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Repetitive transcranial magnetic stimulation (rTMS), a non-invasive neuromodulation therapy most widely used in depression, has shown evidence of secondary benefits for cognition in both neurologic and neuropsychiatric conditions. The recent development of more efficient stimulation protocols, such as accelerated high-dose intermittent theta burst (iTBS)-rTMS, has substantially reduced treatment burden by shortening the treatment course by >50%. This study aimed to establish the safety, feasibility, acceptability, and preliminary efficacy of iTBS-rTMS as a tool for bolstering cognition in individuals with amnestic mild cognitive impairment (aMCI).
Participants and Methods:
Twenty-four patients with aMCI were enrolled in an open-label phase I trial of iTBS-rTMS; 2 withdrew prior to initiating treatment due to personal circumstances. All participants had received a diagnosis of MCI due to possible AD from a healthcare provider (i.e., neurologist or neuropsychologist) and met actuarial neuropsychological criteria for aMCI. This sample of older adults (range: 61.5-85.2 years, M = 74.1, SD = 5.71) was predominantly White/non-Hispanic (n = 23; Black/non-Hispanic: n = 1), roughly half female (n = 13), with a college education (range: 12-20 years, M = 15.9, SD = 2.5). Participants received 24 sessions of iTBS-rTMS to the left dorsolateral prefrontal cortex over 3 days (8 sessions each, lasting roughly 2 hours per day). Participants rated their perceptions and experience of common side effects during and after each treatment session as well as retrospectively at post-treatment and 4-week follow-up. They completed structural and functional brain MRI, neuropsychiatric evaluations, and neuropsychological assessments before and after treatment and were administered a subset of these measures at 4-week follow-up. MoCA scores were used to monitor for adverse neurocognitive effects, and the fluid cognition composite score from the NIH Toolbox Cognition Battery was used to test preliminary efficacy.
Results:
We achieved a high retention rate (95%), with 21 of the 22 participants completing all study procedures. There were no clinically significant adverse neuroradiological, neuropsychiatric, or neurocognitive effects of treatment. Participant reports indicated high tolerability and acceptability, with a modal rating of 0 (on a scale from 0=not at all to 10=extremely) for six common side effects (i.e., headache, pain, scalp irritation, facial twitching, fatigue, fear/anxiety), assessed both during and after each treatment session. They reported very low desire to quit despite some participants rating the treatment as moderately tiring. We observed significant, large effect-size (d = 0.98) improvements in fluid cognition from pre- to post-treatment.
Conclusions:
Our findings support the safety, feasibility, and acceptability of iTBS-rTMS treatment in patients with aMCI. Further, although not explicitly dosed for efficacy, we provide preliminary evidence of improved fluid cognition as a function of treatment, highlighting the potential of this treatment for improving trans-domain cognitive impairment. These promising results can directly inform future trials aimed at optimizing treatment parameters, broadening the indication to other MCI subtypes, and testing the augmentation of established cognitive rehabilitation interventions when combined with rTMS.
The COVID-19 outbreak is a serious global public health issue with wide-ranging negative effects on people’s lives, which is reflected in steadily rising mental health problems. In order to appropriately respond to the increased occurrence of psychiatric illness, protect mental health and strengthen resilience it is necessary to include new technologies, such as extended reality (XR) or socially assistive robots (SAR) in not only psychiatric treatment but also in the prevention of psychiatric diseases. In this context, the use of new technologies offers innovative ways to strengthen resilience, self-efficacy and stress coping skills and plays an important role in improving psychological wellbeing.
Objectives
Preliminary results from studies at the Clinical Department of Psychiatry and Psychotherapeutic Medicine in Graz, Austria, dealing with new technologies in psychiatry, show new options for psychiatric settings.
Methods
Project AMIGA: The aim of this study is to test the effectiveness of a cognitive training session, conducted with the SAR named Pepper. In this randomized controlled trial, the effectiveness of SAR on depressive symptoms and correlates is evaluated in a sample of 60 individuals with major depression. While the intervention group will receive cognitive training with the SAR Pepper, the control group will receive “treatment-as-usual” therapy with a common PC software. Participants will receive 30 minutes of training 2 times per week over a period of 3 weeks.
Project XRes4HEALTH: The aim of this study is to develop an XR resilience training to increase resilience and stress coping mechanisms in healthcare workers. A total of 40 people will be included. To test the effectiveness of the resilience training, 3 XR training sessions of 15 minutes each will be held. A pre-post measurement will test the effectiveness of the training on wellbeing and stress levels as well as the acceptance and satisfaction with the training.
Project AI-REFIT: The overall goal of this study is to explore key information to increase resilience in healthy individuals who are at increased risk for mental health problems. Through a usability study, the artificial intelligence-based prototype app of the resilience training will be tested for acceptance, usability, functionality, and efficiency. During the resilience training, participants are wearing a smartwatch which measures psychophysiological parameters. Conclusions about the success of the therapy can be drawn based on digital data acquisition.
Results
New technologies including XR and SAR support classical psychiatric treatment in the topics of resilience and cognitive training as an add-on therapy in times of reduced availability of healthcare workers.
Conclusions
The rapid development of new technologies holds a lot of potential in the treatment of psychiatric disorders, which is why it is important to scientifically evaluate those innovative tools.
Preventing the occurrence of depression/anxiety and suicide during adolescence can lead to substantive health gains over the course of an individual person’s life. This study set out to identify the expected population-level costs and health impacts of implementing universal and indicated school-based socio-emotional learning (SEL) programs in different country contexts.
Methods
A Markov model was developed to examine the effectiveness of delivering universal and indicated school-based SEL programs to prevent the onset of depression/anxiety and suicide deaths among adolescents. Intervention health impacts were measured in healthy life years gained (HLYGs) over a 100-year time horizon. Country-specific intervention costs were calculated and denominated in 2017 international dollars (2017 I$) under a health systems perspective. Cost-effectiveness findings were subsequently expressed in terms of I$ per HLYG. Analyses were conducted on a group of 20 countries from different regions and income levels, with final results aggregated and presented by country income group – that is, low and lower middle income countries (LLMICs) and upper middle and high-income countries (UMHICs). Uncertainty and sensitivity analyses were conducted to test model assumptions.
Results
Implementation costs ranged from an annual per capita investment of I$0.10 in LLMICs to I$0.16 in UMHICs for the universal SEL program and I$0.06 in LLMICs to I$0.09 in UMHICs for the indicated SEL program. The universal SEL program generated 100 HLYGs per 1 million population compared to 5 for the indicated SEL program in LLMICs. The cost per HLYG was I$958 in LLMICS and I$2,006 in UMHICs for the universal SEL program and I$11,123 in LLMICs and I$18,473 in UMHICs for the indicated SEL program. Cost-effectiveness findings were highly sensitive to variations around input parameter values involving the intervention effect sizes and the disability weight used to estimate HLYGs.
Conclusions
The results of this analysis suggest that universal and indicated SEL programs require a low level of investment (in the range of I$0.05 to I$0.20 per head of population) but that universal SEL programs produce significantly greater health benefits at a population level and therefore better value for money (e.g., less than I$1,000 per HLYG in LLMICs). Despite producing fewer population-level health benefits, the implementation of indicated SEL programs may be justified as a means of reducing population inequalities that affect high-risk populations who would benefit from a more tailored intervention approach.
The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioural, mental, and physical health, presumably with effects on patients with severe mental disorders.
Objectives
This study examines pandemic-related physical and mental health and (compensatory) behavioural changes, in patients with BD as compared to healthy control individuals.
Methods
Physical and mental health and self-reported changes in daily structure and behaviour due to pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) from outpatient clinics in Germany, Austria, and Denmark in individuals with BD and a healthy control group.
Results
The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rate of COVID-19 testing, had more worries concerning health and experienced more anxiety but less social distancing.
Conclusions
The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behaviour due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimising and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as COVID-19 pandemic.
The complete life history of the kleptoparasitic ‘sundew flower fly’, Toxomerus basalis, is presented and illustrated. Adults of this species are photographed alive for the first time, including video recordings of larval and adult behaviour. Adult flies of both sexes visit Drosera (sundews) and show territorial behaviour around the plants, avoiding the dangerous sticky traps and demonstrating recognition of their larval host plant. Females lay eggs directly on non-sticky parts of the Drosera host plants, such as on the lower surface of the leaves and flower stalks, but apparently also on other plants growing in close proximity with the sundews.
Depressive symptoms are highly prevalent among partnered dementia caregivers, but the mechanisms are unclear. This study examined the mediating role of loneliness in the association between dementia and other types of care on subsequent depressive symptoms.
Methods
Prospective data from partnered caregivers were drawn from the English Longitudinal Study of Aging. The sample consisted of 4,672 partnered adults aged 50–70 living in England and Wales, followed up between 2006–2007 and 2014–2015. Caregiving was assessed across waves 3 (2006–2007), 4 (2008–2009), and 5 (2010–2011), loneliness at wave 6 (2012–2013), and subsequent depressive symptoms at wave 7 (2014–15). Multivariable logistic regression models were used to assess the association between caregiving for dementia and depressive symptoms compared to caregiving for other illnesses (e.g., diabetes, coronary heart disease (CHD), cancer, and stroke). Binary mediation analysis was used to estimate the indirect effects of caregiving on depressive symptoms via loneliness.
Results
Care for a partner with dementia was associated with higher odds of depressive symptoms at follow-up compared to those not caring for a partner at all (odds ratio [OR] = 2.6, 95% confidence intervals [CI]: 1.4, 5.1). This association was partially mediated by loneliness (34%). Care for a partner with other conditions was also associated with higher odds of depressive symptoms compared to non-caregiving partners (OR = 1.7, 95% CI: 1.2, 2.5), but there was no evidence of an indirect pathway via loneliness.
Conclusion
Loneliness represents an important contributor to the relationship between dementia caregiving and subsequent depressive symptoms; therefore, interventions to reduce loneliness among partnered dementia caregivers should be considered.
The WHO World Suicide Report ‘Preventing suicide: a global imperative” is the first global report of its kind. The report provides a systematic, evidence-based approach to policy and programme development which can be adapted to suit existing health and social structures and, where countries have already commenced this process, provide guidance on strengthening their approaches. The report aims to increase the awareness of the public health significance of suicide and suicide attempts and to make suicide prevention a higher priority on the global public health and public policy agendas. It aims to encourage and support countries to develop or strengthen comprehensive suicide prevention strategies in a multisectoral public health approach.
The target audience includes Ministries of Health, policy makers, planners, advocates, nongovernmental organizations, academics, researchers, health workers, the media, and the general public. Governments in particular are in a unique position to develop and strengthen surveillance, to provide and disseminate data that are necessary to inform action, and to bring together a multitude of stakeholders who may not otherwise collaborate.
The presentation focuses on the global and regional epidemiology of suicide and suicide attempts, which is the first theme of the report; other themes include risk and protective factors, and related interventions; current situation and working towards a comprehensive national response for suicide prevention; and the way forward.
When a non-violent resistance campaign does not have leverage to challenge powerful opponents, third-party intervention has been shown to assist. While the role of external third-party interveners – foreign activists – has been documented, less attention has been given to intervention from members of the dominant population. Drawing from the literature on civil resistance and through the study of Israeli Jews who intervene in Palestinian resistance campaigns against the Israeli military occupation, I argue that intervention from members of the dominant population is strategically desirable. Through an analysis of three Palestinian campaigns, this article identifies that the physical presence of Israeli Jews was needed to ensure the Palestinians could maintain their resistance efforts and presence on the land, despite the repression they faced. Furthermore, the skills and knowledge of the Israelis were needed to help the Palestinians achieve some of their goals, at least in the short term.
Older workers throughout Europe are increasingly expected to participate longer in the labour market. While training appears to increase workers’ employability, prior research indicates that employers are less prone to provide training with increasing age of the workers. In this study, we aim to provide a better understanding of what affects employers’ considerations. We conduct a vignette experiment among Dutch employers to investigate how the government and workers themselves can exert influence on employers’ willingness to provide training. Our analyses show that employers’ provision of training declines with workers’ age, and additionally reveal two mitigating mechanisms. First, government reimbursements appear to work as a buffer: when reimbursements are offered, the decline in employers’ willingness to offer training is less pronounced throughout workers’ careers. Second, workers’ interest in training has a delaying effect: when workers are interested in training, employers’ willingness to provide training remains rather stable until workers are aged about 55, and decreases only afterwards. This contrasts the constant decline with age when workers had no interest in training. Our findings emphasise that employers’ considerations cannot be understood without taking the context into account, because governments and workers can affect employers’ decisions through cost reduction and social exchange relations, respectively. More research is needed to disentangle other possible underlying mechanisms.
Let K be an algebraically closed field and $\mathbb{A}$n ≅ Kn affine n-space. It is known that a finite group $\frak{G}$ can only act freely on $\mathbb{A}$n if K has characteristic p > 0 and $\frak{G}$ is a p-group. In that case the group action is “non-linear” and the ring of regular functions K[$\mathbb{A}$n] must be a trace-surjectiveK − $\frak{G}$-algebra.
Now let k be an arbitrary field of characteristic p > 0 and let G be a finite p-group. In this paper we study the category $\mathfrak{Ts}$ of all finitely generated trace-surjective k − G algebras. It has been shown in [13] that the objects in $\mathfrak{Ts}$ are precisely those finitely generated k − G algebras A such that AG ≤ A is a Galois-extension in the sense of [7], with faithful action of G on A. Although $\mathfrak{Ts}$ is not an abelian category it has “s-projective objects”, which are analogues of projective modules, and it has (s-projective) categorical generators, which we will describe explicitly. We will show that s-projective objects and their rings of invariants are retracts of polynomial rings and therefore regular UFDs. The category $\mathfrak{Ts}$ also has “weakly initial objects”, which are closely related to the essential dimension of G over k. Our results yield a geometric structure theorem for free actions of finite p-groups on affine k-varieties. There are also close connections to open questions on retracts of polynomial rings, to embedding problems in standard modular Galois-theory of p-groups and, potentially, to a new constructive approach to homogeneous invariant theory.
Although there is evidence that interspecific hybridization can initiate invasion by nonnative plants, there are few documented examples of novel hybridization events between introduced plant species already exhibiting invasive behavior. We conducted morphometric and molecular analyses of toadflax plants with intermediate morphology found at two sites in Montana, which were co-invaded by yellow toadflax and Dalmatian toadflax. Field-collected putative hybrid plants had intermediate morphometric scores (mean 0.47, on a scale of 0.0 = indistinguishable from Dalmatian toadflax to 1.0 = indistinguishable from yellow toadflax) for a suite of phenotypic traits that differentiate the parent species (leaf length : width ratio, growth form, seed morphology, inflorescence type, and ventral petal shape). Inter-simple sequence repeat (ISSR) analysis of a subset of these putative hybrids revealed combinations of species-diagnostic bands, confirming the presence of DNA from both parent species. Controlled interspecific hand-pollinations generated viable first generation (F1) hybrid plants that also had intermediate morphometric scores (mean 0.46) and a mix of species-diagnostic ISSR bands from both parents. The hand-generated F1 hybrids crossed readily with both parent species to produce viable first generation backcrossed (BC1) plants. Our results confirm that hybridization is occurring between invasive populations of yellow toadflax and Dalmatian toadflax, and that the hybrid progeny are viable and fertile. This example of hybridization between alien congeners is of concern as the parent taxa are already known to be highly invasive. Further research is needed to assess the invasive potential of hybrid toadflax populations, and the likelihood of introgressive trait transfer between the parent species.
Globally, over 800 000 people died by suicide in 2012 and there are indications that for each adult who died of suicide there were likely to be many more attempting suicide. There are many millions of people every year who are affected by suicide and suicide attempts, taking into consideration the family members, friends, work colleagues and communities, who are bereaved by suicide. In the WHO Mental Health Action Plan 2013–2020, Member States committed themselves to work towards the global target of reducing the suicide rate in countries by 10% by 2020. Hence, the first-ever WHO report on suicide prevention, Preventing suicide: a global imperative, published in September 2014, is a timely call to take action using effective evidence-based interventions. Their relevance for low- and middle-income countries is discussed in this paper, highlighting restricting access to means, responsible media reporting, introducing mental health and alcohol policies, early identification and treatment, training of health workers, and follow-up care and community support following a suicide attempt.
Queer theory is a relatively new theoretical approach in organizational discourse that we think can uncover power relations and normative and hierarchical processes in diversity management discourse. ‘Heteronormativity’ and ‘performativity’, core concepts of queer theory, critique categorization and fixed identities and thereby problematize and broaden perspectives on current diversity management discourse, especially those associated with organizational constructions of diversity dimensions. In this article, we focus on the discursive and intersectional construction of subject positions and identities within organizations by drawing upon a queer theoretical framework to analyze three companies' codes of conduct that claim to create an inclusive work environment. The deconstructive analysis of these discursive artifacts emphasizes the intersectional power dynamics of and between the categories of sex, gender and sexuality, and can be taken as a point of departure for questioning the heteronormative arrangements of diversity management practices.
Large-scale immigration from Muslim-majority countries to highly secularised North-Western European societies has raised questions about how the European-born children of Muslim immigrants relate to and practise religion. On the one hand, second-generation Muslims are socialised into Islam within their immigrant families and communities. On the other hand, they grow up in societies where the majority is historically Christian, highly secularised and, in a post-9/11 era, increasingly anti-Islamic (Bruce 2011). By secularisation, we refer to a robust downward trend in the importance and impact of religion among Christian-majority populations (Gorski & Altinordu 2008). In European societies, secularism is a normative ideology that represents religiosity as a foreign, backward and/or dangerous force. Islam and its practitioners are particular targets of hostile public attitudes towards religion (Allen & Nielsen 2002). From a majority perspective, the religiosity of second-generation Muslims therefore appears to be a bright boundary, one setting them apart from the so-called mainstream and standing in the way of their successful integration (Fleischmann & Phalet 2012).
By contrast, from the minority perspective of immigrants and their children, religious traditions and ties are highly valued parts of cultural heritage and crucial sources of personal self-esteem, social support and cultural continuity in their socio-cultural environment (Bankston & Zhou 1995; Ebaugh & Chafetz 2000; Warner & Wittner 1998). Accordingly, Muslim immigrant parents purposefully and effectively transmit Islamic religious practices and beliefs to the next generation (Güngör, Fleischmann & Phalet 2011). The second generation is often highly committed to their Muslim identity, which is experienced as central to their sense of self-understanding (Duderija 2007; Fleischmann & Phalet 2012; Şirin, Bikmen, Mir, Fine, Zaal & Katsiaficas 2008; Verkuyten & Yıldız 2009).
In view of the contrasting orientations of Muslim immigrant communities and European receiving societies, this chapter asks how second-generation Turks in Europe negotiate their religious identities. We distinguish between attachment – i.e. the subjective importance of religion – and practice, such as praying or fasting. In addition, we examine how these identities relate to religious socialisation in immigrant families and communities as well as experiences of religious discrimination in receiving societies. Drawing on the TIES survey data, we investigate contextual variation in ways of ‘being Muslim’, namely, the different patterns of religious attachment and practices.
While Wenabozho was walking along the lakeshore he met up with a fellow Indian. He asked him, “Wenabozho, I want to ask you something. How is it that you're so smart?” Wenabozho answered him, “Look here, I always eat smartberries.” …
Wenabozho collected those rabbit turds and handed them to his companion. The one going around being taught took them and popped them in his mouth. But then he said, “Ew! Those are rabbit turds! Those aren't smartberries!” Wenabozho replied, “Yes, you're right. Those aren't smartberries. Now you are smart, too.”
David Treuer translates this Wenabozho story by Rose Foss, an elder from the Mille Lacs reservation, to demonstrate a disconnect between Ojibwe oral tradition and the postmodern sensibilities of Louise Erdrich's novel Love Medicine (Treuer 2005, 31–32). For Treuer, this Wenabozho story moreover allegorizes the quest for “authentic Indigenous culture” that so often impels readers, critics, and even authors in the field of Indigenous literature. Smartberries—discrete, displaced packets of cultural knowledge—are but signs of the literature's desire for a holistic, tribally specific cultural understanding, and should not be mistaken for an end in themselves.
There is a reciprocal irony in the fact that Treuer uses a trickster tale to illustrate the dangers of eating smartberries, since the trickster could be characterized as the smartberry par excellence. The tremendous literary success of Gerald Vizenor and Thomas King, both writing as self-declared trickster-authors, has done much to install a poststructuralist, pan-Indian species of this culture hero as a dominant literary and critical trope, what Kristina Fagan calls “a stable symbol of chaos, disorder, and resistance” (2010, 5).
Nous cherchons l'homme qui a pu prononcer publiquement cette phrase, nous voulons retrouver un Max Weber qui n'est pas seulement le spécialiste de problèmes sociologiques ou économiques, mais qui est en même temps aussi le penseur et le guide de la jeunesse intellectuelle. La recherche minutieuse qui s'impose ici n'a été faite que d'une manière tres incomplète (1), sans doute parce que les différentes filiations, afnnités, fréquentations intellectuelles qui pourraient aider à définir la pensée wébérienne apparaissent sous un jour encore plus déconcertant que les recherches concretes du grand sociologue: le caractère encyclopédique de son savoir, là aussi, l'emportait vers un nombre invraisemblable de doctrines et de systèmes. Ce sont ees fils qu'il nous faut dégager à grand-peine des courants de pensée de la deuxième moitié du XIXe siècle, où ses convictions fondamentales situent Weber. On accordera volontiers que cette richesse, ce foisonnement intellectuel — en contraste avec la richesse de sa sociologie proprement dite — ne pouvait guère conduire Weber qu'à une sorte d'éclectisme philosophique. Mais le lecteur ainsi averti se souviendra sans doute que le «désenchantement»idéologique ne diminue en rien l'importance de la riche contribution qu'apportait Weber à la science, à la sociologie.