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Term Risks (term + risk)
Selected AbstractsAddiction-Related Assessment Tools and Pain Management: Instruments for Screening, Treatment Planning, and Monitoring CompliancePAIN MEDICINE, Issue 2008Steven D. Passik PhD ABSTRACT Objective., To review and critique the various assessment tools currently available to pain clinicians for assessing opioid use and abuse in patients with chronic noncancer pain to allow pain clinicians to make informed selections for their practices. Methods., A literature search on PubMed was conducted in June 2006 using the search terms opioid plus screening or assessment with or without the additional term risk, and opioid-related disorders/prevention and control in order to identify clinical studies published in English over the previous 10 years. Additional studies were identified using the PubMed link feature and Google. When abstracts described or referred to a tool for opioid abuse screening, the corresponding publication was acquired and reviewed for relevance to the pain treatment setting. Results., Forty-three publications were selected for review from the abstracts identified, and 19 were rejected because they did not describe a specific tool or provide adequate information regarding the screening tool used. The remaining 24 publications described relevant screening tools for opioid abuse risk and were reviewed. Conclusions., A variety of self-administered and physician-administered tools differing in their psychometrics and intended uses have been developed, but not all have been validated for use in chronic pain patients seen in a clinical practice setting. Some tools assess abuse potential in patients being considered for opioid therapy, whereas other tools screen for the presence of substance abuse. By recognizing the psychometrics of each tool, clinicians can select the ones most appropriate for their patient population and screening needs. [source] Should we beware of the Precautionary Principle?ECONOMIC POLICY, Issue 33 2001Christian Gollier How should society deal with risks when there is scientific uncertainty about the size of these risks? There has been much recent discussion of the Precautionary Principle, which states that lack of full scientific knowledge should not be used as a reason to postpone cost,effective preventive measures. We show in this paper that the Precautionary Principle contradicts one important intuition about the right way to act in the face of risk, namely the principle of ,looking before you leap'. When we expect to learn more about the future, the effectiveness of our preventive measures will be greater if we learn before we act. However, a number of other ways of taking uncertainty into account are consistent with a reasonable interpretation of the Precautionary Principle. First, postponing preventive measures may increase our vulnerability to damage, which induces a precautionary motive for risk,prevention, similar to the precautionary savings motive. Secondly, stronger preventive actions often yield more flexibility for the future, so that acting early has an option value. Thirdly, when better information comes from a process of learning,by,doing, the risk associated with early events is amplified by the information they yield about the future. This plays a role analogous to that of an increase in risk aversion, making us more cautious. Fourthly, because imperfect knowledge of the risk makes it difficult to insure, the social cost of risk should include a risk premium. Finally, uncertainty about the economic environment enjoyed by future generations should be taken into account. This raises the benefit of acting early to prevent long,term risks. If the Precautionary Principle sometimes gives good and sometimes gives bad advice, there is no escape from the need to undertake a careful cost,benefit analysis. We show that standard cost,benefit analysis can be refined to take account of scientific uncertainty, in ways that balance the Precautionary Principle against the benefits of waiting to learn before we act. Furthermore, it is important that they be used to do so, for instinct is an unreliable guide in such circumstances. Abandoning cost,benefit analysis in favour of simple maxims can result in some seriously misleading conclusions. [source] When Changing from Merit Pay to Variable/Bonus Pay: What Do Employees Want?PERFORMANCE IMPROVEMENT QUARTERLY, Issue 4 2004Jeremy B. Fox ABSTRACT This study examines potential responses to a change in an employee reward system from permanent merit pay increases to one-time bonus payments. Removing long term risks associated with escalating pay is an increasingly common compensation strategy. Often overlooked, however, are employee perceptions of reward fairness under such conditions of change. Receiving lump sum payments in lieu of permanent merit pay increase may de-motivate employees. There has been little or no research conducted on this topic. In this study, using samples of practicing HR managers and university students, an equity questionnaire gathered data on the perceived equivalence between a permanent merit pay increase and what might be demanded by employees as a single payment in its replacement. An analysis of the data collected indicate an approximate 1:2 ratio is needed, such that a proposed lump-sum payment of $2400 would be perceived as a fair replacement for a permanent merit pay allocation of $1200 per year. Our research indicates that this 1:2 ratio holds for both high and low job satisfaction levels. [source] Congenital adrenal hyperplasia in adults: a review of medical, surgical and psychological issuesCLINICAL ENDOCRINOLOGY, Issue 1 2006Cara Megan Ogilvie Summary Our knowledge of the experience of adults with congenital adrenal hyperplasia (CAH) as they pass through life is only now emerging. In this review we gather medical, surgical and psychological literature pertaining to adults with CAH and consider this alongside practical experience gained from a dedicated adult CAH clinic. There is increasing awareness for the need for multidisciplinary teams who have knowledge of CAH particularly with respect to gynaecological surgery and clinical psychology for women and testicular function in men. Routine management of CAH comprises adjustment of glucocorticoid and mineralocorticoid treatment according to individual needs balancing biochemical markers, compliance and long term risks. Bone density is one such long term concern and is not greatly reduced in most individuals with CAH. More recently, attention has turned to cardiovascular risk factors and catecholamine deficiency in adults with CAH. Women with CAH require access to an experienced gynaecologist, specialised pregnancy care and psychosexual support. The very low fertility rates for women with CAH previously reported appear to be improving with time. Men with CAH are often lost to follow up and therefore miss out on surveillance for hypogonadism either through the effect of adrenal rests of from suppression of gonadotrophins resulting in a high prevalence of oligospermia. [source] | |||||||||||||