449 research outputs found
COVID-19 risk stratification algorithms based on sTREM-1 and lL-6 in emergency department
No full textFactors Influencing the Implementation of Antimicrobial Stewardship in Primary Care: A Narrative Review
No full textAntimicrobial resistance (AMR) is directly driven by inappropriate use of antibiotics. Although the majority of antibiotics (an estimated 80%) are consumed in primary care settings, antimicrobial stewardship (AMS) activities in primary care remain underdeveloped and factors influencing their implementation are poorly understood. This can result in promising stewardship activities having little-to-no real-world impact. With this narrative review, we aim to identify and summarize peer-reviewed literature reporting on (1) the nature and impact of AMS interventions in primary care and (2) the individual and contextual factors influencing their implementation. Reported activities included AMS at different contextual levels (individual, collective and policy). AMS activities being often combined, it is difficult to evaluate them as stand-alone interventions. While some important individual and contextual factors were reported (difficulty to reach physicians leading to a low uptake of interventions, tight workflow of physicians requiring implementation of flexible and brief interventions and AMS as a unique opportunity to strengthen physician-patients relationship), this review identified a paucity of information in the literature about the factors that support or hinder implementation of AMS in primary care settings. In conclusion, identifying multilevel barriers and facilitators for AMS uptake is an essential step to explore before implementing primary care AMS interventions
Neural correlates of processing valence and arousal in affective words
No full textPsychological frameworks conceptualize emotion along 2 dimensions, "valence" and "arousal." Arousal invokes a single axis of intensity increasing from neutral to maximally arousing. Valence can be described variously as a bipolar continuum, as independent positive and negative dimensions, or as hedonic value (distance from neutral). In this study, we used functional magnetic resonance imaging to characterize neural activity correlating with arousal and with distinct models of valence during presentation of affective word stimuli. Our results extend observations in the chemosensory domain suggesting a double dissociation in which subregions of orbitofrontal cortex process valence, whereas amygdala preferentially processes arousal. In addition, our data support the physiological validity of descriptions of valence along independent axes or as absolute distance from neutral but fail to support the validity of descriptions of valence along a bipolar continuum
Quality of smartphone apps related to panic disorder.
No full textSmartphone apps have a growing role in health care. This study assessed the quality of English-language apps for panic disorder (PD) and compared paid and free apps. Keywords related to PD were entered into the Google Play Store search engine. Apps were assessed using the following quality indicators: accountability, interactivity, self-help score (the potential of smartphone apps to help users in daily life), and evidence-based content quality. The Brief DISCERN score and the criteria of the Health on the Net label were also used as content quality indicators as well as the number of downloads. Of 247 apps identified, 52 met all inclusion criteria. The content quality and self-help scores of these PD apps were poor. None of the assessed indicators were associated with payment status or number of downloads. Multiple linear regressions showed that the Brief DISCERN score significantly predicted content quality and self-help scores. Poor content quality and self-help scores of PD smartphone apps highlight the gap between their technological potential and the overall quality of available product
Conversion of African Americans to Islam : a sociological analysis of the Nation of Islam and associated groups
No full text'Conversion of African Americans to Islam: A Sociological Analysis of the Nation of
Islam Associated groups' is an empirical study of the religious experience of people
who had/have distinctive features in terms of race, ethnicity and historical experience.
The purpose of this thesis is to demonstrate how African Americans' (AAs) conversion
experience in general, and the Nation of Islam associated groups' conversion in
particular, differ from the studies of recruitment and conversion in the sociology of
religion and New Religion Movements (NRMs). More specifically, their recruitment
and conversion experiences to Islam diverge from those who converted to mainstream
Islam. The study investigates how AAs' historical experience, soci-economic
difficulties and the racism they encountered shaped and influenced their religious
understanding.
Research methods involved participant observations, a survey questionnaire, interviews,
conversations, personal communications and correspondence. To collect ethnographic
data eleven months field research was conducted mainly in the Chicago area and on two
short visits to Detroit, and three years continued communications with Muslim officials
and academics in the area. During the field research and afterwards through personal
communication 181 survey questionnaire responses were received, and 23 Muslim
officials, academics and ordinary Muslims were interviewed through semi-structured,
unstructured interviews, conversation and correspondence.
The thesis begins with a brief history of Islam and Muslims in general and the African
American Muslims (AAMs) in particular. More emphasis is given on the historical
development of the Nation of Islam (NOl). Then in Chapter III, discussions of schisms
in the history of the NOT are examined from sociological perspectives of social and
religious movements. In Chapter IV I aimed to formulate my own perspective to
analyse and study the conversion experiences of AAMs to Islam. I used a multivariate
approach, considering selectively widely held conversion and recruitment theories in the
sociology of the religion. I consider in Chapter V the predisposing conditions for AAMs
that influence their decision-making to join in the NOT, for example, political and
nationalistic sentiments and socio-economic deprivations. In Chapter VI I have applied
different terms to describe their religious experiences, such as conversion, alteration and
reversion. I have analysed further their encounters with the NOT, the methods of
recruitment they used and their major motives for joining the NOT and converting to
Tslam. In the concluding chapters (Chapter VII VTTT) I describe the different responses
of AAMS to Islam following the death of Elijah Muhammad. It is found out that the
Islamic appeal has polarised. While Farakhan's NOT appeared to continue the tradition
and style of the old NOI with the emphasis on nationalistic and socio-economic factors,
Tmam W. D. Mohammed's community turned more to the religious and spiritual aspects
of Tslam. These different approaches led to a polarisation of the appeal of Tslam to
AAMS.
This thesis contributes to knowledge in four key areas; the sociology of religion and
religious movements, the sociology of social and nationalistic movements, religious and
Islamic studies
Neurovisceral phenotypes in the expression of psychiatric symptoms
No full textThis review explores the proposal that vulnerability to psychological symptoms, particularly anxiety, originates in constitutional differences in the control of bodily state, exemplified by a set of conditions that include Joint Hypermobility, Postural Tachycardia Syndrome and Vasovagal Syncope. Research is revealing how brain-body mechanisms underlie individual differences in psychophysiological reactivity that can be important s for predicting, stratifying and treating individuals with anxiety disorders and related conditions. One common constitutional difference is Joint Hypermobility, in which there is an increased range of joint movement as a result of a variant of collagen. Joint hypermobility is over-represented in people with anxiety, mood and neurodevelopmental disorders. It is also linked to stress-sensitive medical conditions such as irritable bowel syndrome, chronic fatigue syndrome and fibromyalgia. Structural differences in ‘emotional’ brain regions are reported in hypermobile individuals, and many people with joint hypermobility manifest autonomic abnormalities, typically Postural Tachycardia Syndrome. Enhanced heart rate reactivity is characteristic of Postural Tachycardia Syndrome, and there is a phenomenological overlap with anxiety disorders, which may be partially accounted for by exaggerated neural reactivity within ventromedial prefrontal cortex. People who experience Vasovagal Syncope, a heritable tendency to fainting induced by emotional challenges (and needle/ blood phobia), are also more vulnerable to anxiety disorders. Neuroimaging implicates brainstem differences in vulnerability to faints, yet the structural integrity of the caudate nucleus appears important for the control of fainting frequency in relation to parasympathetic tone and anxiety. Together there is clinical and neuroanatomical evidence to show that common constitutional differences affecting autonomic responsivity are linked to psychiatric symptoms, notably anxiet
Validation of sTREM-1 and IL-6 based algorithms for outcome prediction of COVID-19
No full textAbstract Background A prospective observational cohort study of COVID-19 patients in a single Emergency Department (ED) showed that sTREM-1- and IL-6-based algorithms were highly predictive of adverse outcome (Van Singer et al. J Allergy Clin Immunol 2021). We aim to validate the performance of these algorithms at ED presentation. Methods This multicentric prospective observational study of PCR-confirmed COVID-19 adult patients was conducted in the ED of three Swiss hospitals. Data of the three centers were retrospectively completed and merged. We determined the predictive accuracy of the sTREM-1-based algorithm for 30-day intubation/mortality. We also determined the performance of the IL-6-based algorithm using data from one center for 30-day oxygen requirement. Results 373 patients were included in the validation cohort, 139 (37%) in Lausanne, 93 (25%) in St.Gallen and 141 (38%) in EOC. Overall, 18% (93/373) patients died or were intubated by day 30. In Lausanne, 66% (92/139) patients required oxygen by day 30. The predictive accuracy of sTREM-1 and IL-6 were similar compared to the derivation cohort. The sTREM-1-based algorithm confirmed excellent sensitivity (90% versus 100% in the derivation cohort) and negative predictive value (94% versus 100%) for 30-day intubation/mortality. The IL-6-based algorithm performance was acceptable with a sensitivity of 85% versus 98% in the derivation cohort and a negative predictive value of 60% versus 92%. Conclusion The sTREM-1 algorithm demonstrated good reproducibility. A prospective randomized controlled trial, comparing outcomes with and without the algorithm, is necessary to assess its safety and impact on hospital and ICU admission rates. The IL-6 algorithm showed acceptable validity in a single center and need additional validation before widespread implementation
COVID-19 isolation measures did not prevent vancomycin resistant enterococci transmissions
No full textImposed Benefit Sanctions and the Unemployment-to-Employment Transition: The German Experience
No full textWe analyze the effect of imposed benefit sanctions on the unemployment-to-employment transition of unemployed people entitled to unemployment compensation on the basis of register data from the German Federal Employment Agency. We combine propensity score matching with a discrete-time hazard rate model which accounts for the dynamic nature of the treatment. We find positive short- and long-term effects of benefit sanctions which are robust for men and women in East and West Germany. The effects diminish with the elapsed unemployment duration until a sanction is imposed. The limited use of benefit sanctions can thus be an effective activation tool if they take place not too late in an individual's unemployment spell.benefit sanctions, unemployment transitions, German labor market reform, ex-post evaluation, propensity score matching, hazard rate model, unobserved heterogeneity
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