Misuse Rate Research Articles

Common Errors in English Aphasic Discourse

The article generalizes the results of research directed onto singling out the common errors in speech of aphasic patients. Aphasia is characterized by partial or complete loss of speech and is caused by damage in the language areas (Broca’s and Wernicke’s areas). A lesion in the middle part of the patient’s left frontal lobe results in Broca’s aphasia and the damage to the left posterior superior temporal gyrus is referred to as Wernicke’s aphasia. The major causes of aphasia are strokes, cortical vein thrombosis, traumas of skull and brain, brain infections, tumors, etc. The research is based on the language-in-use descriptive approach to discourse analysis and presents an investigation of 40 documentary video recordings of aphasic patients’ speech (free narration and dialogues); the overall duration of the recordings is 180 minutes. The inclusion criterion was aphasia of any type in adulthood. All the patients are English-speaking people (English being their native language) recovering from aphasia. The analysis was done according to the following criteria: intelligibility, coherence, cohesion, grammatical structure of utterances, prosody and intonation, thus combining formalist (or structuralist) and functionalist research paradigms. The research has shown that the most common errors that aphasic patients make when speaking are as follows: syntactic errors, articulatory errors, lexical misuse and slow speech rate. Syntactic and articulatory errors prevail (55% and 50% of all the studied cases respectively), whereas 37.5% of the speakers demonstrated slow speech rate. The speech of 75% of people with aphasia is incoherent. The patients’ verbal performance is marked with extensive use of pronouns and repetition of words and phrases.

Misuse of gabapentinoids (pregabalin and gabapentin) in patients with neuropathic pain related to spinal cord injury

Objective To investigate the misuse of gabapentinoids (pregabalin and gabapentin) in patients with neuropathic pain related to spinal cord injury. Study Design Cross-sectional study. Setting Outpatient clinic in a physical therapy and rehabilitation hospital Participants 127 patients, aged 18–70 years, who had neuropathic pain related to spinal cord injury (SCI) and disease duration of at least 12 months Outcome Measures Gabapentinoid use disorder of the patients was determined based on the DSM-5 diagnostic criteria for substance-related disorders. Patients were divided into 2 groups as those with drug misuse and those without drug misuse. Demographic and clinical information of the patients were compared between the groups. Factors associated with drug misuse were analyzed. Results The misuse rate was 81.9% in patients using pregabalin and 69.69% in patients using gabapentin. Duration of disease and the Leeds assessment of neuropathic symptoms and signs (LANSS) score were statistically significantly higher in the drug misuse group. A statistically significant difference was found between the groups in terms of marital status, education and income level, and smoking and alcohol use. A statistically significant relationship was observed between drug misuse and duration of disease and LANSS score. Conclusion Misuse of gabapentinoids is prevalent in patients with neuropathic pain related to spinal cord injury. The duration of disease and the severity of NP are associated with misuse. Clinicians should exercise caution when prescribing gabapentinoids to patients with SCI.

Inter-rater Reliability of a 13-Category Arterial Doppler Waveform Classification and Practice of French Vascular Physicians.

Background: Arterial Doppler Ultrasound waveform (DW) analysis allows the detection and evaluation of lower extremity peripheral artery disease. The high heterogeneity of the reported description of DW is reduced by the use of classification. However, the reliability of these classifications is either unknown or low to moderate and practices of vascular caregivers regarding the use of these classifications remain unknown.Aims: This study aims to assess the inter-observer reliability of the Saint-Bonnet classification, a 13-category DW classification. The secondary objective was to determine the utilization rate of the most common classifications and the ability of these classifications to describe DW.Methods: A national survey was conducted among all vascular physicians of French society of vascular medicine. They were invited by email to describe on a website 20 DW without and with the display of the Saint-Bonnet classification. The reliability of this classification was estimated by Fleiss' Kappa expressed with [95% confidence interval]. A semantic analysis allowed us to classify the physicians' responses according to the terms used. Finally we have evaluated for each classification the rate of misuse, i.e., the addition of a complementary term to the defined categories.Results: One hundred and ten physicians participated and only 5% of these were familiar with Saint-Bonnet classification. Fifty-four percent of vascular physicians used no classification at all. Vascular physicians used the Spronk (four-category), Descotes (five-category) and Saint-Bonnet (13-category) classifications for respectively, 31, 10, and 5%. Kappa coefficient of Fleiss (κ) was 0.546 [0.544–0.547] (p < 0.001). Reliability by category ranges from κ of 0.075 to 0.864. In multivariate analysis, the use of a classification was associated with fewer years of experience and was dependent on geographic location. Misuse rate by classification was 88, 82, and 5% using Spronk, Descotes and Saint-Bonnet classifications respectively.Conclusion: The reliability of Saint-Bonnet classification is weak to moderate by vascular physicians who are not familiar with its use. However, unlike the other classifications, it seems to be sufficiently precise so that the user does not need to complete its description. There is a significant heterogeneity in the use of arterial Doppler classifications in France.

Patterns of non-medical use of benzodiazepines and Z-Drugs among adolescents and young adults: gender differences and related factors

ABSTRACT Background: We aimed to report the prevalence and factors associated with non-medical use of BZD and Z-Drugs in adolescents and young adults residing in Spain from a gender perspective. Nationwide, cross-sectional study on the misuse of BZD and Z-Drugs by young adult population of both sexes. Method: We used individualized secondary data retrieved from the 2015–2016 Household Survey on Alcohol and Drugs in Spain. A total of 10,824 survey respondents aged 15 to 34 years. Results: Prevalence of non-medical use of BZD and Z-Drugs was.42%, 1% in men vs. 1.84% in women, p = .00. Zolpidem presents the highest misuse rate in young males (45.8%), females showing a greater misuse prevalence for Lormetazepam (35.8%). The variables associated with a greater probability of misuse were, smoking habit, consumption of an illicit drug other than marijuana during last year. Low-perceived risk for BZD and Z-Drug consumption, was the variable showing the greatest value in young population (aOR = 3.88, 95% CI 2.53–5.93). Conclusions: Spanish young women are more likely to misuse BZD and Z-Drugs than men. Differentiated consumption is observed for these substances. A low perception of consumption risk and negative perception of health are strongly associated with non-medical use of BZD and Z-Drug among young Spanish population.

Formal versus Informal Credit: Which is Better in Helping Rural Areas in Vietnam?

The study seeks to evaluate the impacts of three types of credit – formal, semi-formal, and informal credits – on the well-being of households in Vietnam’s rural areas. Based on data from the Vietnam Household Living Standard Surveys in 2014 and 2016, the research uses the instrumental variable fixed-effect models to estimate the effects of three kinds of credit on household’s per capita income and expenditure. There are some significant findings. First, in rural areas, formal credit is the most popular source with stable and cheap borrowing costs. Informal credit is a complement to formal credit to meet urgent needs. Funding agriculture activities is the most commonly cited purpose of borrowing, followed by purchasing assets. The highest misuse rate belongs to the group of loans for agriculture production. Second, the results show that credit helps smoothen consumption rather than generate income for rural households. Three types of credit have insignificant or negative effects on household’s per capita income. Formal loans significantly improve total expenditure and spending on healthcare and education. Informal and semi-formal credits show a little influence on consumption. Informal loans have a significantly positive effect on healthcare expenditure. In contrast, having semi-formal loans tends to decrease spending on foods.

Prescription Opioid Misuse Index in sickle cell patients: A brief questionnaire to assess at-risk for opioid abuse

Objective: To develop a survey instrument to identify adult sickle cell disease (SCD) patients on chronic opioid therapy who are at-risk for opioid abuse. Design: Prospective survey and interview.Setting: Adult SCD clinic in a large urban teaching facility.Patients/participants: Convenience sampling of adult patients presenting to the sickle cell clinic.Interventions: None.Main outcome: Primary outcome was “at-risk for opioid misuse,” defined as at least 3/8 “yes” answers (a positive composite score) on the Prescription Opioid Misuse Index (POMI) questionnaire. Secondary outcome was DSM-IV criteria for substance abuse using the DSM IV Diagnostic Interview Schedule.Results: Of the 99 patients who completed the POMI, the mean age was 36 years; 58.6 percent were female, 48 percent were hemoglobin SS (47/99), and 26 percent were SC (26/99). Twenty-four percent (24/99) were identified as at-risk for opioid misuse using the POMI. There were no differences in demographic, SCD genotype, or socioeconomic variables for at-risk versus not-at-risk patients.Conclusion: Twenty-four percent of unselected adult SCD patients on opioids were identified as at-risk for opioid misuse using a quick survey. This may represent as much as 2.5-7 times the national misuse rate. This group of patients may benefit from additional diagnostic and therapeutic interventions to help understand and manage their opioid usage.

Prescription Opioid Misuse Index in sickle cell patients: A brief questionnaire to assess at-risk for opioid abuse.

To develop a survey instrument to identify adult sickle cell disease (SCD) patients on chronic opioid therapy who are at-risk for opioid abuse. Prospective survey and interview. Adult SCD clinic in a large urban teaching facility. Convenience sampling of adult patients presenting to the sickle cell clinic. None. Primary outcome was "at-risk for opioid misuse," defined as at least 3/8 "yes" answers (a positive composite score) on the Prescription Opioid Misuse Index (POMI) questionnaire. Secondary outcome was DSM-IV criteria for substance abuse using the DSM IV Diagnostic Interview Schedule. Of the 99 patients who completed the POMI, the mean age was 36 years; 58.6 percent were female, 48 percent were hemoglobin SS (47/99), and 26 percent were SC (26/99). Twenty-four percent (24/99) were identified as at-risk for opioid misuse using the POMI. There were no differences in demographic, SCD genotype, or socioeconomic variables for at-risk versus not-at-risk patients. Twenty-four percent of unselected adult SCD patients on opioids were identified as at-risk for opioid misuse using a quick survey. This may represent as much as 2.5-7 times the national misuse rate. This group of patients may benefit from additional diagnostic and therapeutic interventions to help understand and manage their opioid usage.

Loperamide Abuse and Dependence: Clinical Features and Treatment Considerations

: Opioid use disorder and its associated mortality have become national epidemic problems. Different measures and regulations have been implemented to curb this trend, including stricter opioid prescribing practice. With the decreased access to prescription opioids, individuals with opioid use disorder have explored alternatives including loperamide, a peripheral opioid mu-receptor agonist. There are reports of increased loperamide misuse, dependence, and mortality rate in the past few years from poison control centers, medical examiners' offices, and clinical settings. Here, we report a case of loperamide use disorder, which led to the death of the patient. Associated clinical features and treatment of loperamide use disorder, including management of intoxication and withdrawal, and long-term maintenance therapy are discussed along with potential prescribing and sale regulations to manage this newly emerging substance use disorder.

A method of eliminating false alarm based on deep learning

Alarm data in intrusion detection system is mixed with a large amount of false alarm data, which brings great interference for network managers to analyze attack behavior. For a large deal of false alarm data in intrusion detection, this paper proposed an DBN construction method based on genetic operator improving the particle swarm, and used this DBN as a false alarm elimination classifier in IDS, firstly, using the improved particle swarm algorithm to search for the candidate network structure of DBN based on the fitness evaluation criteria, considering the candidate network structure with the optimal fitness as the final DBN network structure, secondly, using this DBN for false alarm elimination in intrusion detection. The experimental results showed that the average elimination rate of the proposed method is 5.54% and 2.9% higher than that of the SOM and KNN algorithms respectively, and the average misuse rate is 3.99% and 1.22% lower than that of the SOM and KNN algorithms respectively.

Child Passenger Safety Technician Consultation in the Pediatric Primary Care Setting.

Correct use of a child safety seat (CSS) can reduce the risk of fatal motor vehicle crash-related injury by up to 71%; however, misuse rates for CSS are as high as 70%. We recruited 189 caregivers at 2 large suburban pediatric office practices; 94 in the intervention group and 95 in the control group. All participants completed a baseline survey and received a CSS safety brochure. Intervention participants had their CSS installation checked at enrollment by a certified child passenger safety (CPS) technician. Follow-up was conducted 4 months post enrollment. Intervention group participants had a 21.3% reduction in critical misuse at follow-up, whereas control participants critical misuse rate at follow-up was identical to the intervention group at baseline. A consult with a certified CPS technician, at the time of a routine visit to the pediatrician, resulted in a reduction in CSS misuse rates.

Misuse of Prescribed Pain Medication in a Military Population-A Self-Reported Survey to Assess a Correlation With Age, Deployment, Combat Illnesses, or Injury?

Opioid misuse is a growing epidemic among the civilian and military communities. Five hundred prospective, anonymous surveys were collected in the emergency department waiting room of a military tertiary care hospital over 3 weeks. Demographics, medical and military characteristics were investigated for association with opioid use. Univariate logistic models were used to characterize the probability of misuse in relation to the demographic, medical, and military-specific variables. Traumatic brain injury (TBI) and posttraumatic stress disorder were investigated within different age cohorts with adjustment for deployment. The opioid misuse rate disclosed by the subject was 31%. Subjects with TBI were less likely to misuse opioids. We found a trend among younger cohorts to have a higher likelihood for misusing opioids when diagnosed with TBI or posttraumatic stress disorder with history of deployment in the past 5 years. The most common form of misuse was using a previously prescribed medication for a new pain. Traumatic brain injury and/or enrollment in post-deployment recovery programs maybe protective against opioid misuse. Chronic opioid use among young soldiers maybe viewed as a weakness that could influence opioid misuse. Younger cohorts of active duty service members could be at higher risk for misuse. Efforts to enhance close monitoring of misuse should address these at-risk populations.

Methylphenidate Misuse in Adults: Survey of 414 Primary Care Physicians in Germany and Comparison with the Literature

Objectives: This paper deals with the methylphenidate (MPH) misuse by adults in Germany. Results of a survey among primary care physicians/internists have been supplemented by a comparison with the literature. Methods: In the period from October 5-20, 2015, a survey was sent to 414 primary care physicians/internists in four German cities (n = 10 were undeliverable). The response rate was 58% (n = 235). 34 original works on MPH abuse worldwide were found in the literature and are used in the analysis of the present data situation. The literature published before November 9, 2015 is considered in this paper. Results: 14% of the doctors who took part in the survey said that they had been asked for MPH prescriptions without any medical indication. The most frequent reason given for the request (42%) was adult attention deficit/hyperactivity disorder (ADHD) not verified by documents. According to the comparison with the literature, university students had a lifetime prevalence of MPH misuse ranging from 0.8% to 16.6% and school children had a misuse rate of 4.0%. In the civilian US population, the misuse rate was 4.2%. Among patients in possession of a current MPH prescription due to a diagnosis, the lifetime prevalence was 29% and among adolescents with suspected alcohol and/or drug problems 20%. Conclusions: MPH misuse is a major problem which has not been studied sufficiently. MPH misuse not only plays a role in the field of psychiatry, but also in other disciplines. Misuse particularly following a therapeutic prescription should be taken into account.

The Portable Device for Detecting Smart Meter Fee Control Functions

In view of the current smart meter fee control functions heavy task, work intensity and other issues, we designed a new type of portable smart meter fee control functions test device. The device includes a parallel communication, automatic features such as card issuers, small size, light weight, easy to carry, to achieve automatic control function detects meter fees, enhanced energy meter test bench, between the host computer and the inspector who machine interaction capabilities, improve the detection efficiency of the staff, reducing the misuse rate, and enhance the flexibility of the testing work. The device is able to meet the needs of the current smart meter automatically detects work. Guarantee the accuracy and reliability of the energy meter testing.

Inappropriate use of standard error of the mean when reporting variability of study samples: A critical evaluation of four selected journals of obstetrics and gynecology

ObjectiveThe study was designed to investigate the frequency of misusing standard error of the mean (SEM) in place of standard deviation (SD) to describe study samples in four selected journals published in 2011. Citation counts of articles and the relationship between the misuse rate and impact factor, immediacy index, or cited half-life were also evaluated. Materials and methodsAll original articles in the four selected journals published in 2011were searched for descriptive statistics reporting with either mean ± SD or mean ± SEM. The impact factor, immediacy index, and cited half-life of the journals were gathered from Journal Citation Reports Science edition 2011. Scopus was used to search for citations of individual articles. The difference in citation counts between the SD group and SEM group was tested by the Mann–Whitney U test. The relationship between the misuse rate and impact factor, immediacy index, or cited half-life was also evaluated. ResultsThe frequency of inappropriate reporting of SEM was 13.60% for all four journals. For individual journals, the misuse rate was from 2.9% in Acta Obstetricia et Gynecologica Scandinavica to 22.68% in American Journal of Obstetrics & Gynecology. Articles using SEM were cited more frequently than those using SD (p = 0.025). An approximate positive correlation between the misuse rate and cited half-life was observed. ConclusionInappropriate reporting of SEM is common in medical journals. Authors of biomedical papers should be responsible for maintaining an integrated statistical presentation because valuable articles are in danger of being wasted through the misuse of statistics.

Can nurse education in the postpartum period reduce car seat misuse among newborns?

Despite national, state, and hospital policies that require newborns to be transported in correctly used child safety seats (CSSs), significant CSS misuse frequently occurs among newborn infants. The objective of this study was to evaluate a comprehensive educational CSS training program for nurses and parents in a maternal/newborn unit. In the preintervention phase, we conducted a survey among maternal/newborn unit nurses in a large urban teaching hospital to measure CSS knowledge, attitude, and practice. We then enrolled 60 maternal-newborn dyads at discharge to survey maternal CSS knowledge and observe the CSS misuse rate. Our intervention phase included a 1-hour "mandatory" nurse CSS education classroom session, a nurse hands-on CSS demonstration and practice in a mother's room. During the postintervention phase, we enrolled 70 maternal-newborn dyads at discharge to survey maternal CSS knowledge and observe change in CSS misuse rate. In the preintervention phase, 43 (73%) of 59 eligible nurses completed the survey, and 47 (80%) of 59 completed the CSS education and training program. In the preintervention CSS survey, 23% of the nurses reported that education is part of their routine, 44% have CSS educational materials, 32% feel comfortable providing CSS education to parents, 12% feel CSS trained, 25% have time, 84% identify that CSS misuse is a problem, and 16% received CSS training.Enrolled mothers reflect maternal/newborn unit demographics as follows: maternal mean age of 29 years (range, 16-48 years), white (54%), black (11%), Hispanic origin (28%), English as primary language (83%), high school degree (31%), college degree (30%), Medicaid (23%), and private insurance (65%).Of 70 postintervention mothers, 44% reported receiving no nurse education, 21% reported receiving a brochure only, and 31% reported receiving nurse education. CSS misuse among mothers who received registered nurse education was not reduced compared with mother's who received a brochure only and those who did not receive CSS education.Comparison of CSS misuse before (n = 60) and after (n = 70) observations revealed an increase in average misuse (1.8 vs. 3.0, p < 0.05) and a decreases or no significant change in appropriate use as follows: harness in lowest slot (95% vs. 87%), retainer clip at axilla level (63% vs. 33%, p < 0.01), harness snug (50% vs. 27%, p < 0.01), attached to the vehicle (80% vs. 80%), 45-degree angle (60% vs. 19%, p < 0.01), and CSS moves (32% vs. 27%). Car safety seat misuse did not improve following implementation of a comprehensive nursing education and training program. CSS misuse in our study population was frequent and may increase injury risk in the event of a motor vehicle crash. Future work is needed to develop novel approaches and identify appropriate settings to reduce newborn CSS misuse.

Cognitive Study of Geometric Figure in Man-Machine Interface

Graphic elements is the most likely form to accept in people’s visual perception of man-machine interface, different people will have different cognitive graphics understanding. In this paper, the rectangular cylindrical, triangular prism, cylindrical, conical, spherical geometry as a stimulus, and test the reaction time of the subjects, the misuse rate of indicators above the 5 geometries recognized. The outcome: In terms of “press”, rectangular cylindrical, triangular prism, cylindrical is more sensitive than conical; In terms of “pull”, triangular prism, cylindrical is more sensitive than spherical; In terms of “spin”, cylindrical, spherical is more sensitive than rectangular, triangular prism; In terms of “drag”, rectangular cylindrical, triangular prism-shaped is more sensitive than spherical.

Assessment of errors and misused statistics in dental research

The goal of the study is to assess the level of misused statistics or statistical errors in dental research, and identify the major source of statistical errors prevalent in dental literature. A total of 418 papers, published between 1995 and 2009, was randomly selected from 10 well established dental journals. Every paper in the sample underwent careful scrutiny for the correct use of statistics. Of these, there were 111 papers for which we were unable to judge whether or not the use of statistics was appropriate, due to insufficient information presented in the paper; leaving 307 papers for this study. A paper with at least one statistical error has been classified as 'Misuse of statistics', and a paper without any statistical errors as 'Acceptable'. Statistical errors also included misinterpretation of statistical analytical results. Our investigation showed that 149 were acceptable and 158 contained at least one misuse of statistics or a statistical error. This gave the misuse rate of 51.5%, which is slightly lower than that reported by several studies completed for the medical literature.

Prospective assessment of fluoroquinolone use in a teaching hospital

The aim of this study was to review the use of fluoroquinolone (FQ) drugs in a teaching hospital and to bring to light the factors associated with FQ misuse. A prospective observational study of FQ prescriptions was conducted in a 2,200-bed teaching hospital. Every hospitalized patient receiving a FQ drug during the 3-week survey period was included. A questionnaire was filled out using medical records and face-to-face interviews with FQ prescribers. An infectious diseases specialist reviewed the questionnaires and analyzed FQ therapy according to local guidelines for FQ prescription. Among the group of 174 patients included, FQ therapy was inappropriate in 88 cases (50.6%; 95% CI 43-58) for the following reasons: inappropriate clinical setting, 43; non-first-line recommendation, 24; inappropriate choice of FQ agent, 9; and inappropriate combination of FQs, 12. FQ prescriptions did not comply with prescription rules in 45 cases (25.9%; 95% CI 20-33). Appropriateness and compliance overlapped for 17 of these 45 patients who received an inappropriate FQ course that did not comply with prescription rules. Finally, FQ therapy was misused for 116 of the 174 patients (66.6%; 95% CI 59-74). Characteristics linked with FQ misuse were hospitalization in surgical wards (p = 0.03), intravenous therapy (p < 0.01), and presumptive therapy (p = 0.05). The FQ misuse rate progressively decreased during the survey period (p = 0.04). FQ misuse was a common phenomenon in the teaching hospital studied. The significant improvement in FQ prescribing practices observed during the study period demonstrates that frequent review of antibiotic use with prescribers is warranted.

Triple-type theory of statistics and its application in the scientific research of biomedicine

To point out the crux of why so many people failed to grasp statistics and to bring forth a "triple-type theory of statistics" to solve the problem in a creative way. Based on the experience in long-time teaching and research in statistics, the "three-type theory" was raised and clarified. Examples were provided to demonstrate that the 3 types, i.e., expressive type, prototype and the standardized type are the essentials for people to apply statistics rationally both in theory and practice, and moreover, it is demonstrated by some instances that the "three types" are correlated with each other. It can help people to see the essence by interpreting and analyzing the problems of experimental designs and statistical analyses in medical research work. Investigations reveal that for some questions, the three types are mutually identical; for some questions, the prototype is their standardized type; however, for some others, the three types are distinct from each other. It has been shown that in some multifactor experimental researches, it leads to the nonexistence of the standardized type corresponding to the prototype at all, because some researchers have committed the mistake of "incomplete control" in setting experimental groups. This is a problem which should be solved by the concept and method of "division". Once the "triple-type" for each question is clarified, a proper experimental design and statistical method can be carried out easily. "Triple-type theory of statistics" can help people to avoid committing statistical mistakes or at least to decrease the misuse rate dramatically and improve the quality, level and speed of biomedical research during the process of applying statistics. It can also help people to improve the quality of statistical textbooks and the teaching effect of statistics and it has demonstrated how to advance biomedical statistics.

Increasing the safety of children's vehicle travel: From effective risk communication to behavior change

Introduction: When installed and used correctly, child safety seats reduce the risk of fatal injury by 71% for infants and 54% for toddlers. However, four out of five safety seats are unintentionally misused. Yet, parents fail to participate in safety-seat checks and other child seat interventions aimed at correcting misuse. Method: Such lack of participation is the focus of this article, which argues that most caregivers are naı̈ve to their own vulnerability for misusing their child's seat. Research on risk perception is discussed as a guide to understanding both the high misuse rate and the lack of participation in interventions designed to correct this public safety problem. Results and Impact: A comprehensive intervention plan that incorporates risk communication techniques for maximum parental participation is proposed that includes three essential components: (a) establishing community locations for parents to turn for safety seat advice, (b) making these locations well known to the public, and (c) increasing caregivers' perceptions of risk of misusing their children's seats.