The use and helpfulness of self-management strategies for depression: The experiences of patients

Objective To explore which of 50 self-management strategies are actually used and which are perceived as most helpful by patients in their day-to-day management of depression, in order to empower patients and promote active engagement in their own care. Methods Retrospective study using an online self-report survey to assess the use and perceived helpfulness of 50 previously identified self-management strategies in 193 participants who recently recovered from a major depressive episode. Results Forty-five of the 50 strategies were used by at least half of all participants and about one third of all participants perceived almost 50% of all strategies as (very) helpful. The most used strategies, such as ‘finding strategies to create pleasurable distractions’, ‘engaging in leisure activities’ or ‘identifying the cause of the depression’, were not always perceived as most helpful. In addition, the perceived most helpful strategies, such as ‘completing treatment’ and ‘leaving the house regularly’ were not always the most used ones. Conclusions Patients use and perceive a wide range of self-management strategies as helpful to recover from their depression. Patients use and perceive strategies about engagement in treatment and physical activities as being most helpful. These finding may contribute to the further development and implementation of self-management programs for the prevention or the rehabilitation of depression

Correction: The use and helpfulness of self-management strategies for depression: The experiences of patients.

[This corrects the article DOI: 10.1371/journal.pone.0206262.]

Cloud and precipitation properties from ground-based remote-sensing instruments in East Antarctica

A new comprehensive cloud–precipitation–meteorological observatory has been established at Princess Elisabeth base, located in the escarpment zone of Dronning Maud Land (DML), East Antarctica. The observatory consists of a set of ground-based remote-sensing instruments (ceilometer, infrared pyrometer and vertically profiling precipitation radar) combined with automatic weather station measurements of near-surface meteorology, radiative fluxes, and snow height. In this paper, the observatory is presented and the potential for studying the evolution of clouds and precipitating systems is illustrated by case studies. It is shown that the synergetic use of the set of instruments allows for distinguishing ice, liquid-containing clouds and precipitating clouds, including some information on their vertical extent. In addition, wind-driven blowing snow events can be distinguished from deeper precipitating systems. Cloud properties largely affect the surface radiative fluxes, with liquid-containing clouds dominating the radiative impact. A statistical analysis of all measurements (in total 14 months mainly during summer–beginning of winter) indicates that these liquid-containing clouds occur during as much as 20% of the cloudy periods. The cloud occurrence shows a strong bimodal distribution with clear-sky conditions 51% of the time and complete overcast conditions 35% of the time. Snowfall occurred during 17% of the cloudy periods with a predominance of light precipitation and only rare events with snowfall >1 mm h−1 water equivalent (w.e.). Three of such intense snowfall events occurred during 2011 contributing to anomalously large annual surface mass balance (SMB). Large accumulation events (>10 mm w.e. day−1) during the radar-measurement period of 26 months were always associated with snowfall, but at the same time other snowfall events did not always lead to accumulation. The multiyear deployment of a precipitation radar in Antarctica allows for assessing the contribution of the snowfall to the local SMB and comparing it to the other SMB components. During 2012, snowfall rate was 110 ± 20 mm w.e. yr−1, from which surface and drifting snow sublimation removed together 23%. Given the measured yearly SMB of 52 ± 3 mm w.e., the residual term of 33 ± 21 mm w.e. yr−1 was attributed to the wind-driven snow erosion. In general, this promising set of robust instrumentation allows for improved insight into cloud and precipitation processes in Antarctica and can be easily deployed at other Antarctic stations

Efficacy and safety of high-dose baclofen for the treatment of alcohol dependence:A multicentre, randomised, double-blind controlled trial

Previous randomised placebo-controlled trials with low-to-medium doses of baclofen (30-60mg) showed inconsistent results, but case studies suggested a dose-response effect and positive outcomes in patients on high doses of baclofen (up to 270mg). Its prescription was temporary permitted for the treatment of alcohol dependence (AD) in France, and baclofen is now widely prescribed. Recently, a small RCT found a strong effect of a mean dose of 180mg baclofen. In the present study the efficacy and safety of high doses of baclofen was examined in a multicentre, double-blind, placebo-controlled trial. 151 patients were randomly assigned to either six weeks titration and ten weeks high-dose baclofen (N=58; up to 150mg), low-dose baclofen (N=31; 30mg), or placebo (N=62). The primary outcome measure was time to first relapse. Nine of the 58 patients (15.5%) in the high-dose group reached 150mg and the mean baclofen dose in this group was 93.6mg (SD=40.3). No differences between the survival distributions for the three groups were found in the time to first relapse during the ten-weeks high-dose phase (χ(2)=0.41; p=0.813) or the 16-weeks complete medication period (χ(2)=0.04; p=0.982). There were frequent dose-related adverse events in terms of fatigue, sleepiness, and dry mouth. One medication related serious adverse event occurred in the high-dose baclofen group. Neither low nor high doses of baclofen were effective in the treatment of AD. Adverse events were frequent, although generally mild and transient. Therefore, large-scale prescription of baclofen for the treatment of AD seems premature and should be reconsidered

De briefwisseling tussen Frederik Van Eeden en Lodewijk Van Deyssel /

Van Elslander, Antoni

Modelling the climate and surface mass balance of polar ice sheets using RACMO2 – Part 2: Antarctica (1979–2016)

We evaluate modelled Antarctic ice sheet (AIS) near-surface climate, surface mass balance (SMB) and surface energy balance (SEB) from the updated polar version of the regional atmospheric climate model, RACMO2 (1979–2016). The updated model, referred to as RACMO2.3p2, incorporates upper-air relaxation, a revised topography, tuned parameters in the cloud scheme to generate more precipitation towards the AIS interior and modified snow properties reducing drifting snow sublimation and increasing surface snowmelt.Comparisons of RACMO2 model output with several independent observational data show that the existing biases in AIS temperature, radiative fluxes and SMB components are further reduced with respect to the previous model version. The model-integrated annual average SMB for the ice sheet including ice shelves (minus the Antarctic Peninsula, AP) now amounts to 2229 Gt y−1, with an interannual variability of 109 Gt y−1. The largest improvement is found in modelled surface snowmelt, which now compares well with satellite and weather station observations. For the high-resolution ( ∼  5.5 km) AP simulation, results remain comparable to earlier studies.The updated model provides a new, high-resolution data set of the contemporary near-surface climate and SMB of the AIS; this model version will be used for future climate scenario projections in a forthcoming study.</p

Reading Newspapers in the Dutch Golden Age

Colonial and Global Histor