Schizophrenia in the family: studying the experience of caregiving

Master'sMASTER OF SOCIAL SCIENCE

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Research statistics in Atopic Eczema: what disease is this?

<p><b>Abstract</b></p> <p><b>Background</b></p> <p>Atopic eczema is a common and distressing disease. This study aims to review PubMed indexed research statistics on atopic eczema over a-10 year period to investigate the clinical relevance and research interest about this disease.</p> <p><b>Methods</b></p> <p>PubMed (a service of the U.S. National Library of Medicine) was searched for the terms “atopic dermatitis” and “eczema”, with limits activated (Humans, Clinical Trial, Meta-Analysis, Randomized Controlled Trial, English, published in the last 10 years), and editorials, letters, practice guidelines, reviews, and animal studies excluded. Journal impact factor (IF) is in accordance with Journal Citation Report (JCR) 2009, a product of Thomson ISI (Institute for Scientific Information).</p> <p><b>Results</b></p> <p>A total of 890 articles were retrieved. Taking out publications that were irrelevant and those without an impact factor, 729 articles were obtained. These articles were grouped into dermatology (n = 337, mean IF: 3.01), allergy/immunology (n = 215, mean IF: 4.89), pediatrics (n = 118, mean IF: 2.53) and miscellaneous subject categories (n = 142, mean IF: 5.10). The impact factors were highest in the miscellaneous category (<it>p</it> = 0.0001), which includes such prestigious journals as the New England journal of Medicine (n = 1, IF: 47.05), the Lancet (n = 4, IF: 30.76) and BMJ (n = 6, IF: 13.66). There was no publication in any family medicine or general practice journal. The British Journal of Dermatology (n = 78), Pediatric Allergy and Immunology (n = 49) and Journal of Allergy and Clinical Immunology (n = 46) had the highest number of publications on the subject. Atopic eczema ranked higher in impact factors in allergy/immunology although more publications appeared in the dermatology category.</p> <p><b>Conclusions</b></p> <p>Atopic eczema is a multidisciplinary disease. Its clinical relevance and research interests are definitely beyond that of a mere cutaneous disease. Investigators may consider allergy/immunology and miscellaneous journal categories for higher impact of their research.</p

Volatile Changes during Storage of Shelf Stable Apple Juice: Integrating GC-MS Fingerprinting and Chemometrics

This is the first study to reveal potential markers for volatile changes during ambient and accelerated shelf life of pasteurized apple juice. The volatile changes were monitored at 20, 30 and 40 &deg;C using a headspace solid-phase microextraction-gas chromatography-mass spectrometry fingerprinting method. Using modern chemometrics and feature selection, hexanal, trans-2-hexenal, dimethyl sulphide, furfural, ethyl acetate and 1-pentanol were chosen as potential shelf life markers. Volatiles associated with the green, grassy and fresh apple aroma, such as hexanal and trans-2-hexenal, decreased during storage, whereas thermal load and browning associated compounds, like dimethyl sulphide and furfural, increased during storage. Hexanal and trans-2-hexenal can be markers to monitor the change in green-apple like character. Furfural and dimethyl sulphide can be markers of temperature abuse during juice processing and storage. Furfural can also be an indicator for juice browning. The present work effectively identified potential markers to monitor and predict volatile aroma changes of shelf stable apple juice in different storage conditions. Sensory analysis can be conducted in the future to confirm the aroma relevance of selected markers

Singapore group relief : extent of utilization and effectiveness of implementation.

Group relief was implemented in Singapore with effect from Year of Assessment 2003. This study seeks to establish the extent of utilization of group companies in Singapore. In addition, the effectiveness of implementation of the new tax law was also explored, specifically by establishing the level of understanding and significance of the positive impact

Diet and body condition temporal variations of the French Mediterranean sardines

International audienc

Is the European pilchard crisis in French Mediterranean related to their diet ?

International audienceDuring the last decade there has been a decrease in landings, biomass and body condition of planktivorous fish in the north-western Mediterranean Sea. This induced major fisheries crisis related to commercial European pilchard (Sardina pilchardus). A merging hypothesis is that this may be related to changes in their diet (Le Bourg et al., 2015). Moreover, these planktivorous species play a key role in the food web channeling the organic matter from plankton to higher predators also targeted by fisheries. The aim of our research was to study the temporal variability of the European pilchard's diet in term of species composition, size and energetic quality (proteins, carbohydrates, lipids) related to plankton composition. The analyzed individuals were collected in the Bay of Marseille by local fishermen from October 2016 to July 2017. The stomach contents were compared to the plankton collected by 80 μm mesh size nets. Main prey were copepods: Clauso/Paracalanus spp., Microsetella spp., Corycaeidae and Oncaeidae. Our results showed a particularly selective feeding behavior for the European pilchard mainly for the most energetic plankton groups (and sizes) with the highest percentages of proteins. However, European pilchard continues to consume small prey and their condition remains low compared to recent studies (Le Bourg et al., 2015). Why is European pilchard consuming small prey? Are large size copepods that they used to eat actually missing from the plankton community? Does this diet change have to do with the monthly variations of environmental parameters? This preliminary work will be continued over time and completed by the study of other species of planktivorous fish, as well as by the analysis of stable isotopes. This will lead to hypotheses about the role of fluctuations in plankton composition and abundance as well as its nutritional quality on diet and body condition of planktivorous fish

Is the European pilchard crisis in French Mediterranean related to their diet ?

International audienceDuring the last decade there has been a decrease in landings, biomass and body condition of planktivorous fish in the north-western Mediterranean Sea. This induced major fisheries crisis related to commercial European pilchard (Sardina pilchardus). A merging hypothesis is that this may be related to changes in their diet (Le Bourg et al., 2015). Moreover, these planktivorous species play a key role in the food web channeling the organic matter from plankton to higher predators also targeted by fisheries. The aim of our research was to study the temporal variability of the European pilchard's diet in term of species composition, size and energetic quality (proteins, carbohydrates, lipids) related to plankton composition. The analyzed individuals were collected in the Bay of Marseille by local fishermen from October 2016 to July 2017. The stomach contents were compared to the plankton collected by 80 μm mesh size nets. Main prey were copepods: Clauso/Paracalanus spp., Microsetella spp., Corycaeidae and Oncaeidae. Our results showed a particularly selective feeding behavior for the European pilchard mainly for the most energetic plankton groups (and sizes) with the highest percentages of proteins. However, European pilchard continues to consume small prey and their condition remains low compared to recent studies (Le Bourg et al., 2015). Why is European pilchard consuming small prey? Are large size copepods that they used to eat actually missing from the plankton community? Does this diet change have to do with the monthly variations of environmental parameters? This preliminary work will be continued over time and completed by the study of other species of planktivorous fish, as well as by the analysis of stable isotopes. This will lead to hypotheses about the role of fluctuations in plankton composition and abundance as well as its nutritional quality on diet and body condition of planktivorous fish

Is the European pilchard crisis in French Mediterranean related to their diet ?

International audienceDuring the last decade there has been a decrease in landings, biomass and body condition of planktivorous fish in the north-western Mediterranean Sea. This induced major fisheries crisis related to commercial European pilchard (Sardina pilchardus). A merging hypothesis is that this may be related to changes in their diet (Le Bourg et al., 2015). Moreover, these planktivorous species play a key role in the food web channeling the organic matter from plankton to higher predators also targeted by fisheries. The aim of our research was to study the temporal variability of the European pilchard's diet in term of species composition, size and energetic quality (proteins, carbohydrates, lipids) related to plankton composition. The analyzed individuals were collected in the Bay of Marseille by local fishermen from October 2016 to July 2017. The stomach contents were compared to the plankton collected by 80 μm mesh size nets. Main prey were copepods: Clauso/Paracalanus spp., Microsetella spp., Corycaeidae and Oncaeidae. Our results showed a particularly selective feeding behavior for the European pilchard mainly for the most energetic plankton groups (and sizes) with the highest percentages of proteins. However, European pilchard continues to consume small prey and their condition remains low compared to recent studies (Le Bourg et al., 2015). Why is European pilchard consuming small prey? Are large size copepods that they used to eat actually missing from the plankton community? Does this diet change have to do with the monthly variations of environmental parameters? This preliminary work will be continued over time and completed by the study of other species of planktivorous fish, as well as by the analysis of stable isotopes. This will lead to hypotheses about the role of fluctuations in plankton composition and abundance as well as its nutritional quality on diet and body condition of planktivorous fish