Clinical problems with the performance of euthanasia and physician-assisted suicide in The Netherlands

BACKGROUND AND METHODS: The characteristics and frequency of clinical problems with the performance of euthanasia and physician-assisted suicide are uncertain. We analyzed data from two studies of euthanasia and physician-assisted suicide in The Netherlands (one conducted in 1990 and 1991 and the other in 1995 and 1996), with a total of 649 cases. We categorized clinical problems as technical problems, such as difficulty inserting an intravenous line; complications, such as myoclonus or vomiting; or problems with completion, such as a longer-than-expected interval between the administration of medications and death. RESULTS: In 114 cases, the physician's intention was to provide assistance with suicide, and in 535, the intention was to perform euthanasia. Problems of any type were more frequent in cases of assisted suicide than in cases of euthanasia. Complications occurred in 7 percent of cases of assisted suicide, and problems with completion (a longer-than-expected time to death, failure to induce coma, or induction of coma followed by awakening of the patient) occurred in 16 percent of the cases; complications and problems with completion occurred in 3 percent and 6 percent of cases of euthanasia, respectively. The physician decided to administer a letha

Diverging business strategies towards climate change : a USA-Europe comparison for four sectors of industry

The research project has investigated what strategies specific sectors of industry develop to limit greenhouse gas emissions. In an USA-Europe co-operation, researchers have analysed emerging climate strategies in the oil industry, the automobile industry, the chemical industry and the bank and insurance sector. These sectors are the most important players in the climate policy debate. Special attention has been paid to the questions whether strategies of EU based corporations differ systematically from USA based corporations. Results show rather sectorial specific developments. In most sectors, i.e. oil, automobile and banks, European corporations generally tend to have more advanced policies than their USA counterparts, but this does not apply to chemical companies. Corporate strategies appear to be highly determined by a combination of market situation in the home country and of access to alternative technologies. Objective of the study was to provide information of relevance to the COP (Sixth Session of the UNFCCC Conference of the Parties) 2000 conference, November 2000 in The Hague

Energy Security of China, India, the E.U. and the U.S. under Long-term Scenarios: Results from Six IAMs

This paper assesses energy security in three long-term energy scenarios (a business as usual development, a projection of Copenhagen commitments, and a 450 ppm stabilization scenario) as modeled in six integrated assessment models: GCAM, IMAGE, MESSAGE, ReMIND, TIAM-ECN and WITCH. We systematically evaluate potential long-term vulnerabilities of vital energy systems of four major economies: China, the European Union, India and the U.S., as expressed by several characteristics of energy trade, resource extraction, and diversity of energy options. Our results show that climate policies are likely to lead to significantly lower global energy trade and reduce energy imports of major economies, decrease the rate of resource depletion, and increase the diversity of energy options, particularly in the especially vulnerable transportation sector. China, India and the E.U. will derive particularly strong benefits from climate policies, whereas the U.S. may forego some opportunities to export fossil fuels in the second half of the century

Familial Mediterranean Fever and Hyperimmunoglobulinemia D syndrome: two diseases with distinct clinical, serologic, and genetic features

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Mediators of the effect of the JUMP-in intervention on physical activity and sedentary behavior in Dutch primary schoolchildren from disadvantaged neighborhoods.

<p>Abstract</p> <p>Background</p> <p>Important health benefits can be achieved when physical activity in children from low socio-economic status is promoted and sedentariness is limited. By specifying the mediating mechanisms of existing interventions one can improve future physical activity interventions. This study explored potential mediators of the long-term effect of the school-based multicomponent JUMP-in intervention on sport participation, outdoor play and screen time in Dutch primary schoolchildren from disadvantaged neighborhoods.</p> <p>Methods</p> <p>In total, 600 primary schoolchildren (aged 9.8 ± 0.7, 51% girls, 13% Dutch ethnicity, 35% overweight) from 9 intervention and 10 control schools were included in the analyses. JUMP-in was developed using Intervention Mapping, and targeted psychological and environmental determinants of physical activity. Outcome behaviors were self-reported sport participation, outdoor play, TV-viewing behavior and computer use. Potential mediators were self-reported psychological, social and physical environmental factors.</p> <p>Results</p> <p>JUMP-in was effective in improving sport participation after 20 months, but not in improving outdoor play, or reducing TV-viewing or computer time. JUMP-in was not effective in changing hypothesized mediators so no significant mediated effects could be identified. However, changes in self-efficacy, social support and habit strength were positively associated with changes in sport participation, and changes in social support, self-efficacy, perceived planning skills, enjoyment and habit strength were positively associated with changes in outdoor play. Changes in enjoyment was positively associated with changes in TV-viewing while parental rules were negatively associated. Having a computer in the bedroom and enjoyment were positively associated with changes in computer use, while changes in parental rules were negatively associated.</p> <p>Conclusions</p> <p>Besides a significant positive effect on sports participation, no significant intervention effect on outdoor play, screen time or any of the potential mediators was found. This suggest that other (unmeasured) factors operated as mediating mechanisms of the intervention, that we used unsuccessful intervention strategies, that the strategies were inappropriately implemented, or that children are unable to accurately recall past activities and cognitions. Additionally, the school setting might not be the sole channel to influence leisure time activities. Still, several personal and environmental constructs were found to be relevant in predicting change in sport participation, outdoor play and screen behavior and seem to be potential mediators. Future interventions are recommended including more effective strategies targeting these relevant constructs, addressing different constructs (e.g. pedagogic skills of parents), and focusing on different implementation settings.</p> <p>Trail registration</p> <p>ISRCTN17489378</p

Dietary determinants of changes in waist circumference adjusted for body mass index - a proxy measure of visceral adiposity

Background Given the recognized health effects of visceral fat, the understanding of how diet can modulate changes in the phenotype “waist circumference for a given body mass index (WCBMI)”, a proxy measure of visceral adiposity, is deemed necessary. Hence, the objective of the present study was to assess the association between dietary factors and prospective changes in visceral adiposity as measured by changes in the phenotype WCBMI. Methods and Findings We analyzed data from 48,631 men and women from 5 countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Anthropometric measurements were obtained at baseline and after a median follow-up time of 5.5 years. WCBMI was defined as the residuals of waist circumference regressed on body mass index, and annual change in WCBMI (¿WCBMI, cm/y) was defined as the difference between residuals at follow-up and baseline, divided by follow-up time. The association between energy, energy density (ED), macronutrients, alcohol, glycemic index (GI), glycemic load (GL), fibre and ¿WCBMI was modelled using centre-specific adjusted linear regression, and random-effects meta-analyses to obtain pooled estimates. Men and women with higher ED and GI diets showed significant increases in their WCBMI, compared to those with lower ED and GI [1 kcal/g greater ED predicted a ¿WCBMI of 0.09 cm (95% CI 0.05 to 0.13) in men and 0.15 cm (95% CI 0.09 to 0.21) in women; 10 units greater GI predicted a ¿WCBMI of 0.07 cm (95% CI 0.03 to 0.12) in men and 0.06 cm (95% CI 0.03 to 0.10) in women]. Among women, lower fibre intake, higher GL, and higher alcohol consumption also predicted a higher ¿WCBMI. Conclusions Results of this study suggest that a diet with low GI and ED may prevent visceral adiposity, defined as the prospective changes in WCBMI. Additional effects may be obtained among women of low alcohol, low GL, and high fibre intake

The Large Magellanic Cloud: A power spectral analysis of Spitzer images

We present a power spectral analysis of Spitzer images of the Large Magellanic Cloud. The power spectra of the FIR emission show two different power laws. At larger scales (kpc) the slope is ~ -1.6, while at smaller ones (tens to few hundreds of parsecs) the slope is steeper, with a value ~ -2.9. The break occurs at a scale around 100-200 pc. We interpret this break as the scale height of the dust disk of the LMC. We perform high resolution simulations with and without stellar feedback. Our AMR hydrodynamic simulations of model galaxies using the LMC mass and rotation curve, confirm that they have similar two-component power-laws for projected density and that the break does indeed occur at the disk thickness. Power spectral analysis of velocities betrays a single power law for in-plane components. The vertical component of the velocity shows a flat behavior for large structures and a power law similar to the in-plane velocities at small scales. The motions are highly anisotropic at large scales, with in-plane velocities being much more important than vertical ones. In contrast, at small scales, the motions become more isotropic.Comment: 8 pages, 4 figures, talk presented at "Galaxies and their Masks", celebrating Ken Freeman's 70-th birthday, Sossusvlei, Namibia, April 2010. To be published by Springer, New York, editors D.L. Block, K.C. Freeman, & I. Puerar

Inelastic Proton Scattering at Intermediate Energies to Giant Resonances

Supported by the National Science Foundation and Indiana Universit

Giant Multipole Resonances in the (3-He,t) Reaction at 200 MeV

This work was supported by the National Science Foundation Grants NSF PHY 78-22774 A03, NSF PHY 81-14339, and by Indiana Universit