964 resultados para frequent episodes


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OBJECTIVES: To examine patterns of onset and abuse/dependence episodes of prescription opioid (PO) and heroin use disorders in a national sample of adults, and to explore differences by gender and substance abuse treatment status. METHODS: Analyses of data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (N = 43,093). RESULTS: Of all respondents, 5% (n = 1815) reported a history of nonmedical PO use (NMPOU) and 0.3% (n = 150) a history of heroin use. Abuse was more prevalent than dependence among NMPOUs (PO abuse, 29%; dependence, 7%) and heroin users (heroin abuse, 63%; dependence, 28%). Heroin users reported a short mean interval from first use to onset of abuse (1.5 years) or dependence (2.0 years), and a lengthy mean duration for the longest episode of abuse (66 months) or dependence (59 months); the corresponding mean estimates for PO abuse and dependence among NMPOUs were 2.6 and 2.9 years, respectively, and 31 and 49 months, respectively. The mean number of years from first use to remission from the most recent episode was 6.9 years for PO abuse and 8.1 years for dependence; the mean number of years from first heroin use to remission from the most recent episode was 8.5 years for heroin abuse and 9.7 years for dependence. Most individuals with PO or heroin use disorders were remitted from the most recent episode. Treated individuals, whether their problem was heroin or POs, tended to have a longer mean duration of an episode than untreated individuals. CONCLUSION: Periodic remissions from opioid or heroin abuse or dependence episodes occur commonly but take a long time. Timely and effective use of treatment services are needed to mitigate the many adverse consequences from opioid/heroin abuse and dependence.

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The present randomized, placebo-controlled double-blind multicenter study included a population of 36 subjects with frequent recurrences (at least once a month) of herpes labialis. Most of the patients had failed to respond adequately to previous treatment with other therapeutic tools, including acyclovir. Either 50 mg of thymopentin or of placebo was administered 3 times a week, by the subcutaneous route, for 6 weeks. Subsequently, the patients were observed for nearly 6 months on the average. The results achieved with thymopentin for the individual parameters were significantly superior to those obtained with placebo; thus significant improvement was seen in patients on thymopentin in the duration of the longest symptomfree period (prolonged from 2.1 weeks to 20.9 weeks, p = 0.000), in the number of relapses (reduced from 1.6 to 0.4 episodes/month, p = 0.001), and in the total duration of herpes symptoms per month (shortened from 2.0 to 0.3 weeks, p = 0.000). Placebo treatment also resulted in considerable improvement (p < 0.05 or 0.01), but was significantly inferior to the improvement obtained with thymopentin. The longest symptomfree period in the placebo group was prolonged from 2.4 to 11.2 weeks. The number of relapses per month was reduced from 1.4 to 0.8, and the total duration of herpes symptoms per month from 2 to 0.9 weeks. The results of intergroup analyses, in which the observed parameters and the improvement achieved in either group were compared, significantly favored thymopentin treatment. The effect of thymopentin was in all but one parameters superior to that of placebo and highly significant (p < 0.01). © 1985 Humana Press Inc.

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There is concern in the Cross-Channel region of Nord-Pas-de-Calais (France) and Kent (Great Britain), regarding the extent of atmospheric pollution detected in the area from emitted gaseous (VOC, NOx, S02)and particulate substances. In particular, the air quality of the Cross-Channel or "Trans-Manche" region is highly affected by the heavily industrial area of Dunkerque, in addition to transportation sources linked to cross-channel traffic in Kent and Calais, posing threats to the environment and human health. In the framework of the cross-border EU Interreg IIIA activity, the joint Anglo-French project, ATTMA, has been commissioned to study Aerosol Transport in the Trans-Manche Atmosphere. Using ground monitoring data from UK and French networks and with the assistance of satellite images the project aims to determine dispersion patterns. and identify sources responsible for the pollutants. The findings of this study will increase awareness and have a bearing on future air quality policy in the region. Public interest is evident by the presence of local authorities on both sides of the English Channel as collaborators. The research is based on pollution transport simulations using (a) Lagrangian Particle Dispersion (LPD) models, (b) an Eulerian Receptor Based model. This paper is concerned with part (a), the LPD Models. Lagrangian Particle Dispersion (LPD) models are often used to numerically simulate the dispersion of a passive tracer in the planetary boundary layer by calculating the Lagrangian trajectories of thousands of notional particles. In this contribution, the project investigated the use of two widely used particle dispersion models: the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) model and the model FLEXPART. In both models forward tracking and inverse (or·. receptor-based) modes are possible. Certain distinct pollution episodes have been selected from the monitor database EXPER/PF and from UK monitoring stations, and their likely trajectory predicted using prevailing weather data. Global meteorological datasets were downloaded from the ECMWF MARS archive. Part of the difficulty in identifying pollution sources arises from the fact that much of the pollution outside the monitoring area. For example heightened particulate concentrations are to originate from sand storms in the Sahara, or volcanic activity in Iceland or the Caribbean work identifies such long range influences. The output of the simulations shows that there are notable differences between the formulations of and Hysplit, although both models used the same meteorological data and source input, suggesting that the identification of the primary emissions during air pollution episodes may be rather uncertain.

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The role intra-organizational knowledge exchanges play in innovation processes has been widely acknowledged in the organizational literature. This paper contributes to the understanding of which specific configurations knowledge networks assume during different phases of radical and incremental innovation processes. The case study we selected is a FLOSS (Free/Libre Open Source Software) community consisting of 233 developers committed to the development of a web browser application since November 2002. By harvesting the mailing list, official blog and code repository of a FLOSS community, we investigate the patterns of knowledge exchange and individual contributions of its developers. We measure structural cohesion and compare global and local network properties at different points in time. Preliminary results show that phases of radical and incremental innovation are associated with specific configurations of the knowledge network as a whole as well as with different network positions of the core developers of the software.

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Aims: to study the gambling history and stories of participants, motivations, impact and helpseeking. Method: Details were advertised on websites and newspapers. 30 frequent gamblers were interviewed over the telephone for approximately one hour. Verbatim transcriptions were analysed using NVIVO and grounded theory. Results/conclusions: Not all women had gambled before. However, internet accessibility meant prolonged periods were spent gambling to the neglect of other life areas. Some were originally motivated by excitement but others gambled to escape from current difficulties. Depression, anxiety, panic attacks and suicide ideation were common. The women were ambivalent towards their gambling and receiving help.

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According to dialogical self theory (Hermans, 2001), individual identities reflect cultural and subcultural values, and appropriate voices and discourses from the social environment. Bronfenbrenner’s (1979) systemic theory of human development similarly postulates that individual and social development occur in a symbiotic and interdependent fashion. It would therefore be predicted that individual changes in identity reflect macrocosmic changes in cultural values and social structures. The current study investigated narratives of crisis transitions within adults aged 25-40, by way of interviews with 22 participants. An intensive qualitative analysis showed that the narratives of crisis could indeed be viewed as individual manifestations of contemporary cultural changes. National statistics and academic research have documented in the UK substantial cultural shifts over the last twenty years including the lessening popularity of marriage, the rise of freelance and portfolio careers and the growth of accepted alternative gender roles. In individual crises, changes made over the course of the episode were invariably in the same direction as these social changes; towards flexible work patterns, non-marital relationships and redefined gender identities. Before the crisis, participants described their identity as bound into an established discourse of conventionality, a traditional sense of masculinity or feminitity and a singular career role, while after the crisis alternative and fluid identities are explored, and identity is less defined by role and institution. These findings show that changes in the social macrocosm can be found in the individual microcosm, and therefore support dialogical self theory.

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Frequent locations of thermal fronts in UK shelf seas were identified using an archive of 30,000 satellite images acquired between 1999 and 2008, and applied as a proxy for pelagic diversity in the designation of Marine Protected Areas (MPAs). Networks of MPAs are required for conservation of critical marine habitats within Europe, and there are similar initiatives worldwide. Many pelagic biodiversity hotspots are related to fronts, for example cetaceans and basking sharks around the Isle of Man, Hebrides and Cornwall, and hence remote sensing can address this policy need in regions with insufficient species distribution data. This is the first study of UK Continental Shelf front locations to use a 10-year archive of full-resolution (1.1 km) AVHRR data, revealing new aspects of their spatial and seasonal variability. Frontal locations determined at sea or predicted by ocean models agreed closely with the new frequent front maps, which also identified many additional frontal zones. These front maps were among the most widely used datasets in the recommendation of UK MPAs, and would be applicable to other geographic regions and to other policy drivers such as facilitating the deployment of offshore renewable energy devices with minimal environmental impact.

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The relatively high levels of cannabis use among young people is a cause of concern because of the positive relationship between its early onset use, antisocial behaviours and associated lifestyle. Amongst a survey of 3919 young people at school year 11 in Northern Ireland (aged 14/15 years) 142 reported daily cannabis use. These young people also reported particularly high levels of legal and illegal drug use and accounted for a high proportion of use of hard drugs such as cocaine and heroin for the full school cohort. Daily cannabis users also reported high levels of antisocial behaviour and disaffection with school. The findings perhaps raise questions about the existence of a potentially ‘hidden’ high risk school based group of young people during adolescence who require specific targeted prevention strategies.

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Background Interferon ? receptor 1 (IFN? R1) deficiency is a primary immunodeficiency with allelic dominant and recessive mutations characterised clinically by severe infections with mycobacteria. We aimed to compare the clinical features of recessive and dominant IFN?R1 deficiencies. Methods We obtained data from a large cohort of patients worldwide. We assessed these people by medical histories, records, and genetic and immunological studies. Data were abstracted onto a standard form. Findings We identified 22 patients with recessive complete IFN?R1 deficiency and 38 with dominant partial deficiency. BCG and environmental mycobacteria were the most frequent pathogens. In recessive patients, 17 (77%) had environmental mycobacterial disease and all nine BCG-vaccinated patients had BCG disease. In dominant patients, 30 (79%) had environmental mycobacterial disease and 11 (73%) of 15 BCG-vaccinated patients had BCG disease. Compared with dominant patients, those with recessive deficiency were younger at onset of first environmental mycobacterial disease (mean 3·1 years [SD 2·5] vs 13·4 years [14·3], p=0·001), had more mycobacterial disease episodes (19 vs 8 per 100 person-years of observation, p=0·0001), had more severe mycobacterial disease (mean number of organs infected by Mycobacterium avium complex 4·1 [SD 0·8] vs 2·0 [1·1], p=0·004), had shorter mean disease-free intervals (1·6 years [SD 1·4] vs 7·2 years [7·6], p

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Background We had previously established that inactivation of RUNX3 occurs by frequent promoter hypermethylation and protein mislocalization in invasive ductal carcinomas (IDC) of breast. Here, we hypothesize that inactivation of RUNX3 occurring in ductal carcinoma in situ (DCIS) represent early event in breast carcinogenesis. Methods The study cohort of 40 patients included 17 pure DCIS cases and 23 cases of DCIS with associated IDC (DCIS-IDC). The DCIS and IDC components of mixed cases were manually microdissected to permit separate evaluation. All the 63 samples including 17 pure DCIS, 23 samples each of DCIS and IDC of DCIS-IDC cases were analyzed for RUNX3 protein expression using R3-6E9 monoclonal antibody as well as promoter methylation status by methylation specific PCR. Results Compared to matched normal breast samples (4 of 40, 10%), DCIS (35 of 40, 88%) and IDC (21 of 23, 91%) exhibited significant RUNX3 inactivation (P