75 research outputs found
Screening Questionnaires for Problem Drinking in Adolescents: Performance of AUDIT, AUDIT-C, CRAFFT and POSIT
Background/Aims: Only rather few data on the validity of screening questionnaires to detect problem drinking in adolescents exist. The aim of this study was to compare the performance of the Alcohol Use Disorders Identification Test (AUDIT), its short form AUDIT-C, the Substance Module of the Problem Oriented Screening Instrument for Teenagers (POSIT), and CRAFFT (acronym for car, relax, alone, forget, family, and friends). Methods: The questionnaires were filled in by 9th and 10th graders from two comprehensive schools. All students received an interview using the alcohol section of the Composite International Diagnostic Interview. Alcohol abuse and alcohol dependence according to DSM-IV as well as episodic heavy drinking served as criteria to validate the screening instruments. Results: All 9th and 10th graders (n = 225) of both schools participated. No significant differences were found for areas under the receiver operating characteristic curves ranging from 0.810 to 0.872. Cronbachâs alpha was satisfactory (0.77â0.80) but poor for CRAFFT (0.64). Different cut-offs are discussed. Conclusions: Considering validity as well as reliability, AUDIT, AUDIT-C and POSIT performed well; however, the POSIT is quite lengthy. AUDIT-C showed good psychometric properties and has clear advantages because of its brevity
Chemotherapeutic errors in hospitalised cancer patients: attributable damage and extra costs
<p>Abstract</p> <p>Background</p> <p>In spite of increasing efforts to enhance patient safety, medication errors in hospitalised patients are still relatively common, but with potentially severe consequences. This study aimed to assess antineoplastic medication errors in both affected patients and intercepted cases in terms of frequency, severity for patients, and costs.</p> <p>Methods</p> <p>A 1-year prospective study was conducted in order to identify the medication errors that occurred during chemotherapy treatment of cancer patients at a French university hospital. The severity and potential consequences of intercepted errors were independently assessed by two physicians. A cost analysis was performed using a simulation of potential hospital stays, with estimations based on the costs of diagnosis-related groups.</p> <p>Results</p> <p>Among the 6, 607 antineoplastic prescriptions, 341 (5.2%) contained at least one error, corresponding to a total of 449 medication errors. However, most errors (n = 436) were intercepted before medication was administered to the patients. Prescription errors represented 91% of errors, followed by pharmaceutical (8%) and administration errors (1%). According to an independent estimation, 13.4% of avoided errors would have resulted in temporary injury and 2.6% in permanent damage, while 2.6% would have compromised the vital prognosis of the patient, with four to eight deaths thus being avoided. Overall, 13 medication errors reached the patient without causing damage, although two patients required enhanced monitoring. If the intercepted errors had not been discovered, they would have resulted in 216 additional days of hospitalisation and cost an estimated annual total of 92, 907âŹ, comprising 69, 248⏠(74%) in hospital stays and 23, 658⏠(26%) in additional drugs.</p> <p>Conclusion</p> <p>Our findings point to the very small number of chemotherapy errors that actually reach patients, although problems in the chemotherapy ordering process are frequent, with the potential for being dangerous and costly.</p
Feedback by massive stars and the emergence of superbubbles. II. X-ray properties
This article has an erratum M. Krause, et al., âFeedback by massive stars and the emergence of superbubbles. II. X-ray propertiesâ, Astronomy & Astrophysics, Vol. 566, June 2014. This version of record is available online at: https://www.aanda.org/articles/aa/abs/2014/06/aa23871-14/aa23871-14.html Reproduced with Permission from Astronomy and Astrophysics, © ESO 2014.Context. In a previous paper we investigated the energy transfer of massive stars to the interstellar medium (ISM) as a function of time and the geometrical configuration of three massive stars via 3D-mesh-refining hydrodynamics simulations, following the complete evolution of the massive stars and their supernovaewith the exception of non-thermal processes. Aims. To compare our results against observations we derivethermalX-ray properties of the ISM from our simulations and compare them to observations of superbubbles in general, to the well-studied nearby Orion-Eridanus superbubble and to the diffuse soft X-ray emission of nearby galaxies. Methods. We analysed our ISM simulation results with the help of spectra for plasma temperatures between 0.1 and 10 keV and computed the spectral evolution and the spatio-temporal distribution of the hot gas. Results. Despite significant input of high-temperature gas from supernovae and fast stellar winds, the resultingthermalX-ray spectra are generally very soft, with most of the emission well below 1 keV. We show that this is due to mixing triggered by resolved hydrodynamic instabilities. Supernovae enhance the X-ray luminosity of a superbubble by 1â2 orders of magnitude for a time span of about 0.1 Myr; which is longer if a supernova occurs in a larger superbubble and shorter in higher energy bands. Peak superbubble luminosities of the order of 1036 erg s-1 are reproduced well. The strong decay of the X-ray luminosity is due to bubble expansion, hydrodynamic instabilities related to the acceleration of the superbubbleâs shell thanks to the sudden energy input, and subsequent mixing. We also find global oscillations of our simulated superbubbles, which produce spatial variations of the X-ray spectrum, similar to what we see in the Orion-Eridanus cavity. We calculated the fraction of energy emitted in X-rays and find that with a value of a few times 10-4, it is about a factor of ten below the measurements for nearby galaxies. Conclusions. Our models explain the observed soft spectra and peak X-ray luminosities of individual superbubbles. Each supernova event inside a superbubble produces a fairly similar heating-entrainment-cooling sequence, and the energy content of superbubbles is always determined by a specific fraction of the energy released by one supernova. For a given superbubble, soft X-rays trace the internal energy content well with moderate scatter. Some mechanism seems to delay the energy loss in real superbubbles compared to our simulations. Alternatively, some mechanism other thanthermal emission ofsuperbubbles may contribute to the soft X-ray luminosity of star-forming galaxies.Peer reviewe
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Proceedings of the 13th annual conference of INEBRIA
CITATION: Watson, R., et al. 2016. Proceedings of the 13th annual conference of INEBRIA. Addiction Science & Clinical Practice, 11:13, doi:10.1186/s13722-016-0062-9.The original publication is available at https://ascpjournal.biomedcentral.comENGLISH SUMMARY : Meeting abstracts.https://ascpjournal.biomedcentral.com/articles/10.1186/s13722-016-0062-9Publisher's versio
Solving patients with rare diseases through programmatic reanalysis of genome-phenome data.
Funder: EC | EC Seventh Framework Programm | FP7 Health (FP7-HEALTH - Specific Programme "Cooperation": Health); doi: https://doi.org/10.13039/100011272; Grant(s): 305444, 305444Funder: Ministerio de EconomĂa y Competitividad (Ministry of Economy and Competitiveness); doi: https://doi.org/10.13039/501100003329Funder: Generalitat de Catalunya (Government of Catalonia); doi: https://doi.org/10.13039/501100002809Funder: EC | European Regional Development Fund (Europski Fond za Regionalni Razvoj); doi: https://doi.org/10.13039/501100008530Funder: Instituto Nacional de BioinformĂĄtica ELIXIR Implementation Studies Centro de Excelencia Severo OchoaFunder: EC | EC Seventh Framework Programm | FP7 Health (FP7-HEALTH - Specific Programme "Cooperation": Health)Reanalysis of inconclusive exome/genome sequencing data increases the diagnosis yield of patients with rare diseases. However, the cost and efforts required for reanalysis prevent its routine implementation in research and clinical environments. The Solve-RD project aims to reveal the molecular causes underlying undiagnosed rare diseases. One of the goals is to implement innovative approaches to reanalyse the exomes and genomes from thousands of well-studied undiagnosed cases. The raw genomic data is submitted to Solve-RD through the RD-Connect Genome-Phenome Analysis Platform (GPAP) together with standardised phenotypic and pedigree data. We have developed a programmatic workflow to reanalyse genome-phenome data. It uses the RD-Connect GPAP's Application Programming Interface (API) and relies on the big-data technologies upon which the system is built. We have applied the workflow to prioritise rare known pathogenic variants from 4411 undiagnosed cases. The queries returned an average of 1.45 variants per case, which first were evaluated in bulk by a panel of disease experts and afterwards specifically by the submitter of each case. A total of 120 index cases (21.2% of prioritised cases, 2.7% of all exome/genome-negative samples) have already been solved, with others being under investigation. The implementation of solutions as the one described here provide the technical framework to enable periodic case-level data re-evaluation in clinical settings, as recommended by the American College of Medical Genetics
Political strata and the flows of history: Hans Freyerâs conservatism in light of its metaphors
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