BACKGROUND: The aim of the current study was to assess the accuracy of expert predictions, which were derived using a Delphi panel foresight study between 2009 and 2011, on a variety of drug-related topics in Finland in 2020.
METHODS: The material used to evaluate the accuracy of the predictions consists of published reports on statistics, survey results, official register data, wastewater analyses and official documents. Whenever possible, we used multiple information sources to ascertain possible changes related to the predictions.
RESULTS: Between 2009 and 2011, the majority - but not all - of the experts accurately predicted an increase in drug use. Indeed, more people experimented with or used drugs, and more drug residues were found in wastewater monitoring. The experts also correctly predicted an increase in population-level approval of drug use, but this development has been rather slow. Contrary to predictions, there was no marked increase in the use of new synthetic drugs. However, the misuse of buprenorphine increased during the 2010s. In the drug market, unit prices were surprisingly stable over the ten-year period. There were no changes in legislation related to the legal status of drugs, as was foreseen by the experts. However, enforcement moved in the direction foreseen by the experts: more lenient measures have been taken against users. Drug care system reforms favored a combination of mental health and addiction care units between 2009 and 2011, and 2020, as foreseen by the experts.
CONCLUSIONS: It seems to have been easier for the experts to foresee the continuation of existing trends, e.g., increasing use of drugs or widening approval of drugs, than to predict possible changes in the popularity of distinct groups of drugs such as new psychoactive substances (NPS). Even armed with the prediction that drug imports and wholesale would increasingly fall into the domain of organized crime, this undesirable development could not be stopped. Expert disagreement can also be seen as a valuable indication of uncertainty regarding the future. Foresight related to drug-related issues can produce relatively accurate and realistic views of the future at least up to ten years ahead.

Globally, more people are living into advanced old age, with age-associated frailty, disability and multimorbidity. Achieving equity for all ages necessitates adapting healthcare systems. Clinical practice guidelines (CPGs) have an important place in adapting evidence-based medicine and clinical care to reflect these changing needs. CPGs can facilitate better and more systematic care for older people. But they can also present a challenge to patient-centred care and shared decision-making when clinical and/or socioeconomic heterogeneity or personal priorities are not reflected in recommendations or in their application. Indeed, evidence is often lacking to enable this variability to be reflected in guidance. Evidence is more likely to be lacking about some sections of the population. Many older adults are at the intersection of many factors associated with exclusion from traditional clinical evidence sources with higher incidence of multimorbidity and disability compounded by poorer healthcare access and ultimately worse outcomes. We describe these challenges and illustrate how they can adversely affect CPG scope, the evidence available and its summation, the content of CPG recommendations and their patient-centred implementation. In all of this, we take older adults as our focus, but much of what we say will be applicable to other marginalised groups. Then, using the established process of formulating a CPG as a framework, we consider how these challenges can be mitigated, with particular attention to applicability and implementation. We consider why CPG recommendations on the same clinical areas may be inconsistent and describe approaches to ensuring that CPGs remain up to date.

暂无摘要。

OBJECTIVE: The aim of the study was to explore the subjective views of general practitioners on the applicability of the Adult ADHD Self-Report Screening Scale for DSM-5 (ASRS-5) as a screening tool for attention-deficit/hyperactivity disorder (ADHD) in adults in general practice.
METHODS: Eleven general practitioners, who had participated in the validation study of the German version of the ASRS-5, were interviewed. For this purpose, a semi-structured interview guide was designed using the Consolidated Framework for Implementation Research (CFIR). The interviews were audio-recorded, transcribed, and analyzed using qualitative content analysis according to Kuckartz.
RESULTS: The ASRS-5 seems to work well in general medical practice. But there is evidence for a lack of knowledge about ADHD in adults among general practitioners and a demand for further training in this area. Moreover, insufficient possibilities for subsequent treatment after a positive ADHD screening were claimed.
CONCLUSIONS: In general medicine, the introduction of a screening using ASRS-5 in cases of clinical suspicion could be the first step towards improving the management of adult patients with ADHD.
CONCLUSIONS: Optimizing the management of adults with ADHD requires additional information and training initiatives to support early diagnosis especially in the primary care setting, and to reveal treatment options and care concepts for adults with ADHD.

The analytical equation based on Monin-Obukhov (M-O) similarity theory (i.e., wind profile equation) has been adopted since 1970s for using in the prediction of wind vertical profile over flat terrains, which is mature and accurate. However, its applicability over complex terrains remains unknown. This applicability signifies the accuracy of the estimations of aerodynamic parameters for the boundary layer of non-flat terrain, such as zero-displacement height (d) and aerodynamic roughness length (z0), which will determine the accuracy of frequency correction and source area analysis in calculating carbon, water, and trace gas fluxes based on vorticity covariance method. Therefore, the validation of wind profile model in non-flat terrain is the first step to test whether the flux model needs improvement. We measured three-dimensional wind speed data by using the Ker Towers (three towers in a watershed) at Qingyuan Forest CERN in the Mountainous Region of east Liaoning Province, and compared them with data from Panjin Agricultural Station in the Liaohe Plain, to evaluate the applicability of a generalized wind profile model based on the Monin-Obukhov similarity theory on non-flat terrain. The results showed that the generalized wind profile model could not predict wind speeds accurately of three flux towers separately located in different sites, indicating that wind profile model was not suitable for predicting wind speeds in complex terrains. In the leaf-off and leaf-on periods, the coefficient of determination (R2) between observed and predicted wind speeds ranged from 0.12 to 0.30. Compared to measured values, the standard error of the predicted wind speeds was high up to 2 m·s-1. The predicted wind speeds were high as twice as field-measured wind speed, indicating substantial overestimation. Nevertheless, this model correctly predicted wind speeds in flat agricultural landscape in Panjin Agricultural Station. The R2 between observed wind speeds and predicted wind speed ranged from 0.90 to 0.93. The standard error between observed and predicted values was only 0.5 m·s-1. Results of the F-test showed that the root-mean-square error of the observed and predicted wind speeds in each secondary forest complex terrain was much greater than that in flat agricultural landscape. Terrain was the primary factor affecting the applicability of wind profile model, followed by seasonality (leaf or leafless canopy). The wind profile model was not applicable to the boundary-layer flows over forest canopies in complex terrains, because the d was underestimated or both the d and z0 were underestimated, resulting in inaccurate estimation of aerodynamic height.
基于莫宁-奥布霍夫相似理论的解析方程(风速廓线模型)自20世纪70年代以来一直被用于平坦地形上的风速预测,成熟且准确,但在非平坦地形适用性尚不清楚。其适用性标志着对非平坦地形近地层空气动力学参数(如零平面位移高度及粗糙度)估计的准确性,将决定基于涡度协方差法计算碳水及痕量气体通量中频率修正及其源区分析的准确性。因此,风速廓线模型在非平坦地形的适用性评价是确认通量模型是否需要改进的前提。本研究利用辽东山区清原森林站科尔塔群测量三维风速数据,并与辽河平原盘锦农田站同类数据相比较,评估了以莫宁-奥布霍夫相似理论为基础建立的通用风速廓线模型在非平坦地形上的适用性。结果表明: 通用风速廓线模型无法准确预测清原森林站3座通量塔所在地的风速,不适用于复杂地形。在非生长季和生长季,清原森林站3座通量塔实际观测与模型预测风速的决定系数(R2)为0.12～0.30,观测数据与预测值的标准误超过2 m·s-1,模型风速约为实际观测风速的2.0倍,显著高估。然而,该模型可准确预测盘锦农田站平坦农田景观的水平风速,实际观测风速与模型预测之间的R2为0.90～0.93,观测数据与预测值之间的标准误仅为0.5 m·s-1。经F检验指出,非平坦地形风速观测值与预测值的均方根误差远大于平坦地形,其中,地形是影响通用风速廓线模型适用性的主要因素,其次是季节性(无/有叶期)因素。风速廓线模型在非平坦地形上不适用,原因是零平面位移被低估,或零平面位移和粗糙度均被低估,进而使空气动力高度估计不准。.

The prevention of intimate partner violence (IPV) among young people is a major challenge for public policies. Nevertheless, there are a few prevention programs that have proven effective in France. “Sortir Ensemble & Se Respecter” (SE&SR) is a Swiss adaptation of “Safe Dates,” an American intervention program that has reduced violent behavior by young perpetrators and victims of IPV alike. The aim of this article is to analyze the applicability and “potential transferability” of SE&SR in France.
We described the SE&SR intervention by explaining the intervention theory, the key functions (i.e., the “ingredients” allowing the SE&SR program to work), and we commented on its applicability from a perspective of adapting and transferring it to the French context. We used the ASTAIRE tool and the FIC (key functions, implementation, context) approach.
The intervention theory highlighted various factors, acting at the individual level (i.e., beliefs/representations, knowledge, life skills) and at the level of the living environment (i.e., facilities welcoming young people; families; public policies; networks of actors), that can prevent IPV among young people. Ten key functions have been identified, revealing the “skeleton” of the Swiss intervention. We drew on these results to comment on the intervention’s applicability, with a view to transferability, specifying the contextual elements to consider before implementing SE&SR in France.
This study aims to make the process of evaluating applicability, with a view to transferring an evidence-based program to the French context, more accessible.
La prévention des violences dans les relations amoureuses (VRA) chez les jeunes est un enjeu fort des politiques publiques. Néanmoins, il existe peu de programmes de prévention ayant fait la preuve de leur efficacité en France. « Sortir Ensemble & Se Respecter » (SE&SR) est une adaptation suisse de « Safe Dates », un programme d’intervention américain qui a montré des résultats en matière de réduction des comportements violents tant du côté des jeunes victimes que des auteurs. L’objectif de cet article est d’analyser l’applicabilité et la « potentielle transférabilité » de SE&SR en France.
L’approche adoptée consistait à décrire l’intervention SE&SR en explicitant la théorie d’intervention, les fonctions clés (soit les « ingrédients » permettant que le programme SE&SR fonctionne) et en proposant des commentaires d’applicabilité en vue d’une transférabilité adaptée au contexte français. L’outil ASTAIRE et la démarche FIC ont été utilisés.
La théorie d’intervention a mis en évidence différents facteurs, agissant au niveau individuel (i.e. connaissances, croyances/représentations, compétences psychosociales) et au niveau des milieux de vie (i.e. structures accueillant les jeunes, familles, politiques publiques/réseaux d’acteurs), qui peuvent prévenir les VRA chez les jeunes. Dix fonctions clés ont été identifiées, dégageant le « squelette » de l’intervention suisse. À la suite de ces résultats, des commentaires d’applicabilité en vue d’une transférabilité ont permis de préciser les éléments de contexte à prendre en compte avant la mise en œuvre de SE&SR en France.
Cette étude souhaite rendre accessibles les process d’applicabilité en vue d’une transférabilité d’un programme probant en contexte français.

How do researchers in psychology view the relation between scientific knowledge, its applicability, and its societal relevance? Most research on psychological science and its benefits to society is discussed from a bird\'s eye view (a meta-scientific perspective), by identifying general trends such as psychology\'s dominant focus on lab-based experiments and general descriptive theories. In recent years, several critics have argued that this focus has come at the cost of reduced practical and societal relevance. In this study, we interviewed Dutch psychology professors to gauge their views about the relation between psychological research and its relevance to society. We found that psychology professors engaged in a variety of activities to engage science with society, from work in clinical and applied settings, to consultancy, education, and science communication. However, we found that the role of theory when applying scientific knowledge to practical problems is far from straightforward. While most participants regarded theories as relevant to understanding general contexts of application, psychological theories were seldom directly related to specific applications. We compare and discuss our findings in the light of recent discussions about the lack of applicability and societal relevance of psychological science.

Although many drought indices have been developed to monitor drought conditions, their applicability differs across climatic regions, which results in different characteristics of drought index assessments at different timescales and over different record lengths. Therefore, the applicability of precipitation-based and precipitation-evapotranspiration/temperature-based drought indices was examined in this study using the Generalized Extreme Value Index (GEVI), Homogeneity Index (HI) of precipitation and temperature, K index (K), precipitation anomaly percentage (Pa), Standardized Precipitation Evapotranspiration Index (SPEI), Standardized Precipitation Index (SPI), and China-Z Index (CZI) over different record lengths and at a timescale range of 1-24 months. In addition, the results that were obtained using these indices were compared with the Self-Calibrating Palmer Drought Severity Index (scPDSI). The stability, accuracy, and consistency of the different drought indices were evaluated using precipitation and evapotranspiration/temperature data (1-24 months) collected from different climatic regions in the arid area of northwest China in the 1961-2017 period. The results indicated that the Pa, CZI, K, and SPEI were more stable; the SPI, SPEI, and HI were more accurate; and the GEVI, SPI, HI, and SPEI were more consistent with the scPDSI. In addition, the results indicated that it is more appropriate to select a long record length (> 35 years) to monitor drought when sufficient data are available. However, defining constant drought classes may not be appropriate for all drought timescales. In fact, precipitation and evapotranspiration data from different timescales had different optimal distribution functions. The drought indices also demonstrated that they were applicable to a temperate arid area in the study region. In addition, the HI and SPEI better captured the precipitation and evapotranspiration/temperature characteristics, while the CZI, K, and Pa overestimated or underestimated the frequency of different drought classes at different timescales to some extent in the study region. The results of this study suggest that greater priority should be given to the precipitation-evapotranspiration-based indices. In addition, it is suggested to change the drought index class thresholds in future related studies on drought event recognition at different timescales to ensure more accurate drought monitoring.

UNASSIGNED: Palliative care is characterised by heterogeneous patient and caregiver populations who are provided care in different health systems and a research base including a large proportion of observational, mostly retrospective studies. The inherent diversity of palliative care populations and the often inadequate study descriptions challenge the application of new knowledge into practice and reproducibility for confirmatory studies. Being able to define systematically study populations would significantly increase their generalisability and effective translation into practice.
UNASSIGNED: Based on an informal consensus process by active palliative care researchers challenged by this problem and a review of the current evidence, we propose an approach to creating more comparable cohorts in observational (non-randomised) palliative care studies that relies on defining the study population in relation to a fixed, well-defined event from which analyses are built (\'anchoring\'). In addition to providing a detailed and complete description of the study population, anchoring is the critical step in creating more comparable cohorts in observational palliative care studies. Anchoring can be done with respect to a single or multiple data points, and can support both prospective and retrospective data collection and analysis.
UNASSIGNED: Anchoring the cohort to reproducible data points will help create more comparable cohorts in palliative care whilst mitigating its inherent heterogeneity. This, in turn, will help optimise the generalisability, applicability and reproducibility of observational palliative care studies to strengthen the evidence base and improve practice.

Consideration of how applicable the results of surgical trials are to clinical practice is important to inform decision-making. Randomized controlled trials comparing at least two surgical interventions (of gastric bypass, gastric band, and sleeve gastrectomy) for severe and complex obesity were examined using the PRagmatic Explanatory Continuum Indicator Summary-2 tool, to consider how applicable the trial results are to clinical practice, and the Risk of Bias 2 tool, to examine validity. MEDLINE, Embase, and CENTRAL databases were searched for studies published between November 2013 and June 2021, and 15 were identified. Using the PRagmatic Explanatory Continuum Indicator Summary-2 tool, three were classified as pragmatic, with good applicability to clinical practice. Ten had more explanatory domains but did include some pragmatic characteristics, and two were predominantly explanatory. This was due to some trial design features that would not be considered applicable to the wider clinical setting, including being single-centered, having prescribed intervention delivery methods, and intensive follow-up regimens. Only two trials had low risk of bias, of which one was considered pragmatic. Three had high risk of bias. Overall, few trials in bariatric surgery are pragmatic with low risk of bias. Well-designed pragmatic trials are needed to inform practice and reduce research waste.