Suicidality Treatment Occurring in Paediatrics (STOP) Medication Suicidality Side Effects Scale in young people in two cohorts across Europe.

OBJECTIVES: As part of the 'Suicidality: Treatment Occurring in Paediatrics (STOP)' study, we developed and performed psychometric validation of an electronic-clinical-outcome-assessment (eCOA), which included a patient-reported-outcome (ePRO), an observer-rated-outcome (eObsRO) for parents/carers and a clinician-reported-outcome (eClinRO) that allows identification and monitoring of medication-related suicidality (MRS) in adolescents. DESIGN: STOP: Prospective study: A two phase validation study to assess the impact of medication on suicidal ideations. SETTING: Six participating countries: Netherlands, UK, Germany, France, Spain and Italy that were part of the Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement no. 261411. PARTICIPANTS: Cohort 1 consisted of 41 adolescent-completions, 50 parent-completions and 56 clinician-completions. Cohort 2 consisted of 244 adolescent-completions, 198 parent-completions and 240 clinician-completions from across the six countries. The scale was administered only to participants who have screened positive for the STOP-Suicidality Assessment Scale (STOP-SAS). RESULTS: A total of 24 items for the development of the STOP-Medication Suicidality Side Effects Scale (STOP-MS3) were identified and three versions (for patients, parents and clinicians) of the STOP-MS3 were developed and validated in two separate study cohorts comprising of adolescents, their parents and clinicians. Cronbach's α coefficients were above 0.85 for all domains. The inter-rater reliability of the STOP-MS3 was good and significant for the adolescent (ePRO), clinician (eClinRO) (r=0.613), parent (eObsRO) versions of the scale (r=0.394) and parent and clinician (r=0.347). Exploratory factor analysis identified a 3-factor model across 24 items for the adolescent and parent version of the scale: (1) Emotional Dysregulation, (2) Somatic Dysregulation and (3) Behavioural Dysregulation. For the clinician version, a 4-factor model defined the scale structure: (1) Somatic Dysregulation, (2) Emotional Dysregulation, (3) Behavioural Dysregulation and (4) Mood Dysregulation. CONCLUSION: These findings suggest that the STOP-MS3 scale, a web-based eCOA, allows identification and monitoring of MRS in the adolescent population and shows good reliability and validity.

The key role of propane in a sustainable cooling sector.

Split air conditioners (ACs) are the most used appliance for space cooling worldwide. The phase-down of refrigerants with high global warming potential (GWP) prescribed by the Kigali Amendment to the Montreal Protocol has triggered a major effort to find less harmful alternative refrigerants. HFC-32 is currently the most common refrigerant to replace HFC-410A in split ACs. The GWP of HFC-32 is about one-third that of HFC-410A but still considerably higher than that of a growing number of nonfluorinated alternatives like propane with a GWP of <1, which have recently become commercially available for split ACs. Here, we show that a switch to propane as an energy-efficient and commercially available low-GWP alternative in split ACs could avoid 0.09 (0.06 to 0.12) °C increase in global temperature by the end of the century. This is significantly more than the 0.03 (0.02 to 0.05) °C avoided warming from a complete switch to HFC-32 in split ACs.

Health and well-being management in the military: a systematic review of genetic studies.

BACKGROUND: Genetic research may have therapeutic value for mental and physical disorders and could have an indicative or preventative capacity. Little is known about the extent, form and utility of military-specific genetic research. METHOD: A systematic review was conducted to evaluate existing genetic well-being studies of service personnel. The review specifically aimed to ascertain the current state of knowledge and feasibility of using genetics to aid recruitment and health management within military populations. Databases searched included MEDLINE, Embase, PsycINFO and Web of Science for relevant studies. Papers were rated using a genetics-specific quality assessment framework. RESULTS: Ten papers were included within the final review, with seven mental-health-focused and three physical-health-focused genetic studies found within military populations. Eight papers considered candidate genes, one gene expression and one study was an outline of a future study of significant interest. Genetic commonalties were derived to yield shared physiological pathways. The 10 reviewed papers revealed moderate quality based on quality assessment. CONCLUSIONS: Current genetic research within military populations is limited. Further studies on genetics, cost effectiveness, ethics and continual monitoring need to be explored before considering any movement toward clinical translation.

Stratospheric ozone, global warming, and the principle of unintended consequences--an ongoing science and policy success story.

In 1974, Mario Molina and F. Sherwood Rowland warned that chlorofluorocarbons (CFCs) could destroy the stratospheric ozone layer that protects Earth from harmful ultraviolet radiation. In the decade after scientists documented the buildup and long lifetime of CFCs in the atmosphere; found the proof that CFCs chemically decomposed in the stratosphere and catalyzed the depletion of ozone; quantified the adverse effects; and motivated the public and policymakers to take action. In 1987, 24 nations plus the European Community signed the Montreal Protocol. Today, 25 years after the Montreal Protocol was agreed, every United Nations state is a party (universal ratification of 196 governments); all parties are in compliance with the stringent controls; 98% of almost 100 ozone-depleting chemicals have been phased out worldwide; and the stratospheric ozone layer is on its way to recovery by 2065. A growing coalition of nations supports using the Montreal Protocol to phase down hydrofluorocarbons, which are ozone safe but potent greenhouse gases. Without rigorous science and international consensus, emissions of CFCs and related ozone-depleting substances (ODSs) could have destroyed up to two-thirds of the ozone layer by 2065, increasing the risk of causing millions of cancer cases and the potential loss of half of global agricultural production. Furthermore, because most, ODSs are also greenhouse gases, CFCs and related ODSs could have had the effect of the equivalent of 24-76 gigatons per year of carbon dioxide. This critical review describes the history of the science of stratospheric ozone depletion, summarizes the evolution of control measures and compliance under the Montreal Protocol and national legislation, presents a review of six separate transformations over the last 100 years in refrigeration and air conditioning (A/C) technology, and illustrates government-industry cooperation in continually improving the environmental performance of motor vehicle A/C.