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Impulsivity and aggression are known risk factors for suicide, with observed age and sex differences in their impact.
Aims
To explore variations in impulsivity and aggression based on sex and age and examine their roles in predicting suicide.
Method
We examined 582 participants (406 individuals who died by suicide, 176 non-suicidal sudden-death controls) using the psychological autopsy method. Measures of impulsivity and aggression included the Barratt Impulsiveness Scale (BIS) and the Brown–Goodwin History of Aggression (BGHA). Participants were categorised into four groups: suicide male, control male, suicide female and control female. For group comparisons, we used analyses of variance and Spearman’s rank correlation to assess the relationship between age and BIS and/or BGHA ratings. Stepwise logistic regression was used to identify predictors of suicide for each sex.
Results
Higher levels of BIS and BGHA ratings were found in the suicide group compared with controls (BIS: 51.3 v. 42.2, P = 0.002, η2 = 0.017; BGHA: 7.1 v. 4.1, P < 0.001, η2 = 0.028), with no significant sex differences. BIS and BGHA ratings decreased with age in the suicide groups (suicide male: impulsivity ρ = −0.327, P < 0.001; suicide female: aggression ρ = −0.175, P = 0.038) but not among controls. Logistic regression analysis revealed that for men, aggression (odds ratio 1.072, 95% CI: 1.032–1.112) was a key predictor. For women, younger age (odds ratio 0.970, 95% CI: 0.948–0.993), low BIS impulsivity ratings (odds ratio 1.018, 95% CI: 1.001–1.036) and living with children (odds ratio 0.448, 95% CI: 0.208–0.966) were protective factors.
Conclusions
Impulsive and aggressive behaviours are critical factors in suicide risk among younger individuals, indicating an age effect but no sex dimorphism, with aggressive behaviours being a better predictor for men and impulsive and aggressive behaviours for women.
The concept of total suffering is widely recognized in palliative care (PC), encompassing a range of interconnected and complex factors that collectively shape the evolving and individualized experience of a patient’s illness journey. Studies on will to live (WtL) in terminally ill patients have demonstrated its variability over time and various factors that influence these changes.
Methods
To objectively investigate the concept of total suffering and WtL; including their fluctuation over time and associations with sociodemographic, clinical, physical, and psychological symptoms in a sample of individuals with life-limiting conditions receiving PC. This multicenter Iberian study involved 3 centers in Portugal and 1 in Spain. A total of 107 individuals with life-limiting conditions consented to participate. To capture the dynamic and multifaceted components of total suffering, we had each participant completed the Edmonton Symptom Assessment Scale (ESAS) along an additional WtL visual analogue once daily over a 30-day period.
Results
WtL demonstrated various patterns over time. While some patterns reflected relative stability, other demonstrated substantive fluctuation during the course of illness. Significant correlations were observed between WtL and all other ESAS items. Moderate positive correlations were found between WtL and total ESAS score and its physical and psychological sub-scores. Spearman’s correlation coefficients between all physical and psychosocial items on the ESAS were statistically significant across all 45 correlations performed, with only 5 showing moderate strength; the remaining correlations were weaker.
Significance of results
Evidence-based understanding of WtL is critical to improving care for patients who experience suffering toward end-of-life and their families. Further research is needed to inform and refine interventions targeting total suffering.
Obstetric complications (OCs) are associated with cognitive and brain abnormalities observed in patients with schizophrenia. Gyrification, a measure of cortical integrity sensitive to events occurring during the prenatal and perinatal periods, is also altered in first-episode psychosis (FEP). We examined the relationship between OCs and gyrification in FEP, as well as whether gyrification mediates the relationship between OCs and cognition.
Methods
We examined differences in the Local Gyrification Index (LGI) for the frontal, parietal, temporal, occipital, and cingulate cortices between 139 FEP patients and 125 healthy controls (HCs). Regression analyses explored whether OCs and diagnosis interact to explain LGI variation. Parametric mediation analyses were conducted to assess the effect of LGI on the relationship between OCs and cognition for FEP and HC.
Results
Significant LGI differences were observed between FEP patients and HC in the left parietal and bilateral cingulate and occipital cortices. There was a significant interaction between OCs and diagnosis on the left cingulate cortex (LCC) that was specific to males (p = 0.04) and was driven by gestational rather than intrauterine OCs.
In HCs, OCs had a direct effect on working memory (WM) (p = 0.048) in the mediation analysis, whereas in FEP, we observed no significant effect of OCs on either verbal or WM.
Conclusions
OCs interact with diagnosis to predict LCC gyrification, such that males with FEP exposed to OCs exhibit the lowest LGI. OCs influence WM, and LCC gyrification may mediate this relation only in HC, suggesting a differential neurodevelopmental process in psychosis.
The adoption of a feminist foreign policy (FFP) by Mexico took Mexican feminist civil society by surprise. In September 2019, without prior consultations or dialogues with local feminist civil society, the Mexican Foreign Affairs Secretary announced its FFP during the 74th session of the UN General Assembly. While the UN New York City headquarters roared with applause in response to the Mexican Foreign Affairs Secretary’s claim that the “Mexican government is feminist,” many feminists in Mexico interpreted the statement as an effort to pinkwash the government’s poor track record on gender equality within its borders. Moreover, Mexico’s FFP was charged with racial and colonial undertones since its inception, colloquially known as the “first FFP from the Global South” (Thompson 2020; Thompson, Ahmed, and Khokhar 2021).
The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.
Methods
We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure to the country’s level of development and inequality.
Results
Higher human development was consistently associated with larger hippocampi and more expanded global cortical surface area, particularly in frontal areas. Increased inequality was most consistently associated with smaller hippocampal volume and thinner cortical thickness across the brain.
Conclusions
Our results suggest that the macro-economic conditions of a country are reflected in its inhabitants’ brains and may explain the different incidence of brain disorders across the world. The observed variability of brain structure in health across countries should be considered when developing tools in the field of personalized or precision medicine that are intended to be used across the world.
Interventions based on testing and communication training have been developed to reduce antibiotic prescribing in primary healthcare (PHC) for the treatment of acute lower respiratory infections (ALRTIs). However, research based on the experiences of PHC clinicians participating in ALTRIs interventions to reduce antibiotic prescribing in Barcelona is scanty.
Aim:
This study aimed to explore the perceptions and experiences of clinicians (physicians and nurses) on an intervention to reduce antibiotic prescription in PHC in Barcelona (Spain). This intervention was a randomised controlled study (cRCT) based on three arms: 1) use of a C-reactive protein (CRP) rapid test; 2) enhanced communication skills; and 3) combination of CRP rapid test and enhanced communication skills. In addition, the study aimed to explore the impact of COVID-19 on the detection of ALRTIs.
Methods:
This qualitative study used a socio-constructivist perspective. Sampling was purposive. Participants were selected based on age, sex, profession, intervention trial arm in which they participated, and the socioeconomic area of the PHC where they worked. They were recruited through the healthcare centres participating in the study. Nine participants (7 women and 2 men) participated in two focus groups, lasting 65–66 min, in September–October 2022. Framework analysis was used to analyse the data.
Findings:
Three themes were identified: ‘(The intervention) gave us reassurance’: intervention experiences among health professionals. This theme includes accounts of clinicians’ satisfaction with the intervention, particularly with CRP testing to support clinical diagnoses; ‘We don’t have time in primary healthcare’: structural and community resources in healthcare services. This theme encompasses clinicians’ experiences on healthcare pressures and PHC organisational structures barriers to PHC interventions; and ‘I only did three CRP’: impact of COVID-19 pandemic on the intervention. The last theme focuses on the impact of the COVID-19 pandemic on the intervention’s implementation.
Conclusions:
CPR testing and promoting communication skills can be useful tools to support clinical decisions for ALRTIs. Structural barriers (e.g., healthcare pressures) and social inequities amongst service users were acknowledged as the main barriers for the implementation of ALRTIs interventions.
Distinguishing between Stomylotrema bijugum and S. vicarium is challenging due to their phenotypic plasticity. In this study, adult specimens were recovered from 9 host species in the Mexican tropical lowlands. To explore the morphological differences, 32 morphological characteristics were evaluated in 54 specimens. Linear discriminant analysis provided enough evidence to differentiate the 2 species. Additionally, a principal component analysis (PCA) was performed for each species. The PCA of S. bijugum revealed 3 groups separately corresponding to specimens from the 3 hosts, suggesting host-induced phenotypic plasticity, whereas the PCA of S. vicarium revealed that the specimens from 3 host species were clustered together, indicating morphometric homogeneity. To confirm the morphological differences between the 2 species of Stomylotrema, we sequenced 2 molecular markers: the D1–D3 domains of the large subunit (LSU) from nuclear DNA and nicotinamide adenine dinucleotide dehydrogenase subunit 1 (Nad1) from mitochondrial DNA. Sequences of the LSU were aligned and compared with the LSU sequences of other congeneric species available in GenBank. Phylogenetic analyses supported the monophyly of Stomylotrema, with 2 main subclades that corresponded to S. bijugum and S. vicarium. A haplotype network was predicted with 25 Nad1 sequences, revealing the presence of 2 clusters representing the 2 species separated from each other by 98 substitutions. The current studies on S. bijugum and S. vicarium revealed new hosts and geographical regions in the Americas, suggesting that both species addressed in the current study can complete their life cycle in the Neotropical region of Mexico.
Marine microorganisms play a crucial role in biogeochemical cycles, especially in the surface microlayer (SML), which differs from adjacent subsurface waters (SSW). In this study, we sampled the SML and SSW at 20 sites along the western Antarctic Peninsula during the summers of 2015 and 2019, examining microbial, viral and environmental differences. We focused on phototrophic protists, specifically Phaeocystis-like species, known for their high dimethylsulphoniopropionate (DMSP) contents, which can be released through viral lysis. DMSP is a precursor to dimethylsulphide (DMS), a gas influencing Earth’s climate. We hypothesized a significant relationship between Phaeocystis-like abundance and DMSP concentration, with strong interactions with their specific viruses (V4) in the SML. Most biotic variables showed higher mean values in the SML, although these differences often were not statistically significant. DMSP concentrations correlated with Phaeocystis-like species abundance in both layers (R2 = 0.482, P ≤ 0.01; R2 = 0.532, P ≤ 0.01, respectively), whereas V4 abundance significantly correlated with Phaeocystis-like species only in the SML (R2 = 0.572, P ≤ 0.01). These results suggest stronger interactions between viruses and DMSP-rich hosts in the SML, potentially increasing DMS emissions to the atmosphere and impacting climate regulation.
In an era marked by mounting global challenges, education is often envisioned as an agent of transformative action towards a more sustainable future. This research seeks to delve into the students’ perceptions concerning competencies for sustainability in Physical Education Teacher Education. Adopting a qualitative approach, a non-probabilistic purposive sample of 57 students (35 males, 22 females, mean age: 21.2 ± 3.2 years) was recruited. Data collection comprised semi-structured interviews. Analysis was facilitated through Atlas.ti v.7.5.18, abiding by established qualitative research paradigms. Participants emphasised the intrinsic value of an interdisciplinary approach. The study discerned a strong inclination towards cooperative and introspective tasks. Moreover, this exploration offers valuable insights for academic institutions, suggesting integrative strategies for environmental education. Therefore, these findings invite to adapt curricular designs, ensuring that educators are aptly prepared to respond the multifaceted challenges of the 21st century, driving our collective stride towards a sustainable, equitable future.
Selective serotonin reuptake inhibitors (SSRIs) are the first-line treatment for major depressive disorder (MDD), but initial outcomes can be modest.
Aims
To compare SSRI dose optimisation with four alternative second-line strategies in MDD patients unresponsive to an SSRI.
Method
Of 257 participants, 51 were randomised to SSRI dose optimisation (SSRI-Opt), 46 to lithium augmentation (SSRI+Li), 48 to nortriptyline combination (SSRI+NTP), 55 to switch to venlafaxine (VEN) and 57 to problem-solving therapy (SSRI+PST). Primary outcomes were week-6 response/remission rates, assessed by blinded evaluators using the 17-item Hamilton Depression Rating Scale (HDRS-17). Changes in HDRS-17 scores, global improvement and safety outcomes were also explored. EudraCT No. 2007-002130-11.
Results
Alternative second-line strategies led to higher response (28.2% v. 14.3%, odds ratio = 2.36 [95% CI 1.0–5.6], p = 0.05) and remission (16.9% v. 12.2%, odds ratio = 1.46, [95% CI 0.57–3.71], p = 0.27) rates, with greater HDRS-17 score reductions (−2.6 [95% CI −4.9 to −0.4], p = 0.021]) than SSRI-Opt. Significant/marginally significant effects were only observed in both response rates and HDRS-17 decreases for VEN (odds ratio = 2.53 [95% CI 0.94–6.80], p = 0.067; HDRS-17 difference: −2.7 [95% CI −5.5 to 0.0], p = 0.054) and for SSRI+PST (odds ratio = 2.46 [95% CI 0.92 to 6.62], p = 0.074; HDRS-17 difference: −3.1 [95% CI −5.8 to −0.3], p = 0.032). The SSRI+PST group reported the fewest adverse effects, while SSRI+NTP experienced the most (28.1% v. 75%; p < 0.01), largely mild.
Conclusions
Patients with MDD and insufficient response to SSRIs would benefit from any other second-line strategy aside from dose optimisation. With limited statistical power, switching to venlafaxine and adding psychotherapy yielded the most consistent results in the DEPRE'5 study.
The GLEAM 4-Jy (G4Jy) Sample is a thorough compilation of the ‘brightest’ radio sources in the southern sky (Declination $ \lt 30^{\circ}$), as measured at 151 MHz ($S_{\mathrm{151\,MHz}} \gt 4.0$ Jy) with the Murchison Widefield Array (MWA), through the GaLactic and Extragalactic All-sky MWA (GLEAM) Survey. In addition to flux-density measurements, the G4Jy catalogue (https://github.com/svw26/G4Jy.) provides host-galaxy identifications (through careful visual-inspection) and four sets of spectral indices. Despite their brightness in the radio, many of these sources are poorly studied, with the vast majority lacking a spectroscopic redshift in published work. This is crucial for studying the intrinsic properties of the sources, and so we conduct a multi-semester observing campaign on the Southern African Large Telescope (SALT), with optical spectroscopy enabling us to provide new redshifts to the astronomical community. Initial results show that not all of the host galaxies exhibit emission-line spectra in the optical ($\sim$4 500–7 500Å), which illustrates the importance of radio-frequency selection (rather than optical selection) for creating an unbiased sample of active galactic nuclei. By combining SALT redshifts with those from the 6-degree Field Galaxy Survey (6dFGS) and the Sloan Digital Sky Survey (SDSS), we calculate radio luminosities and linear sizes for 299 G4Jy sources (which includes one newly-discovered giant radio-galaxy, G4Jy 604). Furthermore, with the highest redshift acquired (so far) being $z \sim 2.2$ from SDSS, we look forward to evolution studies of this complete sample, as well as breaking degeneracies in radio properties with respect to, for example, the galaxy environment.
Management practices are constantly changing amid intense competitive global pressure. This can put a strain on managers in terms of adapting to new challenges that arise from rapid transformations. While there is an emphasis on timely transformations in order to increase efficiency and productivity gains, there can also be a relaxation when managers have reached their pinnacle and achieved their goals. The goal of this editorial is to focus on hot management trends which is an important topic given the ever shifting business environment. Well-known academics were asked to write about what they see as the main management trends affecting society at the current time period. They each have diverse views based on their area of expertise and thought processes. For the Journal of Management & Organization, it is critical that we look into management trends in order to inform practice but also to enrichen theory. It is exciting times with many things happening regarding management that makes it exciting to read about what may occur in the future.
Before a binary system enters into a common envelope (CE) phase, accretion from the primary star onto the companion star through Roche Lobe overflow (RLOF) will lead to the formation of an accretion disk, which may generate jets. Accretion before and during the CE may alter the outcome of the interaction. Previous studies have considered different aspects of this physical mechanism. Here we study the properties of an accretion disk formed via 3D hydrodynamic simulations of the RLOF mass transfer between a 7 M$_{\odot}$, red supergiant star and a 1.4 M$_{\odot}$, neutron star companion. We simulate only the volume around the companion for improved resolution. We use a 1D implicit mesa simulation of the evolution of the system during 30 000 yr between the on-set of the RLOF and the CE to guide the binary parameters and the mass-transfer rate, while we simulate only 21 yr of the last part of the RLOF in 3D using an ideal gas quasi-isothermal equation of state. We expect that a pre-CE disk under these parameters will have a mass of $\sim 5\times 10^{-3}$ M$_{\odot}$ and a radius of $\sim40\ R_\odot$ with a scale height of $\sim 5\ R$$_{\odot}$. The temperature profile of the disk is shallower than that predicted by the formalism of Shakura and Sunyaev, but more reasonable cooling physics would need to be included. We stress test these results with respect to a number of physical and numerical parameters, as well as simulation choices, and we expect them to be reasonable within a factor of a few for the mass and 15% for the radius. We also contextualise our results within those presented in the literature, in particular with respect to the dimensionality of simulations and the adiabatic index. We discuss the measured accretion rate in the context of the Shakura and Sunyaev formalism and debate the viscous mechanisms at play, finishing with a list of prospects for future work.
Antidepressants are essential in managing depression, including treatment-resistant cases. Public perceptions of these medications, shaped by social media platforms like X (formerly Twitter), can influence treatment adherence and outcomes. This study explores public attitudes toward antidepressants through sentiment and topic modeling analysis of tweets in English and Spanish from 2007 to 2022.
Methods
Tweets mentioning antidepressants approved for depression were collected. The analysis focused on selective serotonin reuptake inhibitors (SSRIs) and glutamatergic drugs. Sentiment analysis and topic modeling were conducted to identify trends, concerns, and emotions in discussions across both languages.
Results
A total of 1,448,674 tweets were analyzed (1,013,128 in English and 435,546 in Spanish). SSRIs were the most mentioned antidepressants (27.9% in English, 58.91% in Spanish). Pricing and availability were key concerns in English tweets, while Spanish tweets highlighted availability, efficacy, and sexual side effects. Glutamatergic drugs, especially esketamine, gained attention (15.61% in English, 25.23% in Spanish), evoking emotions such as fear, sadness, and anger. Temporal analysis showed significant increases in discussions, with peaks in 2012 and 2021 for SSRIs in Spanish, and exponential growth from 2018 to 2021 for glutamatergic drugs. Emotional tones varied across languages, reflecting cultural differences.
Conclusions
Social media platforms like X provide valuable insights into public perceptions of antidepressants, highlighting cultural variations in attitudes. Understanding these perceptions can help clinicians address concerns and misconceptions, fostering informed treatment decisions. The limitations of social media data call for careful interpretation, emphasizing the need for continued research to improve pharmacovigilance and public health strategies.
Suicidal thoughts and behaviors (STBs) are a major concern in people with psychotic disorders. There is a need to examine their prevalence over long-term follow-up after first-episode psychosis (FEP) and determine their early predictors.
Methods
Of 510 participants with FEP evaluated on 26 risk factors for later outcomes, 260 were reassessed after 21 years of follow-up for lifetime ratings of most severe suicidal ideation, number of suicide attempts, and lethality of the most severe attempt. Risk factors and STB outcomes were modeled using hierarchical linear regression analysis.
Results
Over the 21-year follow-up period, 62.7% of participants experienced suicidal thoughts, 40.8% attempted suicide, and 18 died of suicide (3.5% case fatality and 20.6% proportionate mortality). Suicidal ideation was independently predicted by parental socioeconomic status, familial load of major depression, neurodevelopmental delay, poor adolescence social networks, and suicidal thoughts/behavior at FEP. The number of suicide attempts was independently predicted by years of follow-up, familial load of major depression, obstetric complications, childhood adversity, and suicidal thoughts/behavior at FEP. Lethality was independently predicted by familial load of major depression, male sex, neurodevelopmental delay, and poor adolescence social networks. The proportion of variance in suicidal ideation, attempts, and lethality explained by the independent predictors was 29.3%, 21.2%, and 18.1%, respectively.
Conclusions
STBs are highly prevalent in psychotic disorders and leads to substantial morbidity and mortality. They were predicted by a number of early risk factors, whose clinical recognition should contribute to improved prediction and prevention in people with psychotic disorders.