3,653 research outputs found

    Care for hospitalized patients with unhealthy alcohol use: a narrative review

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    There is increasing emphasis on screening, brief intervention, and referral to treatment (SBIRT) for unhealthy alcohol use in the general hospital, as highlighted by new Joint Commission recommendations on SBIRT. However, the evidence supporting this approach is not as robust relative to primary care settings. This review is targeted to hospital-based clinicians and administrators who are responsible for generally ensuring the provision of high quality care to patients presenting with a myriad of conditions, one of which is unhealthy alcohol use. The review summarizes the major issues involved in caring for patients with unhealthy alcohol use in the general hospital setting, including prevalence, detection, assessment of severity, reduction in drinking with brief intervention, common acute management scenarios for heavy drinkers, and discharge planning. The review concludes with consideration of Joint Commission recommendations on SBIRT for unhealthy alcohol use, integration of these recommendations into hospital work flows, and directions for future research

    An Empirical Evaluation of Statistical Matching Methodologies

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    Using known data, the methodologies available for microdata file merging are compared. Results indicate that various techniques work or do not work in specific circumstances. An optimal-constrined merge model with an absolute difference distance function provide the best results

    Identification and Risk-Stratification of Problem Alcohol Drinkers with Minor Trauma in the Emergency Department

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    BACKGROUND: Brief alcohol intervention may improve outcomes for injury patients with hazardous drinking but is less effective with increased severity of alcohol involvement. This study evaluated a brief method for detecting problem drinking in minor trauma patients and differentiating hazardous drinkers from those with more severe alcohol problems.METHODS: Subjects included 60 minor trauma patients in an academic urban emergency department (ED) who had consumed any amount of alcohol in the prior month. Screening and risk stratification involved the use of a heavy-drinking-day screening item and the Rapid Alcohol Problems Screen (RAPS). We compared the heavy-drinking-day item to past-month alcohol use, as obtained by validated self-reporting methods, and measured the percentage of carbohydrate-deficient transferrin (%CDT) to assess the accuracy of self-reporting. The Alcohol Dependence Scale (ADS) was administered to gauge the severity of alcohol involvement and compared to the RAPS.RESULTS: Eighty percent of the subjects endorsed at least one heavy drinking day in the past year, and all patients who exceeded recommended weekly drinking limits endorsed at least one heavy drinking day. Among those with at least one heavy drinking day, 58% had a positive RAPS result. Persons with no heavy drinking days (n=12) had a median ADS of 0.5 (range 0 to 3). RAPS-negative persons with heavy drinking days (n=20) had a median ADS of 2 (range 0 to 8). RAPS-positive persons with heavy drinking days (n=28) had a median ADS of 8 (range 1 to 43).CONCLUSION: A heavy-drinking-day item is useful for detecting hazardous drinking patterns, and the RAPS is useful for differentiating more problematic drinkers who may benefit from referral from those more likely to respond to a brief intervention. This represents a time-sensitive approach for risk-stratifying non-abstinent injury patients prior to ED discharge. [West J Emerg Med. 2010 May;11(2):133-7.

    The presence of PHOSPHO1 in matrix vesicles and its developmental expression prior to skeletal mineralization

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    PHOSPHO1 is a phosphoethanolamine/phosphocholine phosphatase that has previously been implicated in generating inorganic phosphate (Pi) for matrix mineralization. In this study, we have investigated PHOSPHO1 mRNA expression during embryonic development in the chick. Whole-mount in situ hybridization indicated that PHOSPHO1 expression occurred prior to E6.5 and was initially restricted to the bone collar within the mid-shaft of the diaphysis of long bones but by E11.5 expression was observed over the entire length of the diaphysis. Alcian blue/alizarin red staining revealed that PHOSPHO1 expression seen in the primary regions of ossification preceded the deposition of mineral, suggesting that it is involved in the initial events of mineral formation. We isolated MVs from growth plate chondrocytes and confirmed the presence of high levels of PHOSPHO1 by immunoblotting. Expression of PHOSPHO1, like TNAP activity, was found to be up-regulated in MVs isolated from chondrocytes induced to differentiate by the addition of ascorbic acid. This suggests that both enzymes may be regulated by similar mechanisms. These studies provide for the first time direct evidence that PHOSPHO1 is present in MVs, and its developmental expression pattern is consistent with a role in the early stages of matrix mineralization

    Read-It: A Multi-modal Tangible Interface for Children Who Learn to Read

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    Multi-modal tabletop applications offer excellent opportunities for enriching the education of young children. Read-It is an example of an interactive game with a multi-modal tangible interface that was designed to combine the advantages of current physical games and computer exercises. It is a novel approach for supporting children who learn to read. The first experimental evaluation has demonstrated that the Read-It approach is indeed promising and meets a priori expectations

    Reactions at polymer interfaces: A Monte Carlo Simulation

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    Reactions at a strongly segregated interface of a symmetric binary polymer blend are investigated via Monte Carlo simulations. End functionalized homopolymers of different species interact at the interface instantaneously and irreversibly to form diblock copolymers. The simulations, in the framework of the bond fluctuation model, determine the time dependence of the copolymer production in the initial and intermediate time regime for small reactant concentration ρ0Rg3=0.163...0.0406\rho_0 R_g^3=0.163 ... 0.0406. The results are compared to recent theories and simulation data of a simple reaction diffusion model. For the reactant concentration accessible in the simulation, no linear growth of the copolymer density is found in the initial regime, and a t\sqrt{t}-law is observed in the intermediate stage.Comment: to appear in Macromolecule

    A time-domain control signal detection technique for OFDM

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    Transmission of system-critical control information plays a key role in efficient management of limited wireless network resources and successful reception of payload data information. This paper uses an orthogonal frequency division multiplexing (OFDM) architecture to investigate the detection performance of a time-domain approach used to detect deterministic control signalling information. It considers a type of control information chosen from a finite set of information, which is known at both transmitting and receiving wireless terminals. Unlike the maximum likelihood (ML) estimation method, which is often used, the time-domain detection technique requires no channel estimation and no pilots as it uses a form of time-domain correlation as the means of detection. Results show that when compared with the ML method, the time-domain approach improves detection performance even in the presence of synchronisation error caused by carrier frequency offset

    A two-part seabed geomorphology classification scheme : (v.2). Part 1 : morphology features glossary

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    This report updates the ‘Two-part Seabed Geomorphology classification scheme’ of Dove et al. (2016) and presents a new glossary (Part 1) of Seabed Morphology features. This Morphology glossary is intended to provide marine scientists with a robust and consistent way to characterise the seabed. Each glossary entry includes a feature definition and a representative schematic diagram to support clear and accurate classification. Feature terms and definitions are primarily drawn from the International Hydrographic Organization (IHO) guide for undersea feature names, which are herein modified and augmented with additional terms to ensure the final feature catalogue and glossary encompasses the diversity of morphologies observed at the seabed, while also minimising duplication and/or ambiguity. This updated classification system and new glossary are the result of a collaboration between marine geoscientists from marine mapping programmes/networks in Norway (MAREANO), Ireland (INFOMAR), UK (MAREMAP), and Australia (Geoscience Australia) (MIM-GA). A subsequent report will present the (Part 2) Geomorphology feature glossar
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