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Developing and maintaining quality in poisons information centers.

Abstract

The development of poisons information centers has in general complied with the actual needs and conditions in the society, and a pragmatic approach and limited funds have been characteristic for these units. To operate in a satisfying way a poisons information center is dependent on two cornerstones-a well educated and specifically trained staff on the one hand, and reliable, up-dated and easily manageable information sources on the other. Once a poisons information service has started to operate, it must more or less instantly launch a process to develop and continuously check the standards and the quality of the service. The European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) has for this purpose developed a self-assessment checklist, addressing and defining minimum and optimum standards to be considered when running a poisons information service [J. Toxicol. Clin. Toxicol. 39 (2001) 2226]. Items covered are poisons center operations, direction and management, education and training of staff, location of poisons centers, information sources, documentation of enquiries/cases, funding, publications and quality control.

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BibTeXRIS

Hans Persson, Joanna Tempowski. 2004-05-20. Developing and maintaining quality in poisons information centers.. https://doi.org/10.1016/j.tox.2004.01.033

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Recurrence risk to offspring in extended multiplex schizophrenia pedigrees from a Pacific Island isolate.

Genetic transmission plays a major role in the pathogenesis of schizophrenia. Family, twin, and adoption studies have consistently shown that risks in relatives are many times greater than the general population risk of approximately 1%. McGue, Gottesman, and Rao (1983; Am J Hum Genet 35:1161-1178) calculated risk estimates of 12.8% for offspring and 3.5% for nieces/nephews of schizophrenia patients based on a large data set of Western European families. The present study evaluated corresponding risk levels in Palau, an isolated population in Micronesia where the prevalence of narrowly (broadly) defined schizophrenia is 1.99% (2.67%) and cases cluster in extended pedigrees, 20 of which contain 80% of affected individuals. We hypothesized that offspring in these extended families would have a higher risk for schizophrenia than offspring in smaller schizophrenia pedigrees from more genetically heterogeneous populations. RDC diagnostic data based on complete ascertainment of cases and their families covering the past two generations were used to quantify empirical recurrence risks in the offspring and nieces/nephews of Palauan schizophrenia patients. Risks to 1st- and 2nd-degree offspring were approximately double the rates found in the smaller Western European families: 23.4% in the offspring of an affected parent, 6.4% in offspring with one affected aunt/uncle, and 15.0% in offspring with two or more affected aunts/uncles. Recurrence rates in offspring of an affected parent were 1.6 times higher in males (27.9%) than in females (17.7%). The high risk levels we found in Palauan offspring reflect the elevated population prevalence, strong familial aggregation, and multi-lineal transmission pattern of schizophrenia in Palau.

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