different states presented for evaluation of diverse medical problems. More than half of the participants presented with occupational concerns. The presence of a neurologic or psychiatric illness were the only factors associated with temporary or permanent restrictions. Physicians with medical conditions impacting their ability to practice have a professional obligation to obtain a thorough, objective medical evaluation. Such evaluations should support and protect patients, employers, and the physicians themselves.

Label‐Free Imaging Flow Cytometry for Cell Classification Based on Multiple Interferometric Projections Using Deep Learning

A new label‐free imaging flow cytometry method for noninvasive and automated biological cell classification is presented. Each cell is rolled during flow, and its off‐axis holograms from multiple viewpoints are acquired. Using the reconstructed quantitative phase profiles of the cell projections, highly discriminating features, enabling cell detection, classification, and differentiation, are extracted via a modified ResNet‐18 deep convolutional neural network architecture. The model is first validated by classifying metastatic breast carcinoma cells (MCF‐7) and normal human mammary epithelial cells (MCF‐10A). An increase in classification accuracy by 1% is achieved when processing five interferometric projections versus processing a single interferometric projection. This model is further tested on four types of white blood cells and exhibits an accuracy increase of 5% when processing 12 interferometric projections versus processing a single interferometric projection. This approach is shown to be superior to that of using conventional 2D‐rotation augmentation, and can be used to decrease substantially the number of cell examples needed for training the classification model without impairing the results. This novel concept has great potential to be incorporated into label‐free imaging flow cytometry and improve cell classification, and be used to detect various types of medical conditions and diseases.

VISUAL PROCESSING SPEEDS DIFFERENTIATE OUTCOMES OF DRIVING EVALUATIONS OF CONTROLS AND MEDICALLY AT RISK DRIVERS

Abstract Visual processing speed is considered a critical factor for determining driving capacity in older adults. The specific research questions were: 1) is there a statistically significant difference in performance time between the medically at-risk (n=35) and controls (N=242), 2) does the type of medical condition (e.g., neurological, cognition, complex medical conditions) differentiate performance, and 3) can visual processing speed differentiate between fit and unfit drivers. A cross sectional quasi-experimental design was used to compare the visual processing reaction times between at-risk adult drivers and healthy controls. Participants were medically-at-risk drivers referred for a comprehensive driving evaluation to determine their fitness to drive. The Vision Coach™ "Full-Field-60" task was used to collect reaction times which required participants to tap 60 randomly illuminated red dots. One practice trial was followed by three testing trials that were averaged together. At-risk participants were divided into three diagnostic categories. Fitness-to-drive outcomes were pass, fail, or restrictions. A propensity score method based on age and gender was used to account for the difference in sample sizes by weighting the participants from the two studies for a fair comparison between the two groups. Independent t-tests found a significant difference t(275)=-6.42, p=< 0.001 in trial times between healthy controls (M=53 + 10.82) and medically-at-risk adults (M=72 + 17.04). No significant difference was found between the diagnostic groups (p=0.141), but the Vision Coach™ differentiated between those who "passed" and those who "failed" a driving evaluation (F(2,32)=8.28, p=0.001.

Censoring Intersex Science: A Medical School Scandal.

A senior pediatric endocrinologist at a leading medical school in Canada has for years provided the introductory lecture on Disorders of Sex Development/Intersexuality (DSD/I) in the standard second-year course. In 2020/2021, two students complained to medical school administrators about six specific issues of intersex theory and care that were addressed in the lecture (Polychronakos, 2021). Subsequently, the administration replaced the professor with a different lecturer, thus effectively censoring the dissemination of intersex science. An overview of the status of the clinical literature on intersexuality shows that the students' critiques focus on concepts and facts that have been developed in extensive medical and sexological research over the past 50-60years, as is shown for each of their points of critique. By censoring the professor's teaching, the medical school not only violated academic freedom, but also suppressed well-established scientific facts, kept medical students uninformed about the diverse points of view in this area of clinical management, and likely undermined future evidence-based medical and psychosocial care by these students for individuals with this type of medical condition.

What are the mental health changes associated with the COVID-19 pandemic in people with medical conditions? An international survey

ObjectivesThe COVID-19 pandemic has negatively impacted mental health worldwide but there is paucity of knowledge regarding the level of change in mental health in people with a medical condition (physical/psychiatric)....

Frequency of BCR-ABL P190 & P210, and JAK2 Mutations in Myeloproliferative Patients in Iran

Background: Hematologic malignancies can be divided into two categories: myeloid and lymphoid, each of which is further divided into acute and chronic. Chronic myeloid diseases consist of Myelodysplasia Syndrome (MDS), Myeloproliferative Neoplasms (MPNs), and a rare group of MDS/MPN. According to genetic studies, the prevalence of some mutations related to cell division is higher in these patients. Given that gene analysis is an available way to diagnose the disease quickly, treat it on time, and help promote effective drugs, this study aims to investigate the frequency of JAK2, BCR-ABL P190, and BCR-ABL P210 mutations in patients with neoplasms who refer to Shahid Mostafa Khomeini Hospital, Tehran, Iran, between March 2017 and September 2020. Materials and Methods: The blood samples of the patients were analyzed by PCR for the expression of BCR-ABL P190, BCR-ABL P210, and JAK2 genes to investigate any potential relationship between malfunctioned genes and the existing medical condition. Results: The mean age of the study patients was 60.5±14.7 years. Of whom 28 (53.8%) were male, and the other 24 (46.2%) were female. Also, 29 patients (55.8%) had Essential Thrombocythemia (ET), 37 patients (71.2%) had at least one of the studied mutations, 21 patients (40.4%) had JAK2 mutation, and 16 patients (31.8%) had BCR-ABL mutation. There was no significant relationship between gender and any of the studied variables. Type of disease had a significant relationship with the studied mutations. Conclusion: All CML cases in this study had at least one of three types of mutations. The type of medical condition was significantly associated with the studied mutations, for example, CML patients had fewer JAK2 and more BCR-ABL gene mutations. gender was not significantly related to any factor in the study. There was no mortality during the study. All the patients were alive, and most of them (88.5%) were in remission.

Effect of Clinical Nursing Pathway Intervention Based on Evidence-Based Medicine on Venous Thrombosis in Long-Term Bedridden Patients.

Background Venous thrombosis is a type of medical condition that establishes as deep vein thrombosis of the limb or pulmonary embolism. This disease arises as a result of interrelating hereditary, ecological, and interactive risk aspects. Clinical nursing pathways also known as critical pathways are pathways that guide nurses when developing a patient's care plan. However, the effect of nursing intervention on venous thrombosis in long-term bedridden patients from the perspective of evidence-based medicine had not been reported. Methods A total of 170 patients hospitalized in the hospital from January 2021 to October 2021 were selected, and the bed time was more than 2 weeks. The patients were randomly divided into the control group and observation group. 85 cases in the control group received routine nursing in cardiology, and 85 cases in the observation group received clinical nursing pathway. Venous thrombosis, lower limb pain, swelling, D-dimer level, hemodynamic parameters, and nursing satisfaction were compared in two groups. Results The incidence of deep venous thrombosis in the observation group was 8.2%, lower than 24.7% in the control group (P < 0.05). The incidence of lower limb pain and elevated D-dimer in the observation group was lower than that in the control group (P < 0.05). The improvement of hemodynamic parameters such as SBP, DBP, CBV, PR, CI, and CO in the study group was better than that in the control group (P < 0.05). The satisfaction of the observation group was 90.58%, which was higher than that of the control group (82.35%) (P < 0.05). Conclusion Clinical nursing pathway can improve patients' nursing efficiency, improve the treatment effect, shorten hospital stay, and improve nursing satisfaction.

Medication Changes and Diagnosis of New Chronic Illnesses in COVID-19 Intensive Care Unit Survivors.

Currently, there is limited literature on the impact of the COVID-19 infection on medications and medical conditions in COVID-19 intensive care unit (ICU) survivors. Our study is, to our knowledge, the first multicenter study to describe the prevalence of new medical conditions and medication changes at hospital discharge in COVID-19 ICU survivors. To determine the number of medical conditions and medications at hospital admission compared to at hospital discharge in COVID-19 ICU survivors. Retrospective multicenter observational study (7 ICUs) evaluated new medical conditions and medication changes at hospital discharge in patients with COVID-19 infection admitted to an ICU between March 1, 2020, to March 1, 2021. Patient and hospital characteristics, baseline and hospital discharge medication and medical conditions, ICU and hospital length of stay, and Charlson comorbidity index were collected. Descriptive statistics were used to describe patient characteristics and number and type of medical conditions and medications. Paired t-test was used to compare number of medical conditions and medications from hospital discharge to admission. Of the 973 COVID-19 ICU survivors, 67.4% had at least one new medical condition and 88.2% had at least one medication change. Median number of medical conditions (increased from 3 to 4, P < .0001) and medications (increased from 5 to 8, P < .0001) increased from admission to discharge. Most common new medical conditions at discharge were pulmonary disorders, venous thromboembolism, psychiatric disorders, infection, and diabetes. Most common therapeutic categories associated with medication change were cardiology, gastroenterology, pain, hematology, and endocrinology. Our study found that the number of medical conditions and medications increased from hospital admission to discharge. Our results provide additional data to help guide providers on using targeted approaches to manage medications and diseases in COVID-19 ICU survivors after hospital discharge.

Food sustainability, healthy eating, on-trend diets: media representations of nutrition in Romania and Germany

Abstract The importance of nutrition as a research topic is linked not only to healthy eating and different types of medical conditions, such as obesity, allergies, malnutrition, but also to the relationship between nutrition and physical activity, to state’s and large food companies’ commercial activities, as well as to the sustainability of food production. On that basis, numerous studies have analyzed media content related to food and nutrition, their basic assumption being that (new and old) media have the ability to change the audience’s perceptions, behaviors and attitudes towards various values which are accepted in contemporary societies. This paper presents the results of a comparative study of the way in which Romanian and German media cover the topic of nutrition. The research method used was the content analysis, applied to a sample of articles published on online media from the two countries between 2014 and 2016. Having as research objective the identification of the most relevant aspects regarding the content and shape of nutrition’s coverage in media, this article discusses the similarities and differences recorded in the online press of the two countries on the topic of interest. According to the findings, the similarities are mainly related to some topics and subjects addressed, as well as to the ways of covering them, in particular through analysis articles, while the differences could instead be ascertained regarding the content of the articles, including the ways in which the journalists assume social roles in approaching, informing, debating, and educating concerning issues of public interest.

Capturing the trend of mHealth research using text mining.

With the increasing development and use of mobile technologies, an increasing amount of research on mobile health is being conducted. The purpose of the study was to capture the trends in mHealth research by mining terms related to medical conditions, interventions, study populations, and the relationships between these terms. This study analyzed 5,600 journal articles published in Web of Science from 2008 to 2018. Using text mining techniques, a total of 39,292 terms extracted from the titles and abstracts of the journal articles were independently reviewed to identify meaningful terms related to medical conditions, interventions, and study populations. A total of 48 different types of medical conditions were identified in the dataset. Mood disorders appeared to be the most frequently identified medical condition in mHealth research. Thirty interventions were identified. Cell phone-, SMS-, and Internet-based interventions appeared to be the most prominent types, and "female" appeared to be the most frequently identified term related to the studied population. Females appeared to have been studied in the widest range of medical conditions, including pregnancy issues, overnutrition, neoplasms, and AIDS. Older adults were the least studied population in mHealth. Knowledge gaps that have not been explored in previous studies in mHealth research were identified, which should be addressed by researchers.

Prevalence of Medical Conditions among Dental Patients in Benghazi

Objectives: The aim of this study was to assess the prevalence of medical conditions and its relation to age and gender, among patients requesting dental treatment in private dental clinic, Benghazi University.&#x0D; Material and Methods: This prospective study was conducted on a total of 1192 patients reporting to the private dental clinic of Benghazi University, period from September, 2014 to April, 2016. The patient’s medical history was recorded on a predesigned preformat to find out the type of medical conditions in patients requiring dental treatment. The age range of the study population was from 15 years to 87 years, divided into seven age groups. Results were evaluated to see which medical problem is the most prevalent and to assess its relation to age and gender. &#x0D; Results: This study showed that out of 1192 dental patients, 711 were females and 481 were males. 380 (31.88%) were with medical problems. The five most prevalent conditions in descending order were endocrine diseases which constituted 35.26%, cardiovascular diseases which constituted 27.89%, gastrointestinal disorders (14.73%), hematological disorders (5.79 %) and respiratory conditions (5.79%).&#x0D; Conclusion: The results of the present study confirm that the prevalence of medical conditions is significant among patients requiring dental treatment. Therefore, a thorough medical history and careful clinical examination is mandatory before any dental procedure. It seems absolutely essential for dental practitioners to take a detailed medical history prior to any therapeutic procedure, as certain medical conditions, if unnoticed, will lead to unfavorable consequences and /or repercussions.

Do we know the social complexity of the complex chronic patients?

Introduction: Patient complexity is probably a multifaceted concept not fully captured by the number or type of medical conditions or by previous health care costs. Clinical and psychosocial issues should be taken into account when identifying people with chronic complex care needs. At least one third of patients in general practice have psychosocial problems that they perceive as influencing their present health. Social care and heath care fragmented framework does not respond properly to chronic patients needs. Objectives: 1- Describe general practitioners’ knowledge of a range of psychosocial problems among their complex chronic patients 2- describe the distribution of being identified heathcare integration benefit criteria and being coded as Z60 by age. Theory/Methods: Population-based cross-sectional study based on professional electronic medical records. Setting: primary care urban practice placed in Sabadell (Barcelona), Catalan Institute of Health (ICS). Clinical Risk Groups (CRG) ≥5 population older than 14 years old (24.762 inhabitants) were reviewed and identified as complex chronic patients (CCP) by Family Physicians using a construct based on clinical judgment and clinical and psychosocial issues, promoted by the Chronicity Prevention and Care Programme (CPCP),Catalan Department of Health. Psychosocial issues in electronic medical records are coded as Z60 (Problems related to social environment, ICD-10-CM Diagnosis Codes). The identification and data collection was carried out between 1 July and 30 September 2016. Results: A total of 571 chronic patients were identified by their family physicians, prevalence of 4.16%, 52.3% (298) women. Mean age of males 70.4 (95% CI: 68.6-72.2), females 74.2 (95% CI: 72.5-75.8), p = 0.002. Of the 571, 23 (4%) had the diagnosis of Z60, men 13 (56.5%) mean age: 64.5 (95% CI 55.2-73.7) women 10 (43.5%) mean age 60.2 (95% CI 44-76.37). There is an association between need for integration and being coded Z60 (p=0.018) but social coding is very low and the lack of knowledge of the social reality of CCPs is around 20%. Discussions: Doctors’ knowledge of social problems influence management: extra time, advice, certifying a sick leave, and prescribing a psychotropic drug are the most common actions taken, while referral to other community services was seldom used. It could reflect that the patients had already made such contacts themselves, intend to do so or the doctors could have considered cooperation with community services not to be worth while. Conclusions: Person-centered care implies attention within a health and social collaborative model. Our finding suggests that community services and Primary Heath Care practices are not yet well integrated in Catalonia Lessons learned: Compared with clinical diagnoses, social diagnoses are scarce in electronic health records Limitations: Different providers, different information systems and coding and lack of shared information limit proper social and health management. The review of the study is only done with the health database and therefore unknown social data for these patients. Suggestions for future research: Healthcare integration needs to move from a fragmented framework, in which individuals apply for and receive health benefits and care benefits separately, to a new model of shared responsibility. Interministerial Social and Health Care and Interaction Plan (PIAISS) is already working on the integration of social and health information systems.

Impact of Physical Activity in Cardiovascular and Musculoskeletal Health: Can Motion Be Medicine?

Physical activity is a well-known therapeutic tool for various types of medical conditions, including vasculopathic diseases such as coronary artery disease, stroke, type 2 diabetes, and obesity. Additionally, increased physical activity has been proposed as a therapy to improve musculoskeletal health; however, there are conflicting reports about physical activity potentially leading to degenerative musculoskeletal disease, especially osteoarthritis (OA). Additionally, although physical activity is known to have its benefits, it is unclear as to what amount of physical activity is the most advantageous. Too much, as well as not enough exercise can have negative consequences. This could impact how physicians advise their patients about exercise intensity. Multiple studies have evaluated the effect of physical activity on various aspects of health. However, there is a paucity of systematic studies which review cardiovascular and musculoskeletal health as outcomes. Therefore, the purpose of this review was to assess how physical activity impacts these aspects of health. Specifically, we evaluated the effect of various levels of physical activity on: 1) cardiovascular and 2) musculoskeletal health. The review revealed that physical activity may decrease cardiovascular disease and improve OA symptoms, and therefore, motion can be considered a “medicine”. However, because heavy activity can potentially lead to increased OA risk, physicians should advise their patients that excessive activity can also potentially impact their health negatively, and should be done in moderation, until further study.

Complex care needs in people with chronic diseases: population prevalence and characterization in primary care

Introduction: Risk adjustment variables for population stratification are based, primarily, on the burden of disease and the pattern of use of resources. They do not include other variables that, according to available evidence determines the complexity, such as coordination of care on a regional level, certain patient characteristics (adherence to treatments or visits, mental disorders, etc...) and, especially, socioeconomic, cultural, environmental and behavioural context.In Catalonia, a strategy for proactive identification of complex chronic patients (CCP) by healthcare professionals in primary care, based on clinical judgment and broad criteria, encompassing clinical and psychosocial variables, combined with Clinical Risk Groups (CRG, a risk-adjustment tool and clinically-based classification system used to measure a population’s burden of illness) has been promoted by the Chronicity Prevention and Care Program (CPCP) from the Department of Health. To the best of our knowledge, this strategy of identifying CCP from combination of risk adjustment and clinical judgment is a pioneering and unique experience worldwide. 101415 persons (1.3% of the population of Catalonia) have been identified as CCP by healthcare professionals in primary care between 1st February and 31st December 2013.43.3% of CCP identified (44014 persons) present a complexity not explained by theoretical construct proposed for identifying complex chronic population, defined by mortality, primary care contacts, hospitalization, emergency hospitalizations and pharmaceutical expenditure in the fourth and fifth quintiles of population distribution (CRG 5 severity 6; CRG 6 severity 5-6; CRG 7 severity 2-6, CRG 8 severity 3-6; and CRG 9 severity 2-6), increasing the possibility of being identified in this group when decreases the number of advanced chronic organic failure diseases, visits to primary care, urgent hospitalization and pharmaceutical spending and when increases age. But to date, it is unknown what the variables that would explain this complexity are. On the other hand, prevalence of CCP and, within these group, prevalence of those patients with advanced chronic disease (CCP-ACD) has not been yet established.The objectives of this study are 1) to determine the population prevalence of patients with chronic diseases and complex care needs (CCP and CCP-ACD), according to the construct based on clinical judgment and broad criteria, encompassing clinical and psychosocial variables, promoted by the CPCP in an urban population, 2) to describe the frequency and distribution of CPCP criteria for identifying patients with chronic diseases and complex care needs, and 3) to identify CPCP criteria that predict complexity.Methods: Population-based cross-sectional study based on information contained in the morbidity database of Catalonia in 2015 and professional electronic medical records. Setting: three primary care urban practices placed in Sabadell (Barcelona) belonging to the Catalan Institute of Health (ICS). According to this database, population with CRG≥5 and older than 14 years old (24762 inhabitants) were reviewed and CCP and CCP-ACD were identified and coded in the Shared Clinical Record of Catalonia, a common technological platform accessible to all providers of public health network.Study population is that which was recorded by healthcare professionals as CCP and CCP-ACD in the Shared Clinical Record of Catalonia on 30th September 2015.We will characterize chronic patients and compare the characteristics of people with and without complex care needs, according to professionals’ criteria by using chi-square or t-student tests, as appropriate. We will also compare the characteristics of primary care professionals who report the highest versus the lowest proportions of patients with complex care needs. We will construct a multivariate logistic regression model to identify independent predictors of professional-defined patient complexity with the following steps: a) selection of variables that predict complex care needs identified according to professionals’ criteria (bivariate analysis); b) process of model construction (likelihood ratio test) and c) validation of its predictive ability (goodness of fit) using discrimination index (C statistic) and index calibration (Hosmer-Lemeshow). In addition, there will be a logistic regression tree and, as an exploratory way, a multivariate factor analysis will be performed.Results: (progress report) The identification and data collection was carried out between 1st July and 30th September 2015. It is expected to have the results of the study in February 2016.Discussion: Patient complexity is probably a multifaceted concept not fully captured by the number or type of medical conditions or by previous health care costs. The data provided by this study will allow to characterize the complexity beyond the risk-adjustment tools that, according to available evidence, are not enough to identify people with chronic complex care needs. This research can also help for a deeper understanding of the multiple sources of patient complexity and their interactions.Conclusion: Not applicable

Descriptive epidemiology of deployment-related medical conditions and shipboard training-related injuries in a Chinese Navy population

ObjectivesTo investigate the deployment-related medical conditions and shipboard tactical training-related injuries in a Chinese Navy population. Study designA retrospective study with the Chinese Navy was conducted. MethodsThe medical records of 1543 Navy crewmembers from 2011 to 2015 were collected. The distribution and incidence rate (IR) of different types of medical conditions were provided and compared between the Aden Gulf deployment and nondeployment periods. The occurrence of military training-related injuries in crewmembers receiving 12-week shipboard tactical training was compared with that of 956 marines and 4371 recruits receiving combat and physical training, respectively. The anatomic locations and types of training-related injury were analyzed. ResultsCompared with the nondeployment period, the percentages of the following injuries were significantly higher during deployment: injuries and certain other consequences of external causes (16.97% vs 7.76%), diseases of the musculoskeletal system and connective tissue (15.40% vs 10.34%) and mental and behavioral disorders (11.23% vs 3.45%); however, respiratory system diseases had a lower percentage (19.84% vs 28.35%). Far seas deployment significantly increased the IRs of acute upper respiratory infection, skin and eye infection, sprains and low back pain as well as aphthous ulcer, insomnia, and seasickness (P < 0.05, 0.01 or 0.001). Shipboard training induced higher IRs of injuries to the upper extremities, spine and back and head and face than physical training and a higher incidence of head and face injury than combat training (P < 0.05 or 0.001). Physical training had higher IRs of overuse injuries than shipboard and combat training (P < 0.001). The IR of fracture was higher during combat and physical training than shipboard training (P < 0.01 and 0.001). ConclusionsThe Chinese Navy has experienced novel health issues in crewmembers in recent years. Corresponding countermeasures should be taken to address deployment-related medical conditions and shipboard training-related injuries in the future.

Variability in medical marijuana laws in the United States.

Marijuana use and its distribution raise several complex health, social, and legal issues in the United States. Marijuana is prohibited in only 23 states and promarijuana laws are likely to be introduced in these states in the future. Increased access to and legalization of medical marijuana may have an impact on recreational marijuana use and perception through increased availability and decreased restrictiveness around the drug. The authors undertook an analysis to characterize the policy features of medical marijuana legislation, including an emphasis on the types of medical conditions that are included in medical marijuana laws. A high degree of variability in terms of allowable medical conditions, limits on cultivation and possession, and restrictiveness of policies was discovered. Further research is needed to determine if this variability impacts recreational use in those states.

Autologous Osteoblast Transplantation, an Innovative Method of Bone Defect Treatment: Role of a Tissue and Cell Bank in the Process

BackgroundThe idea of cell treatment of various diseases and medical conditions has become very popular. Some procedures are well established, as is autologous chondrocyte implantation, whereas others are still in the process of early development, laboratory experiments, and some clinical trials. MethodsThis report is devoted to an example of an emerging cell treatment: bone augmentation with the use of autologous cells and its legal and technical background. Various requirements set by law must be met by tissue banks performing cell seeding of grafts. In Europe, the requirements are described in directives 2004/23/EC, 2006/17/EC, 2006/86/EC, and in the regulation 2007/1394/EC. ResultsRevitalization of biostatic allografts gives new, promising tools for creation of functional parts of organs; brings the methodology used in tissue banks closer to tissue engineering; places the enterprise in the mainstream of advanced biotechnology; allows the full potential of tissue allografts; and opens a new, large area for clinical and laboratory research. Cell and tissue processing also have a financial impact on the treatment: it produces additional expenditures. ConclusionsClinical effectiveness will be the most decisive factor of whether this innovative treatment will be applied in a particular type of medical condition. From a tissue establishment perspective, the most important issue is to develop a procedure that ensures safety for the patient in graft quality terms.

Does anxiety predict the use of urgent care by people with long term conditions? A systematic review with meta-analysis

ObjectiveThe role of anxiety in the use of urgent care in people with long term conditions is not fully understood. A systematic review was conducted with meta-analysis to examine the relationship between anxiety and future use of urgent healthcare among individuals with one of four long term conditions: diabetes; coronary heart disease, chronic obstructive pulmonary disease and asthma. MethodsElectronic searches of MEDLINE, EMBASE, PSYCINFO, CINAHL, the British Nursing Library and the Cochrane Library were conducted These searches were supplemented by hand-searching bibliographies, citation tracing eligible studies and asking experts within the field about relevant studies. Studies were eligible for inclusion if they: a) used a standardised measure of anxiety, b) used prospective cohort design, c) included adult patients diagnosed with coronary heart disease (CHD), asthma, diabetes or chronic obstructive pulmonary disease (COPD), d) assessed urgent healthcare use prospectively. Data regarding participants, methodology, and association between anxiety and urgent care use was extracted from studies eligible for inclusion. Odds ratios were calculated for each study and pooled using random effects models. Results8 independent studies were identified for inclusion in the meta-analysis, with a total of 28,823 individual patients. Pooled effects indicate that anxiety is not associated with an increase in the use of urgent care (OR=1.078, p=0.476), regardless of the type of service, or type of medical condition. ConclusionsAnxiety is not associated with increased use of urgent care. This finding is in contrast to similar studies which have investigated the role of depression as a risk factor for use of urgent care.

Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature

Patient knowledge, perceptions, and acceptance of generic medicines: a comprehensive review of the current literature Alian A Alrasheedy,1 Mohamed Azmi Hassali,1 Kay Stewart,2 David CM Kong,2 Hisham Aljadhey,3 Mohamed Izham Mohamed Ibrahim,4 Saleh Karamah Al-Tamimi1 1Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia; 2Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, VIC, Australia; 3Medication Safety Research Chair, Clinical Pharmacy Department, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia; 4College of Pharmacy, Qatar University, Doha, Qatar Background: Generic medicines have the same quality, safety, and efficacy as their counterpart original brand medicines. Generic medicines provide the same therapeutic outcomes but at a much cheaper cost, so are promoted in many countries to contain pharmaceutical expenditure and sustain the health care system. Thus, the perspective of patients and medicine consumers as end users of these medicines is an important factor to enhance the use and utilization of generic medicines. The objective of this paper is to review patients&rsquo; and consumers&rsquo; knowledge, perceptions, acceptance, and views of generic medicines in the current literature. Methods: An extensive literature search was performed in several databases, namely Scopus, PubMed, ISI Web of Knowledge, Proquest, and the Wiley online library, to identify relevant studies published in the English literature for the period 1990&ndash;2013. Results: A total of 53 studies were included in the review, comprising 24 studies from Europe, ten from North America, six from Asia, five from Australia and New Zealand, five from the Middle East, one from Africa, one from Latin America, and one from the Caribbean region. A large body of literature has reported misconceptions and negative perceptions about generic medicines on the part of patients and medicine consumers. Moreover, although it is reported in almost all countries, the percentage of consumers who had such misconceptions varied from one country to another. However, in many countries, there was a meaningful percentage of patients who had negative perceptions and misconceptions about generic medicines. Moreover, such misconceptions and negative perceptions were reported as major obstacles to the use and acceptance of generic medicines among patients. Further, studies that focused on specific populations (eg, patients with epilepsy, psychosis, or renal disease) reported a more negative perception and more resistance to the use of generic medicines. The type of medical condition and its level of seriousness or severity, recommendations by health care professionals, price difference (ie, cost saving), previous experience of generic medicines, and knowledge/information about generic medicines were considered to be important factors that affect a patient&rsquo;s decision to use a generic medicine or a brand medicine. Conclusion: The results from this literature search show that patients and medicine consumers tend to prefer original brand medicines over generic medicines. Further, in many countries, there is still a considerable proportion of patients and consumers who lack adequate knowledge or have insufficient information about generic medicines. Thus, there is a need for educational interventions and activities to educate patients about generic medicines. It is also evident in the literature that health care professionals (physicians and pharmacists) play a key role in the promotion of generic medicines and in patients&rsquo; acceptance of generic medicines and generic substitution. Hence, health care professionals need to play a more active role by educating patients and recommending generic medicines to their patients. Keywords: patients, generic substitution, perceptions, policy