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Two new sites, identified during a survey of the Tajuña River Valley, central Iberia, show evidence of both flint extraction and working, specifically for the production of long blades. These are an important addition to the limited number of such sites known in Eurasia.
It is widely acknowledged that personal therapy positively contributes to the continued personal well-being and ongoing professional development of mental health professionals, including psychiatrists. As a result, most training bodies continue to recommend personal therapy to their trainees. Given its reported value and benefits, one might hypothesize that a high proportion of psychiatrists avail of personal therapy. This systematic review seeks to investigate whether this is the case.
Aim:
To identify and evaluate the findings derived from all available survey-based studies reporting quantitative data regarding psychiatrists’ and psychiatry trainees’ engagement in personal therapy.
Method:
A systematic search for survey-based studies about the use of personal therapy by psychiatric practitioners was conducted in four databases and platforms (PubMed, Scopus, Embase and EbscoHost) from inception to May 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Studies were assessed for quality using the quality assessment checklist for survey studies in psychology (Q-SSP) and findings summarized using narrative synthesis.
Results:
The proportion of trainees who engaged in personal therapy ranged from a low of 13.4% in a recent UK based study to a high of 65.3% among Israeli residents. The proportion of fully qualified psychiatrists who engaged in personal therapy varied from 32.1% in South Korea to 89% in New Zealand.
Conclusion:
This review represents the first known attempt to collect and synthesize data aimed at providing insights into the past and current trends in psychiatrists’ use of personal therapy across different geographic regions and career stages.
Notre recherche visait à mettre en lumière les pratiques bientraitantes des préposées aux bénéficiaires en milieux d’hébergement pour aînés au Québec. L’objet de l’article est de faire ressortir la dichotomie entre les définitions de la bientraitance et son opérationnalisation. Dans la première partie, la notion de bientraitance dans le cadre de deux politiques gouvernementales québécoises est présentée. Ensuite, il est question du travail des préposées aux bénéficiaires en tant que vectrices de cette bientraitance dans la pratique. La troisième partie présente les résultats de notre recherche qui viennent soulever trois constats remettant en cause l’applicabilité des politiques publiques en cette matière : l’absence de reconnaissance d’un métier par définition bientraitant; les injonctions normatives à l’encontre du sens attribué à la bientraitance, et les obstacles organisationnels et sociopolitiques à la bientraitance. Ces constats sont réexaminés à la lumière des écrits dans la discussion, laquelle ouvre sur la notion de maltraitance organisationnelle.
The first size reduction (FSR) in the Reticulofenestra-Gephyrocapsa-Emiliania (RGE) lineage (order Isochrysidales), which occurred in the early Oligocene (~32 Ma), is of great significance for understanding the Lilliput effect that has affected coccolithophore communities from the late Eocene to this day. We conducted a morphologic analysis on the coccoliths of Reticulofenestra species that lived during the late middle Eocene to early Oligocene (~40–31 Ma), using marine sediments from the South Atlantic Ocean. Our data show increasing size and decreasing abundance of the large species during the late Eocene, leading to their disappearance at the FSR, and a concurrent decrease in the size variability of the small- to medium-sized coccoliths whose central opening diameter had become very reduced. Although the cosmopolitan late Paleogene through Neogene size decrease in coccolithophores has been linked to the concomitant long-term decline in global pCO2, we suggest here that the FSR was the result of environmental destabilization caused by the expansion of eutrophic environments following the late Eocene establishment of overturning circulation associated with ice buildup on Antarctica. This study also leads us to propose a hypothetical model that links coccolith morphology of species of the RGE lineage and trophic resources in the upper ocean: the small- to medium-sized, r-selected coccolithophores with smaller coccolith central openings live in nutrient-rich waters where they rely mostly on photosynthesis and little on mixotrophy, whereas the larger, K-selected species with larger coccolith central openings live in oligotrophic waters where they are more dependent on mixotrophy.
Debris-covered glaciers are an important component of the mountain cryosphere and influence the hydrological contribution of glacierized basins to downstream rivers. This study examines the potential to make estimates of debris thickness, a critical variable to calculate the sub-debris melt, using ground-based thermal infrared radiometry (TIR) images. Over four days in August 2019, a ground-based, time-lapse TIR digital imaging radiometer recorded sequential thermal imagery of a debris-covered region of Peyto Glacier, Canadian Rockies, in conjunction with 44 manual excavations of debris thickness ranging from 10 to 110 cm, and concurrent meteorological observations. Inferring the correlation between measured debris thickness and TIR surface temperature as a base, the effectiveness of linear and exponential regression models for debris thickness estimation from surface temperature was explored. Optimal model performance (R2 of 0.7, RMSE of 10.3 cm) was obtained with a linear model applied to measurements taken on clear nights just before sunrise, but strong model performances were also obtained under complete cloud cover during daytime or nighttime with an exponential model. This work presents insights into the use of surface temperature and TIR observations to estimate debris thickness and gain knowledge of the state of debris-covered glacial ice and its potential hydrological contribution.
With Plotinus, Neoplatonism was inaugurated with the positing of a radical transcendence: the first principle, the One, or the Good,1 is beyond the essence, epekeina tēs ousias. In book 6 of the Republic, Plato already designated the Good as beyond essence, which it surpasses in seniority and in power, ‘epekeina tēs ousias presbeiai kai dunamei huperekhontos’ (509b9–10), but whereas in Plato this formula is found only once, and its interpretation is, moreover, disputed,2 it is recurrent and systematized in Plotinus.3 It also allows a series of variations; beyond essence, the One-Good is also ‘beyond thought’, ‘beyond knowledge’, ‘beyond life’, and, again, ‘beyond act’.4
Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment.
Aims
To use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder.
Method
This study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework.
Results
The best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data.
Conclusions
Using PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.
Economic inequalities are increasingly prominent in public debates – from Thomas Piketty’s seminal Capital in the Twenty-First Century (Piketty 2014) and the subsequent creation of the World Inequality Database (Wid.World n.d.), to civil society reports such as that of Oxfam (Oxfam International 2019). In addition, major social movements of the last decade, including Tunisia’s 2011 revolution (Srebernik 2014) and the rise to power of demagogic leaders such as Donald Trump (Shiller 2016), have been attributed, at least in part, to economic inequalities.
Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools.
Aims
To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics.
Method
Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts.
Results
Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = −0.34 years, s.e. = 0.08), major depression (β = −0.34 years, s.e. = 0.08), schizophrenia (β = −0.39 years, s.e. = 0.08), and educational attainment (β = −0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO.
Conclusions
AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
Discovered at the beginning of the twentieth century, the Abri Casserole (Dordogne, France) was the subject of salvage excavations in the early nineties. The fieldwork revealed a sequence of 13 archaeological levels that document human occupations from the Gravettian to the Magdalenian, including very rare and poorly known assemblages (e.g. Early Badegoulian, Protosolutrean) that afford a particular importance to this sequence. Results of a previous dating program that focused on the Badegoulian levels were obtained in 1994 but were neither extensively published nor discussed. Five AMS 14C ages obtained for the Gravettian and Solutrean assemblages in the early 2010s served to complement the site’s chronology. However, since the beta counting ages for the Badegoulian levels were in conflict with the accepted AMS chronology for the region’s late Pleniglacial archaeological record, a new AMS dating program was implemented to renew the radiometric framework of this specific portion of the sequence. Compared to the previous beta counting measurements, the seven newly obtained AMS ages are about 1000 years older (23.3–20.5 cal ka BP) and congruent with other AMS-dated Badegoulian sequences. These results thereby restore the inter-site chronological coherence of the Solutrean–Badegoulian and Badegoulian–Magdalenian transitions.
The timing of the Neanderthal-associated Middle Palaeolithic demise and a possible overlap with anatomically modern humans (AMH) in some regions of Eurasia continues to be debated. The Iberian Peninsula is considered a possible refuge zone for the last Neanderthals, but the chronology of the later Middle Palaeolithic record has undergone revision and has increased the debate on the timing of Neanderthal extinction. Here we report on a study of the 5-m-thick archaeological stratigraphy of the Cardina-Salto do Boi, an open-air site located in inland Iberia, from which optically stimulated luminescence (OSL) ages were obtained for Middle and Upper Palaeolithic occupations preserved in overbank alluvial deposits. Geomorphology, archaeostratigraphy, stone-tool evolution, and OSL dating support the persistence of Neanderthals after 41 ka in central Iberia; the transition between the Middle Palaeolithic material culture and the AMH-associated Aurignacian blade and bladelet production is estimated to lie between 34.0 ± 2.0 ka and 38.4 ± 1.9 ka. Our results demonstrate that investigations focusing on different geomorphological situations are necessary to overcome the current limitations of the evidence and to establish more consistent models for Neanderthal disappearance and AMH expansion in the Iberian Peninsula.
Residual depressive symptoms are generally documented as a risk factor for recurrence. In the absence of a specific instrument for the assessment of residual symptoms, a new 25-item Depression Residual Symptom Scale (DRSS) was elaborated and tested for recurrence prediction over a 1-year follow-up.
Sampling and methods
Fifty-nine patients in remission after a major depressive episode (MDE) were recruited in two centres. They were assessed with the DRSS and the Montgomery-Asberg Depression Rating Scale (MADRS) at inclusion and followed for 1 year according to a seminaturalistic design. The DRSS included specific depressive symptoms and subjective symptoms of vulnerability, lack of return to usual self and premorbid level of functioning.
Results
Severity of residual symptoms was not significantly associated with increased risk of recurrence. However, DRSS score was significantly higher among patients with three or more episodes than one to two episodes. Number of previous episodes and treatment interruption were not identified as significant predictors of recurrence.
Conclusion
The proposed instrument is not predictive of depressive recurrence, but is sensitive to increased perception of vulnerability associated with consecutive episodes. Limitations include small sample size, seminaturalistic design (no standardisation of treatment) and content of the instrument.
To evaluate the performance of the French version of the Mood Disorder Questionnaire (MDQ) in patients attending a general psychiatric outpatient service as well as whether MDQ scores are independent of patient mood state at time of completion.
Method
183 patients completed the MDQ and were assessed with the MADRS and YMRS scales, before being interviewed with the SCID (time 1). MDQ, MADRS and YMRS assessment was repeated four to six weeks later (time 2).
Results
According to the SCID, 44 patients were suffering from bipolar spectrum disorder and 102 from unipolar disorder (37 patients dropped out). The MDQ provided high specificity (83.3%). Sensitivity was 63.6%, with better identification of bipolar I (85.0%) than bipolar II patients (45.8%). In the whole sample, test-retest reliability was satisfactory (kappa = 0.64). Modest correlations were observed between the number of endorsed MDQ items and YMRS scores at time 1 (Spearman r = 0.19; p = 0.021) and time 2 (r = 0.26; p = 0.002).
Conclusions
Despite some fluctuations over time and a discrete influence of symptom severity, the screening algorithm can be used reliably, whether in the acute or remission phase of a depressive episode.
The present open study investigates the feasibility of Mindfulness-based cognitive therapy (MBCT) in groups solely composed of bipolar patients of various subtypes. MBCT has been mostly evaluated with remitted unipolar depressed patients and little is known about this treatment in bipolar disorder.
Methods
Bipolar outpatients (type I, II and NOS) were included and evaluated for depressive and hypomanic symptoms, as well as mindfulness skills before and after MBCT. Patients’ expectations before the program, perceived benefit after completion and frequency of mindfulness practice were also recorded.
Results
Of 23 included patients, 15 attended at least four MBCT sessions. Most participants reported having durably, moderately to very much benefited from the program, although mindfulness practice decreased over time. Whereas no significant increase of mindfulness skills was detected during the trial, change of mindfulness skills was significantly associated with change of depressive symptoms between pre- and post-MBCT assessments.
Conclusions
MBCT is feasible and well perceived among bipolar patients. Larger and randomized controlled studies are required to further evaluate its efficacy, in particular regarding depressive and (hypo)manic relapse prevention. The mediating role of mindfulness on clinical outcome needs further examination and efforts should be provided to enhance the persistence of meditation practice with time.
Children of patients with substance use disorders (SUD) are at high risk for mental disorders. The effects of specific SUD in both parents on the risk of psychopathology in offspring have hardly been studied.
Objectives
To gain a better understanding of the morbid risk of these children.
Aims
To assess, 1) the associations between alcohol dependence (AD) or heroin dependence (HD) in patients and psychopathology in their children; 2) the morbid risk conferred by having a second parent with SUD.
Methods
The sample included 276 children aged from 6 to 17.9 years (mean age = 11.5): 23 children of 15 patients with HD, 101 offspring of 50 patients with AD, 152 children of 81 orthopedic patients (controls) and 158 biological co-parents of the children. Subjects were interviewed by psychologists blind to patient diagnoses, using a semi-structured diagnostic interview.
Results
1) Children of HD or AD patients had largely elevated rates of recurrent major depressive disorder and children of HD patients were also at an increased risk for ADHD and SUD; 2) There were interactions between drug disorders and alcohol disorders in both parents to increase the risk of early SUD in offspring.
Conclusions
The early manifestations of mental disorders in children of SUD patients emphasize the need for prompt identification and treatment of these disorders. The involvement of co-parental disorders in the development of offspring psychopathology highlights the need to pay clinical attention not only to the patient, but also to the co-parent in order to optimize prevention in offspring.
Early life adversity plays a critical role in the emergence of borderline personality disorder (BPD) and this could occur through epigenetic programming. In this perspective, we aimed to determine whether childhood maltreatment could durably modify epigenetic processes by the means of a whole-genome methylation scan of BPD subjects. Using the Illumina Infinium® Human Methylation450 BeadChip, global methylation status of DNA extracted from peripheral blood leucocytes was correlated to the severity of childhood maltreatment in 96 BPD subjects suffering from a high level of child adversity and 93 subjects suffering from major depressive disorder (MDD) and reporting a low rate of child maltreatment. Several CpGs within or near the following genes (IL17RA, miR124-3, KCNQ2, EFNB1, OCA2, MFAP2, RPH3AL, WDR60, CST9L, EP400, A2ML1, NT5DC2, FAM163A and SPSB2) were found to be differently methylated, either in BPD compared with MDD or in relation to the severity of childhood maltreatment. A highly relevant biological result was observed for cg04927004 close to miR124-3 that was significantly associated with BPD and severity of childhood maltreatment. miR124-3 codes for a microRNA (miRNA) targeting several genes previously found to be associated with BPD such as NR3C1. Our results highlight the potentially important role played by miRNAs in the etiology of neuropsychiatric disorders such as BPD and the usefulness of using methylome-wide association studies to uncover such candidate genes. Moreover, they offer new understanding of the impact of maltreatments on biological processes leading to diseases and may ultimately result in the identification of relevant biomarkers.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Previous functional magnetic resonance imaging studies in bipolar disorder (BD) have evidenced changes in functional connectivity (FC) in brain areas associated with emotion processing, but how these changes vary with mood state and specific clinical symptoms is not fully understood.
Methods
We investigated resting-state FC between a priori regions of interest (ROIs) from the default-mode network and key structures for emotion processing and regulation in 27 BD patients and 27 matched healthy controls. We further compared connectivity patterns in subgroups of 15 euthymic and 12 non-euthymic patients and tested for correlations of the connectivity strength with measures of mood, anxiety, and rumination tendency. No correction for multiple comparisons was applied given the small population sample and pre-defined target ROIs.
Results
Overall, regardless of mood state, BD patients exhibited increased FC of the left amygdala with left sgACC and PCC, relative to controls. In addition, non-euthymic BD patients showed distinctive decrease in FC between right amygdala and sgACC, whereas euthymic patients showed lower FC between PCC and sgACC. Euthymic patients also displayed increased FC between sgACC and right VLPFC. The sgACC–PCC and sgACC–left amygdala connections were modulated by rumination tendency in non-euthymic patients, whereas the sgACC-VLPFC connection was modulated by both the current mood and tendency to ruminate.
Conclusions
Our results suggest that sgACC-amygdala coupling is critically affected during mood episodes, and that FC of sgACC play a pivotal role in mood normalization through its interactions with the VLPFC and PCC. However, these preliminary findings require replication with larger samples of patients.
Early life adversity plays a critical role in the emergence of borderline personality disorder (BPD) and this could occur through epigenetic programming. In this perspective, we aimed to determine whether childhood maltreatment could durably modify epigenetic processes by the means of a whole-genome methylation scan of BPD subjects. Using the Illumina Infinium® Human Methylation 450 Bead Chip, global methylation status of DNA extracted from peripheral blood leucocytes was correlated to the severity of childhood maltreatment in 96 BPD subjects suffering from a high level of child adversity and 93 subjects suffering from major depressive disorder (MDD) and reporting a low rate of child maltreatment. Several CpGs within or near the following genes (IL17RA, miR124-3, KCNQ2, EFNB1, OCA2, MFAP2, RPH3AL, WDR60, CST9L, EP400, A2ML1, NT5DC2, FAM163A and SPSB2) were found to be differently methylated, either in BPD compared with MDD or in relation to the severity of childhood maltreatment. A highly relevant biological result was observed for cg04927004 close to miR124-3 that was significantly associated with BPD and severity of childhood maltreatment. miR124-3 codes for a microRNA (miRNA) targeting several genes previously found to be associated with BPD such as NR3C1. Our results highlight the potentially important role played by miRNAs in the etiology of neuropsychiatric disorders such as BPD and the usefulness of using methylome-wide association studies to uncover such candidate genes. Moreover, they offer new understanding of the impact of maltreatments on biological processes leading to diseases and may ultimately result in the identification of relevant biomarkers.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
European pig production faces economic and environmental challenges. Modelling can help farmers simulate and understand how changes in their management practices affect the efficiency of their production system. We developed an individual-based model of a pig-fattening unit that considers individual variability in performance among pigs, farmers’ feeding practices and animal management and estimates environmental impacts (using life cycle assessment) and economic results of the unit. We previously demonstrated that this model provides reliable estimates of farm performance for different combinations of management practices, pig types and building characteristics. The objectives of this study were to quantify how interactions between feeding practices and animal management influence fattening unit results in healthy or impaired health conditions using the model. A virtual experiment was designed to evaluate effects of interactions between feeding practices, health status of the pig herd and infrastructure constraints on the technical performance, economic results and environmental impacts of the unit. The virtual experiment consisted of 96 scenarios, which combined chosen values of 6 input parameters of the model: batch interval (35 days and 7 days), use or non-use of a buffer room to manage the lightest pigs, feed rationing (ad libitum and restricted) and sequence plans (two-phase (2P), daily-phase (DP)), scale at which the feeding plan is applied (i.e. room, pen and individual) and health status of the pig herd (i.e. healthy v. impaired). Variance analysis was used to test effects of the factors in these 96 scenarios, and multivariate data analyses were used to classify the scenarios. Healthy populations obtained on average higher economic results (e.g. gross margin of 11.20 v. 1.50 €/pig) and lower environmental impacts (e.g. 2.24 v. 2.38 kg CO2-eq/kg pig live weight gain) than the population with impaired health. With 35 days batch interval and DP feeding, populations with impaired health reached gross margin similar to healthy populations with 2P ad libitum feeding and 7 days batch interval. Restricted, DP and individual feeding plans improved the economic and environmental performances of the unit for both health statuses. This study highlighted that health status of the pig herd is the main factor that affects technical, economic and environmental performances of a pig-fattening unit, and that adequate feeding strategies and animal management can compensate, to some extent, the effects of impaired health on environmental impacts but not on gross margin.