ABSTRACT
The success of global outreach surgical programs depends on many factors including the preparation of the surgeons involved in the program. Surgeons in preparing for global outreach programs often focus on surgical procedures or techniques as the most important aspect of the preparation for the program. Just as important to success of the outreach program is the surgeon's familiarity with the language, cultural, and social norms of the host country or region. This article provides valuable information on these issues from three oral and maxillofacial surgeons who have been engaged in global oral and maxillofacial surgery outreach programs for decades.
Subject(s)
Oral and Maxillofacial Surgeons , Surgery, Oral , HumansABSTRACT
Psychopharmacology is a challenge for health care providers treating adolescents. A detailed and accurate assessment, including developmental issues relevant to adolescence in general and to the individual adolescent, guides clinicians in formulating thoughtful and effective treatment plans to meet the needs of each patient. Parents play an important role in providing family history regarding psychiatric diagnoses and the response to various drugs, in making decisions to initiate medication and to change a medication regimen, and in monitoring an adolescent's adherence to a prescribed regimen. The role of parents is especially important for younger patients. Following the biopsychosocial model, rarely should psychopharmacologic agents be used as the sole means to treat a psychiatric condition in adolescents. Pharmacologic agents described in this article are tools that have their effect in the biological domain of central neurotransmitters, but psychosocial interventions addressing the emotional and behavioral issues that are the indications for such medication are generally also required. The development of newer medications holds promise for more effective treatment of target symptoms with minimal side effects.
Subject(s)
Adolescent Medicine/methods , Mental Disorders/drug therapy , Psychopharmacology , Psychotropic Drugs/therapeutic use , Adolescent , Adolescent Psychiatry/methods , Dose-Response Relationship, Drug , Drug Administration Schedule , Female , Humans , Male , Mental Disorders/diagnosis , Mood Disorders/diagnosis , Mood Disorders/drug therapy , Psychotropic Drugs/adverse effects , Risk Assessment , Sensitivity and SpecificityABSTRACT
PURPOSE OF REVIEW: Anxiety disorders constitute a significant problem among children and adolescents, with estimated prevalence of 6 to 10%. Left untreated, anxiety disorders can have major effect on academic, social, and family function, as well as impact on developmental progress. Effective treatment of childhood anxiety disorders with medications may help reduce morbidity and improve functioning and stress management. RECENT FINDINGS: There are many reviews, but few studies, that examine the effect of psychotropic medication on anxiety disorders in children and adolescents. Most of our understanding comes from extrapolation from literature on adult medication trials. Available data indicate relative effectiveness of serotonin selective reuptake inhibitors in many childhood anxiety disorders, along with minimal side effects and good tolerability. Many other psychotropic medications have been considered and used to manage anxiety, with little data to support in children. SUMMARY: The serotonin selective reuptake inhibitors are considered a first-line pharmacological treatment for anxiety disorders in children and adolescents. Numerous other psychotropic medications may be considered, alone or in combination. Definitive research is lacking; further research studies are sorely needed to help guide clinical decision making. Because there are few studies of pharmacologic treatment of anxiety in children and adolescents, this article will consider the most current literature and provide an overall summary of the topic.
