Mortality post inpatient alcohol detoxification: a descriptive case series

<br>Background: Individuals with alcohol dependence often die prematurely. Scotland in particular has high rates of alcohol misuse compared to the rest of the UK and Europe. Although there is some evidence that rates of alcoholrelated harm and alcohol-related deaths are reducing in Europe, there is little evidence of this trend occurring in Scotland. Inpatient detoxification is an important, but expensive, option in the management of alcohol dependence. Little work has been done with regard possible clinical characteristics associated with mortality post discharge in this cohort of patients.</br> <br>Methods: Retrospective electronic records were used to identify patients admitted electively for alcohol detoxification into a psychiatric ward in a district general hospital under the care of a single consultant addiction psychiatrist between 1/1/05 and 31/12/07 inclusively. Demographic and clinical factors were recorded. 5-year mortality data was obtained by linkage to the National Records of Scotland.</br> <br>Results: 25.2% of patients admitted for elective alcohol detoxification died during the 5-year follow up period. 42.9% of deaths (n=12) were due to alcoholic liver disease, one death (3.6%) was of undetermined intent. A higher proportion of the deceased cohort was likely to have continued disulfiram (93% vs. 80%) and acamprosate (81% vs. 60%) than those surviving. There was no statistically significant difference in survival between individuals on medication and those not on medications in our cohort. The average consumption of units of alcohol per week in the deceased cohort was significantly higher than that calculated for the surviving cohort (298.8 units vs. 233.3 units p=0.0137).</br> <br>Conclusion: Inpatient detoxification was associated with significant mortality at 5-year follow up post- discharge. The majority of deaths were due to liver disease while deaths due to accidents and of undetermined intent were relatively infrequent. Increased education and practical strategies such as “space and pace” aimed both at an individual and societal level to reduce alcohol consumption may help to reduce mortality associated with alcohol dependence post inpatient detoxification.</br&gt

Applying Models to National Surveys of Undergraduate Science Students: What Affects Ratings of Satisfaction?

Many countries use national-level surveys to capture student opinions about their university experiences. It is necessary to interpret survey results in an appropriate context to inform decision-making at many levels. To provide context to national survey outcomes, we describe patterns in the ratings of science and engineering subjects from the UK’s National Student Survey (NSS). New, robust statistical models describe relationships between the Overall Satisfaction’ rating and the preceding 21 core survey questions. Subjects exhibited consistent differences and ratings of “Teaching”, “Organisation” and “Support” were thematic predictors of “Overall Satisfaction” and the best single predictor was “The course was well designed and running smoothly”. General levels of satisfaction with feedback were low, but questions about feedback were ultimately the weakest predictors of “Overall Satisfaction”. The UK’s universities affiliated groupings revealed that more traditional “1994” and “Russell” groups over-performed in a model using the core 21 survey questions to predict “Overall Satisfaction”, in contrast to the under-performing newer universities in the Million+ and Alliance groups. Findings contribute to the debate about “level playing fields” for the interpretation of survey outcomes worldwide in terms of differences between subjects, institutional types and the questionnaire items

Variability in stream discharge and temperature: a preliminary assessment of the implications for juvenile and spawning Atlantic salmon

This study focuses on understanding the temporal variability in hydrological and thermal conditions in a small mountain stream and its potential implication for two life stages of Atlantic salmon (<I>Salmo salar</I>) &ndash; stream resident juveniles and returning adult spawners. Stream discharge and temperature in the Girnock Burn, NE Scotland, were characterised over ten hydrological years (1994/1995&ndash;2003/2004). Attention was focussed on assessing variations during particular ecologically 'sensitive' time periods when selected life-stages of salmon behaviour may be especially influenced by hydrological and thermal conditions. <P style='line-height: 20px;'> Empirical discharge data were used to derive hydraulic parameters to predict the Critical Displacement Velocity (CDV) of juvenile salmon. This is the velocity above which fish may no longer be able to hold station in the water column and thus can be used as an index of time periods where feeding behaviour might be constrained. In the Girnock Burn, strong inter- and intra-annual variability in hydrological and thermal conditions may have important implications for feeding opportunities for juvenile fish; both during important growth periods in late winter and early spring, and the emergence of fry in the late spring. Time periods when foraging behaviour of juvenile salmon may be constrained by hydraulic conditions were assessed as the percentage time when CDV for 0+ and 1+ fish were exceeded by mean daily stream velocities. Clear seasonal patterns of CDV were apparent, with higher summer values driven by higher stream temperatures and fish length. Inter-annual variability in the time when mean stream velocity exceeded CDV for 0+ fish ranged between 29.3% (1997/1998) and 44.7% (2000/2001). For 1+ fish mean stream velocity exceeded CDV between 14.5% (1997/1998) and 30.7% (2000/2001) of the time. <P style='line-height: 20px;'> The movement of adult spawners into the Girnock Burn in preparation for autumn spawning (late October to mid-November) exhibited a complex relationship with hydrological variability with marked inter-annual contrasts. In years when discharge in the period prior to spawning was low, fish movement was increasingly triggered by suboptimal flow increases as spawning time approached. In contrast, wet years with numerous events allowed a much more even distribution of fish entry. Elucidating links between discharge/temperature variability and foraging opportunities and upriver migration of adult Atlantic salmon have the potential to contribute to the improvement of conservation strategies in both regulated and unregulated rivers

Case Study: Extreme Weight Making Causes Relative Energy Deficiency, Dehydration and Acute Kidney Injury in a Male Mixed Martial Arts Athlete.

The aim of the present case study was to quantify the physiological and metabolic impact of extreme weight cutting by an elite male MMA athlete. Throughout an 8-week period, we obtained regular assessments of body composition, resting metabolic rate (RMR), VO2peak and blood clinical chemistry to assess endocrine status, lipid profiles, hydration and kidney function. The athlete adhered to a "phased" weight loss plan consisting of 7 weeks of reduced energy (ranging from 1300 - 1900 kcal.d-1) intake (phase 1), 5 days of water loading with 8 L per day for 4 days followed by 250 ml on day 5 (phase 2), 20 h fasting and dehydration (phase 3) and 32 h of rehydration and refuelling prior to competition (phase 4). Body mass declined by 18.1 % (80.2 to 65.7 kg) corresponding to changes of 4.4, 2.8 and 7.3 kg in phase 1, 2 and 3, respectively. We observed clear indices of relative energy deficiency, as evidenced by reduced RMR (-331 kcal), inability to complete performance tests, alterations to endocrine hormones (testosterone: 6 mmol.L-1). Moreover, severe dehydration (reducing body mass by 9.3%) in the final 24 hours prior to weigh-in induced hypernatremia (plasma sodium: 148 mmol.L-1) and acute kidney injury (serum creatinine: 177 μmol.L-1). These data therefore support publicised reports of the harmful (and potentially fatal) effects of extreme weight cutting in MMA athletes and represent a call for action to governing bodies to safeguard the welfare of MMA athletes

Diseño de un instrumento de caracterización de rasgos de personalidad en agresores sexuales

Especial InterésEl objetivo del instrumento es brindar una medida de los rasgos de personalidad predominantes en los agresores sexuales. Gracias a la revisión teórica y empírica, se identificó que se encuentran similitudes en sus rasgos de personalidad, a partir de los cuales se proponen 4 rasgos principales: Narcisista, Obsesivo Compulsivo, Antisocial y Límite de la personalidad. El cuestionario está compuesto por 35 ítems, de tipo dicotómico, que definen los 4 rasgos mencionados, dirigido a población penitenciaria condenada por delito de Agresión Sexual.RESUMEN 1. JUSTIFICACIÓN 2. MARCO LEGAL 3. MARCO ÉTICO 4. OBJETIVOS 5. PRODUCTO VISIBLE 6. ESTUDIO DE MERCADEO 7. El PRODUCTO RESULTADOS DISCUSIÓNPregradoPsicólog