Bolette Sandford Pedersen

The Efficacy of Disulfiram for the Treatment of Alcohol Use Disorder

BACKGROUND Alcohol use disorders (AUD) involving hazardous, harmful, and addictive misuse of alcohol are widespread in most parts of the world. The aim of this study was to review the effect of disulfiram in the treatment of patients with AUD. The effect of disulfiram was evaluated according to the primary outcome of an intake of alcohol below 30 and 20 g/d for men and women, respectively, as well as secondary outcomes such as days until relapse, alcohol intake, and numbers of drinking days. METHODS A systematic review of the literature was conducted using MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL). RESULTS Eleven randomized controlled trials were included with a total of 1,527 patients. They compared disulfiram treatment with placebo, none or other abstinence-supportive treatments. Overall, 6 studies reported of a significant better effect on abstinence for patients treated with disulfiram. Six of 9 studies measuring secondary outcomes reported that patients treated with disulfiram had significantly more days until relapse and fewer drinking days, respectively. The quality of the included studies was moderate. Heterogeneity was significant in most of the meta-analyses, but valid results were found regarding the effect of disulfiram versus placebo over 12 months and unsupervised disulfiram versus other or no treatment. The vast majority of significant studies were of shorter duration, while only 3 studies of 12 months were significant regarding more days until relapse and/or reduction in drinking days. CONCLUSIONS Supervised treatment with disulfiram has some effect on short-term abstinence and days until relapse as well as number of drinking days when compared with placebo, none, or other treatments for patients with alcohol dependency or abuse. Long-term effect on abstinence has not been evaluated yet. However, there is a need for more homogeneous and high-quality studies in the future regarding the efficacy of disulfiram.

Content-based text querying with ontological descriptors

This paper describes a method and a system for content-based querying of texts based on the availability of an ontology for the concepts in the text domain. A key principle in the system is the extraction of conceptual content of noun phrases into descriptors forming an integral part of the ontology.The retrieval of text passages rests on matching descriptors from the text against descriptors from the noun phrases in the query. The match does not need to be exact but is mediated by the ontology invoking in particular taxonomic reasoning with sub- and super-concepts. The paper also reports on a prototype implementation of the system.

DanNet: the challenge of compiling a wordnet for Danish by reusing a monolingual dictionary

This paper is a contribution to the discussion on compiling computational lexical resources from conventional dictionaries. It describes the theoretical as well as practical problems that are encountered when reusing a conventional dictionary for compiling a lexical-semantic resource in terms of a wordnet. More specifically, it describes the methodological issues of compiling a wordnet for Danish, DanNet, from a monolingual basis, and not—as is often seen—by applying the translational expansion method with Princeton WordNet as the English source. Thus, we apply as our basis a large, corpus-based printed dictionary of modern Danish. Using this approach, we discuss the issues of readjusting inconsistent and/or underspecified hyponymy hierarchies taken from the conventional dictionary, sense distinctions as opposed to the synonym sets of wordnets, generating semantic wordnet relations on the basis of sense definitions, and finally, supplementing missing or implicit information.

Ontological Extraction of Content for Text Querying

This paper describes a method and a system ONTOQUERY for content-based querying of texts based on the availability of an ontology for the concepts in the text domain. A key principle in the system is the extraction of conceptual content of noun phrases into descriptors forming an integral part of the ontology.The retrieval of text passages rests on matching descriptors from the text against descriptors from the noun phrases in the query. The match need not be exact but is mediated by the ontology, invoking in particular taxonomic reasoning with sub- and super concepts. The paper also reports on a prototype implementation of the system.

Health and the need for health promotion in hospital patients

BACKGROUND Integrated health promotion improves clinical outcomes after hospital treatment. The first step towards implementing evidence-based health promotion in hospitals is to estimate the need for health promoting activities directed at hospital patients. The aim of this study was to identify the distribution and association of individual health risk factors in a Norwegian hospital population and to estimate the need for health promotion in this population. METHODS We used a validated documentation model (HPH-DATA Model) to identify the prevalence of patients with nutritional risk (measurements of waist and weight), self-reported physical inactivity, daily smoking and hazardous drinking. We used logistic regression to describe the associations between health risk factors and demographic characteristics. RESULTS Out of 10 included patients, 9 (N = 1522) had one or more health risk factors. In total 68% (N = 1026) were overweight, 44% (N = 660) at risk of under-nutrition, 38% (N = 574) physically inactive, 19% (N = 293) were daily smokers and 4% (N = 54) hazardous drinkers. We identified a new clinical relevant association between under-nutrition and smoking. The association between hazardous drinking and smoking was sustained. CONCLUSION Nearly all patients included in this study had one or more health risk factors that could aggravate clinical outcomes. There is a significant need, and potential, for health-promoting interventions. Multi-factorial interventions may be frequently indicated and should be the subject of interventional studies.

Alcohol-related hospital admissions: Missed opportunities for follow up? A focus group study about general practitioners’ experiences

Aims: To explore general practitioners’ (GPs’) follow-up experiences with patients discharged from hospital after admittance for alcohol-related somatic conditions. Design and participants: Two focus groups with GPs (four women and 10 men), calling for stories about whether the intervention given in the hospital had been recognised by the GP and how this knowledge affected their follow up of the patient’s alcohol problem. Systematic text condensation was applied for analysis. Findings: A majority of the GPs had experienced patients with already recognised alcohol problems being rediscovered by the hospital staff. Still, they presented examples of how seeing the patient in a different context might present new opportunities. Few participants had received adequate information from the hospital about their patient’s alcohol status, and they emphasised that a report about what had happened and what was planned was needed for follow up. Care pathways for patients with alcohol problems were seen as fragmented. Yet they described how alcohol-related hospital admissions might function as an eye-opener for the patient and a window of opportunity for lifestyle change. Conclusions: Hospital admittances provide important opportunities for change, but hospital care is seen as fragmented and poorly communicated to the GPs. For shared responsibility and follow up, all participating agents, including the patient, must be sufficiently informed about what has happened and what will follow. For the patient, hospital admittance is usually brief, while the relationship with their GP is long term, even lifelong. GPs are therefore key partners for programme development.

Applying language technology to ontology-based querying: The ontoquery project

This paper addresses the issue of how language technology resources and components can be applied in ontology-based querying. In particular, it presents the approach to text and query analysis adopted in the Danish research project OntoQuery, where shallow syntactic analysis and ontology-based parsing are combined in order to identify nominal phrases (NPs) and assign them a semantic description. Semantic descriptions are used by the search engine to match queries against texts in a database, and a ranking of the texts retrieved is produced based on a domain ontology. This is intended to be a general methodology applicable to texts from different domains, including those relevant to cultural heritage, although OntoQuery has chosen nutrition as its first target domain. The paper focuses on the language technology aspects of the methodology, the ontology-based lexicon inherited from the SIMPLE project, and the development of the domain-specific ontology. The methodology is partly implemented in a prototype.

Fractures and Alcohol Abuse – Patient Opinion of Alcohol Intervention.

Purpose: To clarify patient opinions about alcohol intervention in relation to surgery before investigating the effect in a Scandinavian multi-centre randomized trial. Material and Methods: A qualitative study. Thirteen consecutive alcohol patients with fractures participated after informed consent. They were interviewed during their hospital stay. The number of participants was based on the criteria of data-saturation. The analysis followed the applied qualitative framework model aimed at evaluation of specific participant needs within a larger overall project. Results: All patients regarded alcohol intervention in relation to surgery as a good idea. They did not consider quit drinking as a major problem during their hospital stay and had all remained abstinent in this period. About half of the patients were ready or partly ready to participate in an alcohol intervention. Patient opinions and their readiness to participate were expressed in four groups, which also reflected their readiness to stop drinking in the perioperative period, their general acceptance of supportive disulfiram as part of an alcohol intervention as well as their awareness of postoperative complications. Conclusion: This study clarified that the patients found alcohol intervention relevant in relation to surgery.

Using shallow linguistic analysis to improve search on Danish compounds

In this paper we focus on a specific search-related query expansion topic, namely search on Danish compounds and expansion to some of their synonymous phrases. Compounds constitute a specific issue in search, in particular in languages where they are written in one word, as is the case for Danish and the other Scandinavian languages. For such languages, expansion of the query compound into separate lemmas is a way of finding the often frequent alternative synonymous phrases in which the content of a compound can also be expressed. However, it is crucial to note that the number of irrelevant hits is generally very high when using this expansion strategy. The aim of this paper is therefore to examine how we can obtain better search results on split compounds, partly by looking at the internal structure of the original compound, partly by analyzing the context in which the split compound occurs. In this context, we pursue two hypotheses: (1) that some categories of compounds are more likely to have synonymous ‘split’ counterparts than others; and (2) that search results where both the search words (obtained by splitting the compound) occur in the same noun phrase, are more likely to contain a synonymous phrase to the original compound query. The search results from 410 enhanced compound queries are used as a test bed for our experiments. On these search results, we perform a shallow linguistic analysis and introduce a new, linguistically based threshold for retrieved hits. The results obtained by using this strategy demonstrate that compound splitting combined with a shallow linguistic analysis focusing on the argument structure of the compound head as well as on the recognition of NPs, can improve search by substantially bringing down the number of irrelevant hits.

Systematic Verb Polysemy in MT: A Study of Danish Motion Verbswith Comparisons with Spanish

In this paper we propose a semantic apparatus based on Frame Semanticswhich enables us to treat the systematic polysemy of Danish motionverbs in a satisfactory way in relation to Machine Translation (MT).Abandoning the strategy applied in more traditional MT systems whererelated and unrelated meanings are in essence treated alike, i.e. asunrelated, we suggest an approach where relatedness in meaning isexpressed via frame element assignments and where systematicallyderived senses can thus be generated on the basis of prototypicalsenses. By contrasting Danish data with Spanish, we demonstrate thatthe identified meaning variations in Danish motion verbs are crucialnot only for analysis but also in the transfer phase where deviationsin evoked frame elements prove to trigger translations which differfrom the “prototypical” translations of the relevant verbs.