Connected Health in Europe: Where are we today?

This report, which has grown out of an ENJECT survey of 19 European countries, examines the situation of Connected Health in Europe today. It focuses on creating a clear understanding of the current and developing presence of Connected Health throughout European healthcare systems under five headings: The Policy Environment, Education, Business and Health Models, Interoperability, and The Perso

Effectiveness of an outpatient intervention targeting suicidal young adults: Preliminary results

This study evaluated the effectiveness of a time-limited, outpatient intervention targeting suicidal young adults. Participants (N = 264) were randomly assigned to either the experimental treatment or the control condition (i.e., treatment as usual). In addition to intake assessments, participants completed follow-ups at 1, 6, 12, 18, and 24 months. Both treatment and control participants evidenced significant improvement across all outcome measures throughout the follow-up period. Reductions were reported in suicidal ideation and behavior, associated symptomatology, and experienced stress, along with marked improvement in self-appraised problem- solving ability. Results also indicated that the experimental treatment was more effective than treatment as usual at retaining the highest risk participants. Available data demonstrate the efficacy of a time-limited, outpatient intervention for suicidal young adults. Implications of current findings for intervention with and treatment of this population are discussed

Plasma morphine and morphine-6-glucuronide during chronic morphine therapy for cancer pain: plasma profiles, steady-state concentrations and the consequences of renal failure.

Morphine-6-glucuronide (M-6-G) is an active metabolite of morphine that may contribute to drug effects. To understand better the relationship between morphine and M-6-G in cancer patients receiving chronic therapy, we employed high performance liquid chromatography with electrochemical detection to measure: (1) morphine and M-6-G plasma concentrations following discontinuation of dosing in 2 patients, one receiving oral therapy and the other an intravenous infusion; (2) morphine and M-6-G concentrations in random blood samples taken at apparent steady state from 8 patients, 7 with normal renal function and 1 with mild renal insufficiency, who were receiving continuous morphine infusions; and (3) morphine and M-6-G concentrations in random blood samples taken over a period of weeks from 4 patients, 2 with stable and 2 with declining renal function. Results demonstrated a slightly slower decline in plasma M-6-G than morphine concentrations following drug discontinuation, as would be expected for metabolite and parent relationship; roughly similar M-6-G: morphine ratios (mean molar ratio = 1.22) across a broad range of morphine doses in patients with normal renal function; and an increase in this ratio over time in patients with progressive renal dysfunction. These data illustrate the kinetics of M-6-G in cancer patients receiving chronic morphine therapy and confirm the importance of renal function in determining the concentration of the metabolite