Family doctors' involvement with families in Estonia

BACKGROUND: Family doctors should care for individuals in the context of their family. Family has a powerful influence on health and illness and family interventions have been shown to improve health outcomes for a variety of health problems. The aim of the study was to investigate the Estonian family doctors' (FD) attitudes to the patients' family-related issues in their work: to explore the degree of FDs involvement in family matters, their preparedness for management of family-related issues and their self-assessment of the ability to manage different family-related problems. METHODS: A random sample (n = 236) of all FDs in Estonia was investigated using a postal questionnaire. Altogether 151 FDs responded to the questionnaire (response rate 64%), while five of them were excluded as they did not actually work as FDs. RESULTS: Of the respondents, 90% thought that in managing the health problems of patients FDs should communicate and cooperate with family members. Although most of the family doctors agreed that modifying of the health damaging risk factors (smoking, alcohol and drug abuse) of their patients and families is their task, one third of them felt that dealing with these problems is ineffective, or perceived themselves as poorly prepared or having too little time for such activities. Of the respondents, 58% (n = 83) were of the opinion that they could modify also relationship problems. CONCLUSIONS: Estonian family doctors are favourably disposed to involvement in family-related problems, however, they need some additional training, especially in the field of relationship management

Neutrophils in cancer: neutral no more

Neutrophils are indispensable antagonists of microbial infection and facilitators of wound healing. In the cancer setting, a newfound appreciation for neutrophils has come into view. The traditionally held belief that neutrophils are inert bystanders is being challenged by the recent literature. Emerging evidence indicates that tumours manipulate neutrophils, sometimes early in their differentiation process, to create diverse phenotypic and functional polarization states able to alter tumour behaviour. In this Review, we discuss the involvement of neutrophils in cancer initiation and progression, and their potential as clinical biomarkers and therapeutic targets

Short-lived climate forcers have long-term climate impacts via the carbon–climate feedback

International audienceShort-lived climate forcers (SLCFs) like methane, ozone and aerosols have a shorter atmospheric lifetime than CO2 and are often assumed to have a short-term effect on the climate system: should their emissions cease, so would their radiative forcing (RF). However, via their climate impact, SLCFs can affect carbon sinks and atmospheric CO2, causing additional climate change. Here, we use a compact Earth system model to attribute CO2 RF to direct CO2 emissions and to climate–carbon feedbacks since the pre-industrial era. We estimate the climate–carbon feedback contributed 93 ± 50 mW m−2 (~5%) to total RF of CO2 in 2010. Of this, SLCF impacts were −13 ± 50 mW m−2, made up of cooling (−115 ± 43 mW m−2) and warming (102 ± 26 mW m−2) terms that largely cancel. This study illustrates the long-term impact that short-lived species have on climate and indicates that past (and future) change in atmospheric CO2 cannot be attributed only to CO2 emissions