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Childhood irritability and harsh parenting are associated with youth suicide attempts. Parents’ harsh reactions have been associated with children’s irritable behavior. While studies have shown individual associations of irritability and parenting behaviors with suicide risk, few have considered these factors jointly. We aimed to identify profiles of children based on irritability and parenting during childhood and examine their associations with youth suicide attempt.
Methods
Participants (N = 1626) were from the Québec Longitudinal Study of Child Development. Mothers reported on childhood irritability, harsh parenting, and positive parenting between ages 3.5 and 8; youth self-reported suicide attempt between ages 13 and 23.
Results
We identified four profiles based on the joint development of irritability and parenting during childhood: (1) low irritability, low harsh parenting, and high positive parenting (30.3%); (2) moderate irritability, moderate harsh parenting, and high positive parenting (28.4%); (3) moderate irritability, moderate harsh parenting, and low positive parenting (26.6%); and (4) high irritability, high harsh parenting, and low positive parenting (14.8%). In logistic regression analyses, only children in the high irritability, high harsh parenting, and low positive parenting profile had higher odds of attempting suicide (OR = 2.51; 95% CI = 1.55–4.09) compared to those in the low irritability, low harsh parenting, and high positive parenting profile. This association remained significant (OR = 1.80; 95% CI = 1.03–3.15) in models adjusting for covariates.
Conclusion
Children with chronically high irritability were also those experiencing the harshest parenting and the least positive parenting, as well as those most at risk of suicide attempt. Targeting both child and parental behavior may maximize suicide prevention efforts among children with high irritability.
CBT for psychosis is an established and evolving psychological therapy. Historical controversies about the nature of psychosis persist, and more recent debates about the outcome literature lack precision, muddying the waters further. Based on our experience as clinicians, teachers and supervisors, and following NHS and national lead roles, we describe ten common misconceptions about CBT for psychosis. These include misconceptions about the evidence, the focus of therapy, ‘thinking positively’, and the nature of collaboration and the therapeutic relationship. We refute these misconceptions based on current theory, research, and best practice guidelines. We highlight the need to get out of the clinic room, measure the impact of therapy on personal recovery and autonomy, and meet training and governance requirements. It is essential that clinicians, service leads, and our professional bodies uphold core standards of care if people with psychosis are to have access to high quality CBT of the standard we would be happy to see offered to our own family and friends.
Key learning aims
(1) To recognise common misconceptions about CBT for psychosis.
(2) To counter these misconceptions theoretically and empirically – to inform ourselves, colleagues and service leads committed to ensuring high quality CBT for psychosis.
(3) To highlight statutory and professional body responsibilities to ensure parity of esteem for people with psychosis, who deserve high quality, ‘full dose’ treatments delivered by appropriately trained clinicians, and supported by robust governance systems, just as we would expect for people with physical health conditions.
We develop a powerful tool for embedding any tree poset P of height k in the Boolean lattice which allows us to solve several open problems in the area. We show that:
• If $\mathcal {F}$ is a family in $\mathcal {B}_n$ with $|\mathcal {F}|\ge (q-1+\varepsilon ){n\choose \lfloor n/2\rfloor }$ for some $q\ge k$, then $\mathcal {F}$ contains on the order of as many induced copies of P as is contained in the q middle layers of the Boolean lattice. This generalizes results of Bukh [9] and Boehnlein and Jiang [8] which guaranteed a single such copy in non-induced and induced settings, respectively.
• The number of induced P-free families of $\mathcal {B}_n$ is $2^{(k-1+o(1)){n\choose \lfloor n/2\rfloor }}$, strengthening recent independent work of Balogh, Garcia, and Wigal [1] who obtained the same bounds in the non-induced setting.
• The largest induced P-free subset of a p-random subset of $\mathcal {B}_n$ for $p\gg n^{-1}$ has size at most $(k-1+o(1))p{n\choose \lfloor n/2\rfloor }$, generalizing previous work of Balogh, Mycroft, and Treglown [4] and of Collares and Morris [10] for the case when P is a chain.
All three results are asymptotically tight and give affirmative answers to general conjectures of Gerbner, Nagy, Patkós, and Vizer [18] in the case of tree posets.
To determine the prevalence and severity of anxiety and depression among health care professionals in Khyber Pakhtunkhwa and the impact of gender and professional roles on mental health outcomes.
Methodology
A cross-sectional study was conducted between March and November 2023 using stratified random sampling among health care professionals, including doctors, nurses, paramedics, and emergency staff, across multiple hospitals. The Generalized Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) were used to assess anxiety and depression. Data were analyzed using R/RStudio, employing descriptive statistics, chi-square tests, independent t-tests, Mann-Whitney U tests, and Pearson’s correlation coefficient.
Results
Among 651 participants, 65% were male. Anxiety prevalence was significant, with 42% experiencing minimal anxiety, 35% mild, 16% moderate, and 7.7% severe. Depression prevalence included 10% with no depression with 7.8% moderately severe and 5.9% severe depression. Nurses (40%) and doctors (34%) had the highest depression rates. Females exhibited significantly higher anxiety and depression scores. Anxiety prevalence varied across hospitals (P = 0.024). A strong positive correlation was observed between GAD-7 and PHQ-9 scores.
Conclusion
Mental health challenges among frontline health care workers in Khyber Pakhtunkhwa are substantial, with anxiety and depression particularly prevalent among nurses and doctors. Female workers experience greater psychological distress. We recommend implementation of hospital-based mental health support systems, prioritizing interventions for female staff and high-burden departments. Policies ensuring regular psychological screening and peer support mechanisms are urgently needed.
This study aimed to report the outcomes of patient-specific quality assurance (QA) in spot-scanning proton therapy using a two-dimensional ionisation chamber array and investigate the relationship between gamma passing rate and plan parameters.
Materials and methods:
Patient-specific QA was performed and evaluated by gamma analysis using a 3% dose difference and 2-mm distance-to-agreement with 172 treatment plans in the head and neck, breast, chest, abdominal and pelvic regions. The outcomes of patient-specific quality assurance regarding the gamma passing rate of the treatment sites, monitor unit (MU) per spot, measurement depth, range shifter, number of spots, energy layer and target volume were analysed.
Results:
No significant difference (p = 0·10) in the gamma passing rates between the treatment sites. The gamma passing rate was >98% in all the regions. The overall result of patient-specific QA with the gamma evaluation was 99·1 ± 1·6%. For the MU per spot, range shifter and measurement depth, the gamma passing rate was >98%. The gamma passing rate of the number of spots, energy layer and target volume was >97%.
Conclusion:
Patient-specific QA measurements showed that the gamma passing rate was >98% and was independent of the treatment site, MU per spot, range shifter, number of spots, energy layer and target volume but depend on measurement depth (p < 0·05). A gamma index of 3%, 2 mm forms reasonable criteria for patient-specific QA in spot-scanning proton therapy.
The manufacturing industry, notably the aeronautics sector, involves tasks presenting risks of low back pain. One of the preventive strategies could be the use of passive back exoskeletons, which have demonstrated benefits during activities involving trunk bending. This study aims to evaluate the effects of four passive back exoskeletons on trunk neuromuscular activity, kinematics, and perceived discomfort during polishing tasks simulated in a laboratory setting. Nineteen participants performed four tasks (two static bending tasks and two load-carrying tasks) without and with two soft (CORFOR and BionicBack) and two rigid (BackX and Laevo FLEX) exoskeletons. The results showed varying effects depending on the tested exoskeleton model, beyond the distinction between rigid and soft designs. Reductions in lumbar erector spinae (LES) neuromuscular activity were observed with Laevo FLEX and CORFOR during static tasks compared to the condition without exoskeleton (8–18%; p < .05). However, reductions in LES muscle activity were not significant during load carrying. Biceps femoris neuromuscular activity was significantly lower in the four tasks when using the Laevo FLEX, with reductions ranging from 8 to 17% (p < .01). The two rigid exoskeletons decreased perceived back discomfort across all tasks (p < .05). Finally, the BionicBack exoskeleton significantly altered participants’ kinematics across all four tasks, reducing both trunk range of motion and average flexion (p < .05). The Laevo FLEX exoskeleton was the only one to significantly reduce both neuromuscular activity and perceived back discomfort, while causing no adverse effects, appearing advantageous when polishing in the aeronautical industry.
The 2017 French Law on the Duty of Vigilance of Parent and Lead Companies has been hailed as a pioneering national legislation to hold corporations accountable for human rights and environmental abuses. Most lawsuits brought under this law have faced a plethora of admissibility objections, and so far, only one case has resulted in a decision on the merits. Initial formalistic court decisions on admissibility have now been mostly dismissed. However, critical questions around the role and powers entrusted to judges under the law remain contested.
Reward can influence cognitive control; however, dysfunctional interactions between reward and cognitive control in adolescents with major depressive disorder (MDD) remain unclear.
Methods
We recruited 35 adolescents with MDD and 29 healthy controls (HC) who completed the AX version of the Continuous Performance Test (AX-CPT) under reward and non-reward conditions, while undergoing functional Near-Infrared Spectroscopy (fNIRS).
Results
Adolescents with MDD exhibited slower response times and higher error rates compared to healthy controls. Under reward conditions, they responded more quickly but made more errors. Hierarchical Drift Diffusion Modeling (HDDM) revealed that adolescents with MDD showed a reduced starting bias toward more rewarding responses and a broader decision threshold in reward contexts. Neuroimaging results indicated that the MDD group showed diminished activation differences in the left dorsolateral prefrontal cortex (DLPFC), left ventrolateral prefrontal cortex (VLPFC), and right VLPFC in response to cues requiring high versus low cognitive control. Additionally, they exhibited weaker functional connectivity between these regions during reward-related cognitive control. Correlation analyses further showed that greater anhedonia severity was associated with poorer behavioral performance and less flexible activation in the prefrontal cortex.
Conclusions
Cognitive control impairments in depressed adolescents may be related to dysfunction in the motivational system. Our findings provide behavioral, computational, and neural evidence for the Expected Value of Control (EVC) theory. Diminished reward sensitivity and inflexible cognitive control may jointly contribute to these deficits, highlighting the importance of considering motivational factors in the diagnosis and intervention of cognitive control impairments in adolescents with depression.
This study examines how individualism influences patriarchal gender norms across 93 countries, using data from the Integrated Values Surveys. We hypothesize that individualism, emphasizing personal autonomy and egalitarian values, reduces patriarchal attitudes directly and indirectly through formal institutions. Our findings reveal a robust negative association between individualism and patriarchal attitudes, with a one-standard deviation increase in individualism linked to a 0.78 standard deviation decrease in patriarchal attitudes. This association holds across various controls and instrumental variable techniques addressing endogeneity. Mediation analysis shows that institutions, particularly liberal democracy and legal gender parity, mediate 5% to 37% of this association. These results underscore individualism’s role in promoting egalitarian gender norms and suggest that culturally aligned institutional reforms, such as strengthening women’s economic rights or democratic participation, can amplify these effects.
Redistricting is often a hotly contested affair within states as the party in power attempts to maximize its chances for electoral success through injecting partisanship into the process. Previous works have evaluated how different redistricting practices can influence elections, but little is known about how redistricting can impact citizen attitudes toward government. Using an original survey with a unique experiment, we evaluate the relationship between how redistricting is performed and how satisfied citizens are with the state of democracy in the United States. We find that the mere perception of redistricting being done in a partisan manner leads to decreased levels of system support. Furthermore, our models show that independent redistricting commissions tend to reduce the perceived prevalence of gerrymandering and boost citizens’ evaluations of the democratic process.
How might international society serve as an ontological security provider? Ontological security studies sees societies as both containers of anxiety and providers of security, but there is little research on how international society relates to this. Any answer to my question is further complicated by multiple takes (Lacanian, Kleinian, and Winnicottian) on the way the subject secures its self. I demonstrate how this multiplicity is accommodated by the conceptual heterogeneity of the ‘English School’ and offer three separate answers. Lacanian theory suggests a ‘pluralist’ international society can mitigate ontological insecurity because its institutions encircle ‘the lack’ that constitutes (collective) subjectivity. Kleinian theory supports the institutions of a ‘thin solidarist’ international society because it demonstrates how the collective action needed to protect the legal rights that recognise and secure the (collective) self does not necessarily cause anxiety. Drawing on Winnicott, Honneth argues that the (collective) self can only be fully secured if the institutions of a ‘thick solidarist’ international society go beyond legal recognition to socially esteem the contribution the subject makes to realising the common good. The analytical framework is applied to interpret and respond to Russia’s invasion of Ukraine, offering a timely intervention into debates on a post-liberal international order.
Radiofrequency catheter ablation of ventricular arrhythmias, originating from the left ventricular summit, is challenging due to epicardial localisation of the substrate, surrounded by coronary arteries. This paper highlights the successful elimination of LVOT summit ventricular arrhythmia which was ablated from the aortic cusp and aortic mitral continuity in two paediatric patients.
Case Report:
Ventricular tachycardia arising from the basal region of the left ventricular summit was identified in two male patients aged 9 and 13 years. Electroanatomic mapping of ventricular arrhythmia revealed the earliest ventricular signal within the left coronary artery which was successfully ablated from the left coronary cusp. The second patient with exactly similar ECG of ventricular arrhythmia was treated by delivering energy to the aorta-mitral continuity beneath the aortic valve. No recurrences were observed during the follow-up period of 20 months.
Conclusion:
Ventricular tachycardia arising from the basal region of the left ventricular summit is very rarely observed in paediatric patients. Utilising radiofrequency catheter ablation in proximity to the source can effectively and safely eliminate tachycardia.
The Scytho-Siberian ‘animal style’ encapsulates a broad artistic tradition, which was widespread across the Eurasian Steppe in the first millennium BC, but the scarcity of secure contexts limits the exploration of temporal and regional trends. Here, the authors present animal-style items excavated from a late-ninth-century BC kurgan, Tunnug 1, in Tuva Republic. The limited range of animals and the utilitarian associations of the artefacts suggest a narrow symbolic focus for early Scythian art, yet stylistic diversity evidences the co-operation of multiple social groups in the construction and funerary ritual activities of monumental burial mounds in the Siberian Valley of the Kings.
A non-uniqueness phase for infinite clusters is proven for a class of marked random connection models (RCMs) on the d-dimensional hyperbolic space, ${\mathbb{H}^d}$, in a high volume-scaling regime. The approach taken in this paper utilizes the spherical transform on ${\mathbb{H}^d}$ to diagonalize convolution by the adjacency function and the two-point function and bound their $L^2\to L^2$ operator norms. Under some circumstances, this spherical transform approach also provides bounds on the triangle diagram that allows for a derivation of certain mean-field critical exponents. In particular, the results are applied to some Boolean and weight-dependent hyperbolic RCMs. While most of the paper is concerned with the high volume-scaling regime, the existence of the non-uniqueness phase is also proven without this scaling for some RCMs whose resulting graphs are almost surely not locally finite.
In this multicenter cross-sectional study of two different approaches to universal SARS-CoV-2 admission testing, hybrid testing (SARS-CoV-2 for asymptomatic and multiplex for symptomatic) resulted in increased isolation days due to ordering errors among symptomatic patients. Universal multiplex testing minimized such errors while detection of asymptomatic non-SARS-CoV-2 viruses remained infrequent.
Although mental disorders have long been considered complex dynamic systems, our understanding of the mutual interactions and temporal patterns of their symptoms remains limited.
Methods
In this longitudinal study, we examined the structure and dynamics of four key mental health indicators – depression, anxiety, post-traumatic stress disorder, and insomnia – in a representative sample of the Slovak population (effective N = 3,874) over 10 waves spanning 3.5 years. For each construct, a longitudinal panel network model was estimated.
Results
The temporal relationships between symptoms were mostly weak, with the autoregressive effects typically being stronger. In depression, anxiety, and insomnia, some causal chains and feedback loops were identified. In all constructs, both contemporaneous and between-person networks showed dense connections.
Conclusions
The findings provide critical insights into the complexity of mental health development, offering potential targets for intervention and prevention strategies.
In recent years, prominent Republican elites have instituted statewide migrant transportation programs in which asylum-seeking migrants are “bused” to liberal cities across the country. These programs are often justified by invoking NIMBYism (not-in-my-backyard), suggesting that when people must consider the effects of immigration policy in terms of their community, their attitudes toward immigrants will vary. Despite this, extant scholarship has yet to document the extent to which American immigration preferences vary by spatial scale and gives no expectation about how important any variation is relative to other determinants of immigration attitudes. Findings from a conjoint experiment reveal that Americans, on average, oppose immigrants proposed to move into their neighborhoods, but spatial scale does not alter considerations at the national, state, or city level. The relative importance of this NIMBY effect, however, is modest compared to a host of other individual-level characteristics of an immigrant. Moreover, despite elite claims of “liberal hypocrisy” in immigration, we find no evidence that the NIMBY effect varies by partisanship. Both Democrats and Republicans exhibit modest preferences against immigrants expected to move to their neighborhoods.
The co-occurrence of cannabis use and internalizing symptoms, such as depression and anxiety, during emerging adulthood (18–25 years) is well documented. However, while bidirectional relationships are often assumed, empirical evidence is mixed. This study investigates bidirectional longitudinal relationships between cannabis frequency and consequences and internalizing symptoms (depressive and anxiety) among high-risk emerging adults.
Methods
Data came from seven assessments collected over a 2-year period among 961 (54% female) high-risk emerging adults participating in two longitudinal cohorts (Ontario, Canada; Tennessee, USA). Assessments were at 4-month intervals spanning 2018–2020. Latent curve models with structured residuals were used to explore bidirectional between- and within-person relationships between cannabis-related variables and internalizing symptoms.
Results
At baseline, higher levels of cannabis frequency and consequences were associated with higher internalizing symptoms. In between-person model components, cannabis-related and internalizing variables decreased across emerging adulthood. Significant within-person bidirectional relationships were observed, partially supporting both symptom-driven and substance-induced pathways, but the findings were specific to negative cannabis consequences, not frequency, and for depressive symptoms, not anxiety symptoms, for symptom-driven pathways. These bidirectional relationships were more pronounced among females and those surpassing clinical thresholds for internalizing symptoms at baseline.
Conclusions
This study found evidence of bidirectional relationships between cannabis consequences and internalizing symptoms across emerging adulthood, with the prevailing direction from cannabis-related negative consequences to increases in internalizing symptoms. These findings highlight the importance of cannabis intervention in emerging adults, both to reduce consequences and to prevent internalizing disorders, especially targeting females and those with clinically elevated internalizing symptoms.
Indigenous communities have long been marginalized and underrepresented in democracies, yet we know little about how publics evaluate Indigenous people who are thinking of running as candidates. Using two experimental surveys with nationally representative samples of Australian adults, we examine how citizens assess the personality traits of eight women and men who are interested in running for office. All eight have identical biographies, other than the fact that they are from White, Chinese, and both dark-skinned and light-skinned Indigenous Australian backgrounds. Surprisingly, we find an inverted hierarchy of bias, moderated by respondent ideology, in which darker-skinned Indigenous potential candidates fare better than all others. Although this may be due to a positive violation of expectations, our results have implications for theories about how people view Indigenous and ethnic minority aspirant politicians. They also point to the need for further research globally into how the public and parties evaluate Indigenous candidates.