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In this study, we made an attempt to identify the physician-related factors that determine the choice of drugs in Serbian psychiatric practice.
The study was conducted at two major teaching psychiatric hospitals in Serbia. The structured questionnaire was used, and 41 psychiatrists were interwieved.
Physicians cited approximately four (of eight offered) categories of factors that determine the choice of drugs. Most often, these categories were: safety (adverse effects) (78%), proven efficacy of the drug (73%), recommendations of the relevant guidelines (65%), and reimbursement of the treatment costs by the mandatory health insurance (46%). About 65% of psychiatrists stated that they adhere to the national, or (where there are not national), relevant international therapeutic guidelines. When asked to cite which international or foreign guidelines in particular they used, approximately 50% failed to do so. The other half cited mostly the American Psychiatric Association (APA) Guidelines or National Institute for Health Care and Clinical Excellence (NICE) Guidelines.
The majority of the Serbian psychiatrists rely on the efficacy and safety of the drugs as major determining factors in the choice of therapy. However, substantial percentage of psychiatrists obtain indicators on drugs’ efficacy and safety from their personal professional experience. It is doubtful whether these indicators are valid, or just represent unproven prescribers’ habits. The majority of psychiatrists are willing to accept the relevant guidelines, and the effort should be made on the national level to further develop those guidelines and implement them into everyday practice.
Torture is considered as physical or mental harassment, torment, causing pain, injuries and humiliation of an innocent person occurring during the shorter or longer period of time.
Is human emotional behavior based on primary biological mechanism that human inherited not only from close animal predecessors, but also significantly more distant kinds on evolutionary ladder?
Results of researches indicate that aggressiveness is stable pattern of behavior in children and young people. Aggressive behavior of humans decreases over the years, although certain types of personalities preserve stability of aggressive behavior.
Psychological profile of torturer includes diagnostical category of antisocial personality disorder.
Mental consequences resulting from torture are depression, psychosomatic reactions, aggression, state of anxiety. The contribution of victimology is significant, particularly from aspect of “selecting” psychopathological reaction. It is also important whether the torturer is known to be victims or it is a stranger. It is understandable that consequences are much more severe with people who had unfortunate to be tortured by known person.
The most common psychopathological reactions are:
1. Fear lived during the torture.
2. Depressive reaction.
3. Aggression - which may not be demonstrated in adequate manner, may be shifted to other people, which may create interpersonal disputes, before all for the victim and represents one of physical consequences resulting from torture.
Torture prevention is problem of individuals, community and society as whole.
Degradation of authorities in one society leads to moral erosion, and on its part, to torture on all functioning levels.
High rate of prescribing of psychiatric drugs causes medical, social and economic consequences.
This research was performed by collecting and analysing all the papers published on this matter in Serbia.
In former Yugoslavia (of which Serbia was a constitutive republic), during the eighties, a study of benzodiazepines use showed a trend of the increase of their use (17,9 defined daily doses - DDDs in 1983 - 22,3 DDDs in 1988) (Macolic V et al. Benzodiazepines utilization in Yugoslavia 1983–1988. Pharmaca 1990;217–97). Similar trends continued in the nineties. In 1994 diazepam was at the first position on the list of most prescribed drugs (Miljković M. et al. Analysis of Drug Utilization in Serbia During the Years 1996 and 1997. Pharmacoepidemiol Drug Saf 2000;9:59–64.). The analysis of the trend of prescribing of psychiatric drugs in Serbia (2000–2004) shows the increase, with the emphasis on the use of benzodiazepines and antidepressants (Divac N. et al. Trends in consumption of psychiatric drugs in Serbia and Montenegro 2000–2004. Pharmacoepidemiol Drug Saf. 2006;15:835–8.). There are also positive, qualitative changes in the prescribing practice: the increase of the use of SSRI antidepressants and atypical antipsychotics. Specific prescribing habits were noticed: the common practice of polypharmacy in the treatment of psychoses (Divac N. et al. Antipsychotic polypharmacy at the University Psychiatric Hospital in Serbia. Pharmacoepidemiol Drug Saf. 2007;16:1250–1.).
Pharmacoepidemiologic methods have found its place in Serbian science. The methodology used in these studies is mostly up-to-date. Main limitation of these studies is the lack of databases.
The relationship between the use of antibiotics and the presence of antibiotic resistant strains of E. coli, as well as antibiotic residues in poultry litter, mainly due to irregular use of antibiotics is reviewed in the present paper. The aim of this review is to examine the existing problem of poultry waste management and how it can impact agricultural ecology and economy. Actions such as monitoring and reporting incidents of disease outbreaks in the future should provide an outline of how to improve and implement suitable regulations.
Childhood maltreatment (CM) has consistently been linked with adverse outcomes including substance use disorders and adult sexual revictimization. Adult sexual victimization itself has been linked with psychopathology but has predominately been studied in women. The current investigation examines the impact of CM and co-occurring psychopathology on adult sexual victimization in men and women, replicating findings in three distinct samples.
We investigated the association between continuous CM factor scores and adult sexual victimization in the Childhood Trauma Study (CTS) sample (N = 2564). We also examined the unique relationship between childhood sexual abuse (CSA) and adult sexual victimization while adjusting for co-occurring substance dependence and psychopathology. We replicated these analyses in two additional samples: the Comorbidity and Trauma Study (CATS; N = 1981) and the Australian Twin-Family Study of Alcohol Use Disorders (OZ-ALC; N = 1537).
Analyses revealed a significant association with CM factor scores and adult sexual victimization for both men and women across all three samples. The CSA factor score was strongly associated with adult sexual victimization after adjusting for substance dependence and psychopathology; higher odds ratios were observed in men (than women) consistently across the three samples.
A continuous measure of CSA is independently associated with adult sexual trauma risk across samples in models that included commonly associated substance dependence and psychopathology as covariates. The strength of the association between this CSA measure and adult sexual victimization is higher in magnitude for men than women, pointing to the need for further investigation of sexual victimization in male community samples.
Nonlinear eigenvalue problems for fluxons in long Josephson junctions with exponentially varying width are treated. Appropriate algorithms are created and realized numerically. The results obtained concern the stability of the fluxons, the centering both magnetic field and current for the magnetic flux quanta in the Josephson junction as well as the ascertaining of the impact of the geometric and physical parameters on these quantities. Each static solution of the nonlinear boundary-value problem is identified as stable or unstable in dependence on the eigenvalues of associated Sturm-Liouville problem. The above compound problem is linearized and solved by using of the reliable Continuous analogue of Newton method.
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