Development of a risk model for adverse drug events in the elderly

The aim of this study was to develop a predictive model for adverse drug events (ADEs) in elderly patients. Socio-demographic and medical data were collected from chart reviews, computerised information and a patient interview, for a population of 929 elderly patients (aged greater than or equal to 65 years) whose admission to the Waveney/B raid Valley Hospital in Northern Ireland was not scheduled. A further 204 patients formed a validation group. An ADE score was assigned to each patient using a modified Naranjo algorithm scoring system. The ADE scores ranged from 0 to 8. For the purposes of developing a risk model, scores of 4 or more were considered to constitute a high risk of an ADE.

The anomaly in the candidate microlensing event PA-99-N2

The light curve of PA-99-N2, one of the recently announced microlensing candidates toward M31, shows small deviations from the standard Paczynski form. We explore a number of possible explanations, including correlations with the seeing, the parallax effect, and a binary lens. We find that the observations are consistent with an unresolved red giant branch or asymptotic giant branch star in M31 being microlensed by a binary lens. We find that the best-fit binary lens mass ratio is similar to1.2x10(-2), which is one of the most extreme values found for a binary lens so far. If both the source and lens lie in the M31 disk, then the standard M31 model predicts the probable mass range of the system to be 0.02-3.6 M-circle dot (95% confidence limit). In this scenario, the mass of the secondary component is therefore likely to be below the hydrogen-burning limit. On the other hand, if a compact halo object in M31 is lensing a disk or spheroid source, then the total lens mass is likely to lie between 0.09 and 32 M-circle dot, which is consistent with the primary being a stellar remnant and the secondary being a low-mass star or brown dwarf. The optical depth (or, alternatively, the differential rate) along the line of sight toward the event indicates that a halo lens is more likely than a stellar lens, provided that dark compact objects comprise no less than 15% (or 5%) of halos.

A candidate M31/M32 intergalactic microlensing event

We report the discovery of a microlensing candidate projected 2'54

A short-timescale candidate microlensing event in the point-agape pixel lensing survey of M31

We report the discovery of a short-duration microlensing candidate in the northern field of the POINT-AGAPE pixel lensing survey toward M31. Almost certainly, the source star has been identified on Hubble Space Telescope archival images, allowing us to infer an Einstein crossing time of t(E) = 10.4 days, a maximum magnification of A(max) similar to 18, and a lens-source proper motion mu (rel) > 0.3 mu as day(-1). The event has a projected separation of 8' from the center of M31, beyond the bulk of the stellar lens population. There are three plausible identifications/locations for the lensing object: a massive compact halo object (MACHO) in either M31 or the Milky Way, or a star in the M31 disk. The most probable mass is 0.06 M-. for an M31 MACHO, 0.02 M-. for a Milky Way MACHO, and 0.2 M-. for an M31 stellar lens. While the stellar interpretation is possible, the MACHO interpretation is the most probable for halo fractions above 20%.

Adverse reactions to drugs: in vitro studies with isolated cells

Objective and design: Drug-induced adverse reactions can be allergic or pseudoallergic in nature, in this study the histamine releasing ability of 4 radiographic contrast media and 2 opioid analgesics was tested on a variety of mast cell containing cell suspensions.

Prevalence of Adverse Childhood Experiences in a University Population: Associations with Use of Social Services

This paper is part of a series published by the Multiple Adverse Childhood Experiences research group based at QUB. First-year undergraduates took part in an online survey, self-reporting on Adverse Childhood Experiences (ACE) and measures of social service contact. The 10-item ACE questionnaire measures abuse, neglect and household dysfunction (current sample ?????????The study achieved a response rate of 18.6%. (N=765; 552 (72.7%) females and 212 (27.2%) males; 21.8% reporting having been educated at a ‘Protestant’ school, 42% reporting having been educated at a ‘Catholic’ school and 20.4% reporting previous school religious affiliation as ‘other’). Despite obvious non-response bias, ACE scores for this student population are comparable with college-educated populations in the US. Current respondents with previous social service contact are over twenty three times more likely than peers to have experienced multiple adversities. Findings support the hypothesis that social service contact, alone, acts as a proxy indicator for the presence of multiple adverse childhood experiences, with no significant elevation in ACE scores for those going through court proceedings or subject to child protection registration. This study supports current concerns by policy makers to target those children experiencing multiple adversities.

Relatedness of O-specific lipopolysaccharide side chain genes from strains of Shigella boydii type 12 belonging to two clonal groups and from Escherichia coli O7:K1

The O-specific lipopolysaccharide side chains of Escherichia coli O7 and Shigella boydii type 12 possess similar but not identical chemical structures. We investigated the genetic relatedness between the O-specific side chain genes in members of these two species. Examination of outer membrane protein and lipopolysaccharide (LPS) banding patterns demonstrated that five strains which had been identified as S. boydii type 12 fell into two clonal groups, SB1 and SB2. Hybridizations with O7-specific radiolabeled probes derived from the chromosomal DNA of an E. coli O7 strain detected identical fragments among the three SB1 strains of S. boydii type 12 and the two E. coli O7 reference isolates. The two other S. boydii type 12 strains, which belonged to the SB2 clone, did not show homologies with the O7 probe under high-stringency conditions of hybridization. The homology between the O7 and type 12 LPS gene regions from the SB1 strains was further confirmed by the construction of O-specific side chain-deficient mutations in these strains by homologous recombination of a suicide plasmid containing O7-specific DNA sequences. Immunoblot experiments with O7 antiserum gave a weak cross-reaction with LPS purified from the SB2 strains but a very strong cross-reaction with the LPS from SB1 isolates. Antiserum raised to one of the SB2 strains cross-reacted only with S. boydii type 12 LPS from the SB1 clone but failed to react with O7 LPS.

Associations between maternal characteristics and pregnancy-related stress among low-risk mothers: An observational cross-sectional study

Background: Pregnancy is viewed as a major life event and, while the majority of healthy, low-risk women adapt well to pregnancy, there are those whose levels of stress are heightened by the experience.

Objectives: To determine the level of pregnancy-related stress experienced by a group of healthy, low-risk pregnant women and to relate the level of stress with a number of maternal characteristics.

Design: An observational cross-sectional study.

Setting: A large, urban maternity centre in Northern Ireland.

Participants: Of the 306 pregnant women who were invited to participate, 278 provided informed consent and were administered one self-complete questionnaire. Due to the withdrawal criteria, 15 questionnaires were removed from the analysis, resulting in a final sample of 263 healthy, low-risk pregnant women.

Methods: Levels of stress were measured using a self-report measure designed to assess specific worries and concerns relating to pregnancy. Maternal characteristics collected included age, marital status, social status, parity, obstetric history, perceived health status and 'wantedness' for the pregnancy. Regression analysis was undertaken using an ordinary linear regression model.

Results: The mean prenatal distress score in the sample was 15.1 (SD = 7.4; range 0-46). The regression model showed that women who had had previous pregnancies, with or without complications, had significantly lower mean prenatal distress scores than primiparous women (p < 0.01). Women reporting poorer physical health had higher mean prenatal distress scores than those who reported at least average health, while women aged 16-20 experienced a mean increase in the reported prenatal distress score (p < 0.05) in comparison to the reference group of 36 years and over.

Conclusions: This study brings to light the prevalence of pregnancy-related stress within a sample representative of healthy, low-risk women. Current antenatal care is ill-equipped to identify women suffering from high levels of stress; yet a growing body of research evidence links stress with adverse pregnancy outcomes. This study emphasises that healthy, low-risk women experience a range of pregnancy-related stress and identification of stress levels, either through the use of a simple stress measurement tool or through the associated factors identified within this research study, provides valuable data on maternal well-being. (C) 2010 Elsevier Ltd. All rights reserved.

The Emotional Paradoxes of Adverse Possession

Property lawyers are generally viewed as a serious lot, not prone to feverish bursts of excitement as we seek comfort and solace in established legal rules and precepts. In the same way, property law disputes tend to have a fairly low profile and fail to capture the public imagination in the same way as, for example, those involving criminal or human rights law. Such apparent indifference might seem a little strange, given the centrality of property in everyday human life and the significance which legal systems and individuals attach to property rights. However, there is one issue which always inflames passions amongst lawyers and non-lawyers alike: the acquisition of land through the doctrine of adverse possession, often described as ‘squatter’s rights’. No property-related topic is likely to light up a radio show phone-in switchboard quite like squatting

The developmental character of cardiac autonomic responses to an acute noxious event in 4- and 8-month-old healthy infants

Heart rate (HR) has been widely studied as a measure of an individual's response to painful stimuli. It remains unclear whether changes in mean HR or the variability of HR are specifically related to the noxious stimulus (i.e. pain). Neither is it well understood how such changes reflect underlying neurologic control mechanisms that produce these responses, or how these mechanisms change during the first year of life. To study the changes in cardiac autonomic modulation that occur with acute pain and with age during early infancy, the relationship between respiratory activity and short-term variations of HR (i.e. respiratory sinus arrhythmia) was quantified in a longitudinal study of term born healthy infants who underwent a finger lance blood collection at 4 months of age (n = 24) and again at 8 months of age (n = 20). Quantitative respiratory activity and HR were obtained during baseline, lance, and recovery periods. Time and frequency domain analyses from 2.2-min epochs of data yielded mean values, spectral measures of low (0.04-0.15 Hz) and high (0.15-0.80 Hz) frequency power (LF and HF), and the LF/HF ratio. To determine sympathetic and parasympathetic cardiac activity, the transfer relation between respiration and HR was used. At both 4 and 8 months, mean HR increased significantly with the noxious event (p > 0.01). There were age-related differences in the pattern of LF, HF, and LF/HF ratio changes. Although these parameters all decreased (p > 0.01) at 4 months, LF and LF/HF increased at 8 months and at 8 months HF remained stable in response to the noxious stimulus. Transfer gain changes with the lance demonstrated a change from predominant vagal baseline to a sympathetic condition at both ages. The primary finding of this study is that a response to an acute noxious stimulus appears to produce an increase in respiratory-related sympathetic HR control and a significant decrease in respiratory-related parasympathetic control at both 4 and 8 months. Furthermore, with increasing age, the sympathetic and parasympathetic changes appear to be less intense, but more sustained.