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Background: One of the most consistent findings reported in the paediatric cochlear implant (CI) literature is the heterogeneity of language performance observed more in grammatical morphology than in lexicon or pragmatics. As most of the corpus studies addressing these issues have been conducted in English, it is unclear whether their results can be generalized to other languages. In particular, little is known about languages known for their grammatical complexity, such as French. Aims: The aim of this corpus study was to compare the productive use of function words (FWs) and some agreement features (AGRs) in children with CIs and children with typical development (TD) matched for mean length of utterance in words (MLUwords), a general index of grammatical complexity, and auditory experience, as measured by hearing age (HA) and chronological age (CA), respectively. Methods & Procedures: Natural speech samples from 116 monolingual French‐speaking children, including 40 children with CIs followed longitudinally and 76 TD children, were collected. FWs and AGRs were analysed using a Part of Speech Tagger (POS‐T) from the Child Language Data Exchange System (CHILDES). Outcomes & Results: The two groups differed by 3 years for HA and CA. No effect of family socio‐economic status (SES) was found in the CI group. Stepwise regression analyses showed that the two groups did not share the same predictors of MLUwords: plurals and determiners predicted MLUwords in children with CIs, at 2 and 3 years of HA, whereas feminine markers and subject‐pronouns were found to best predict MLUwords in TD children at 2 and 3 years of CA. Structural equation models (SEMs), a combination of confirmatory factor analysis (CFA) and path analysis, yielded a different hierarchical structure of grammatical relations (GRs). Selective difficulties affecting verbal clitics and other pronominal forms were found specifically in the CI group (object‐pronouns, reflexive, relative and past participles). Dependency grammar analysis confirmed these contrasting developmental profiles in multiword utterances, such as preposition/nouns, subject/verbs, and verb/determiner/nouns. Conclusions & Implications: Atypical grammatical patterns in children with CIs reflect a specific architecture of syntactic dependencies of FWs underpinning morphological complexity and syntactic connectivity. Clinical implications are discussed for assessment and intervention planning. What This Paper Adds: What is already known on this subject: The productive use of FWs has been identified as a particular area of weakness in children with CIs compared with TD children. In addition, heterogenous grammatical performance has often been found after 1–3 years of CI use, regardless of demographic factors such as age at implantation, duration of deafness or SES. What this paper adds to existing knowledge: Assessing the early building of FWs and AGRs in children with CIs helps to understand the syntactic complexity and hierarchical structure of their language. Since most corpus studies on grammatical morphology have been conducted in English, it is not clear whether their difficulties can be generalized to other languages. The French language has a system of FWs and inflections that determine the morphophonological properties of nominal and verbal forms. Early grammar learning in children with CIs born with profound deafness were compared with the two groups of TD children matched both for duration of auditory experience (i.e., HA of CI children, CA of TD children) and for MLUwords. We found a similar profile between groups at 2 years but not at 3 years for HA and CA. The two groups do not share the same predictors of MLUwords: namely, plurals and determiners for CI children versus feminine markers and subject pronouns for TD children. They show a different syntactic organization of GRs. Children with CIs struggle with selective difficulties affecting verbal clitics and pronominal forms (object‐pronouns, reflexive, relative and past participles). Consistent with theories of morphophonological richness and syntactic connectivity, our results support the distributional learning hypothesis of language acquisition that infants and toddlers are sensitive to FWs and AGRs at an early age. Specific components of syntactic organization are disrupted in children with CIs. What are the potential or actual clinical implications of this work?: This work has potential clinical implications because it unravels the limitations of morphophonological processing in children with CIs. Its results highlight a specific difficulty in learning FWs and AGRs in a verbal inflectional morphology context. [ABSTRACT FROM AUTHOR]

Various types of anti‐immigrant sentiments have been taken as the characteristic independent variable to explain specific support for radical right parties. However, some survey respondents tend to conceal their attitudes towards socially sensitive issues. To overcome this challenge, the present study used a list experiment method (item count technique) to reveal respondents' covert attitudes towards immigrants (and compared these with overt expressions) based on party support in France. Results indicated similar levels of anti‐immigrant sentiments among radical right National Front supporters and other centre‐rightist parties. In addition, comparison with the direct question method revealed that while supporters of centre‐right parties were reluctant to express their anti‐immigrant sentiment in overt expressions, National Front supporters willingly expressed it overtly more than in covert expressions. Using regression analysis, this paper demonstrates the diversity of anti‐immigrant norms and the social desirability bias gap in the French political space. [ABSTRACT FROM AUTHOR]

This paper assesses the impact of eligibility for a free means-tested complementary health insurance plan, called Couverture Maladie Universelle Complémentaire (CMUC), on doctor visits. We use information on the selection rule to qualify for the plan to identify the effect of eligibility and adopt a regression discontinuity approach. Our sample consists of low-income individuals enrolled in the Health Insurance Fund and recipients of social benefits from the Family Allowance Fund of an urban area in Northern France. Our findings do not show significant impacts of the CMUC threshold on the number of doctor visits within the full sample. Among the subsample of adults under 30 years old, however, eligible individuals are more likely to see a specialist and have, on average, significantly more specialist visits than non-eligible individuals. This specific impact of the CMUC cut-off point among young adults may be explained by the fact that young adults are less likely to be covered by a complementary health insurance plan when they are not recipients of the CMUC plan. © 2017 The Authors. Health Economics Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Why are some countries characterized by more income redistribution than others? Based mainly on Trans‐Atlantic comparisons, the literature has referred to dissimilarities in preferences for redistribution. In this article, we extend this literature by focusing on multiple dimensions of redistributive preferences and adding Japan to the comparison. More precisely, using data for France, the US, and Japan from ISSP 2009, we apply cross‐sectional regression models and the Blinder–Oaxaca decomposition technique to address two distinct questions about preferences for redistribution—the role of government in reducing income gaps and tax progressivity. We find that each of these dimensions are related to different mechanisms: i.e. one depends more on individuals' specific situations, such as income/wealth and social beliefs, as stressed in the literature, whereas the other depends more on an unobservable but common factor within a country, such as the historical and cultural background of each society. [ABSTRACT FROM AUTHOR]

This paper introduces a new spatial scan statistic designed to adjust cluster detection for longitudinal confounding factors indexed in space. The functional-model-adjusted statistic was developed using generalized functional linear models in which longitudinal confounding factors were considered to be functional covariates. A general framework was developed for application to various probability models. Application to a Poisson model showed that the new method is equivalent to a conventional spatial scan statistic that adjusts the underlying population for covariates. In a simulation study with single and multiple covariate models, we found that our new method adjusts the cluster detection procedure more accurately than other methods. Use of the new spatial scan statistic was illustrated by analyzing data on premature mortality in France over the period from 1998 to 2013, with the quarterly unemployment rate as a longitudinal confounding factor. [ABSTRACT FROM AUTHOR]

Information seeking (IS) has become a critical activity in video‐based environments. Up to now, the effects of support on information seeking (i.e., scaffolding) have seldom been assessed. The twofold aim of the current study was to (a) assess the effects of scaffolding on IS in videos and (b) determine the characteristics of the users' mental models after an IS activity with or without scaffolding. We divided 50 participants into two groups that either did or did not benefit from initial scaffolding during an IS task. Both groups then had to perform a localization task without any further access to scaffolding. Results showed that scaffolding the video by providing a table of contents and markers on a timeline helped students to engage in highly efficient IS, but they had less accurate mental representations of the video than those without scaffolding. The hypothesis that scaffolding provides a usable but external model was therefore supported. Lay Description: What is already known about this topic: Videos are increasingly used in learning.Searching for information in videos may be a complex activity.So far, very few studies have been conducted on the potential effect of scaffolding videos during an information‐seeking (IS) task. What this paper adds: In this study, we put in place the scaffolding of the video by adding a table of contents and markers on the timeline.Structuration and segmentation have positive effects on the performance in IS, in terms of response success, time spent on each search, relevance, and perceived difficulty.Scaffolding has a negative impact on the users' internal representations of the video. Implications for practice: Incorporating a table of contents and a structured timeline into a video facilitates the search activity.Without scaffolding, the search activity is longer and cognitively more costly.Paradoxically, users have a poorer representation of the video (i.e., poorer mental model) after the IS task when they were given scaffolding.Future studies should focus on the benefits of providing structuring and segmentation in learning tasks. [ABSTRACT FROM AUTHOR]

Flashbulb memories are vivid autobiographical memories of the circumstances where an individual first learns about emotionally significant public events. Our paper assesses whether these memories were triggered by the attacks of Friday 13 November 2015 in Paris. Two hundred and ninety-one participants answered a web-based questionnaire that assessed their memory of the circumstances in which they first learned of the attacks. The questionnaire also assessed vividness, rehearsal, emotion, surprise and novelty. The results showed substantial and vivid recall of the context in which the participants first learned of the event. This recall was associated with fair rehearsal, negative emotional valence, surprise, and novelty. Regression analysis showed that the flashbulb recall was predicted by negative emotion. Negative emotion seems to play a key role in the formation of flashbulb memories, at least those associated with the Paris attacks. [ABSTRACT FROM AUTHOR]

Background: Direct support workers (DSWs) accompany adults with autism spectrum disorder (ASD) and intellectual disability (ID) in residential care homes. Such DSWs, without specialised ASD training, are exposed to chronic stress linked to supporting ASD‐ID clients and must adjust by coping strategies adapted to the needs of the residents. Nevertheless, difficulties adjusting constitute a burnout risk for DSWs, characterised by high levels of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment. We aimed to describe the burnout of DSWs who support adults with ASD‐ID and to identify personal variables (experience and specialised training for ASD) and transactional variables (perceived stress and coping strategies) that could predict and mediate burnout. Method: In total, 125 DSWs accompanying ASD‐ID adults on a daily basis were included. Each participant answered four questionnaires measuring burnout, sociodemographic and professional variables, coping strategies and perceived stress. Results: Five per cent of DSWs were in a state of burnout. Eighteen, six and fifty‐nine per cent showed high average scores of emotional exhaustion, depersonalisation and loss of a sense of personal accomplishment, respectively. Being older, specialised training in ASD, stress perceived as a challenge and problem‐focused coping strategies were associated with low levels of depersonalisation and loss of a sense of personal accomplishment. Conclusions: Understanding the burnout process of ASD‐ID DSWs may require the assessment of the organisational characteristics linked to the quality of life of the DSWs and the recognition of their specific needs when facing difficulties. The necessary ASD‐focused training and support depends on an appraisal that would be individualised to adult ASD‐ID DSWs. [ABSTRACT FROM AUTHOR]

Summary: Background: Cord blood leptin is an indicator of neonatal fat mass and could shape postnatal adiposity trajectories. Investigating genetic polymorphisms of the leptin receptor gene (LEPR) could help understand the mechanisms involved. Objectives: We aimed to investigate the association of cord blood leptin level and the LEPR rs9436303 polymorphism, with body mass index (BMI) at adiposity peak (AP) and age at adiposity rebound (AR). Methods: In the EDEN cohort, BMI at AP and age at AR were estimated with polynomial mixed models, for 1713 and 1415 children, respectively. Multivariable linear regression models allowed for examining the associations of cord blood leptin level and LEPR rs9436303 genotype with BMI at AP and age at AR adjusted for potential confounders including birth size groups. We also tested interactions between cord blood leptin level and rs9436303 genotype. Results: Increased leptin level was associated with reduced BMI at AP and early age at AR (comparing the highest quintile of leptin level to the others). Rs9436303 G‐allele carriage was associated with increased BMI at AP and later age at AR but did not modulate the association with leptin level. Conclusion: These results illustrate the role of early life body composition and the intrauterine environment in the programming of adiposity in childhood. [ABSTRACT FROM AUTHOR]

Breastfeeding (BF) initiation rates in French maternity units are among the lowest in Europe. After increasing for several years, they decreased between 2010 and 2016, although several maternal characteristics known to be positively associated with BF in France were more frequent. We aimed to (1) quantify adjusted trends in BF initiation rates between 2010 and 2016; (2) examine associations between BF initiation rates and newborn, maternal, maternity unit, and department‐level characteristics. Using data from the 2010 (n = 12,224) and 2016 (n = 11,089) French National Perinatal Surveys, we analysed BF initiation (exclusive, mixed, and any) through a succession of six mixed‐effect multinomial regression models, progressively adding adjustment covariates. Adjusted exclusive and any BF initiation rates decreased by 9.6 and 4.5 points, respectively, versus by 7.7 and 1.8 points, respectively, in the crude analysis. In both years, adjusted exclusive and any BF initiation rates were lowest in the following categories of mothers: low education level, single, high body mass index and multiple or premature births. Exclusive BF initiation decreased most in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. The 2010–2016 decrease in BF initiation rates in France cannot be explained by changes in mothers' characteristics; quite the opposite, adjustment increased its magnitude. Additional efforts should be put in place to understand why this decrease is particularly sharp in some subgroups of mothers. Key points: While some maternal characteristics previously known to be positively associated with breastfeeding (BF) in France were more frequent in 2016 than 2010, any BF initiation rate in maternity units in France decreased by 2 points (from 68.7% to 66.7%), and exclusive BF by 8 points (from 60.3% to 52.2%). Even greater decreases (4.5 and 9.6 points, respectively) were observed after adjusting for the characteristics of mothers, newborns, maternity units, and departments.Between 2010 and 2016, the largest decreases in adjusted exclusive BF initiation rates were observed in primiparous mothers, those with the lowest household income, mothers that had a vaginal delivery, women born in an African country and those who delivered in a maternity unit without Baby‐Friendly Hospital Initiative designation. [ABSTRACT FROM AUTHOR]

Background and purpose: Social engagement is an important active aging strategy to promote older adults' mental health. The purposes of this study were to compare social engagement in older populations around the world and explore associations with mental health outcomes. Materials and methods: An international cross‐sectional survey was conducted from 2017 to 2019. Data were retrieved from The International Social Survey Programme for a secondary data analysis across 30 countries. This study applied the Taxonomy of Social Activities and its six levels as operational definitions for a consistent concept of social engagement for international comparisons. Results: In total, 9403 older adults with a mean age of 72.85 ± 6.40 years responded. The highest levels of older adults' social engagement were found in Switzerland, Thailand, and New Zealand. Older adults of a higher age, with a lower educational level, who were permanently sick or disabled, who had no partner, who were widowed or whose civil partner had died, who lived alone, and who had lower self‐placement in society had significantly lower social engagement than did their counterparts. In the regression model, older adults' social engagement positively predicted general health, self‐accomplishment, and life satisfaction, but negatively predicted loneliness and depression. Conclusions: In aging societies worldwide, encouraging older adults' social engagement would be beneficial to promote mental health. Implications for nursing practice and health policies: Community professional nurses can develop strategies of social engagement based on the needs and sociodemographic factors of older adults to improve their mental health. Developing efficient strategies and local policies by learning from successful experiences in other countries is important to promote social engagement in aging societies. [ABSTRACT FROM AUTHOR]

While the survival function of culture against infectious disease has been investigated, little is known about its psychological processes under the real‐world threat of infection. Here, we compare the subjective COVID‐19‐related symptoms of Japanese and French adults during the spring of 2021. We tested two regression models describing the downregulation of symptoms by germ aversion, and by interdependent happiness, together with relational mobility and demographics. We regard germ aversion as an individualized fending‐off process marked by discomfort with the general other in the face of possible infection. We regard interdependent happiness as a relational safeguarding process against possible infection. Results suggest that the effect of germ aversion differed across nations, negatively explaining symptoms in Japan but not in France, and that the effect of interdependent happiness was shared. A possible psychological mechanism whereby collectivist culture suppresses infection in the face of the pandemic is discussed. [ABSTRACT FROM AUTHOR]

This article investigates the effects of union and nonunion employee representation (ER) on the use of high-performance work systems (HPWSs) in the French context. We use microdata from a nationally representative survey (REPONSE 2010-11) and estimate models dealing with the potential endogeneity of ER. After controlling for endogeneity and for a range of workplace characteristics, regression analyses suggest that neither union nor nonunion representatives are inherently against the use of HPWSs. Moreover, these forms of ER cannot be regarded as substitutes for one another. Results vary, depending on what type of bundle of practices is considered. [ABSTRACT FROM AUTHOR]

Summary: Background: In several systematic reviews, rapid weight gain in early life has been related to increased risk of later obesity. In line with this finding, the "early protein hypothesis" suggests that reducing early protein intake is a potential lever for obesity prevention. Objective: To determine whether the variability of protein content of infant formula used in France over the period 2003‐2012 is significantly associated with early growth in children. Methods: A pooled sample of infants from the EDEN (Etude des Déterminants pré et postnatals de la santé et du développement de l'Enfant) mother‐child cohort (born in 2003‐2006) and the ELFE (Etude Longitudinale Française depuis l'Enfance) birth cohort (born in 2011) (ntotal = 5846) was used. Protein content of the infant formula received at 4 months was classified into five groups. Associations between protein content (or breastfed status) at 4 months and weight‐, length‐ and BMI‐for‐age z‐scores at 6, 12 and 18 months were analysed by multivariable linear regression. Results: This analysis showed a positive association between protein content and weight‐, length‐ and BMI‐for‐age z‐scores at 6 months and only for weight‐for‐age at 12 months. At 6 months, as compared with the intermediate protein‐content group (2.1‐2.5 g/100 kcal), infants receiving very‐high protein content (>2.8 g/100 kcal) had higher BMI‐for‐age z‐score and those from the very‐low protein‐content group (<2.0 g/100 kcal) had lower BMI‐for‐age z‐score. Exclusively breastfed infants had lower length and weight z‐scores than formula‐fed infants at any age. Conclusions: Our findings show a positive association, under real conditions of use, between protein contents in infant formula still on the market and weight‐, length‐ and BMI‐for‐age z‐scores from 6 to 18 months. [ABSTRACT FROM AUTHOR]

Background: The objectives of this study are to estimate the prevalence of iron deficiency (ID) among French whole‐blood (WB) donors to identify factors associated with ID and to generate decision trees. Study design and methods: A prospective National multicentre study was performed on WB donors from March 11, to April 5th, 2019. Samples were selected randomly to perform serum ferritin. ID was defined as ferritin value under 26 ng/ml. All results were stratified by sex. Factors associated with ID were analysed using multivariate logistic regression model. CART algorithm was used for decision trees. Results: Eleven thousand two hundred fifty eight WB donors were included. ID was more frequent in women (39·5%) than in men (18·0%). Among 7200 repeated donors, women below 50 yo had a higher risk (OR = 2·37; [1·97–2·85] IC95) than those above 50 yo. Factors associated with ID were: haemoglobin level under the threshold at donation n‐1 except for women and n‐2 donation; a low mean corpuscular haemoglobin at n‐1 and n‐2 donations; a shorter interval since n‐1 donation and between n‐1 and n‐2 donations except for women; and women who had given three or four times in the last year. CART algorithm defined high risk of ID subgroups within three populations of donors, new female donors, repeated male donors and repeated female donors. In these identified subgroups, prevalence of ID was up to 72·1%. Conclusions: Our study showed the high prevalence of ID among French WB donors, identified well‐known and new factors associated with ID and defined algorithms predicting ID in three populations. [ABSTRACT FROM AUTHOR]

The aim of the Impact d'une démarche QUAlité sur l'évolution des pratiques et le déclin fonctionnel des Résidents en Établissement d'hébergement pour personnes âgées dépendantes ( IQUARE) study was to examine the effects of a global intervention comprising professional support and education for nursing home ( NH) staff on quality indicators ( QIs) and functional decline and emergency department ( ED) transfers of residents. One hundred seventy-five NHs in France (a total of 6,275 residents randomly selected from NHs) volunteered and were enrolled in a nonrandomized controlled multicenter individually customize trial with 18-month follow-up. NHs were allocated to a quality audit and feedback intervention (control group: 90 NHs, 3,258 residents) or to the quality audit and feedback intervention plus collaborative work meetings between a hospital geriatrician and NH staff (experimental group: 85 NHs, 3,017 residents). At the NH level, prevalence of assessment of kidney function, cognitive function, risk of pressure ulcers, behavioral disturbances, depression, pain, weight measurement, and transfer to the ED were recorded. Ability to perform basic activities of daily living was assessed at the resident level. At baseline, NH QIs were generally low (with large standard deviations), and annual rate of transfer to the ED was high (~20%) and similar in both groups. The intervention had a significant positive effect on the prevalence of assessment of pressure ulcer risk, depression, pain, and prevalence of ED transfers. It had no significant effect on functional decline. Large-scale efforts to improve QIs involving collaboration between hospital and NH providers and based on audit and collaborative discussion are feasible and improve some aspects of quality of care in NHs. [ABSTRACT FROM AUTHOR]

Background and aims It is well established that craving increases following exposure to substance-related 'cues', but the role of life-styles or substance use habits that are unique to each person remains poorly understood. This study examines the association of substance-specific and personal cues with craving and substance use in daily life. Design Ecological momentary assessment was used during a 2-week period. Setting Data were collected in a French out-patient addiction treatment centre. Participants A total of 132 out-patients beginning treatment for alcohol, tobacco, cannabis or opiate addiction were included. Measurements Using mobile technologies, participants were questioned four times per day relative to craving, substance use and exposure to either substance-specific cues (e.g. seeing a syringe) or personal cues unique to that individual (e.g. seeing the specific person with whom the substance is used). Findings Craving intensity was associated with the number of concurrently assessed substance-specific cues ( t = 4.418, P < 0.001) and person-specific cues ( t = 4.006, P < 0.001) when analysed jointly within the same model. However, only person-specific cues were associated with increases in craving over subsequent hours of the day ( t = 2.598, P < 0.05). Craving intensity, in turn, predicted increases in later substance use ( t = 4.076, P < 0.001). Causal mediation analyses demonstrated that the association of cues with later substance use was mediated by craving intensity (mediated effect = 0.007, 95% confidence interval = 0.004-0.011). Conclusions Unique person-specific cues appear to have a robust effect on craving addictive substances, and the duration of this association may persist longer than for more general substance-specific cues. Mobile technologies provide new opportunities for understanding these person-specific risk factors and for providing individually tailored interventions. [ABSTRACT FROM AUTHOR]

Objective/Background This study aims to compare differences in pain beliefs according to headache type, chronic vs episodic migraine, in a large cohort of patients, using the Pain Beliefs and Perceptions Inventory ( PBPI), and to identify possible predictive factors of the same pain beliefs. Methods All patients referring for the first time at our center in 2011 were screened using PBPI and the Hamilton Anxiety and Depression Scale (a total of 1032 patients). PBPI is a 4-subscale questionnaire that explores a patient's personal beliefs on their subjective experience of pain. Headache patients also completed the Headache Impact Test ( HIT-6) and a 30-day headache diary. For all participants, age, gender, duration of pain were collected. The sample was narrowed down to 899 as we experienced a nonresponse rate of 12.8%. For the purpose of this study, 2 groups were identified: chronic and episodic migraine, consisting of 116 and 126 patients, respectively, which were compared using Student's t-test; correlation analyses were conducted to investigate the relationship between variables before running a model selection based on Akaike's Information Criterion to identify possible predictive factors of different pain beliefs. Patients below 18 years of age and those diagnosed with other painful conditions were excluded from the analysis. Results Beliefs from chronic and episodic migraine patients were very similar, with only a difference in beliefs related to constancy of pain ( Mean value ± SD 0.5 ± 1.1 vs −0.6 ± 1.1, P < .001). Predictive factors were depression and HIT-6 scores for all PBPI subscales apart from Self-Blame, which showed a stronger relation to anxiety scores. Number of days with headache per month was correlated to higher constancy values. Diagnosis was a predictive factor for any particular belief. Discussion This is the first study, to our knowledge, that addresses differences and predictive factors in pain beliefs according to headache diagnosis. A deeper knowledge of beliefs pattern in patients could lead to better-tailored psychological management. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives To assess the impact of an automated drug distribution system on medication errors ( MEs). Methods Before-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system ( WSS) to a unit dose dispensing system ( UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet ( AMDC). Results A total of 615 opportunities of errors ( OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error ( MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period ( P < 0.001). Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P = 0.005) and 93.7% (1.9% versus 0.01%, P = 0.009), respectively. Conclusion An automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly. [ABSTRACT FROM AUTHOR]