Adolescents’ nonmedical use of prescription medications and other problem behaviors

See Editorial p. 539 Purpose: This study examines adolescent nonmedical use of prescription medications (NUPM) and its relationship to other problem behaviors. Methods: A secondary analysis was conducted with data gathered from 912 adolescents in 2007. Four mutually exclusive groups were created from the data. Adolescents who: 1) did not use controlled prescription medications (nonusers); 2) used their own controlled medications as prescribed (medicalusers); 3) engaged in nonmedical use for self-treatment motivations (self-treaters), and 4) engaged in nonmedical use for sensation-seeking motivations (sensation-seekers). These four groups were compared on problem behaviors as well as depression and impulsivity. Results: Approximately 10.9% of the sample engaged in NUPM and 36.8% had a legal prescription for a controlled medication. Sensation-seekers were more likely to engage in most problem behaviors when compared with all other groups; impulsivity and depression was variable among groups. Conclusions: The findings suggest there are different subtypes of nonmedical users of prescription medications.

Original Article Randomized Controlled Trial of Mindfulness-Based Therapy for Dyspnea in Chronic Obstructive Lung Disease

Abstract Objectives: Patients with chronic obstructive lung disease (COPD) suffer from significant dyspnea and may benefit from complementary and alternative medicine (CAM) therapies aimed at mitigating symptoms. The objective of this study was to test the efficacy of a mindfulness-based breathing therapy (MBBT) on improving symptoms and health-related quality of life in those with COPD. Design: We conducted a randomized controlled trial of 8-week mindfulness-based breathing therapy (MBBT) compared to support groups to test efficacy on improving symptoms and health-related quality of life in those with COPD. Setting: The setting for this study was an academic-affiliated veterans healthcare system. Subjects: The subjects consisted of 86 patients with COPD. Interventions: MBBT included weekly meetings practicing mindfulness mediation and relaxation response. Outcome measures: The main outcome measure was a post 6-minute-walk test (6MWT) Borg dyspnea assessment. Other outcome measures included health-related quality of life measures, 6MWT distance, symptom scores, exacerbation rates, and measures of stress and mindfulness. Analysis of covariance compared differences in outcomes between groups; paired t test evaluated changes within groups. Results: Participants were predominantly elderly men with moderate to severe COPD. We found no improvements in dyspnea (post 6MWT Borg difference between the MBBT and support group was 0.3 (95% confidence interval [CI]: À

(Sub)mm Interferometry Applications in Star Formation Research

This contribution gives an overview about various applications of (sub)mm interferometry in star formation research. The topics covered are molecular outflows, accretion disks, fragmentation and chemical properties of low- and high-mass star-forming regions. A short outlook on the capabilities of ALMA is given as well.Comment: 20 pages, 7 figures, in proceedings to "2nd European School on Jets from Young Star: High Angular Resolution Observations". A high-resolution version of the paper can be found at http://www.mpia.de/homes/beuther/papers.htm

Total Intravenous Anesthesia Including Ketamine versus Volatile Gas Anesthesia for Combat-related Operative Traumatic Brain Injury

Background: Traumatic brain injury is a leading cause of death and severe neurologic disability. The effect of anesthesia techniques on neurologic outcomes in traumatic brain injury and potential benefits of total intravenous anesthesia (TIVA) compared with volatile gas anesthesia (VGA), although proposed, has not been well evaluated. The purpose of this study was to compare TIVA versus VGA in patients with combatrelated traumatic brain injury. Methods: The authors retrospectively reviewed 252 patients who had traumatic brain injury and underwent operative neurosurgical intervention. Statistical analyses, including propensity score and matched analyses, were performed to assess differences between treatment groups (TIVA vs. VGA) and good neurologic outcome. Results: Two hundred fourteen patients met inclusion criteria and were analyzed; 120 received VGA and 94 received TIVA. Good neurologic outcome (Glasgow Outcome Score 4 -5) and decreased mortality were associated with TIVA compared with VGA (75% vs. 54%; P ‫؍‬ 0.002 and 5% vs. 16%; P ‫؍‬ 0.02, respectively). Multivariate logistic regression found admission Glasgow Coma Scale score of 8 or greater (odds ratio, 13.3; P < 0.001) and TIVA use (odds ratio, 2.3; P ‫؍‬ 0.05) to be associated with good neurologic outcomes. After controlling for confounding factors using propensity analysis and repeated one-to-one matching of patients receiving TIVA with those receiving VGA with regard to Injury Severity Score, Glasgow Coma Scale score, base deficit, Head Abbreviated Injury Score, and craniectomy or craniotomy, the authors could not find an association between treatment and neurologic outcome. Conclusion: Total intravenous anesthesia often including ketamine was not associated with improved neurologic outcom

Hyperbolic contraction measuring systems for extensional flow

In this paper an experimental method for extensional measurements on medium viscosity fluids in contraction flow is evaluated through numerical simulations and experimental measurements. This measuring technique measures the pressure drop over a hyperbolic contraction, caused by fluid extension and fluid shear, where the extensional component is assumed to dominate. The present evaluative work advances our previous studies on this experimental method by introducing several contraction ratios and addressing different constitutive models of varying shear and extensional response. The constitutive models included are those of the constant viscosity Oldroyd-B and FENE-CR models, and the shear-thinning LPTT model. Examining the results, the impact of shear and first normal stress difference on the measured pressure drop are studied through numerical pressure drop predictions. In addition, stream function patterns are investigated to detect vortex development and influence of contraction ratio. The numerical predictions are further related to experimental measurements for the flow through a 15:1 contraction ratio with three different test fluids. The measured pressure drops are observed to exhibit the same trends as predicted in the numerical simulations, offering close correlation and tight predictive windows for experimental data capture. This result has demonstrated that the hyperbolic contraction flow is well able to detect such elastic fluid properties and that this is matched by numerical predictions in evaluation of their flow response. The hyperbolical contraction flow technique is commended for its distinct benefits: it is straightforward and simple to perform, the Hencky strain can be set by changing contraction ratio, non-homogeneous fluids can be tested, and one can directly determine the degree of elastic fluid behaviour. Based on matching of viscometric extensional viscosity response for FENE-CR and LPTT models, a decline is predicted in pressure drop for the shear-thinning LPTT model. This would indicate a modest impact of shear in the flow since such a pressure drop decline is relatively small. It is particularly noteworthy that the increase in pressure drop gathered from the experimental measurements is relatively high despite the low Deborah number range explored

Improving the quality of self-monitoring blood glucose measurement: a study in reducing calibration errors. Diabetes Technol Ther.

ABSTRACT Background: Two independent studies reported that 16% of people who self-monitor blood glucose used incorrectly coded meters. The degree of analytical error, however, was not characterized. Our study objectives were to demonstrate that miscoding can cause analytical errors and to characterize the potential amount of bias that can occur. The impact of calibration error with three selfblood glucose monitoring systems (BGMSs), one of which has an autocoding feature, is reported. Methods: Fresh capillary fingerstick blood from 50 subjects, 18 men and 32 women ranging in age from 23 to 82 years, was used to measure glucose with three BGMSs. Two BGMSs required manual coding and were purposely miscoded using numbers different from the one recommended for the reagent lot used. Two properly coded meters of each BGMS were included to assess within-system variability. Different reagent lots were used to challenge a third system that had autocoding capability and could not be miscoded. Results: Some within-system comparisons showed deviations of greater than Ϯ30% when results obtained with miscoded meters were compared with data obtained with ones programmed using the correct code number. Similar erroneous results were found when the miscoded meter results were compared with those obtained with a glucose analyzer. For some miscoded meter and test strip combinations, error grid analysis showed that 90% of results fell into zones indicating altered clinical action. Such inaccuracies were not found with the BGMS having the autocoding feature. Conclusions: When certain meter code number settings of two BGMSs were used in conjunction with test strips having code numbers that did not match, statistically and clinically inaccurate results were obtained. Coding errors resulted in analytical errors of greater than Ϯ30% (Ϫ31.6 to ϩ60.9%). These results confirm the value of a BGMS with an automatic coding feature