Quality of life depends on the drinking pattern in alcohol-dependent patients.

AIMS: In patients with alcohol dependence, health-related quality of life (QOL) is reduced compared with that of a normal healthy population. The objective of the current analysis was to describe the evolution of health-related QOL in adults with alcohol dependence during a 24-month period after initial assessment for alcohol-related treatment in a routine practice setting, and its relation to drinking pattern which was evaluated across clusters based on the predominant pattern of alcohol use, set against the influence of baseline variables METHODS: The Medical Outcomes Study 36-Item Short-Form Survey (MOS-SF-36) was used to measure QOL at baseline and quarterly for 2 years among participants in CONTROL, a prospective observational study of patients initiating treatment for alcohol dependence. The sample consisted of 160 adults with alcohol dependence (65.6% males) with a mean (SD) age of 45.6 (12.0) years. Alcohol use data were collected using TimeLine Follow-Back. Based on the participant's reported alcohol use, three clusters were identified: 52 (32.5%) mostly abstainers, 64 (40.0%) mostly moderate drinkers and 44 (27.5%) mostly heavy drinkers. Mixed-effect linear regression analysis was used to identify factors that were potentially associated with the mental and physical summary MOS-SF-36 scores at each time point. RESULTS: The mean (SD) MOS-SF-36 mental component summary score (range 0-100, norm 50) was 35.7 (13.6) at baseline [mostly abstainers: 40.4 (14.6); mostly moderate drinkers 35.6 (12.4); mostly heavy drinkers 30.1 (12.1)]. The score improved to 43.1 (13.4) at 3 months [mostly abstainers: 47.4 (12.3); mostly moderate drinkers 44.2 (12.7); mostly heavy drinkers 35.1 (12.9)], to 47.3 (11.4) at 12 months [mostly abstainers: 51.7 (9.7); mostly moderate drinkers 44.8 (11.9); mostly heavy drinkers 44.1 (11.3)], and to 46.6 (11.1) at 24 months [mostly abstainers: 49.2 (11.6); mostly moderate drinkers 45.7 (11.9); mostly heavy drinkers 43.7 (8.8)]. Mixed-effect linear regression multivariate analyses indicated that there was a significant association between a lower 2-year follow-up MOS-SF-36 mental score and being a mostly heavy drinker (-6.97, P < 0.001) or mostly moderate drinker (-3.34 points, P = 0.018) [compared to mostly abstainers], being female (-3.73, P = 0.004), and having a Beck Inventory scale score ≥8 (-6.54, P < 0.001), at baseline. The mean (SD) MOS-SF-36 physical component summary score was 48.8 (10.6) at baseline, remained stable over the follow-up and did not differ across the three clusters. Mixed-effect linear regression univariate analyses found that the average 2-year follow-up MOS-SF-36 physical score was increased (compared with mostly abstainers) in mostly heavy drinkers (+4.44, P = 0.007); no other variables tested influenced the MOS-SF-36 physical score. CONCLUSION: Among individuals with alcohol dependence, a rapid improvement was seen in the mental dimension of QOL following treatment initiation, which was maintained during 24 months. Improvement was associated with the pattern of alcohol use, becoming close to the general population norm in patients classified as mostly abstainers, improving substantially in mostly moderate drinkers and improving only slightly in mostly heavy drinkers. The physical dimension of QOL was generally in the normal range but was not associated with drinking patterns

Nonlinear force-free and potential field models of active-region and global coronal fields during the Whole Heliospheric Interval

Between 2008/3/24 and 2008/4/2, the three active regions NOAA active regions 10987, 10988 and 10989 were observed daily by the Synoptic Optical Long-term Investigations of the Sun (SOLIS) Vector Spectro-Magnetograph (VSM) while they traversed the solar disk. We use these measurements and the nonlinear force-free magnetic field code XTRAPOL to reconstruct the coronal magnetic field for each active region and compare model field lines with images from the Solar Terrestrial RElations Observatory (STEREO) and Hinode X-ray Telescope (XRT) telescopes. Synoptic maps made from continuous, round-the-clock Global Oscillations Network Group (GONG) magnetograms provide information on the global photospheric field and potential-field source-surface models based on these maps describe the global coronal field during the Whole Heliospheric Interval (WHI) and its neighboring rotations. Features of the modeled global field, such as the coronal holes and streamer belt locations, are discussed in comparison with extreme ultra-violet and coronagraph observations from STEREO. The global field is found to be far from a minimum, dipolar state. From the nonlinear models we compute physical quantities for the active regions such as the photospheric magnetic and electric current fluxes, the free magnetic energy and the relative helicity for each region each day where observations permit. The interconnectivity of the three regions is addressed in the context of the potential-field source-surface model. Using local and global quantities derived from the models, we briefly discuss the different observed activity levels of the regions.Comment: Accepted for publication in the Solar Physics Whole Heliospheric Interval (WHI) topical issue. We had difficulty squeezing this paper into arXiv's 15 Mb limit. The full paper is available here ftp://gong2.nso.edu/dsds_user/petrie/PetrieCanouAmari.pd

The free energy of NOAA active region AR 11029

The NOAA active region AR 11029 was a small but highly active sunspot region which produced 73 GOES soft X-ray flares. The flares appear to show a departure from the well known power-law frequency-size distribution. Specifically, too few GOES C-class and no M-class flares were observed by comparison with a power-law distribution (Wheatland in Astrophys. J. 710, 1324, 2010). This was conjectured to be due to the region having insufficient magnetic energy to power large events. We construct nonlinear force-free extrapolations of the coronal magnetic field of active region AR 11029 using data taken on 24 October by the SOLIS Vector-SpectroMagnetograph (SOLIS/VSM), and data taken on 27 October by the Hinode Solar Optical Telescope SpectroPolarimeter (Hinode/SP). Force-free modeling with photospheric magnetogram data encounters problems because the magnetogram data are inconsistent with a force-free model, and we employ a recently developed `self-consistency' procedure which addresses this and accommodates uncertainties in the boundary data (Wheatland and Regnier in Astrophys. J. 700, L88, 2009). We calculate the total energy and free energy of the self-consistent solution and find that the free energy was 4x10^29 erg on 24 October, and 7x10^31 erg on 27 October. An order of magnitude scaling between RHESSI non-thermal energy and GOES peak X-ray flux is established from a sample of flares from the literature and is used to estimate flare energies from observed GOES peak X-ray flux. Based on the scaling, we conclude that the estimated free energy of AR 11029 on 27 October when the flaring rate peaked is sufficient to power M-class or X-class flares, and hence the modeling does not appear to support the hypothesis that the absence of large flares is due to the region having limited energy.Comment: Accepted for publication in Solar Physic

Prediction of unplanned hospital admissions in older community dwellers using the 6-item Brief Geriatric Assessment: Results from REPERAGE, an observational prospective population-based cohort study.

The 6-item Brief Geriatric Assessment (BGA) provides a priori risk stratification of incident hospital health adverse events, but it has not been used yet to assess the risk of unplanned hospital admission for older patients in primary care. This study aims to examine the association between the a priori risk stratification levels of the 6-item BGA performed by general practitioners (GPs) and incident unplanned hospital admissions in older community patients. Based on an observational prospective cohort design, 668 participants (mean age 84.7 ± 3.9 years; 64.7% female) were recruited by their GPs during an index primary care visit. The 6-item BGA was completed at baseline and provided an a priori risk stratification in three levels (low, moderate, high). Incident unplanned hospital admissions were recorded during a 6-month follow-up. The incidence of unplanned hospital admissions increased with the risk level of the 6-item BGA stratification, the highest prevalence (35.3%) being reported with the high-risk level (P = 0.001). The risk of unplanned hospital admission at the high-risk level was significant (crude odds ratio (OR) = 5.48, P = 0.001 and fully adjusted OR = 3.71, P = 0.032, crude hazard ratio (HR) = 4.20; P = 0.002 and fully adjusted HR = 2.81; P = 0.035). The Kaplan-Meier's distributions of incident unplanned hospital admissions differed significantly between the three risk levels (P-value = 0.002). Participants with a high-risk level were more frequently admitted to hospital than those at a low-risk level (P = 0.001). Criteria performances of all risk levels were poor, except the specificity of the high-risk level, which was 98.2%. The a priori 6-item BGA risk stratification was significantly associated with incident unplanned hospital admissions in primary care older patients. However, except for the specificity of the high-risk level, its criteria performances were poor, suggesting that this tool is unsuitable for screening older patients in primary care settings at risk of unplanned hospital admission