The election of the Labour government last year shifted the issue of inequality in health to the ... more The election of the Labour government last year shifted the issue of inequality in health to the top of the policy agenda. In its White Paper on the “New NHS”, promises were made about reducing unacceptable variations in services and ensuring fair access. Publication of the Green Paper “Our Healthier Nation” also reinforced the government’s aim of narrowing the health
In a health care system where resources are scarce and the principle of equity is of central conc... more In a health care system where resources are scarce and the principle of equity is of central concern, mechanisms for the appropriate allocation of resources based on the notion of relating resource use to some concept of need are essential. Two key issues raised in the UK government’s White Paper The New NHS: modern, dependable are the ability first to
Schneider SP. Local circuit connections between neurons in spinal laminae III and IV of hamster. ... more Schneider SP. Local circuit connections between neurons in spinal laminae III and IV of hamster. To better understand the role of intrinsic spinal cord circuits in the integration of mechanosensory information, we studied synaptic transmission between neurons in Rexed's laminae III-IV, a major termination zone for cutaneous mechanoreceptor afferents, using dual, simultaneous whole cell electrophysiological recordings in young hamsters. Synaptic connections were detected between 32 of 106 cell pairs (linkage probability of 0.3) and were predominantly unidirectional (91%). Inhibitory connections outnumbered excitatory connections by 2:1. Amplitude of single-axon postsynaptic potentials (PSPs) was independent of postsynaptic cell input resistance. Intracellular labeling suggested that recordings were obtained from local axon interneurons. In connected cell pairs, the percentage of presynaptic action potentials that failed to evoke a postsynaptic response was 44 Ϯ 29%. Shape indices of PSPs suggested that synaptic contacts were widely distributed along the postsynaptic membrane. Linkage probability was unrelated to intrinsic firing properties, laminar position of the cells or the distance (Ͻ160 m) separating them. However, PSPs in target cells following action potentials in neurons with phasic firing patterns had longer duration and lower failure rates than PSPs activated by neurons with tonic firing patterns. Thus transmission reliability at synapses between lamina III/IV interneurons overall is low, and efficacy of these connections is related to firing properties of the presynaptic cells. The observations also suggest that synaptic organization in LIII-IV is fundamentally different from the superficial dorsal horn (LI-II) where neural circuits may be composed of stereotyped units made from connections between a few functional types of neurons.
Tendon transfers are invaluable in the treatment of severe children&a... more Tendon transfers are invaluable in the treatment of severe children's foot deformities. They are often preferable to simple releases, lengthening, or fusion in surgical treatment because they provide an active motor function for deformity correction and, when properly selected, the procedures stabilize the foot against progressive deformity. The authors describe 4 commonly used tendon transfer procedures that are useful in children's foot deformity surgeries.
A. Smith. Regulation in organotypic cultures of dorsal root ganglia (DRG) from of N-and L-type Ca... more A. Smith. Regulation in organotypic cultures of dorsal root ganglia (DRG) from of N-and L-type Ca 2/ channels in adult frog sympathetic ganglion 13 d fetal mice. They proposed that this effect may reflect B cells by nerve growth factor in vitro and in vivo. J. Neurophysiol. modulation of Ca 2/ channel current (I Ca ) in neurons that no 78: 3359-3370, 1997. To examine mechanisms responsible for the longer require NGF for survival. By contrast, Ritter and long-term regulation of Ca 2/ -channels in an adult neuron, changes showed that treatment of neonatal rats with in whole cell Ba 2/ current (I Ba ) were examined in adult bullfrog NGF in vivo from birth to 5 wk of age produced essentially sympathetic ganglion B cells in vitro. Cells were cultured at low the reverse effect; ap duration was increased. This effect density in defined, serum free medium. After 15 days, total I Ba was was confined to high-threshold mechanoreceptor (HTMR) similar to the initial value, whereas I Ba density was reduced by neurons and other types of sensory neuron were unaffected. Ç36%, presumably due to an increase in neuronal surface area.
Chronic constriction injury of rat sciatic nerve promotes signs of neuropathic pain. This is asso... more Chronic constriction injury of rat sciatic nerve promotes signs of neuropathic pain. This is associated with an increase in the levels of interleukin 1β (IL-1β) in primary afferents that peak at 7 d. This initial cytokine exposure has been proposed to trigger an enduring alteration in neuronal phenotype that underlies chronic hyper-excitability in sensory nerves that initiates and maintains chronic neuropathic pain. We have shown previously that 5-6 d exposure of rat dorsal root ganglia (DRG) to 100pM IL-1β increases the excitability of medium-sized neurons. We have now found using whole-cell recording that this increased excitability reverts to control levels within 3-4 d of cytokine removal. The effects of IL-1β were dominated by changes in K(+) currents. Thus, the amplitudes of A-current, delayed rectifier and Ca(2+) sensitive K(+) currents were reduced by ∼68%, ∼64% and ∼36% respectively. Effects of IL-1β on other cation currents were modest by comparison. There was thus a sligh...
This report is a survey of current capitation methods in health care finance in developed countri... more This report is a survey of current capitation methods in health care finance in developed countries. It was commissioned as part of the fundamental review by UK Ministers of the formula used to allocate health care finance to local areas in England, being carried out under the auspices of the Advisory Committee on Resource Allocation (ACRA). The study was commissioned
This editorial introduces the new journal and sets out some of the editors' principles. It notes ... more This editorial introduces the new journal and sets out some of the editors' principles. It notes the apparently haphazard approach towards the improvement in management practice in health care, and contrasts it with the more scientific approach adopted by the medical profession. The journal aims to provide for the first time a single forum for all those engaged in the systematic evaluation of the management of health care, and seeks to nurture a move towards "evidence based management". We will consider papers from a wide range of institutional settings and disciplinary perspectives. As well as presenting high quality research, authors will be encouraged to make clear the policy implications of their contributions.
The Journal of neuroscience : the official journal of the Society for Neuroscience, 1998
There is some doubt as to the effectiveness of opioids in the management of neuropathic pain. We ... more There is some doubt as to the effectiveness of opioids in the management of neuropathic pain. We therefore examined the actions of morphine and the opioid-like peptide nociceptin (both 1 mu) on dorsal root ganglion (DRG) neurons that were isolated from control or from nerve-injured rats. Both substances reduced omega-conotoxin (CTX) GVIA-sensitive, N-type Ca2+ channel current and small persistent nifedipine/ CTX-insensitive (non-N, non-L type) current. Nifedipine-sensitive L-type current was unaffected. The effect of nociceptin was antagonized by naloxone benzoylhydrazone (nalbzoh) but not by naloxone. Sciatic nerve section (axotomy) profoundly reduced the effects of morphine and the mu-receptor agonist D-ala2, N-Me-Phe4,Gly-ol5 enkephalin (DAMGO). The effect of the kappa-agonist [(+)-(5alpha,7alpha, 8beta)-N-methyl-N-(7-(1-pyrrolidinyl)-1-oxaspiro(4, 5)dec-8-yl)-benzeneacetamide] (U69593) was unchanged, whereas the effect of nociceptin was increased. All agonists produced their str...
For most individuals, the use made of health care in a given year is determined principally by un... more For most individuals, the use made of health care in a given year is determined principally by unpredictable random incidents. Of course, some individuals have a predictably higher predisposition to illness than others. However, the general consensus is that only a fraction of individual variability in health care costs can be predicted. The purpose of this paper is to explore the implications of this inherent randomness for setting health care budgets for general practitioner purchasers of health care. The paper argues that variability in utilization in health care is very high: that no capitation formula can ever completely capture that variability, even for large populations: that the variability may give rise to certain dysfunctional consequences if not managed carefully; and that therefore careful attention should be given to the managerial arrangements associated with any devolution of health care budgets.
Investigative ophthalmology & visual science, Jan 17, 2015
By reducing rod intrusion and improving efficiency of neural signaling throughout the visual syst... more By reducing rod intrusion and improving efficiency of neural signaling throughout the visual system, macular pigment (MP) could improve many aspects of visual performance in low-light level conditions. We examined this possibility for spatial resolution, dark adaptation kinetics, and color detection. Twenty-seven subjects participated in the study. Spatial profiles of MP optical density (MPOD) were determined using heterochromatic flicker photometry. Mesopic- and scotopic-adaptation level experiments were conducted in Maxwellian view. Subjects with higher MP optical density (MPOD) required significantly lower contrast to detect the mesopic-level resolution targets; this effect became stronger with increasing spatial frequency. Dark adaptation recovery times were significantly faster as a function of MPOD (by nearly two minutes for the lowest mesopic-level task [high vs. low MPOD]; p < 0.001). Absolute scotopic thresholds were also significantly associated with MPOD (p < 0.001)...
Neurodegenerative diseases are characterized by chronic and progressive structural or functional ... more Neurodegenerative diseases are characterized by chronic and progressive structural or functional loss of neurons. Limitations related to the animal models of these human diseases have impeded the development of effective drugs. This emphasizes the need to establish disease models using human-derived cells. The discovery of induced pluripotent stem cell (iPSC) technology has provided novel opportunities in disease modeling, drug development, screening, and the potential for "patient-matched" cellular therapies in neurodegenerative diseases. In this study, with the objective of establishing reliable tools to study neurodegenerative diseases, we reprogrammed human umbilical vein endothelial cells (HUVECs) into iPSCs (HiPSCs). Using a novel and direct approach, HiPSCs were differentiated into cells of central nervous system (CNS) lineage, including neuronal, astrocyte and glial cells, with high efficiency. HiPSCs expressed embryonic genes such as nanog, sox2 and Oct-3/4, and f...
The α2δ-ligands pregabalin (PGB) and gabapentin (GBP) are used to treat neuropathic pain. We used... more The α2δ-ligands pregabalin (PGB) and gabapentin (GBP) are used to treat neuropathic pain. We used whole cell recording to study their long-term effects on substantia gelatinosa and dorsal root ganglion (DRG) neurons. Spinal cord slices were prepared from embryonic day 13 rat embryos and maintained in organotypic culture for >5 wk (neuronal age equivalent to young adult rats). Exposure of similarly aged DRG neurons (dissociated and cultured from postnatal day 19 rats) to GBP or PGB for 5-6 days attenuated high-voltage-activated calcium channel currents (HVA ICa). Strong effects were seen in medium-sized and in small isolectin B4-negative (IB4-) DRG neurons, whereas large neurons and small neurons that bound isolectin B4 (IB4+) were hardly affected. GBP (100 μM) or PGB (10 μM) were less effective than 20 μM Mn(2+) in suppression of HVA ICa in small DRG neurons. By contrast, 5-6 days of exposure to these α2δ-ligands was more effective than 20 μM Mn(2+) in reducing spontaneous excita...
Single screening questions (SSQs) are recommended for the evaluation of unhealthy alcohol use and... more Single screening questions (SSQs) are recommended for the evaluation of unhealthy alcohol use and other drug use (risky use through dependence). In addition, SSQs could provide information on severity that is necessary for brief intervention, information thought to be available only from longer questionnaires. We assessed SSQ accuracy for identifying dependence. In a cross-sectional study, 286 primary care patients were administered SSQs for alcohol and for other drugs (each asks how many times they were used in the past year), the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), the Drug Abuse Screening Test (DAST), and a diagnostic interview reference standard for dependence. For each test, we calculated area under the receiver operating characteristic (ROC) curve and the ability to discriminate dependence at an optimal cutoff. The prevalence of alcohol and other drug dependence was 9% and 12%, respectively. Optimal cut points were eight or more times for the alcoh...
The election of the Labour government last year shifted the issue of inequality in health to the ... more The election of the Labour government last year shifted the issue of inequality in health to the top of the policy agenda. In its White Paper on the “New NHS”, promises were made about reducing unacceptable variations in services and ensuring fair access. Publication of the Green Paper “Our Healthier Nation” also reinforced the government’s aim of narrowing the health
In a health care system where resources are scarce and the principle of equity is of central conc... more In a health care system where resources are scarce and the principle of equity is of central concern, mechanisms for the appropriate allocation of resources based on the notion of relating resource use to some concept of need are essential. Two key issues raised in the UK government’s White Paper The New NHS: modern, dependable are the ability first to
Schneider SP. Local circuit connections between neurons in spinal laminae III and IV of hamster. ... more Schneider SP. Local circuit connections between neurons in spinal laminae III and IV of hamster. To better understand the role of intrinsic spinal cord circuits in the integration of mechanosensory information, we studied synaptic transmission between neurons in Rexed's laminae III-IV, a major termination zone for cutaneous mechanoreceptor afferents, using dual, simultaneous whole cell electrophysiological recordings in young hamsters. Synaptic connections were detected between 32 of 106 cell pairs (linkage probability of 0.3) and were predominantly unidirectional (91%). Inhibitory connections outnumbered excitatory connections by 2:1. Amplitude of single-axon postsynaptic potentials (PSPs) was independent of postsynaptic cell input resistance. Intracellular labeling suggested that recordings were obtained from local axon interneurons. In connected cell pairs, the percentage of presynaptic action potentials that failed to evoke a postsynaptic response was 44 Ϯ 29%. Shape indices of PSPs suggested that synaptic contacts were widely distributed along the postsynaptic membrane. Linkage probability was unrelated to intrinsic firing properties, laminar position of the cells or the distance (Ͻ160 m) separating them. However, PSPs in target cells following action potentials in neurons with phasic firing patterns had longer duration and lower failure rates than PSPs activated by neurons with tonic firing patterns. Thus transmission reliability at synapses between lamina III/IV interneurons overall is low, and efficacy of these connections is related to firing properties of the presynaptic cells. The observations also suggest that synaptic organization in LIII-IV is fundamentally different from the superficial dorsal horn (LI-II) where neural circuits may be composed of stereotyped units made from connections between a few functional types of neurons.
Tendon transfers are invaluable in the treatment of severe children&amp;amp;amp;amp;amp;amp;a... more Tendon transfers are invaluable in the treatment of severe children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s foot deformities. They are often preferable to simple releases, lengthening, or fusion in surgical treatment because they provide an active motor function for deformity correction and, when properly selected, the procedures stabilize the foot against progressive deformity. The authors describe 4 commonly used tendon transfer procedures that are useful in children&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s foot deformity surgeries.
A. Smith. Regulation in organotypic cultures of dorsal root ganglia (DRG) from of N-and L-type Ca... more A. Smith. Regulation in organotypic cultures of dorsal root ganglia (DRG) from of N-and L-type Ca 2/ channels in adult frog sympathetic ganglion 13 d fetal mice. They proposed that this effect may reflect B cells by nerve growth factor in vitro and in vivo. J. Neurophysiol. modulation of Ca 2/ channel current (I Ca ) in neurons that no 78: 3359-3370, 1997. To examine mechanisms responsible for the longer require NGF for survival. By contrast, Ritter and long-term regulation of Ca 2/ -channels in an adult neuron, changes showed that treatment of neonatal rats with in whole cell Ba 2/ current (I Ba ) were examined in adult bullfrog NGF in vivo from birth to 5 wk of age produced essentially sympathetic ganglion B cells in vitro. Cells were cultured at low the reverse effect; ap duration was increased. This effect density in defined, serum free medium. After 15 days, total I Ba was was confined to high-threshold mechanoreceptor (HTMR) similar to the initial value, whereas I Ba density was reduced by neurons and other types of sensory neuron were unaffected. Ç36%, presumably due to an increase in neuronal surface area.
Chronic constriction injury of rat sciatic nerve promotes signs of neuropathic pain. This is asso... more Chronic constriction injury of rat sciatic nerve promotes signs of neuropathic pain. This is associated with an increase in the levels of interleukin 1β (IL-1β) in primary afferents that peak at 7 d. This initial cytokine exposure has been proposed to trigger an enduring alteration in neuronal phenotype that underlies chronic hyper-excitability in sensory nerves that initiates and maintains chronic neuropathic pain. We have shown previously that 5-6 d exposure of rat dorsal root ganglia (DRG) to 100pM IL-1β increases the excitability of medium-sized neurons. We have now found using whole-cell recording that this increased excitability reverts to control levels within 3-4 d of cytokine removal. The effects of IL-1β were dominated by changes in K(+) currents. Thus, the amplitudes of A-current, delayed rectifier and Ca(2+) sensitive K(+) currents were reduced by ∼68%, ∼64% and ∼36% respectively. Effects of IL-1β on other cation currents were modest by comparison. There was thus a sligh...
This report is a survey of current capitation methods in health care finance in developed countri... more This report is a survey of current capitation methods in health care finance in developed countries. It was commissioned as part of the fundamental review by UK Ministers of the formula used to allocate health care finance to local areas in England, being carried out under the auspices of the Advisory Committee on Resource Allocation (ACRA). The study was commissioned
This editorial introduces the new journal and sets out some of the editors' principles. It notes ... more This editorial introduces the new journal and sets out some of the editors' principles. It notes the apparently haphazard approach towards the improvement in management practice in health care, and contrasts it with the more scientific approach adopted by the medical profession. The journal aims to provide for the first time a single forum for all those engaged in the systematic evaluation of the management of health care, and seeks to nurture a move towards "evidence based management". We will consider papers from a wide range of institutional settings and disciplinary perspectives. As well as presenting high quality research, authors will be encouraged to make clear the policy implications of their contributions.
The Journal of neuroscience : the official journal of the Society for Neuroscience, 1998
There is some doubt as to the effectiveness of opioids in the management of neuropathic pain. We ... more There is some doubt as to the effectiveness of opioids in the management of neuropathic pain. We therefore examined the actions of morphine and the opioid-like peptide nociceptin (both 1 mu) on dorsal root ganglion (DRG) neurons that were isolated from control or from nerve-injured rats. Both substances reduced omega-conotoxin (CTX) GVIA-sensitive, N-type Ca2+ channel current and small persistent nifedipine/ CTX-insensitive (non-N, non-L type) current. Nifedipine-sensitive L-type current was unaffected. The effect of nociceptin was antagonized by naloxone benzoylhydrazone (nalbzoh) but not by naloxone. Sciatic nerve section (axotomy) profoundly reduced the effects of morphine and the mu-receptor agonist D-ala2, N-Me-Phe4,Gly-ol5 enkephalin (DAMGO). The effect of the kappa-agonist [(+)-(5alpha,7alpha, 8beta)-N-methyl-N-(7-(1-pyrrolidinyl)-1-oxaspiro(4, 5)dec-8-yl)-benzeneacetamide] (U69593) was unchanged, whereas the effect of nociceptin was increased. All agonists produced their str...
For most individuals, the use made of health care in a given year is determined principally by un... more For most individuals, the use made of health care in a given year is determined principally by unpredictable random incidents. Of course, some individuals have a predictably higher predisposition to illness than others. However, the general consensus is that only a fraction of individual variability in health care costs can be predicted. The purpose of this paper is to explore the implications of this inherent randomness for setting health care budgets for general practitioner purchasers of health care. The paper argues that variability in utilization in health care is very high: that no capitation formula can ever completely capture that variability, even for large populations: that the variability may give rise to certain dysfunctional consequences if not managed carefully; and that therefore careful attention should be given to the managerial arrangements associated with any devolution of health care budgets.
Investigative ophthalmology & visual science, Jan 17, 2015
By reducing rod intrusion and improving efficiency of neural signaling throughout the visual syst... more By reducing rod intrusion and improving efficiency of neural signaling throughout the visual system, macular pigment (MP) could improve many aspects of visual performance in low-light level conditions. We examined this possibility for spatial resolution, dark adaptation kinetics, and color detection. Twenty-seven subjects participated in the study. Spatial profiles of MP optical density (MPOD) were determined using heterochromatic flicker photometry. Mesopic- and scotopic-adaptation level experiments were conducted in Maxwellian view. Subjects with higher MP optical density (MPOD) required significantly lower contrast to detect the mesopic-level resolution targets; this effect became stronger with increasing spatial frequency. Dark adaptation recovery times were significantly faster as a function of MPOD (by nearly two minutes for the lowest mesopic-level task [high vs. low MPOD]; p < 0.001). Absolute scotopic thresholds were also significantly associated with MPOD (p < 0.001)...
Neurodegenerative diseases are characterized by chronic and progressive structural or functional ... more Neurodegenerative diseases are characterized by chronic and progressive structural or functional loss of neurons. Limitations related to the animal models of these human diseases have impeded the development of effective drugs. This emphasizes the need to establish disease models using human-derived cells. The discovery of induced pluripotent stem cell (iPSC) technology has provided novel opportunities in disease modeling, drug development, screening, and the potential for "patient-matched" cellular therapies in neurodegenerative diseases. In this study, with the objective of establishing reliable tools to study neurodegenerative diseases, we reprogrammed human umbilical vein endothelial cells (HUVECs) into iPSCs (HiPSCs). Using a novel and direct approach, HiPSCs were differentiated into cells of central nervous system (CNS) lineage, including neuronal, astrocyte and glial cells, with high efficiency. HiPSCs expressed embryonic genes such as nanog, sox2 and Oct-3/4, and f...
The α2δ-ligands pregabalin (PGB) and gabapentin (GBP) are used to treat neuropathic pain. We used... more The α2δ-ligands pregabalin (PGB) and gabapentin (GBP) are used to treat neuropathic pain. We used whole cell recording to study their long-term effects on substantia gelatinosa and dorsal root ganglion (DRG) neurons. Spinal cord slices were prepared from embryonic day 13 rat embryos and maintained in organotypic culture for >5 wk (neuronal age equivalent to young adult rats). Exposure of similarly aged DRG neurons (dissociated and cultured from postnatal day 19 rats) to GBP or PGB for 5-6 days attenuated high-voltage-activated calcium channel currents (HVA ICa). Strong effects were seen in medium-sized and in small isolectin B4-negative (IB4-) DRG neurons, whereas large neurons and small neurons that bound isolectin B4 (IB4+) were hardly affected. GBP (100 μM) or PGB (10 μM) were less effective than 20 μM Mn(2+) in suppression of HVA ICa in small DRG neurons. By contrast, 5-6 days of exposure to these α2δ-ligands was more effective than 20 μM Mn(2+) in reducing spontaneous excita...
Single screening questions (SSQs) are recommended for the evaluation of unhealthy alcohol use and... more Single screening questions (SSQs) are recommended for the evaluation of unhealthy alcohol use and other drug use (risky use through dependence). In addition, SSQs could provide information on severity that is necessary for brief intervention, information thought to be available only from longer questionnaires. We assessed SSQ accuracy for identifying dependence. In a cross-sectional study, 286 primary care patients were administered SSQs for alcohol and for other drugs (each asks how many times they were used in the past year), the Alcohol Use Disorders Identification Test-Consumption (AUDIT-C), the Drug Abuse Screening Test (DAST), and a diagnostic interview reference standard for dependence. For each test, we calculated area under the receiver operating characteristic (ROC) curve and the ability to discriminate dependence at an optimal cutoff. The prevalence of alcohol and other drug dependence was 9% and 12%, respectively. Optimal cut points were eight or more times for the alcoh...
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Papers by peter smith