IRIS: A new tool for suicide risk assessment

Na introdução os autores procedem a uma revisão histórica e conceptual dos instrumentos psicométricos que têm como objectivo a avaliação do risco de suicídio em indivíduos que apenas verbalizam ideação suicida. Nas secções seguintes é apresentado todo o processo de desenvolvimento do IRIS (Índice de Risco de Suicídio) - um novo índice com o mesmo objectivo de avaliação mas construído utilizando metodologias que proporcionam avanços qualitativos em relação aos índices existentes, bem como uma melhor adequação a contingências e características da realidade portuguesa. The introduction contains a historical and conceptual review of psychometric tools that aim at assessing the risk of suicide in individuals presenting suicidal ideation. In the following sections the whole process of development of IRIS (“Índice de Risco de Suicídio” – Suicide Risk Index) is presented - a new tool with the same objective but built using methods that provide qualitative advances over existing indexes, while better accounting for the contingencies and characteristics of the Portuguese reality

GP-support by means of AGnES-practice assistants and the use of telecare devices in a sparsely populated region in Northern Germany – proof of concept

<p>Abstract</p> <p>Background</p> <p>In many rural regions in Germany, the proportion of the elderly population increases rapidly. Simultaneously, about one-third of the presently active GPs will retire until 2010. Often it is difficult to find successors for vacant GP-practices. These regions require innovative concepts to avoid the imminent shortage in primary health care.</p> <p>The AGnES-concept comprises the delegation of GP-home visits to qualified AGnES-practice assistants (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention). Main objectives were the assessment of the acceptance of the AGnES-concept by the participating GPs, patients, and AGnES-practice assistants, the kind of delegated tasks, and the feasibility of home telecare in a GP-practice.</p> <p>Methods</p> <p>In this paper, we report first results of the implementation of this concept in regular GP-practices, conducted November 2005 – March 2007 on the Island of Rügen, Mecklenburg-Western Pomerania, Germany. This study was meant as a proof of concept.</p> <p>The GP delegated routine home-visits to qualified practice employees (here: registered nurses). Eligible patients were provided with telecare-devices to monitor disease-related physiological values.</p> <p>All delegated tasks, modules conducted and questionnaire responses were documented. The participating patients were asked for their acceptance based on standardized questionnaires. The GPs and AGnES-practice assistants were asked for their judgement about different project components, the quality of health care provision and the competences of the AGnES-practice assistants.</p> <p>Results</p> <p>550 home visits were conducted. 105 patients, two GPs and three AGnES-practice assistants (all registered nurses) participated in the project. 48 patients used telecare-devices to monitor health parameters. 87.4% of the patients accepted AGnES-care as comparable to common GP-care. In the course of the project, the GPs delegated an increasing number of both monitoring and interventional tasks to the AGnES-practice assistants. The GPs agreed that delegating tasks to a qualified practice assistant relieves them in their daily work.</p> <p>Conclusion</p> <p>A part of the GPs home visits can be delegated to AGnES-practice assistants to support GPs in regions with an imminent or already existing undersupply in primary care. The project triggered discussions among the institutions involved in the German healthcare system and supported a reconciliation of the respective competences of physicians and other medical professions.</p

Contesting language policy for asylum seekers in the Northern periphery: The story of Tailor F

This article is about navigating asylum, employment and language policy in a new country as an asylum seeker. Through the story of one individual, we show that profound inequalities are exacerbated when forced migrants are limited in their choice of language they might study or use. The individual is Tailor F, an Iraqi man seeking asylum, and the country is Finland, officially bilingual, with a majority language (Finnish) and a minority language (Swedish). Finland’s official bilingualism does not extend evenly to language education provided for asylum seekers, who are taught Finnish regardless of the region where they are placed. Upon arrival, Tailor F was housed in a reception centre for asylum seekers located in a Swedish-dominant rural area of the country. Through our linguistic ethnography we examine how he navigates multilingually in his early settlement, his current work and his online life. We relate his story to explicit and implicit official bilingualism in Finland and discuss his lived experiences in relation to the contexts of asylum policy and employment. Tailor F’s story shows how, through his practices, he has contested implicit language policy for asylum seekers in order to gain membership of the local Swedish-dominant community, achieve a sense of belonging, and potentially realise his aspirations for the future

Very rare, exclusive, hadronic decays in QCD factorization

We study exclusive hadronic decays of the electroweak bosons Z, W and h in the framework of QCD factorization. We show that the theory uncertainties in these channels are remarkably small compared to past applications of the QCD factorization framework. While the branching ratios are small, many of the modes are accessible at future colliders. The Higgs decays exhibit interesting dependences on the couplings due to the interferences of different diagram topologies, making the h → Vγ decays possible probes of the quark Yukawa couplings and the h → VZ decays probes of the coupling between the Higgs boson, a photon and a Z-boson

Self-perceived quality of life predicts mortality risk better than a multi-biomarker panel, but the combination of both does best

<p>Abstract</p> <p>Background</p> <p>Associations between measures of subjective health and mortality risk have previously been shown. We assessed the impact and comparative predictive performance of a multi-biomarker panel on this association.</p> <p>Methods</p> <p>Data from 4,261 individuals aged 20-79 years recruited for the population-based Study of Health in Pomerania was used. During an average 9.7 year follow-up, 456 deaths (10.7%) occurred. Subjective health was assessed by SF-12 derived physical (PCS-12) and mental component summaries (MCS-12), and a single-item self-rated health (SRH) question. We implemented Cox proportional-hazards regression models to investigate the association of subjective health with mortality and to assess the impact of a combination of 10 biomarkers on this association. Variable selection procedures were used to identify a parsimonious set of subjective health measures and biomarkers, whose predictive ability was compared using receiver operating characteristic (ROC) curves, C-statistics, and reclassification methods.</p> <p>Results</p> <p>In age- and gender-adjusted Cox models, poor SRH (hazard ratio (HR), 2.07; 95% CI, 1.34-3.20) and low PCS-12 scores (lowest vs. highest quartile: HR, 1.75; 95% CI, 1.31-2.33) were significantly associated with increased risk of all-cause mortality; an association independent of various covariates and biomarkers. Furthermore, selected subjective health measures yielded a significantly higher C-statistic (0.883) compared to the selected biomarker panel (0.872), whereas a combined assessment showed the highest C-statistic (0.887) with a highly significant integrated discrimination improvement of 1.5% (p < 0.01).</p> <p>Conclusion</p> <p>Adding biomarker information did not affect the association of subjective health measures with mortality, but significantly improved risk stratification. Thus, a combined assessment of self-reported subjective health and measured biomarkers may be useful to identify high-risk individuals for intensified monitoring.</p

GILLARDON AG financial software

The analysis of many complex problems and complex dynamic systems shows that there are dependencies between high complexity and the existence of large grids in the underlying structures containing inhomogeneous elements and including an irregular flow of information. This complexity criterion is formulated in a precise way and analysed in different areas of application, particularly for selected problems from economics and finance. We discuss how our criterion can be applied to make complex problems more tractable by exploring structural parameters to control the complexity of problems and systems in complexity engineering. In some areas the criterion is provable in a strong mathematical sense, whereas in others it is confirmed by numerous examples, without finding a counterexample. The areas of application cover: complexity theory, design of efficient algorithms, dynamic systems, chaos theory, neural networks, auctions, capital markets, portfolio credit risk and operational risk management