HON Label and DISCERN as Content Quality Indicators of Health-Related Websites

Content quality indicators are warranted in order to help patients and consumers to judge the content quality of health-related on-line information. The aim of the present study is to evaluate web-based information on health topics and to assess particular content quality indicators like HON (Health on the Net) and DISCERN. The present study is based on the analysis of data issued from six previous studies which assessed with a standardized tool the general and content quality (evidence-based health information) of health-related websites. Keywords related to Social phobia, bipolar disorders, pathological gambling as well as cannabis, alcohol and cocaine addiction were entered into popular World Wide Web search engines. Websites were assessed with a standardized proforma designed to rate sites on the basis of accountability, presentation, interactivity, readability and content quality (evidence-based information). "Health on the Net” (HON) quality label, and DISCERN scale scores were used to verify their efficiency as quality indicators. Of 874 websites identified, 388 were included. Despite an observed association with higher content quality scores, the HON label fails to predict good content quality websites when used in a multiple regression. Sensibility and specificity of a DISCERN score >40 in the detection of good content quality websites were, respectively, 0.45 and 0.96. The DISCERN is a potential quality indicator with a relatively high specificity. Further developments in this domain are warranted in order to facilitate the identification of high-quality information on the web by patient

Mirtazapine in drug-induced excessive sweating

Excessive sweating is a well-known side effect of a selective serotonin reuptake inhibitor treatment, but little is known about the impact of sweating on treatment discontinuation or the general quality of life of patients. In this case report, we present a patient suffering from excessive sweating induced by escitalopram. When mirtazapine was administered as an additional treatment, a dose-dependent reduction of drug-induced excessive sweating was observed. Taking into account the particular serotonin antagonistic properties of mirtazapine, its eventual influence on the regulation of body temperature and diaphoresis in the central nervous system is discusse

Quetiapine Dosage Across Diagnostic Categories

Objective The aim of the current study was to evaluate quetiapine doses used across diagnosis categories in a sample of psychiatric inpatients. Methods Discharge letters of all adult inpatients who had received quetiapine between 1999 and 2005 were retrospectively reviewed. Logistic regressions were carried-out to assess links between quetiapine discharge dosage (≥800mg/day vs. <800mg/day), diagnostic categories, substance abuse or dependence, benzodiazepine discharge doses, age and sex. Results The data of 231 patients were included. Five hundred and for discharge documents were analyzed: 113 for psychotic disorders, 190 for personality disorders, 134 for bipolar and schizoaffective bipolar disorders, 29 for unipolar depression or anxiety disorders, and 35 for mental retardation. Considering psychotic disorders as a reference group, patients with personality disorders were statistically significantly less likely to be in the high quetiapine dosage group at discharge (P=0.007, OR=0.1 and CI [0.03; 0.6]). Conclusions Quetiapine seems to be used in a variety of clinical situations, with a wide range of doses and a lower dosage in patients treated for personality disorder

A follow-up study on the quality of alcohol dependence-related information on the web

In order to evaluate the one-year evolution of web-based information on alcohol dependence, we re-assessed alcohol-related sites in July 2007 with the same evaluating tool that had been used to assess these sites in June 2006. Websites were assessed with a standardized form designed to rate sites on the basis of accountability, presentation, interactivity, readability, and content quality. The DISCERN scale was also used, which aimed to assist persons without content expertise in assessing the quality of written health publications. Scores were highly stable for all components of the form one year later (r = .77 to .95, p < .01). Analysis of variance for repeated measures showed no time effect, no interaction between time and scale, no interaction between time and group (affiliation categories), and no interaction between time, group, and scale. The study highlights lack of change of alcohol-dependence-related web pages across one year

SY29-2CONTRASTING THE CONCEPTS OF COMPLIANCE AND ENGAGEMENT

Compliance has been defined as "the degree of constancy and accuracy with which a patient follows a prescribed regimen, and engagement can be thought of as the "emotional involvement or commitment of a person. Compliance is related to algorithmic tasks with well-defined rules of conduct and with a priori acknowledged outcomes. They follow (a) a set of established instructions, (b) down a single pathway, (c) to one conclusion. Algorithmic tasks, which require compliance to be successful, are best suited to routine work. Engagement, on the other hand, is related to heuristic tasks, for which no algorithm exists, where one has to experiment with possibilities and devise new solutions. Therapy, and even more specifically, psychotherapy with addicted patients, has continuously to be developed between these two pole

Law-Invariant Return and Star-Shaped Risk Measures

This paper presents novel characterization results for classes of law-invariant star-shaped functionals. We begin by establishing characterizations for positively homogeneous and star-shaped functionals that exhibit second- or convex-order stochastic dominance consistency. Building on these characterizations, we proceed to derive Kusuoka-type representations for these functionals, shedding light on their mathematical structure and intimate connections to Value-at-Risk and Expected Shortfall. Furthermore, we offer representations of general law-invariant star-shaped functionals as robustifications of Value-at-Risk. Notably, our results are versatile, accommodating settings that may, or may not, involve monotonicity and/or cash-additivity. All of these characterizations are developed within a general locally convex topological space of random variables, ensuring the broad applicability of our results in various financial, insurance and probabilistic contexts

Dynamic Return and Star-Shaped Risk Measures via BSDEs

This paper establishes characterization results for dynamic return and star-shaped risk measures induced via backward stochastic differential equations (BSDEs). We first characterize a general family of static star-shaped functionals in a locally convex Fr\'echet lattice. Next, employing the Pasch-Hausdorff envelope, we build a suitable family of convex drivers of BSDEs inducing a corresponding family of dynamic convex risk measures of which the dynamic return and star-shaped risk measures emerge as the essential minimum. Furthermore, we prove that if the set of star-shaped supersolutions of a BSDE is not empty, then there exists, for each terminal condition, at least one convex BSDE with a non-empty set of supersolutions, yielding the minimal star-shaped supersolution. We illustrate our theoretical results in a few examples and demonstrate their usefulness in two applications, to capital allocation and portfolio choice