Measuring quality of life in opioid dependent people : a systematic review of assessment instruments

Purpose Opioid dependence is a chronic relapsing disorder. Despite increasing research on quality of life (QOL) in people with opioid dependence, little attention has been paid to the instruments used. This systematic review examines the suitability of QOL instruments for use in opioid-dependent populations and the instruments’ quality. Methods A systematic search was performed in the databases Medline, PsycInfo, The Cochrane Library, and CINAHL. Articles were eligible if they assessed QOL of opioid-dependent populations using a validated QOL instrument. Item content relevance to opioid-dependent people was evaluated by means of content analysis, and instrument properties were assessed using minimum standards for patient-reported outcome measures. Results Eighty-nine articles were retrieved, yielding sixteen QOL instruments, of which ten were assessed in this review. Of the ten instruments, six were disease specific, but none for opioid dependence. Two instruments had good item content relevance. The conceptual and measurement model were described in seven instruments. Four instruments were developed with input from the respective target population. Eight instruments had low respondent and administrator burden. Psychometric properties were either not assessed in opioid-dependent populations or were inconclusive or moderate. Conclusions No instrument scored perfectly on both the content and properties. The limited suitability of instruments for opioid-dependent people hinders accurate and sensitive measurement of QOL in this population. Future research is in need of an opioid dependence-specific QOL instrument to measure the true impact of the disease on people’s lives and to evaluate treatment-related services

The James Webb Space Telescope Mission

Twenty-six years ago a small committee report, building on earlier studies, expounded a compelling and poetic vision for the future of astronomy, calling for an infrared-optimized space telescope with an aperture of at least $4m$. With the support of their governments in the US, Europe, and Canada, 20,000 people realized that vision as the $6.5m$ James Webb Space Telescope. A generation of astronomers will celebrate their accomplishments for the life of the mission, potentially as long as 20 years, and beyond. This report and the scientific discoveries that follow are extended thank-you notes to the 20,000 team members. The telescope is working perfectly, with much better image quality than expected. In this and accompanying papers, we give a brief history, describe the observatory, outline its objectives and current observing program, and discuss the inventions and people who made it possible. We cite detailed reports on the design and the measured performance on orbit.Comment: Accepted by PASP for the special issue on The James Webb Space Telescope Overview, 29 pages, 4 figure

Factors associated with health-related quality of life in a large national sample of patients receiving opioid substitution treatment in Germany: A cross-sectional study

Abstract Background Knowledge of health-related quality of life (HRQOL) of patients receiving opioid substitution treatment (OST) is limited and fragmented. The present study examines the HRQOL of a large national sample of OST patients in Germany and sociodemographic and clinical correlates. Methods Cross-sectional data on the HRQOL of 2176 OST patients was compared with German general population norms. Patients were recruited from 63 OST practices across Germany. To identify correlates of HRQOL, as measured with the SF-12, we performed bi- and multivariate analyses with sociodemographic and clinical variables, including patient- and clinician-reported outcomes on physical and mental health. Results Patients’ HRQOL was significantly poorer than in the general population, especially their mental HRQOL. Factors associated with lower physical HRQOL were older age, longer duration of opioid dependence, hepatitis C virus infection, and HIV infection. Benzodiazepine use was associated with lower mental HRQOL, and amphetamine use with higher physical HRQOL, compared to non-use of these substances. For both mental and physical HRQOL, the factor with the strongest positive association was employment and the factors with the strongest negative associations were physical and mental health symptom severity, psychiatric diagnosis, and psychopharmacological medication. Conclusions Compared to the general population, we found substantially lower HRQOL in OST patients, especially in their mental HRQOL. OST programs can benefit from further improvement, particularly with regard to mental health services, in order to better serve their patients’ needs. Clinicians may consider the use of patient-reported outcome measures to identify patients’ subjective physical and psychological needs. Further research is needed to determine if employment is a cause or consequence of improved HRQOL. Trial registration ClinicalTrials.gov: NCT02395198, retrospectively registered 16/03/201

Afforestation impact on soil temperature in regional climate model simulations over Europe

International audienceAbstract. In the context of the first phase of the Coordinated Regional Climate Downscaling Experiment in the European domain (EURO-CORDEX) flagship plot study on Land Use and Climate Across Scales (LUCAS), we investigate the biophysical impact of afforestation on the seasonal cycle of soil temperature over the European continent with an ensemble of 10 regional climate models. For this purpose, each ensemble member performed two idealized land cover experiments in which Europe is covered either by forests or grasslands. The multi-model mean exhibits a reduction of the annual amplitude of soil temperature (AAST) due to afforestation over all European regions, although this is not a robust feature among the models. In the Mediterranean, the spread of simulated AAST response to afforestation is between −4 and +2 ∘C at 1 m below the ground, while in Scandinavia the inter-model spread ranges from −7 to +1 ∘C. We show that the large range in the simulated AAST response is due to the representation of the summertime climate processes and is largely explained by inter-model differences in leaf area index (LAI), surface albedo, cloud fraction and soil moisture, when all combined into a multiple linear regression. The changes in these drivers essentially determine the ratio between the increased radiative energy at surface (due to lower albedo in forests) and the increased sum of turbulent heat fluxes (due to mixing-facilitating characteristics of forests), and consequently decide the changes in soil heating with afforestation in each model. Finally, we pair FLUXNET sites to compare the simulated results with observation-based evidence of the impact of forest on soil temperature. In line with models, observations indicate a summer ground cooling in forested areas compared to open lands. The vast majority of models agree with the sign of the observed reduction in AAST, although with a large variation in the magnitude of changes. Overall, we aspire to emphasize the biophysical effects of afforestation on soil temperature profile with this study, given that changes in the seasonal cycle of soil temperature potentially perturb crucial biochemical processes. Robust knowledge on biophysical impacts of afforestation on soil conditions and its feedbacks on local and regional climate is needed in support of effective land-based climate mitigation and adaption policies

Afforestation impact on soil temperature in regional climate model simulations over Europe

In the context of the first phase of the Coordinated Regional Climate Downscaling Experiment in the European domain (EURO-CORDEX) flagship plot study on Land Use and Climate Across Scales (LUCAS), we investigate the biophysical impact of afforestation on the seasonal cycle of soil temperature over the European continent with an ensemble of 10 regional climate models. For this purpose, each ensemble member performed two idealized land cover experiments in which Europe is covered either by forests or grasslands. The multi-model mean exhibits a reduction of the annual amplitude of soil temperature (AAST) due to afforestation over all European regions, although this is not a robust feature among the models. In the Mediterranean, the spread of simulated AAST response to afforestation is between −4 and +2 ∘C at 1 m below the ground, while in Scandinavia the inter-model spread ranges from −7 to +1 ∘C. We show that the large range in the simulated AAST response is due to the representation of the summertime climate processes and is largely explained by inter-model differences in leaf area index (LAI), surface albedo, cloud fraction and soil moisture, when all combined into a multiple linear regression. The changes in these drivers essentially determine the ratio between the increased radiative energy at surface (due to lower albedo in forests) and the increased sum of turbulent heat fluxes (due to mixing-facilitating characteristics of forests), and consequently decide the changes in soil heating with afforestation in each model. Finally, we pair FLUXNET sites to compare the simulated results with observation-based evidence of the impact of forest on soil temperature. In line with models, observations indicate a summer ground cooling in forested areas compared to open lands. The vast majority of models agree with the sign of the observed reduction in AAST, although with a large variation in the magnitude of changes. Overall, we aspire to emphasize the biophysical effects of afforestation on soil temperature profile with this study, given that changes in the seasonal cycle of soil temperature potentially perturb crucial biochemical processes. Robust knowledge on biophysical impacts of afforestation on soil conditions and its feedbacks on local and regional climate is needed in support of effective land-based climate mitigation and adaption policies

Biogeophysical impacts of forestation in Europe: first results from the LUCAS (Land Use and Climate Across Scales) regional climate model intercomparison

The Land Use and Climate Across Scales Flagship Pilot Study (LUCAS FPS) is a coordinated community effort to improve the integration of land use change (LUC) in regional climate models (RCMs) and to quantify the biogeophysical effects of LUC on local to regional climate in Europe. In the first phase of LUCAS, nine RCMs are used to explore the biogeophysical impacts of re-/afforestation over Europe: two idealized experiments representing respectively a non-forested and a maximally forested Europe are compared in order to quantify spatial and temporal variations in the regional climate sensitivity to forestation. We find some robust features in the simulated response to forestation. In particular, all models indicate a year-round decrease in surface albedo, which is most pronounced in winter and spring at high latitudes. This results in a winter warming effect, with values ranging from +0.2 to +1 K on average over Scandinavia depending on models. However, there are also a number of strongly diverging responses. For instance, there is no agreement on the sign of temperature changes in summer with some RCMs predicting a widespread cooling from forestation (well below −2 K in most regions), a widespread warming (around +2 K or above in most regions) or a mixed response. A large part of the inter-model spread is attributed to the representation of land processes. In particular, differences in the partitioning of sensible and latent heat are identified as a key source of uncertainty in summer. Atmospheric processes, such as changes in incoming radiation due to cloud cover feedbacks, also influence the simulated response in most seasons. In conclusion, the multi-model approach we use here has the potential to deliver more robust and reliable information to stakeholders involved in land use planning, as compared to results based on single models. However, given the contradictory responses identified, our results also show that there are still fundamental uncertainties that need to be tackled to better anticipate the possible intended or unintended consequences of LUC on regional climates.ISSN:2190-4987ISSN:2190-497

Opioid agonist maintenance treatment outcomes : the OPTIMUS international consensus towards evidence-based and patient-centred care, an interim report

Abstract: Non-medical opioid use is a major public health concern causing high mortality. While opioid agonist maintenance treatment (OMT) is a key life-saving intervention, there is (a) no international consensus on opioid treatment outcomes and (b) few opioid treatment outcome studies include key (public) health outcomes, such as overdose or HIV/hepatitis C. We report the rationale and study protocol for, and preliminary results of, an on-going international OMT outcomes consensus study that aims to address this double gap (n= 110 collaborating experts from 32 countries, plus a n = 477 Delphi evaluation panel from 26 of those countries: 58% male, 41% female; 47% OMT patients, 53% OMT professionals). We present a first draft of a patient interview guide (including a \u2018clinical form\u2019) to monitor OMT outcomes in six domains. The form appears to be well accepted and feasible in early testing. Through this, we aim to enhance the quality of and access to OMT and improve the survival, health, and quality of life of people who use opioids, while promoting nonstigmatising patient-physician relationships