ABSTRACT
A nosografia dos transtornos do humor e do afeto relaciona-se diretamente com as formas de apreensão dos quadros clínicos em cada contexto histórico. É indagado se o resgate histórico contribuiria para melhor compreensão e utilização da atual nosologia dos transtornos de humor. Objetiva-se realizar uma revisão histórica e crítica acerca de suas transformações conceituais e nosológicas com enfoque ao campo médico-psiquiátrico. O recorte pretendido se inicia com a proposição da "Insanidade Maníaco-Depressiva" por Emil Kraepelin em 1899, que é confrontada com as propostas pós-kraepelianas, em especial as de Karl Leonhard. Analisa-se a influência dessas na criação dos sistemas diagnósticos operacionalizados, DSM e CID. O "Transtorno Bipolar" foi um constructo introduzido pelo DSM-III e se mantém em uso até os dias atuais. Aborda-se também propostas posteriores, como a do "Espectro Bipolar".
Nosography of mood and affective disorders is directly related to how clinical pictures are understood in each historical context. Inquiring on whether a historical recollection would contribute to a better understanding and use of the current nosology of mood disorders, the study carries out a historical and critical review of its conceptual and nosological transformations on the medical-psychiatric field. Starting from Emil Kraepelin's "Manic-Depressive Insanity," proposed in 1899, the text confronts this concept with post-Kraepelian proposals, especially those of Karl Leonhard. It then analyzes their influence in the creation of two operationalized diagnostic systems — DSM and ICD. "Bipolar Disorder," a construct introduced by the DSM-III, remains in use today. Later proposals are also addressed, such as the "Bipolar Spectrum".
La nosographie des troubles de l'humeur et des troubles affectifs est directement liée à la manière dont les tableaux cliniques sont compris dans chaque contexte historique. En se demandant si un rappel historique contribuerait à une meilleure compréhension et utilisation de la nosologie actuelle des troubles de l'humeur, l'étude procède a un examen historique et critique de ses transformations conceptuelles et nosologiques dans le domaine médico-psychiatrique. Partant de la "Folie maniaco-dépressive" d'Emil Kraepelin, proposée en 1899, l'article confronte ce concept aux propositions post-Kraepeliennes, notamment celles de Karl Leonhard. On analyse ensuite leurs influence dans la création de systèmes de diagnostic opérationnalisés — le DSM et la CIM. Le "trouble bipolaire", une construction introduite par le DSM-III, est toujours utilisé aujourd'hui. D'autres propositions sont égalemment abordées, comme le "spectre bipolaire".
La nosografía de los trastornos afectivos está directamente relacionada con las formas en que se aprehenden las condiciones clínicas en cada contexto histórico. Se pregunta si la revisión histórica contribuiría a una mejor comprensión y uso de la nosología actual de los trastornos del humor. El objetivo de este artículo es realizar una revisión histórica y crítica de sus transformaciones conceptuales y nosológicas con un enfoque en el campo médico-psiquiátrico. El recorte comienza con la propuesta en el texto "Locura maníaco-depresiva", de Emil Kraepelin, en 1899, que se enfrenta a propuestas postkraepelianas, especialmente las de Karl Leonhard. Se analiza la influencia de estas propuestas en la creación de sistemas diagnósticos operacionalizados, el Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM) y la Clasificación Internacional de Enfermedades (CID). El "trastorno bipolar" es una construcción introducida por el DSM-3 y sigue en uso hoy. También se abordan propuestas posteriores, como la del "espectro bipolar".
ABSTRACT
In 2013,the Chinese Society of Endocrinology published the'Management ofhyperuricemia and gout:Chinese experts consensus'.In the following five years,a large number of basic researches,clinical studies,and epidemiological results had emerged and need to be popularized in order to improve the understanding and standardizing management of these conditions in general physicians.On the other hand,the methodology of developing clinical guidelines has become more and more scientific,standardized and international.Therefore,based on the 2013 version of the consensus,Chinese Society of Endocrinology decided to develop a guideline for the diagnosis and management of hyperuricemia and gout under standardized methods and procedures of evidence-based clinical practice guidelines.This article will give a review of the status of clinical practice guideline development in China and explain the methods and procedures followed when developing this guideline.We hope this work may provide some useful recommendations for other developers to draft evidence-based clinical practice guidelines.
ABSTRACT
@#The importance of nontechnical skills among healthcare professionals is gaining widespread recognition as criticalelements complementing technical skills that are used to improve patients’ safety. These skills are typically acquiredthrough simulation training which has emerged as an effective way to complement clinical training. Effective simulationrequires structure and effective debriefing methods to enhance its learning outcome. In previous literature, evidence of theeffectiveness of healthcare simulation was available but studies evaluating debriefing method(s) remain sparse. In thispaper, the effectiveness of debriefing methods in eight studies on the acquisition of nontechnical skills among healthcareprofessionals is reviewed. Articles published from 1st January 2016 across three different databases were referred to. Theresults of the review show a statistically significant improvement in the performance of nontechnical and technical skillsacross different professionals through various methods of debriefing. Nontechnical skills such as teamwork, effectivecommunication, decision-making, and situational awareness have improved significantly. In addition, integration ofrealism in simulation learning has begun to emerge as an effective technique of providing a real world experience.However, there was lack of detailed information on the length and type of debriefing conducted in the studies. Thesemethods clearly require further research since the key to successful simulation learning is through debriefing which isthe heart of simulation.
ABSTRACT
Falls are the most prevalent and serious accident older people suffer in their homes and also, they are the main reason for their hospital admission. In a great part of the cases falls expose at risk elderly people’s well-being and quality of life. A critical narrative literature review was undertaken to inform research in the area of falls in older people living in the community. Articles were retrieved from Medline and Scopus data bases from November 2011 to January 2013. Citation searching was also used as a complement by hand searching of relevant journals. Additionally, an alert mechanism was established in Scopus for a period of one year to identify relevant studies or literature. Reviewed studies have provided valuable evidence about falls in older people and potential prevention strategies. However, evidence from relatives, caregivers and significant others is conspicuously absent. Falls in the community and falls prevention happen in social and family contexts that must be empirically studied and reported.
Las caídas son el accidente más serio y prevalente que los mayores sufren en sus domicilios y son la principal razón de ingreso hospitalario. Las caídas ponen en riesgo el bienestar y la calidad de vida de los mayores. Se llevó a cabo una revisión narrativa crítica de la bibliografía a fin de informar estudios de investigación en el área de las caídas de los mayores que viven en la comunidad. Se recuperaron estudios de las bases de datos Medline y Scopus de Noviembre 2012 a Enero 2013. Se usó también búsqueda de citaciones que se complementó con búsqueda manual en revistas relevantes. Se estableció un sistema de alertas en Scopus a lo largo de un año para identificar estudios relevantes o bibliografía. Los estudios revisados han proporcionado una evidencia valiosa sobre las caídas de las personas mayores y las estrategias potenciales de prevención. No obstante, evidencia proveniente de sus familiares, cuidadores y otros significativos esta notablemente ausente. Las caídas en la comunidad y su prevención suceden en contextos familiares y sociales que deben ser empíricamente estudiados y registrados.
ABSTRACT
Objective: Critical appraisal is a process of systematically examining research evidence to assess its validity, results and relevance before using it to form a decision. A basic knowledge in statistic and epidemiology is important among postgraduate students in psychiatry to acquire the skills for appraising clinical research evidence. This is a descriptive study that attempts to look into the level of knowledge among the postgraduate psychiatry students in terms of statistic and epidemiology. Methods: A total of 31 postgraduate students in their second (N= 26) and third year (N=5) Master of Medicine (Psychiatry) and Master of Psychological Medicine from three different universities, namely: Universiti Kebangsaan Malaysia, Universiti Malaya and Universiti Sains Malaysia participated in this research. The participants were asked to answer 7 questions within 30 minutes. The passing mark for this critical review paper is set at 25 out of 50. Results: Overall, only 32.3% passed the mock critical review paper. About 67.7% of the students passed their epidemiology component and only 19.4% passed the statistic component. Conclusion: We found poor performance in basic statistics among psychiatric trainees which highlights the need for further improvement in the subject’s training.