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1 Executive summary Education reform is top of the agenda of almost every country in the world. Yet despite massive increases in spending (last year, the world's governments spent $2 trillion on education) and ambitious attempts at reform, the performance of many school systems has barely improved in decades. This is all the more surprising because there(More)
BACKGROUND Optimizing polypharmacy is often difficult, and critical appraisal of medication use often leads to one or more changes. We developed the Prescribing Optimization Method (POM) to assist physicians, especially general practitioners (GPs), in their attempts to optimize polypharmacy in elderly patients. The POM is based on six questions: (i) is(More)
INTRODUCTION In geriatric patients, atypical presentation and limitations in diagnostic scope may lead to underdiagnosis. The aim of this study was to establish the frequency, nature and causes of clinical diagnostic errors in a geriatric population. DESIGN A retrospective study. METHODS We assessed the accuracy of clinical diagnosis using autopsy(More)
Hyponatraemia is known to occur as a rare but clinically important adverse reaction to treatment with different psychotropic drugs, including selective serotonin reuptake inhibitors and antiepileptic drugs. In past decades, reports have been published that describe the development of hyponatraemia in association with antipsychotic drug treatment. Our(More)
OBJECTIVES To investigate the association between antipsychotic drug use and risk of pneumonia in elderly people. DESIGN A nested case-control analysis. SETTING Data were used from the PHARMO database, which collates information from community pharmacies and hospital discharge records. PARTICIPANTS A cohort of 22,944 elderly people with at least one(More)
The purpose of the study was to analyze efficacy and safety of quick pergolide titration combined with domperidone. In an open-label prospective study, pergolide was titrated in 16 days to a maximum of 3 mg/d doses as adjunctive treatment to L-Dopa in 10 elderly patients with Parkinson's disease. Sixty milligrams domperidone was started 2 days before and(More)
BACKGROUND Hyponatraemia due to antipsychotic use is a potentially serious problem; however, it is not known whether it is an adverse drug reaction (ADR) to antipsychotic use or is due to the underlying psychiatric disease. OBJECTIVE To estimate the strength of the association between antipsychotics and hyponatraemia or syndrome of inappropriate(More)
BACKGROUND Polypharmacy poses threats to patients' health. The Systematic Tool to Reduce Inappropriate Prescribing (STRIP) is a drug optimization process for conducting medication reviews in primary care. To effectively and efficiently incorporate this method into daily practice, the STRIP Assistant--a decision support system that aims to assist physicians(More)
The program package ACRITH (High-Accuracy Arithmetic Subroutine Library) provides FORTRAN subroutines for the solution of several standard mathematical problems. The routines use floating point operations with extended precision and interval arithmetic and are designated especially for the solution of ill-conditioned problems. Test results for most of the(More)