Characteristics of medication overdose presentations to the ED: how do they differ from illicit drug overdose and self-harm cases?

Background Medication overdose accounts for >80% of hospital presentations for self-harm. Previous research has identified typical characteristics of medication overdose cases; however, these cases have not been well differentiated from other similar presentations, namely (1) illicit drug overdose and (2) self-harm by means other than overdose. Method A 12-month audit of medication overdose cases (both intentional and unintentional) attending the emergency department (ED) of a major metropolitan public hospital in Melbourne, Australia was conducted. Comparison was made with patients attending for illicit drug overdose or for self-harm by means other than overdose.Results Medication overdose cases (n=453) showed a broadly comparable profile with those found in earlier studies (predominantly female gender, aged in their 30s and referred for psychosocial assessment). A similar though not identical profile was noted for self-harm cases (n=545). In contrast, patients attending for illicit drug overdose (n=409) could be characterised as male, in their 20s and not referred for psychosocial assessment. Illicit drug overdose cases were more likely than either the medication overdose or self-harm cases to be triaged in the most urgent category (19.3, 3.8 and 3.9% respectively), suggesting a high level of acuity in this group. However, the illicit drug overdose group on average spent less time in the ED than medication overdose patients, and were less likely to require hospital admission. Conclusion On both demographic and treatment variables, patients attending the ED following a medication overdose more closely resemble those attending for self-harm by means other than overdose than those attending for illicit drug overdose

Discrimination of different volcanic rock units by magnetic properties — geothermal field at Reykjanes peninsula (SW-Iceland)

The geothermal field at Reykjanes peninsula is located at the boundary where the submarine Reykjanes Ridge passes over into the rift zone of southwestern Iceland. The geothermal field coincides with a magnetic low in the aeromagnetic anomaly map and is situated within a dense NE–SW fissure and fault zone. Surface geology is characterized by different historic fissure eruptions (youngest from 1226AD), shield lava (12.5–14.5 ka) and intercalated pillow basalt–hyaloclastite ridges probably formed during the last glacial episode (14.5–20 ka). During a field magnetic study in the vicinity of the geothermal field in summer 2005 different volcanic rock units have been sampled to correlate rock magnetic and magneto-mineralogical properties with magnetic field intensity. Additionally, measurements on a dense dolerite intrusion, recovered from the RN–19 borehole (2245–2248m depth) in May 2005 within the frame of IDDP, should shed light on the influence of crustal rocks on the total magnetic field intensity. Generally, the natural remanent magnetization and magnetic susceptibility, measured on rock specimen, is high, ranging between 2.5 and 33.6Am−1 and 2–37 ×10−3 SI, respectively...conferenc

CEP-stable Tunable THz-Emission Originating from Laser-Waveform-Controlled Sub-Cycle Plasma-Electron Bursts

We study THz-emission from a plasma driven by an incommensurate-frequency two-colour laser field. A semi-classical transient electron current model is derived from a fully quantum-mechanical description of the emission process in terms of sub-cycle field-ionization followed by continuum-continuum electron transitions. For the experiment, a CEP-locked laser and a near-degenerate optical parametric amplifier are used to produce two-colour pulses that consist of the fundamental and its near-half frequency. By choosing two incommensurate frequencies, the frequency of the CEP-stable THz-emission can be continuously tuned into the mid-IR range. This measured frequency dependence of the THz-emission is found to be consistent with the semi-classical transient electron current model, similar to the Brunel mechanism of harmonic generation

Initiation to heroin injecting among heroin users in Sydney, Australia: cross sectional survey

BACKGROUND: Heroin injection is associated with health and social problems including hepatitis C virus (HCV) transmission. Few studies have examined the circumstances surrounding initiation to heroin injecting, especially current users initiating others. The current study aimed to examine the age of first heroin use and injection; administration route of first heroin use; relationship to initiator; the initiation of others among a group of heroin users; and to examine these factors in relation to HCV status and risk. METHOD: Heroin users in Sydney were recruited through needle and syringe programs, a methadone clinic and snowballing. Participants were interviewed about their own initiation to heroin use, blood-borne virus risk and knowledge, and whether they had initiated others to heroin injecting. Information on HCV status was collected via self-report. Data was analysed using univariate and multivariate statistical techniques for Normally distributed continuous and categorical data. RESULTS: The study recruited 399 heroin users, with a mean age of 31 years, 63% were male, 77% reported heroin as their primary drug and 59% were HCV positive (self-report). Mean age at first heroin use and injection was 19 and 21 years, respectively. The majority of heroin users commenced heroin use via injecting (65%), younger users (<25 years, 25–30 years) were less likely than older users (>30 years) to commence heroin use parenterally. Participants were initiated to injection mainly by friends (63%). Thirty-seven percent reported initiating others to heroin injection, but few factors were related to this behaviour. Those with longer heroin using careers were more likely to report initiating others to heroin injection, but were no more likely to have done so in the preceding 12 months. Participants who had initiated others were more likely to have shared injecting equipment (12 vs 23%), but were no more likely to be HCV positive (self-report) than those who did not. CONCLUSION: Interventions to prevent heroin users initiating others to injecting are necessary. Peer groups may be well positioned to implement such interventions

A field study of proteinuria in individuals infected with Schistosoma mansoni

Proteinúria foi detectada em 24,7% de 89 pacientes com a forma hepatoesplênica da esquistos- somose e em apenas 4,6% de 86 pacientes com a forma hepatointestinal dessa parasitose. Todos os pacientes viviam em condições epidemiológicas semelhantes em duas áreas endêmicas da Bahia, Brasil. Dos nove indivíduos que tinham proteinúria acima de 30mg/100ml, oito tinham a forma hepatoesplênica da doença. Estes achados podem estar relacionados à presença de uma glomerulopatia esquistossomótica e mostra o significado desta condição no campo, em áreas endêmicas de esquistos- somose.Proteinuria was detected in 24.7% of 89 individuals with hepatosplenic schistosomiasis and in only 4.6% of 86 subjects with mild hepato-intestinal schistosomiasis, all of them living in comparable conditions in two endemic areas in Bahia, Brazil. From nine individuals who hadproteinuria over30 mg/100ml, eight had hepatosplenic schistosomiasis. These findings maybe related to the presence of schistosomal nephropathy and reveal the significance of this condition in thefield in endemic areas of schistosomiasis

Results for the response function determination of the Compact Neutron Spectrometer

The Compact Neutron Spectrometer (CNS) is a Joint European Torus (JET) Enhancement Project, designed for fusion diagnostics in different plasma scenarios. The CNS is based on a liquid scintillator (BC501A) which allows good discrimination between neutron and gamma radiation. Neutron spectrometry with a BC501A spectrometer requires the use of a reliable, fully characterized detector. The determination of the response matrix was carried out at the Ion Accelerator Facility (PIAF) of the Physikalisch-Technische Bundesanstalt (PTB). This facility provides several monoenergetic beams (2.5, 8, 10, 12 and 14 MeV) and a 'white field'(Emax ~17 MeV), which allows for a full characterization of the spectrometer in the region of interest (from ~1.5 MeV to ~17 MeV. The energy of the incoming neutrons was determined by the time of flight method (TOF), with time resolution in the order of 1 ns. To check the response matrix, the measured pulse height spectra were unfolded with the code MAXED and the resulting energy distributions were compared with those obtained from TOF. The CNS project required modification of the PTB BC501A spectrometer design, to replace an analog data acquisition system (NIM modules) with a digital system developed by the 'Ente per le Nuove tecnologie, l'Energia e l'Ambiente' (ENEA). Results for the new digital system were evaluated using new software developed specifically for this project.Comment: Proceedings of FNDA 201

Working together: Expanding the availability of naloxone for peer administration to prevent opioid overdose deaths in the Australian Capital Territory and beyond

Issue. Since the mid-1990s, there have been calls to make naloxone, a prescription-only medicine in many countries, available to heroin and other opioid users and their peers and family members to prevent overdose deaths. Context. In Australia there were calls for a trial of peer naloxone in 2000, yet at the end of that year, heroin availability and harm rapidly declined, and a trial did not proceed. In other countries, a number of peer naloxone programs have been successfully implemented. Although a controlled trial had not been conducted, evidence of program implementation demonstrated that trained injecting drug-using peers and others could successfully administer naloxone to reverse heroin overdose, with few, if any, adverse effects. Approach.In 2009 Australian drug researchers advocated the broader availability of naloxone for peer administration in cases of opioid overdose. Industrious local advocacy and program development work by a number of stakeholders, notably by the Canberra Alliance for Harm Minimisation and Advocacy, a drug user organisation, contributed to the rollout of Australia’s first prescription naloxone program in the Australian Capital Territory (ACT). Over the subsequent 18 months, prescription naloxone programs were commenced in four other Australian states. Implications. The development of Australia’s first take-home naloxone program in the ACT has been an ‘ice-breaker’ for development of other Australian programs. Issues to be addressed to facilitate future scale-up of naloxone programs concern scheduling and cost, legal protections for lay administration,prescribing as a barrier to scale-up; intranasal administration, administration by service providers and collaboration between stakeholders

Patterns in reduction or cessation of drinking in Australia (2001-2013) and motivation for change

Aims: This paper examines: 1) change over time (2001-2013) in recently reducing or ceasing drinking in the Australian population, and 2) the reasons given for reducing or ceasing drinking in the most recent survey (2013); stratified by sex and age group. Methods: Data are from five waves of the National Drug Strategy Household Survey (N=119,397). Logistic regression models with interaction terms were used to identify a shift in sex or age over time in predicting reduction or cessation of drinking, and to predict motivations for reducing or ceasing drinking by sex and age. Results: Reports of recently reducing the quantity or frequency of drinking increased from 2001 to 2007, and remained stable between 2007 and 2013. There was a steady increase in the number of Australians reporting recently ceasing drinking from 2001 to 2013, with a significant effect for age (younger groups more likely than older groups to cease drinking in the past two waves). Reasons for reducing or ceasing drinking varied by age, with older people more likely to report health reasons, and younger people more likely to report lifestyle reasons or enjoyment. Conclusion: Increases over time in reports of reduction or cessation of drinking due to health, lifestyle, social and enjoyment reasons, suggests that the social position of alcohol in Australia may be shifting, particularly among young people