bluuebunny/crossref_metadata_2025 huggingface dataset:
Detecting Severe Weather Trends Using an Additive Regressive Convective Hazard Model (AR-CHaMo)
Authors: Rädler Anja T. , Groenemeijer Pieter , Faust Eberhard , Sausen Robert
Published: December 2017

A statistical model for the occurrence of convective hazards was developed and applied to reanalysis data to detect multidecadal trends in hazard frequency. The modeling framework is based on an additive logistic regression for observed hazards that exploits predictors derived from numerical model data. The regression predicts the probability of a severe hazard, which is considered as a product of two components: the probability that a storm occurs and the probability of the severe hazard, given the presence of a storm [P(severe) = P(storm) × P(severe|storm)]. The model was developed using lightning data as an indication of thunderstorm occurrence and hazard reports across central Europe. Although it uses only two predictors per component, it is capable of reproducing the observed spatial distribution of lightning and yields realistic annual cycles of lightning, hail, and wind fairly accurately. The model was applied to ERA-Interim (1979–2016) across Europe to detect any changes in lightning, hail, and wind hazard occurrence. The frequency of conditions favoring lightning, wind, and large hail has increased across large parts of Europe, with the exception of the southwest. The resulting predicted occurrence of 6-hourly periods with lightning, wind, and large hail has increased by 16%, 29%, and 41%, respectively, across western and central Europe and by 23%, 56%, and 86% across Germany and the Alps during the period considered. It is shown that these changes are caused by increased instability in the reanalysis rather than by changes in midtropospheric moisture or wind shear.
High-Resolution Temperature Datasets in Portugal from a Geostatistical Approach: Variability and Extremes
Authors: Fonseca A. R. , Santos J. A.
Published: December 2017

Climate research in Portugal is often constrained by the lack of homogeneous, temporally and spatially consistent, and long-term climatic series. To overcome this limitation, the authors developed new high-resolution gridded datasets (~1 km) of daily mean, minimum, and maximum air temperatures over Portugal (1950–2015, 66 yr), based on gridded daily temperatures (E-OBS) at ~25-km spatial resolution. A two-step approach was followed, under the assumption that daily temperature variability in Portugal is mainly controlled by atmospheric large-scale forcing, while local processes are mostly expressed as strong spatial gradients. First, monthly baseline (1971–2000) patterns were estimated at 1-km grid resolution by applying multivariate linear regressions (exploratory variables: elevation, latitude, and distance to coastline). A kriging of residuals from baseline normals of 36 weather stations was applied for bias corrections. Second, bilinearly interpolated daily temperature anomalies were then added to the daily baseline patterns to obtain the final datasets. The method performance was evaluated using fivefold cross-validations. The datasets were also validated using daily temperatures from 23 stations not incorporated in E-OBS. A climatological analysis based on these datasets was carried out, highlighting spatial heterogeneities, seasonality, long-term trends, interannual variability, and extremes. The spatial and temporal variability is generally coherent with previous studies at coarser resolutions. An overall warming trend is apparent for all variables and indices, but showing different strengths and spatial variability. These datasets show important advantages over preexisting data, including more detailed and accurate information on trends and interannual variability of precipitation extremes, and can thus be applied to several areas of research in Portugal, such as hydrology, ecology, agriculture, and forestry.
Unraveling Causes for the Changing Behavior of the Tropical Indian Ocean in the Past Few Decades
Authors: Zhang Lei , Han Weiqing , Sienz Frank
Published: December 2017

Observations show that decadal (10–20 yr) to interdecadal (>20 yr) variability of the tropical Indian Ocean (TIO) sea surface temperature (SST) closely follows that of the Pacific until the 1960s. Since then, the TIO SST exhibits a persistent warming trend, whereas the Pacific SST shows large-amplitude fluctuations associated with the interdecadal Pacific oscillation (IPO), and the decadal variability of the TIO SST is out of phase with that of the Pacific after around 1980. Here causes for the changing behavior of the TIO SST are explored, by analyzing multiple observational datasets and the recently available large-ensemble simulations from two climate models. It is found that on interdecadal time scales, the persistent TIO warming trend is caused by emergence of anthropogenic warming overcoming internal variability, while the time of emergence occurs much later in the Pacific. On decadal time scales, two major tropical volcanic eruptions occurred in the 1980s and 1990s causing decadal SST cooling over the TIO during which the IPO was in warm phase, yielding the out-of-phase relation. The more evident fingerprints of external forcing in the TIO compared to the Pacific result from the much weaker TIO internal decadal–interdecadal variability, making the TIO prone to the external forcing. These results imply that the ongoing warming and natural external forcing may make the Indian Ocean more active, playing an increasingly important role in affecting regional and global climate.
Attitudes among young adults in Palestine about peers with substance use problems: Challenges and opportunities for community intervention design
Authors: Hreish Khalid , Okkeh Mohammad , Fareed Anan J , Byers David S
Published: December 2017

Social reintegration is necessary to support people in recovery from addiction, but it is often difficult in Palestine due to stigma. Bin Hussein’s instrument for measuring receptivity to social reintegration in various contexts in Saudi Arabia was employed for comparison in the West Bank. Data were collected in 2013 at Al-Quds University at the Abu Dis campus. More than half of the respondents have moderate attitudes toward social reintegration of people in recovery. There were no significant relationships between perceptions about social reintegration and gender, age, year in college, area of academic focus, and form of residence. Implications are discussed.
Vem tvångsvårdas? Utmärkande drag för tvångsvårdade respektive frivilligt vårdade personer med alkohol- och narkotikaproblem
Authors: Storbjörk Jessica
Published: December 2017

J. Storbjörk: Who is in compulsory treatment? Charasteristics for compulsory treated and voluntary treated persons misusing alcohol and drugs

The article studies what characterized those committed to compulsory treatment (CT) according to the Care of Alcoholics, Drug abusers and Abusers of Volatile Solvents (Special Provision) Act as compared to those in voluntary treatment in Stockholm County 2001–2002. The aim is to analyze who is in CT by studying which client characteristics (sex, age, drug of choice, consumption, route of administration, social situation, physical health, incl. municipality) are associated with CT. Responses from 361 CT-clients who were interviewed with DOK (Documentation of Clients) are compared to comparable responses from 1772 clients in voluntary treatment from the study Women and Men in Swedish Alcohol and Drug Treatment. Bivariate and multivariate analyses show that the two groups differ significantly in many respects. Clients in CT are younger, report more frequent consumption of their main drug of choice and an inferior social situation (housing, livelihood). An analysis of interaction terms shows that old alcohol misusers are less likely to be in CT than young drug misusers. Women are not more likely to be in CT than men. However, CT was more often used for women, but not for men, with children under the age of 18 or who were living with another misuser.
Escapes from compulsory treatment
Authors: Svensson Bengt
Published: December 2017

B. Svensson: Escapes from compulsory treatment

Aims

The aim of this article is to describe and analyse the escape as a phenomenon in compulsory treatment of people with drug addiction. The primary research questions are: Why do the clients want to escape? What escape possibilities are available in different stations of the treatment? How are escapes planned and accomplished? What do the absconders do during the escape? How do they avoid getting caught? What are the health risks for the clients in connection with escapes? In what ways are escapes a problem in compulsory treatment?

Methods

The study is based upon semi-structured interviews with 74 clients (38 women) at four LVM-homes, two for men, two for women. In addition to the interviews, the author also conducted informal conversations with both personnel and clients and carried out extensive observations of the conditions of compulsory treatment.

Results

The clients make preparations in order to make the escapes as successful as possible. The fight is connected with feelings of excitement but also with the fear of getting caught before the primary aim(s) of the escape has been accomplished, namely to get high on drugs and to meet friends and partners. During their stay outside the institution, help from the client's personal network is important in order to get a secure place to stay, food and money. Almost all clients describe that, during the escape, they return to a similar pattern of the drug and risk-taking behaviour they had before they were put into compulsory treatment.

Conclusions

When people with drug addiction are locked in for treatment they often show resistance and wish to regain control. Escapes are an unavoidable feature of compulsory treatment as eventually locked doors have to be opened in order to prepare the clients for life outside the institutions. It would seem that the best way to reduce the amount of escapes is to make the treatment as meaningful as possible for the clients.
Gendered discourse in Swedish national alcohol policy action plans 1965–2007: Invisible men and problematic women
Authors: Abrahamson Maria , Heimdahl Karin
Published: December 2017

M. Abrahamson & K. Heimdahl: Gendered discourse in Swedish national alcohol policy action plans 1965-2007: Invisible men and problematic women

In a critical discourse analysis of Swedish alcohol policy action plans, we have compared five different documents between 1965–2007 to examine problems with and reasons for women's and men's drinking, and recommendations for policy actions. The results display a hierarchical logic between the genders. During the early years, men's drinking is implicitly constituted as the norm. A basic tenet is that female and male drinking are the same. Women may drink less, but their drinking is not of a different character. It is highly exceptional to make a separation between men's and women's drinking. In later documents, however, the separation of these spheres results in female drinking being depicted as more problematic because of women's more vulnerable condition and individual psychological reasons. In order to highlight female drinking problems, male drinking is being erased from the picture and constructed in a positive contrast. As a consequence, men's drinking is normalised. Finally, in the most recent documents, attention has exceedingly shifted to women as containers of the foetus and to young women's and girls’ sexual behaviour and psychiatric problems.
Artikel
Authors: Anderberg Mats , Dahlberg Mikael
Published: December 2017

Between simplification and complexity – structured interviews and treatment results in substance abuse treatment

AIM

The article draws on an empirical case study to analyse and discuss the application of structured interviews in evaluating outcomes of substance abuse treatment.

METHODS

The empirical example, a follow-up study, is based on the structured interview DOK (a Swedish interview instrument similar to the ASI) with 39 clients at an inpatient substance abuse treatment unit, at intake and six months after completed treatment. Changes in self-reported data were analysed between intake and follow-up. The analyses differentiate between subjective client estimations and verifiable data. This is followed by an analysis of individual variations in changes of alcohol and drug use.

RESULTS

The study shows how it is possible within a sample from a local treatment unit to illustrate relatively big changes on a group level in some of the objective, verifiable variables. Further, depending on the time period (last 30 days or last 6 months), the clients reported significantly differently on their use of the primary drug of abuse. At group level, there was a reduction of self-reported problems within all life areas. There were indications of some relation between verifiable variables and estimation variables. All clients reported, however, that their estimated problems in all life areas persisted to a relatively high degree at follow-up. In order to further point at individual variations in the patterns of change, the results of three different verifiable variables within the area of Alcohol and drugs are reported. The share of positive treatment results vary between 13–64 %, depending on definition and operationalisation.

CONCLUSIONS

The study is an example of an analytical model that can be applied in a local treatment unit with data from structured interviews. The results illustrate the problems with using questions about alcohol and drug use only for the last 30 days in follow-up studies. The results also indicate that subjective evaluations have no self-evident relation to reported changes within one life area. It is thus problematic to use a self-reported problem as an outcome measure or mix this measure with other outcome data.
Where Do Adolescents Get Drunk?
Authors: Storvoll Elisabet E. , Rossow Ingeborg , Pape Hilde
Published: December 2017

E. E. Storvoll & I. Rossow & H. Pape: Where do adolescents get drunk? A study of the relative importance of various drinking locations among Norwegian adolescents

To curb the harmful consequences of drunkenness among adolescents, it may be useful to know where they usually drink to the point of intoxication. We have analysed data from a school survey among 14–17 year-old Norwegians in 2005 to shed light on this issue (n=13 399). We assessed the prevalence of getting drunk at various locations and estimated the relative importance of various locations (i.e., the proportion of the total number of episodes of getting drunk that had taken place in various locations). About half of the episodes of getting drunk occurred in private homes. Although the respondents were too young to drink at licensed premises, about one in ten episodes took place in such locations. Relatively few episodes occurred at social events at school or in connection with organized leisure activities. The relative importance of the various locations varied with age and frequency of intoxication, whereas gender differences were less pronounced. Implications for prevention and further research are discussed.
Conceptual Problems with Studies of the Social Cost of Alcohol and Drug Use
Authors: Melberg Hans Olav
Published: December 2017

H. O. Melberg: Conceptual problems with studies of the social cost of alcohol and drug use

Existing studies of the social cost of substance abuse give very different answers. Part of the reason for the differences is that the contributions differ in their definition of costs and the types of costs that are included or excluded from the study. Closer attention to the concept of cost employed in these studies also reveals some weaknesses with many of the existing studies. The policy relevant concept of cost necessarily implies a comparison between all realistically expected consequences (both positive and negative) of two policy alternatives and many cost studies do not use the concept of cost in this way. Finally, it is argued that cost estimates in this area cannot be neutral or scientific because the results depend on our views on when a choice can be characterized as voluntary and rational, how we deal with the problem of inconsistent preferences, and which preferences we consider to be legitimate. Since there is no agreed consensus on these issues, the cost estimate necessarily becomes subjective.
Polarized Drinking Patterns and Alcohol Deregulation
Authors: Meier Petra Sylvia
Published: December 2017

This paper sets out to chart key trends in alcohol consumption and harm, and of related policy activity in the UK between 1990 and 2010. As a journal paper cannot provide a comprehensive picture, the focus will be on England as the most populous region, with comments on salient developments in the other regions where these are different. The paper draws on a variety of data sources, especially general population surveys, government reports, industry figures, National Statistics products, and recent reviews of data trends. It is structured around the themes: 1) trends in volume and patterns of consumption in adults and children; 2) trends in major alcohol-related harms; 3) changes in the affordability and availability of alcohol; 4) influences of major players including policy makers, media and industry and 5) the current (mid-2010) status of policy efforts. The reviewed data show that the UK has seen significant changes in the patterns and contexts of consumption during the 1990s and 2000s. Major consumption changes include falling per capita consumption, a rise in heavy episodic drinking, increasing preference of higher alcohol content beverages and a polarisation of the distribution of consumption in the population where heavy drinkers consume even higher volumes whilst moderate drinkers appearing to decrease their average intake. Context changes include rising availability and affordability of alcohol, with few alcohol control policy efforts, and a switch from predominantly on-trade to off-trade drinking. Such trends help explain the current rapid increase in alcohol-related admissions and other heavy end consequences in the context of falling per capita consumption.
Changes in Consumption and Harms, yet Little Policy Progress
Authors: Hope Ann , Butler Shane
Published: December 2017

This paper reports on trends in alcohol consumption and related problems in the Republic of Ireland during the years 1990–2010, and on alcohol policy developments over this same period. Prior to the collapse of the Irish economy in late-2008, Ireland had enjoyed almost fifteen years of unprecedented economic growth, with commensurate increases in levels of personal disposable income. As predicted by economists, economic growth was accompanied by substantial increases in levels of alcohol consumption, with corresponding increases in all the main indicators of alcohol-related problems. Although numerous policy reports from the health sector advocated alcohol control strategies, due to the generally neoliberal ethos of this era and active lobbying from the drinks industry, little or no implementation of such strategies occurred. Reflecting the current economic down-turn, levels of alcohol consumption have now stabilized. It is concluded, however, that implementation of comprehensive, top-down, alcohol strategies remains unlikely, and that bottom-up, community mobilization offers the best prospect for change in this sphere.
A New Alcohol Environment
Authors: Karlsson Thomas , Mäkelä Pia , Österberg Esa , Tigerstedt Christoffer
Published: December 2017

■ AIMS

This article reports developments in the Finnish alcohol field from 1990 to 2010, focusing on changes and trends in alcohol consumption, drinking habits and alcohol-related harm. We pay special attention to changes in alcohol availability and alcohol policy and look at the factors behind changes in alcohol policies. The article will also discuss the current status and future prospects of alcohol policy and alcohol control as well as differences between Finland and the situation in the neighbouring countries with a similar alcohol monopoly.

■ METHODS

Routinely collected statistical data on alcohol consumption and related harm as well as repeated cross-sectional representative population surveys will be reviewed, as will changes in alcohol policy and availability.

■ RESULTS

Apart from the economic recession in the early 1990s, alcohol consumption and related harm have increased in Finland. Changes in alcohol consumption are mostly explained by changes in consumer incomes and alcohol policy measures. However, EU membership has restricted tightened alcohol control and given more room for private alcohol industry to affect alcohol policy.

■ CONCLUSIONS

While increased alcohol-related harm has stopped the Finns from moving toward a more liberal alcohol policy, EU membership and private alcohol interests have made it considerably more difficult to combat alcohol-related harm with alcohol control measures.
A Complex Picture
Authors: Giesbrecht Norman , Thomas Gerald
Published: December 2017

This paper examines access to alcohol, trends in consumption, drinking patterns, damage from alcohol, and developments in prevention and alcohol policy – focusing on the Canadian experience over the last two decades. Consumption, as measured by official sales, declined initially and then has increased since 1996. During this time there was a gradual increase in access to alcohol, with steeper increase in some jurisdictions undergoing partial or full privatization of retail alcohol sales. According to survey data, the proportion drinking in a high risk manner is greater among youth and young adults, and the trend in the proportion of high risk drinkers does not necessarily follow the trend in alcohol sales. In light of intensive and multi-dimensional efforts to curtail drinking and driving, these rates have gone down during the period under study. Several provinces have introduced alcohol strategies and a national strategy introduced in 2007 is being implemented. Nevertheless there are ongoing challenges of getting alcohol on the broader public health agenda, even though it is major contributor to disease and disability. The rising consumption and increased access to alcohol, combined with intensive marketing, represent a major public health challenge. It is unlikely that there will be significant strides in reducing the damage from alcohol to Canadian populations, unless there is a substantial change in the status quo involving implementation of the most effective policies and prevention strategies.
Substance Abuse Treatment as Part of a Total System of Community Response
Authors: Holder Harold D.
Published: December 2017

Treatment of substance abuse in many communities throughout the world is often separated from other social and health responses to alcohol and other drug harms. Current responses exist like silos within the community. In addition, there are population-level policy approaches concerning the distribution and sales of alcohol and the restrictions on and enforcement of illegal drugs which also exist only loosely connected to treatment (or prevention for that matter). A systems approach to substance abuse and related problems is described in which evaluation addresses both clinical patient needs as well as overall performance demonstration. Effectiveness can be measured both by population level reductions in use and associated problems, a second level of accountability, i.e., documented reductions in problems of at risk groups or clients whose drinking or drug use patterns place them at risk for future problems, and a third level of response for individuals with clearly identified substance-related problems, which requires intervention at the person level (typically called treatment). Thus within such a comprehensive system, treatment and prevention would lose their separate identities and would be employed according to local needs and the potential to achieve desired effects where the overall system is required to select the mix of strategies which maximizes effectiveness at each level.
On the Idea of Treatment Systems
Authors: Bergmark Anders
Published: December 2017

This article addresses certain problems associated with the use of a system approach in studying the organisation and character of treatment for alcohol and drug problems. There are three main approaches of system concept use. The first concerns what could be called the dream of rationality, which tends to have the structure of an attempt to reform a present state of affairs. It is guided by a traditional system concept, which claims that systems consist of interrelated parts and constitute wholes. The second type of use is characterised by an ad hoc approach inasmuch as the actual use of the system concept is primarily to delimit populations of treatment services, rather than of treatment systems. The third approach can be called the extensive system approach since it emphasises the inclusion of a large number of relations that to some extent make the boundaries of the system less distinct. While all three approaches stand out as reasonable and relevant research strategies, their different limitations may nevertheless make it worthwhile to consider some alternatives. I suggest that a possible alternative approach can be found in a market perspective. This suggestion is premised on the specific context of current alcohol and drug treatment organisation in Sweden. However, it is not impossible that similar circumstances could also be present in other countries.
Shifting Focus in Substitution Treatment in the Nordic Countries
Authors: Skretting Astrid , Rosenqvist Pia
Published: December 2017

The article compares the development of substitution treatment in Denmark, Finland, Norway and Sweden. The focus is on the official guidelines: under what conditions, for whom and by whom should substitution treatment be organised? For many years, substitution treatment was fiercely opposed in Finland, Norway and Sweden, all of which had a restrictive drug policy and relied on social work rather than medicine. The debate cut through the professions and was at times the main political issue. Methadone treatment started in Denmark and Sweden in the 1960s, and while Finland and Norway did not give the go-ahead until the latter part of the 1990s, they have today expanded their substitution treatment considerably. In all four countries, substitution treatment has become an accepted and established part of treatment responses to abuse problems. The guidelines have become less strict even if the regimes in practice include various kinds of control measures. The thresholds of substitution treatment have remained the lowest in Denmark where this treatment mode is more geared toward harm reduction than in the other countries.
Tiered Frameworks for Planning Substance Use Service Delivery Systems: Origins and Key Principles
Authors: Rush Brian
Published: December 2017

It is well known that only a relatively small proportion of people in the community who experience substance use problems seek assistance from the specialized sector of services that have been commissioned to provide treatment and support for these problems. Going back to seminal reports from the early 1990s there has been a call for a systems approach to “broaden the base of treatment” in order to achieve wider coverage and yield positive outcomes at a population level. In some jurisdictions conceptual models referred to as “tiered models” have been advanced to support planning, system design and performance monitoring. This paper traces the evolution of such tiered models for substance use services and describes a recent model advanced in Ontario Canada for design of an integrated system of mental health, substance use and problem gambling services and supports. The paper concludes by highlighting key features and principles of the tiered approach that are critical for its actual operationalization. Some challenges operationalizing such a comprehensive system design framework are also noted.
Implementing an Ideology. A Case Study from Leicestershire, England
Authors: Cameron Douglas
Published: December 2017

In the late 1970s, we established for the county of Leicestershire in England (pop. 850,000) what was then a highly innovative service for problem drinkers. It was based upon a number of core beliefs about the nature of people with alcohol problems and about what would be helpful for them. Most notably it rejected the concept of “alcoholism” and treated the clients (“customers”) at all times as being responsible and therefore able to make decisions about what would be helpful for them. It was a community based tiered service, non-abstinence oriented and client demand led.

That system of intervention generated a burgeoning referral rate and there was evidence that compared with neighbouring similar counties, the service may have had a positive impact on the long term morbidity and mortality related to alcohol use. The data available were correlational and incomplete but were encouraging.

Changes in the style of provision in the neighbouring counties and administrative and structural changes in health and social services nationally meant that it was not possible to continue the service in its comprehensive form, and tracking changes in the indirect indicators of alcohol problems became unfeasible. The natural experiment was terminated by factors beyond our control. Nonetheless, the service still exists, though in a truncated form. Its presence played a part in the development of the template for local alcohol service provision in Britain.
The Norwegian Substance Treatment Reform
Authors: Nesvaag Sverre , Lie Terje
Published: December 2017

■ BACKGROUND

In 2004, the responsibilities for all substance abuse treatment and rehabilitation services in Norway were transferred from the county level to the state owned regional healthcare enterprises.

■ AIM

This reform, as many other European health reforms, was inspired by the same ideological and expert policy prescriptions for organizing public services. The aim of this paper is to analyze how these organizational principles influence the probability of services meeting the conditions of recognized prerequisites for a high quality of care.

■ DATA

The paper builds on data from one national and two regional evaluations of the reform.

■ RESULTS

The new organization principles have created a system of fragmented, linear transfer of responsibilities from one agency to the next, preventing the realization of fundamental preconditions for effective treatments of substance abuse. Initiatives of bottom-up organization are seen as attempts to counteract these consequences.

■ CONCLUSIONS

There seems to be an inherent contradiction between the overall organization of healthcare and social services for substance abusers in Norway, and recognized preconditions for a high quality of care. Bottom-up organization is, to some degree an effective counteract in alleviating the consequences of this contradiction. Top-down and bottom-up organizing seems to have been established as two parallel forms of organizational development in the Norwegian substance treatment system.
The role of radiation therapy in the management of small cell lung cancer
Authors: Glatzer Markus , Schmid Sabine , Radovic Marco , Früh Martin , Putora Paul Martin
Published: December 2017

Small cell lung cancer (SCLC) is a very aggressive form of lung cancer. SCLC treatment requires multidisciplinary management and timely treatment. Radiation therapy is an important part of management of all stages of SCLC, in the curative as well as in the palliative setting. The role of radiation therapy in all stages of SCLC has changed in recent years; this article describes these changes and highlights the role of radiation therapy in the management of SCLC.
Talking about end-of-life care in a timely manner
Authors: Smeenk Frank W.J.M. , Schrijver Laurien A. , van Bavel Hennie C.J. , van de Laar Eric F.J.
Published: December 2017

In 2014, a group of physicians of the Catharina Hospital in Eindhoven (The Netherlands) started a project called “Talking about end-of-life care in a timely manner”. Just like others in the country, the Eindhoven group noticed that regularly, very frail elderly people were admitted to hospital in acute situations without there ever having been conversations about their wishes concerning treatment options at the end of life. The project aimed to prevent unnecessary admissions and treatments for these frail patients by stimulating physicians, patients and informal caregivers to start conversations about end-of-life care together at an earlier stage. The first phase of the project consisted of research: a study of the relevant literature on previous projects on the matter and a small empirical study in the Eindhoven region. This yielded as the most important causes of the delay of these conversations: the factors of timing (when is the right moment?), reserve (because of the potential emotional despair of the patient) and hope (who am I to rob a patient of their hope?).

In the second phase of the project, several approaches were developed to help caregivers, patients and informal caregivers with the planning and execution of conversations about  end-of-life care. Meetings were organised for patients and informal caregivers to foster awareness and to provide information. For caregivers, information was provided (viasymposia and an app) and specifically designed training sessions were developed. The training sessions consist of reflection on the caregivers’ personal choices with regard to end-of-life care (research has shown that caregivers choose less intensive medical treatments at the end of life) and of practising with the known complicating factors of timing, reserve and hope, and the different ways of thinking and talking about death and dying (typology of death and dying).

Educational aims

To understand the importance of discussing end-of-life care preferences with your patients at the appropriate time.

To become aware of the possible interfering factors of timing, reserve and hope in talking about end-of-life care.

Key points

Using the Surprise Question may be a useful tool in determining the appropriate moment to discuss this with your patients.

By talking with your patients about end-of-life care in a timely manner, unnecessary and unwanted treatment can be prevented.

Constraints of doctors to implement this in their practice can be overcome by implementing a training session as described in this article.

Collaboration between primary and secondary care on this issue is strongly recommended in order to assure the care continuum maximally.
Genome sequence of the model plant pathogen Pectobacterium carotovorum SCC1
Authors: Niemi Outi , Laine Pia , Koskinen Patrik , Pasanen Miia , Pennanen Ville , Harjunpää Heidi , Nykyri Johanna , Holm Liisa , Paulin Lars , Auvinen Petri , Palva E. Tapio , Pirhonen Minna
Published: December 2017

Bacteria of the genus Pectobacterium are economically important plant pathogens that cause soft rot disease on a wide variety of plant species. Here, we report the genome sequence of Pectobacterium carotovorum strain SCC1, a Finnish soft rot model strain isolated from a diseased potato tuber in the early 1980’s. The genome of strain SCC1 consists of one circular chromosome of 4,974,798 bp and one circular plasmid of 5524 bp. In total 4451 genes were predicted, of which 4349 are protein coding and 102 are RNA genes.
Draft genome sequence of Dethiosulfovibrio salsuginis DSM 21565T an anaerobic, slightly halophilic bacterium isolated from a Colombian saline spring
Authors: Díaz-Cárdenas Carolina , López Gina , Alzate-Ocampo José David , González Laura N. , Shapiro Nicole , Woyke Tanja , Kyrpides Nikos C. , Restrepo Silvia , Baena Sandra
Published: December 2017

A bacterium belonging to the phylum Synergistetes, genus Dethiosulfovibrio was isolated in 2007 from a saline spring in Colombia. Dethiosulfovibrio salsuginis USBA 82T (DSM 21565
T
= KCTC 5659
T
) is a mesophilic, strictly anaerobic, slightly halophilic, Gram negative bacterium with a diderm cell envelope. The strain ferments peptides, amino acids and a few organic acids. Here we present the description of the complete genome sequencing and annotation of the type species Dethiosulfovibrio salsuginis USBA 82T. The genome consisted of 2.68 Mbp with a 53.7% G + C. A total of 2609 genes were predicted and of those, 2543 were protein coding genes and 66 were RNA genes. We detected in USBA 82T genome six Synergistetes conserved signature indels (CSIs), specific for Jonquetella, Pyramidobacter and Dethiosulfovibrio. The genome of D. salsuginis contained, as expected, genes related to amino acid transport, amino acid metabolism and thiosulfate reduction. These genes represent the major gene groups of Synergistetes, related with their phenotypic traits, and interestingly, 11.8% of the genes in the genome belonged to the amino acid fermentation COG category. In addition, we identified in the genome some ammonification genes such as nitrate reductase genes. The presence of proline operon genes could be related to de novo synthesis of proline to protect the cell in response to high osmolarity. Our bioinformatics workflow included antiSMASH and BAGEL3 which allowed us to identify bacteriocins genes in the genome.
The effect of externalities on adoption of social customer relationship management (SCRM)
Authors: Gu Vicky , Davis Jonathan , Cao Ray , Vogt John
Published: December 2017

The rise of social media technology has led to new customer relationship management tools that engage customers more easily and directly (social customer relationship management, SCRM). However, the usefulness of SCRM is contingent upon a successful adoption by an organization. Various technology adoption theoretical frameworks have been proposed for social media technologies generally, and for SCRM specifically. This paper extends the literature by exploring network externalities as a potential driver of SCRM adoption in organizations by surveying 363 supply chain professionals regarding their behaviors and uses of SCRM. The results suggest that network externalities have a substantial effect on adoption of SCRM in business organizations and that a perception of higher network externalities has a positive effect on adoption. This implies that organizations should select SCRM systems with better network externalities and also that they should educate their workforce about those strong network externalities leading up to the adoption.
Seven-Month Prostate-Specific Antigen Is Prognostic in Metastatic Hormone-Sensitive Prostate Cancer Treated With Androgen Deprivation With or Without Docetaxel
Authors: Harshman Lauren C. , Chen Yu-Hui , Liu Glenn , Carducci Michael A. , Jarrard David , Dreicer Robert , Hahn Noah , Garcia Jorge A. , Hussain Maha , Shevrin Daniel , Eisenberger Mario , Kohli Manish , Plimack Elizabeth R. , Cooney Matthew , Vogelzang Nicholas J. , Picus Joel , Dipaola Robert , Sweeney Christopher J. ,   on behalf of the ECOG-ACRIN 3805 Investigators
Published: December 2017

Purpose

We evaluated the relationship between prostate-specific antigen (PSA) and overall survival in the context of a prospectively randomized clinical trial comparing androgen-deprivation therapy (ADT) plus docetaxel with ADT alone for initial metastatic hormone-sensitive prostate cancer.

Methods

We performed a landmark survival analysis at 7 months using the E3805 Chemohormonal Therapy Versus Androgen Ablation Randomized Trial for Extensive Disease in Prostate Cancer (CHAARTED) database ( ClinicalTrials.gov identifier: NCT00309985). Inclusion required at least 7 months of follow-up and PSA levels at 7 months from ADT initiation. We used the prognostic classifiers identified in a previously reported trial (Southwest Oncology Group 9346) of PSA ≤ 0.2, > 0.2 to 4, and > 4 ng/mL.

Results

Seven hundred nineteen of 790 patients were eligible for this subanalysis; 358 were treated with ADT plus docetaxel, and 361 were treated with ADT alone. Median follow-up time was 23.1 months. On multivariable analysis, achieving a 7-month PSA ≤ 0.2 ng/mL was more likely with docetaxel, low-volume disease, prior local therapy, and lower baseline PSAs (all P ≤ .01). Across all patients, median overall survival was significantly longer if 7-month PSA reached ≤ 0.2 ng/mL compared with > 4 ng/mL (median survival, 60.4 v 22.2 months, respectively; P < .001). On multivariable analysis, 7-month PSA ≤ 0.2 and low volume disease were prognostic of longer overall survival (all P < 0.01). The addition of docetaxel increased the likelihood of achieving a PSA ≤ 0.2 ng/mL at 7 months (45.3% v 28.8% of patients on ADT alone). Patients on ADT alone who achieved a 7-month PSA ≤ 0.2 ng/mL had the best survival and were more likely to have low-volume disease (56.7%).

Conclusion

PSA ≤ 0.2 ng/mL at 7 months is prognostic for longer overall survival with ADT for metastatic hormone-sensitive prostate cancer irrespective of docetaxel administration. Adding docetaxel increased the likelihood of a lower PSA and improved survival.
Non-cell autonomous control of precerebellar neuron migration by Slit and Robo proteins
Authors: Dominici Chloé , Rappeneau Quentin , Zelina Pavol , Fouquet Stéphane , Chédotal Alain
Published: December 2017

During development, precerebellar neurons migrate tangentially from the dorsal hindbrain to the floor plate. Their axons cross it but their cell bodies stop their ventral migration upon reaching the midline. It has previously been shown that Slit chemorepellents and their receptors, Robo1 and Robo2, might control the migration of precerebellar neurons in a repulsive manner. Here, we have used a conditional knockout strategy in mice to test this hypothesis. We show that the targeted inactivation of the expression of Robo1 and Robo2 receptors in precerebellar neurons does not perturb their migration and that they still stop at the midline. The selective ablation of the expression of all three Slit proteins in floor-plate cells has no effect on pontine neurons and only induces the migration of a small subset of inferior olivary neurons across the floor plate. Likewise, we show that the expression of Slit proteins in the facial nucleus is dispensable for pontine neuron migration. Together, these results show that Robo1 and Robo2 receptors act non-cell autonomously in migrating precerebellar neurons and that floor-plate signals, other than Slit proteins, must exist to prevent midline crossing.
ENDOMETRIAL MARKERS OF POLYCYSTIC OVARY SYNDROME (A LITERATURE REVIEW)
Authors: Шарифулин Эльдар , Sharifulin Eldar , Шарифулин Махарам , Sharifulin Makharam , Сутурина Лариса , Suturina Larisa
Published: December 2017

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women and has a significant impact on
various aspects of their health and the quality of life. The epidemiology of PCOS is well understood, while the preva-
lence of this syndrome depends on diagnostic criteria used, the characteristics of the population sample, and vary from
6–10 % to 15 % and higher. A number of studies suggest that the endometrium in women with PCOS differs from the
normal endometrium morphologically and functionally. PCOS is associated with infertility problems, higher incidence
of pregnancy complications and with increased risk of endometrial cancer, especially when obesity is present.
The purpose of this review was to systematize the available data on molecular markers of endometrial pathology as-
sociated with PCOS.
The information search was conducted using Internet resources (PubMed, EMBASE); literature sources for the period
1992–2016 were analyzed. Although the available information on the pathology of the endometrium is inconsistent,
as a result of the analysis of published data, several mechanisms of endometrial disorders characteristic of PCOS have
been identified: changes of hormonal effects (changes in hormone receptor expression, HOXA gene expression, changes
in the synthesis of sex hormone binding globulin, enzymes involved in the metabolism of sex hormones in situ in the
endometrium), hyperinsulinemia and disturbance of the glucose transport system, ratio of proinflammatory and anti-
inflammatory factors.
Authors conclude that the majority of analyzed studies report an increased prevalence of histologically confirmed
hyperplasia or endometrial cancer in women with PCOS. However, there are no clinical guidelines and approaches to
prognosis of endometrial changes women with PCOS. It is still unclear if endometrial biopsy is necessary for all women
with PCOS. The clinical significance of endometrial markers requires further investigation.
THE STATE OF LIPOPEROXIDATION PROCESSES IN BOYS WITH OBESITY
Authors: Даренская Марина , Darenskaya Marina , Гаврилова Оксана , Gavrilova Oksana , Гребенкина Людмила , Grebyonkina Lyudmila , Кравцова Ольга , Kravtsova Olga , Натяганова Лариса , Natyaganova Larisa
Published: December 2017

The problem of obesity is extremely relevant for modern medical science and healthcare, and child and adolescent
obesity deserves special attention. It seems to be interesting to trace the interrelation of pathological processes in
obesity in the form of metabolic disorders at the level of the organism and at the cell level - disorders in the system
of lipid peroxidation. Studies in adolescent boys are relevant, as there has been a general increase in the incidence in
this age category. The purpose of the research was to study the state of the system “lipid peroxidation – antioxidant
protection” in adolescent boys with exogenous-constitutional obesity. 19 adolescent boys with obesity were examined
in comparison with the control group. Spectrophotometric and fluorometric methods of examination were used. An
increase in the level of secondary lipid peroxidation products – ketodienes and conjugated trienes (1.65 times) – was
revealed in adolescent boys with obesity. In the antioxidant defense system, differences in this group included reduced
values of α-tocopherol (1.42 times), retinol (1.51 times) and superoxide dismutase activity (1.19 times), in the absence
of statistically significant changes in the total antioxidant activity (AOA) in blood and components of glutathione status.
The revealed disorders allow to recommend the complex therapy including prescription of antioxidants and medicines
directed on normalization of lipid exchange at the given category of patients.
GENDER DIFFERENCES FOR MYOCARDIAL INFARCTION AS OUTCOME OF ST ELEVATION ACS IN THE REPUBLIC OF BURYATIA
Authors: Содномова Лариса , Sodnomova Larisa , Булутова Наталья , Bulutova Natalya
Published: December 2017

Evidential base for diagnosis and treatment of myocardial infarction is based on the results of randomized clinical
studies that included mostly male patients.
Objective: to determine gender specifics in development, progression, methods of treatment, diagnostics, outcomes of
myocardial infarction for defining customized approaches to its treatment.
Study material and methods: 84 medical records of patients with myocardial infarction – 50 male and 54 female patients
admitted in the emergency cardiac care department. Statistical data is processed in Microsoft Excel and Statistica v. 10.0.
Results. Female patients suffer myocardial infarction late in life; they display higher obesity rate, renal dysfunction, type
2 diabetes as compared to male patients. At the time of admission to hospital the risk of hemorrhage is higher among
female patients, which is related to the higher rate of renal disfunction and age. Average CRUSADE score for female
patients is 39.14 ± 2.5, for male patients – 22.7 ± 1.4 points. Female patients demonstrate higher frequency of atypical
symptoms for myocardial infarction – 18 %, compared to 8 % for males (p = 0.05), that leads to prolongated period
of symptom-hospitalization. Thus, there are less women who are hospitalized within first 3 hours – 6 % against 28 %
men (p = 0.01). Women display tendency to a higher frequency of Q-negative and recurrent myocardial infarctions,
men – to first-time and Q-positive infarctions. As for the frequency of CAG, TLT and PCI, as well as mortality rate due
to MI there is no difference between the groups.