ObjectiveThe study was designed to establish and evaluate the impact of a 6-week Balint group on empathy and resilience in fourth-year medical students during their psychiatry rotation.MethodologyThis prospective study used the Jefferson Scale of Empathy – Student Version and the Brief Resilience Scale before and after 6-week Balint groups. Participating students also completed a qualitative assessment of their experience.ResultsStudents who participated were enthusiastic regarding the value of Balint groups in promoting self-reflection and gaining insight into self- and patient-care dynamics. There was a significant difference in empathy scores pre- and post-Balint intervention. There was no significant difference in resilience scores.ConclusionThe establishment of a 6-week Balint group for fourth-year medical students was successful in increasing empathy. Students reported a positive view of Balint and its beneficial role in this study group.
Aims and MethodWe describe the Balint case discussion group method and how it can be applied to training psychiatrists. In a group that we ran, the performance of members on a clinical task before and after a year in the group was investigated. Written responses to a case vignette were appraised blindly by psychotherapists who were also examiners for the Royal College of Psychiatrists.ResultsThere were eight members in the Balint group, which met weekly for one year. We found that members' performance on the clinical task improved significantly following the year spent in the Balint group.Clinical ImplicationsA Balint group, as part of an introduction to psychotherapy for psychiatrists, may represent a step towards achieving comprehensive training that is relevant to ordinary clinical practice.
PCSK9 inhibitors are monoclonal antibodies to proprotein convertase-subtilisin/kexin type 9 which significantly reduce LDL cholesterol concentration in vivo by inhibiting degradation of the LDL receptor in hepatocytes. The introduction of PCSK9 inhibitors heralded a new era of intensive LDL-C reduction with LDL-C concentrations lowered below levels ever thought possible with conventional treatments such as statins. With their introduction considerations regarding cost, clinical outcomes and long-term safety are paramount. Areas covered: This review examines the pharmacology of PCSK9 inhibitors and summarizes the current evidence base for use in clinical practice from an efficacy, safety, and cardiovascular outcome perspective including recently presented data on alirocumab. It also examines the potential role of these agents into the future. Potential issues with PCSK9 inhibitors are examined and future pharmacologic targets are examined including siRNA and PCSK9 vaccination. Expert commentary: It is clear that the PCSK9 inhibitors are highly effective in the lowering of LDL cholesterol. However, this reduction comes at a large financial cost, and although early outcome data has been positive, the role of PCSK9 inhibition remains confined to limited patient groups at present. As more long-term data is gathered on clinical outcomes and safety, the role for these agents may expand.
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