Pattern of healthcare resource utilization and direct costs associated with manic episodes in Spain

<p>Abstract</p> <p>Background</p> <p>Although some studies indicate that bipolar disorder causes high health care resources consumption, no study is available addressing a cost estimation of bipolar disorder in Spain. The aim of this observational study was to evaluate healthcare resource utilization and the associated direct cost in patients with manic episodes in the Spanish setting.</p> <p>Methods</p> <p>Retrospective descriptive study was carried out in a consecutive sample of patients with a DSM-IV diagnosis of bipolar type I disorder with or without psychotic symptoms, aged 18 years or older, and who were having an active manic episode at the time of inclusion. Information regarding the current manic episode was collected retrospectively from the medical record and patient interview.</p> <p>Results</p> <p>Seven hundred and eighty-four evaluable patients, recruited by 182 psychiatrists, were included in the study. The direct cost associated with healthcare resource utilization during the manic episode was high, with a mean cost of nearly €4,500 per patient, of which approximately 55% corresponded to the cost of hospitalization, 30% to the cost of psychopharmacological treatment and 10% to the cost of specialized care.</p> <p>Conclusions</p> <p>Our results show the high cost of management of the patient with a manic episode, which is mainly due to hospitalizations. In this regard, any intervention on the management of the manic patient that could reduce the need for hospitalization would have a significant impact on the costs of the disease.</p

Thinking Outside the Polygon: A Study of Tornado Warning Perception Outside of Warning Polygon Bounds

When the National Weather Service (NWS) issues a tornado warning, the alert is rapidly and widely disseminated to individuals in the general area of the warning. Historically, the assumption has been that a false-negative warning perception (i.e., when someone located within a warning polygon does not believe they have received a tornado warning) carries a higher cost than a false-positive warning perception (i.e., when someone located outside the warning area believes they have received a warning). While many studies investigate tornado warning false alarms (i.e., when the NWS issues a tornado warning, but a tornado does not actually occur), less work focuses on studying individuals outside of the warning polygon bounds who believe they received a warning (i.e., false-positive perceptions). This work attempts to quantify the occurrence of false-positive perceptions and possible factors associated with the rate of occurrence. Following two separate storm events, Oklahomans were asked whether they perceived a tornado warning. Their geolocated responses were then compared to issued warning polygons. Individuals closer to tornado warnings or within a different type of warning (e.g., a severe thunderstorm warning) are more likely to report a false-positive perception than those farther away or outside of other hazard warnings. Further work is needed to understand the rate of false-positive perceptions across different hazards and how this may influence warning response and trust in the National Weather Service

Probing molecular choreography through single-molecule biochemistry

Single-molecule approaches are having a dramatic impact on views of how proteins work. The ability to observe molecular properties at the single-molecule level allows characterization of subpopulations and acquisition of detailed kinetic information that would otherwise be hidden in the averaging over an ensemble of molecules. In this Perspective, we discuss how such approaches have successfully been applied to in vitro-reconstituted systems of increasing complexity