Euthanasia and assisted suicide in selected European countries and US states: systematic literature review

BACKGROUND Legal in some European countries and US states, physician-assisted suicide and voluntary active euthanasia remain under debate in these and other countries. OBJECTIVES The aim of the study was to examine numbers, characteristics, and trends over time for assisted dying in regions where these practices are legal: Belgium, Luxembourg, the Netherlands, Switzerland, Oregon, Washington, and Montana. DESIGN This was a systematic review of journal articles and official reports. Medline and Embase databases were searched for relevant studies, from inception to end of 2012. We searched the websites of the health authorities of all eligible countries and states for reports on physician-assisted suicide or euthanasia and included publications that reported on cases of physician-assisted suicide or euthanasia. We extracted information on the total number of assisted deaths, its proportion in relation to all deaths, and socio-demographic and clinical characteristics of individuals assisted to die. RESULTS A total of 1043 publications were identified; 25 articles and reports were retained, including series of reported cases, physician surveys, and reviews of death certificates. The percentage of physician-assisted deaths among all deaths ranged from 0.1%-0.2% in the US states and Luxembourg to 1.8%-2.9% in the Netherlands. Percentages of cases reported to the authorities increased in most countries over time. The typical person who died with assistance was a well-educated male cancer patient, aged 60-85 years. CONCLUSIONS Despite some common characteristics between countries, we found wide variation in the extent and specific characteristics of those who died an assisted death.

Are great Cascadia earthquakes recorded in the sedimentary records from small forearc lakes?

Here we investigate sedimentary records from four small inland lakes located in the southern Cascadia forearc region for evidence of earthquakes. Three of these lakes are in the Klamath Mountains near the Oregon–California border, and one is in the central Oregon Coast range. The sedimentary sequences recovered from these lakes are composed of normal lake sediment interbedded with disturbance event layers. The thickest of these layers are graded, and appear to be turbidites or linked debrites (turbidites with a basal debris-flow deposit), suggesting rapid deposition. Variations in particle size and organic content of these layers are reflected in the density and magnetic susceptibility data. The frequency and timing of these events, based on radiocarbon ages from detrital organics, is similar to the offshore seismogenic turbidite record from trench and slope basin cores along the Cascadia margin. Stratigraphic correlation of these anomalous deposits based on radiocarbon ages, down-core density, and magnetic susceptibility data between lake and offshore records suggest synchronous triggering. The areal extent and multiple depositional environments over which these events appear to correlate suggest that these deposits were most likely caused by shaking during great Cascadia earthquakes.

An Innovative Family Preservation Program in an African American Community: Longitudinal Analysis

This paper presents a secondary analysis of data from a longitudinal evaluation of a community-based family preservation program in Portland, Oregon, designed for and by African Americans. Families served by the Family Enhancement Program (FEP) resemble chronically neglecting families in terms of numbers of children and length of contact with child protective services. Six- and twelve-month follow-ups for FEP clients were compared to data on families served by the Oregon State Office of Services to Children and Families (SOSCF). The author found that FEP families are more likely than SOSCFfamilies to show greater improvement between the pretest scores and the posttest scores for number of days in placement, number of placements, and number of founded maltreatment reports.

Can homeopathic verum and placebo globules be distinguished by UV spectroscopy?

Purpose: Homeopathic preparations are used in homeopathy and anthroposophically extended medicine. Previous studies described differences in UV transmission between homeopathic preparations of CuSO4 and controls. The aim of the present study was to investigate whether statistically significant differences can be found between homeopathic verum and placebo globules by UV spectroscopy. Methods: Verum (aconitum 30c, calcium carbonate/quercus e cortice) and placebo globules used in two previous clinical trials were dissolved in distilled water at 10mg/ml 20-23h prior to the measurements. Absorbance was measured at 190 – 340nm with a Shimadzu UV-1800 double beam spectrophotometer. Duplicates of each sample were measured in a randomized order 4 times on each of the 5 measurement days. To correct for differences between measurement days, average absorbance of all samples on one day was deduced from absorbance of the individual samples. The Kruskal-Wallis test was used to determine group differences between the samples, and finally the coding of the samples was revealed. Results: First analysis showed significant differences (p≤0.05) in average UV absorbance at 200 – 290nm between the samples and a tendency of a correlation (p≤0.1) between absorbance and globule weight. More results will be presented at the conference. Conclusion: Since the absorbance of the samples at the wavelengths between 200 and 290nm was small, a number of aspects had to be considered and should be corrected for if they are present when performing UV spectroscopy on homeopathic globules: 1. Exact weighing of the globules. 2. Measurement error of the spectrophotometer at small absorbances. 3. Drift of the spectrophotometer during a measurement day. 4. Differences between measurement days. The question remains what caused the differences in absorbance found in these experiments: the use of the original material for the production of the verum globules, differences in the production of verum and placebo globules, or other context factors.

Spatial Patterns in Seasonal and Interannual Variability of Chlorophyll and Sea Surface Temperature in the California Current

Physical forcing and biological response within the California Current System (CCS) are highly variable over a wide range of scales. Satellite remote sensing offers the only feasible means of quantifying this variability over the full extent of the CCS. Using six years (1997-2003) of daily SST and chlorophyll imagery, we map the spatial dependence of dominant temporal variability at resolutions sufficient to identify recurrent mesoscale circulation and local pattern associated with coastal topography. Here we describe mean seasonal cycles and interannual variation; intraseasonal variability is left to a companion paper ( K. R. Legaard and A. C. Thomas, manuscript in preparation, 2006). Coastal upwelling dictates seasonality along north-central California, where weak cycles of SST fluctuate between spring minima and late summer maxima and chlorophyll peaks in early summer. Off northern California, chlorophyll maxima are bounded offshore by the seasonally recurrent upwelling jet. Seasonal cycles differ across higher latitudes and in the midlatitude Southern California Bight, where upwelling winds are less vigorous and/or persistent. Seasonality along south-central Baja is strongly affected by processes other than upwelling, despite year-round upwelling-favorable winds. Interannual variation is generally dominated by El Nino and La Nina conditions. Interannual SST variance is greatest along south-central Baja, although interannual variability constitutes a greater fraction of total variance inshore along southern Oregon and much of California. Patterns of interannual chlorophyll variance are consistent with dominant forcing through the widespread depression and elevation of the nutricline during El Nino and La Nina, respectively. Interannual variability constitutes a greater fraction of total chlorophyll variance offshore.

Satellite-Derived Variability in Chlorophyll, Wind Stress, Sea Surface Height, and Temperature in the Northern California Current System

Satellite-derived data provide the temporal means and seasonal and nonseasonal variability of four physical and biological parameters off Oregon and Washington ( 41 degrees - 48.5 degrees N). Eight years of data ( 1998 - 2005) are available for surface chlorophyll concentrations, sea surface temperature ( SST), and sea surface height, while six years of data ( 2000 - 2005) are available for surface wind stress. Strong cross-shelf and alongshore variability is apparent in the temporal mean and seasonal climatology of all four variables. Two latitudinal regions are identified and separated at 44 degrees - 46 degrees N, where the coastal ocean experiences a change in the direction of the mean alongshore wind stress, is influenced by topographic features, and has differing exposure to the Columbia River Plume. All these factors may play a part in defining the distinct regimes in the northern and southern regions. Nonseasonal signals account for similar to 60 - 75% of the dynamical variables. An empirical orthogonal function analysis shows stronger intra-annual variability for alongshore wind, coastal SST, and surface chlorophyll, with stronger interannual variability for surface height. Interannual variability can be caused by distant forcing from equatorial and basin-scale changes in circulation, or by more localized changes in regional winds, all of which can be found in the time series. Correlations are mostly as expected for upwelling systems on intra-annual timescales. Correlations of the interannual timescales are complicated by residual quasi-annual signals created by changes in the timing and strength of the seasonal cycles. Examination of the interannual time series, however, provides a convincing picture of the covariability of chlorophyll, surface temperature, and surface height, with some evidence of regional wind forcing.

Spatial Patterns of Intraseasonal Variability of Chlorophyll and Sea Surface Temperature in the California Current

Six years of daily satellite data are used to quantify and map intraseasonal variability of chlorophyll and sea surface temperature (SST) in the California Current. We define intraseasonal variability as temporal variation remaining after removal of interannual variability and stationary seasonal cycles. Semivariograms are used to quantify the temporal structure of residual time series. Empirical orthogonal function (EOF) analyses of semivariograms calculated across the region isolate dominant scales and corresponding spatial patterns of intraseasonal variability. The mode 1 EOFs for both chlorophyll and SST semivariograms indicate a dominant timescale of similar to 60 days. Spatial amplitudes and patterns of intraseasonal variance derived from mode 1 suggest dominant forcing of intraseasonal variability through distortion of large scale chlorophyll and SST gradients by mesoscale circulation. Intraseasonal SST variance is greatest off southern Baja and along southern Oregon and northern California. Chlorophyll variance is greatest over the shelf and slope, with elevated values closely confined to the Baja shelf and extending farthest from shore off California and the Pacific Northwest. Intraseasonal contributions to total SST variability are strongest near upwelling centers off southern Oregon and northern California, where seasonal contributions are weak. Intraseasonal variability accounts for the majority of total chlorophyll variance in most inshore areas save for southern Baja, where seasonal cycles dominate. Contributions of higher EOF modes to semivariogram structure indicate the degree to which intraseasonal variability is shifted to shorter timescales in certain areas. Comparisons of satellite-derived SST semivariograms to those calculated from co-located and concurrent buoy SST time series show similar features.

Efficacy of motivational enhancement therapy on alcohol use disorders in patients with chronic hepatitis C: a randomized controlled trial

AIMS: To determine the efficacy of motivational enhancement therapy (MET) on alcohol use in patients with the hepatitis C virus (HCV) and an alcohol use disorder (AUD). DESIGN: Randomized, single-blind, controlled trial comparing MET to a control education condition with 6-month follow-up. SETTING: Patients were recruited from hepatitis clinics at the Minneapolis, Minnesota and Portland, Oregon Veterans Affairs Health Care Systems, USA. PARTICIPANTS AND INTERVENTION: Patients with HCV, an AUD and continued alcohol use (n = 139) were randomized to receive either MET (n = 70) or a control education condition (n = 69) over 3 months. MEASUREMENTS: Data were self-reported percentage of days abstinent from alcohol and number of standard alcohol drinks per week 6 months after randomization. FINDINGS: At baseline, subjects in MET had 34.98% days abstinent, which increased to 73.15% at 6 months compared to 34.63 and 59.49% for the control condition. Multi-level models examined changes in alcohol consumption between MET and control groups. Results showed a significant increase in percentage of days abstinent overall (F(1120.4)  = 28.04, P < 0.001) and a significant group × time effect (F(1119.9)  = 5.23, P = 0.024) with the MET group showing a greater increase in percentage of days abstinent at 6 months compared with the education control condition. There were no significant differences between groups for drinks per week. The effect size of the MET intervention was moderate (0.45) for percentage of days abstinent. CONCLUSION: Motivational enhancement therapy (MET) appears to increase the percentage of days abstinent in patients with chronic hepatitis C, alcohol use disorders and ongoing alcohol use. Published 2014. This article is a U.S. Government work and is in the public domain in the USA.

Segmentation and Segregation Patterns of Women-Owned High-Tech Firms in Four Metropolitan Regions in the United States

Mayer H. Segmentation and segregation patterns of women-owned high-tech firms in four metropolitan regions in the United States, Regional Studies. The number of women starting and owning a business has increased dramatically and female entrepreneurs are entering non-traditional sectors such as high technology, construction and manufacturing. This paper investigates the trends in high-tech entrepreneurship by women in four US metropolitan regions (Silicon Valley, California; Boston, Massachusetts; Washington, DC; and Portland, Oregon). The research examines the sectoral and spatial segmentation patterns of women-owned high-tech firms. Although women are entering non-traditional sectors, the research finds that women entrepreneurs tend to own businesses in female-typed high-tech sectors. In established high-tech regions like Silicon Valley and Boston, male-typed and female-typed women-owned high-tech firms differ significantly in terms of sectoral and spatial segmentation regardless of firm age. While differences between male-typed and female-typed firms are not significant at the regional level for Washington, DC, the analysis shows significant intra-metropolitan differences for the female-typed high-tech firms. The paper concludes that sectoral and spatial segmentation are powerful dynamics that shape business ownership by women in high technology.