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This review encompasses all published and many unpublished studies of refusal of antipsychotic medication by psychiatric inpatients. Many of the extant studies in this area have methodologic flaws in the means employed to gather or analyze data; where relevant to the points being considered, these flaws are noted. The review is broken down into five sections: frequency of refusal, characteristics of medication refusers, reasons for refusal, the natural history of medication refusal, and responses to refusal. A final section summarizes the extent of our knowledge today and points to future areas of investigation. 相似文献
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Paul S. Appelbaum 《The American journal of bioethics : AJOB》2013,13(3):48-49
This report offers recommendations to physicians who provide information or services through online sites. The recommendations maintain that physicians responsible for health-related information should ensure that it is accurate, timely, reliable, and scientifically sound. Also, advice to online users with whom physicians do not have preexisting relationships or the use of decision-support programs that generate personalized information directly transmitted to users should be consistent with general and specialty-specific standards. In particular, these standards should address truthfulness, protection of privacy, informed consent, and disclosures including limitations inherent in the technology. Finally, physicians who establish or are involved in health-related online sites must minimize conflicts of interest and commercial biases and, if patient specific information is transmitted, they must provide high-level security protections, as well as privacy and confidentiality safeguards. 相似文献
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Lingling Wang Kristina Krasich Tarik Bel-Bahar Lauren Hughes Stephen R. Mitroff L. Gregory Appelbaum 《Acta psychologica》2015
The ability to quickly detect and respond to visual stimuli in the environment is critical to many human activities. While such perceptual and visual–motor skills are important in a myriad of contexts, considerable variability exists between individuals in these abilities. To better understand the sources of this variability, we assessed perceptual and visual–motor skills in a large sample of 230 healthy individuals via the Nike SPARQ Sensory Station, and compared variability in their behavioral performance to demographic, state, sleep and consumption characteristics. Dimension reduction and regression analyses indicated three underlying factors: Visual–Motor Control, Visual Sensitivity, and Eye Quickness, which accounted for roughly half of the overall population variance in performance on this battery. Inter-individual variability in Visual–Motor Control was correlated with gender and circadian patters such that performance on this factor was better for males and for those who had been awake for a longer period of time before assessment. The current findings indicate that abilities involving coordinated hand movements in response to stimuli are subject to greater individual variability, while visual sensitivity and occulomotor control are largely stable across individuals. 相似文献
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Melissa Salm Kristopher Abbate Paul Appelbaum Ruth Ottman Wendy Chung Karen Marder Cheng-Shiun Leu Roy Alcalay Jill Goldman Alexander Malik Curtis Christopher Leech Katherine Johansen Taber Robert Klitzman 《Journal of genetic counseling》2014,23(2):156-163
This study explores neurologists’ and psychiatrists’ knowledge, attitudes, and practices concerning genetic tests. Psychiatrists (n?=?5,316) and neurologists (n?=?2,167) on the American Medical Association master list who had agreed to receive surveys were sent an email link to a survey about their attitudes and practices regarding genetic testing; 372 psychiatrists and 163 neurologists responded. A higher proportion of neurologists (74 %) than psychiatrists (14 %) who responded to the survey had ordered genetic testing in the past 6 months. Overall, most respondents thought that genetic tests should be performed more frequently, but almost half believed genetic tests could harm patients psychologically and considered legal protections inadequate. Almost half of neurologists (49 %) and over 75 % of psychiatrists did not have a genetics professional to whom to refer patients; those who had ordered genetic tests were more likely than those who did not do so to have access to a genetic counselor. Of respondents, 10 % had received patient requests not to document genetic information and 15 % had received inquiries about direct-to-consumer genetic testing. Neurologists reported themselves to be relatively more experienced and knowledgeable about genetics than psychiatrists. These data, the first to examine several important issues concerning knowledge, attitudes and behaviors of neurologists and psychiatrists regarding genetic tests, have important implications for future practice, research, and education. 相似文献
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