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TwinsMX: Exploring the Genetic and Environmental Influences on Health Traits in the Mexican Population
- Brisa García-Vilchis, Talia V. Román-López, Diego Ramírez-González, Xanat J. López-Camaño, Vanessa Murillo-Lechuga, Xóchitl Díaz-Téllez, C. Itzamná Sánchez-Moncada, Ian M. Espinosa-Méndez, Diego Zenteno-Morales, Zaida X. Espinosa-Valdes, Sofia Pradel-Jiménez, Andrea Tapia-Atilano, Ana V. Zanabria-Pérez, Federica Livas-Gangas, Oscar Aldana-Assad, Ulises Caballero-Sánchez, César A. Dominguez-Frausto, Miguel E. Rentería, Alejandra Medina-Rivera, Sarael Alcauter, Alejandra E. Ruiz-Contreras
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- Twin Research and Human Genetics / Volume 27 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 03 May 2024, pp. 85-96
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TwinsMX registry is a national research initiative in Mexico that aims to understand the complex interplay between genetics and environment in shaping physical and mental health traits among the country’s population. With a multidisciplinary approach, TwinsMX aims to advance our knowledge of the genetic and environmental mechanisms underlying ethnic variations in complex traits and diseases, including behavioral, psychometric, anthropometric, metabolic, cardiovascular and mental disorders. With information gathered from over 2800 twins, this article updates the prevalence of several complex traits; and describes the advances and novel ideas we have implemented such as magnetic resonance imaging. The future expansion of the TwinsMX registry will enhance our comprehension of the intricate interplay between genetics and environment in shaping health and disease in the Mexican population. Overall, this report describes the progress in the building of a solid database that will allow the study of complex traits in the Mexican population, valuable not only for our consortium, but also for the worldwide scientific community, by providing new insights of understudied genetically admixed populations.
Risk factors for suicide reattempt: a systematic review and meta-analysis
- Andres Pemau, Carolina Marin-Martin, Marina Diaz-Marsa, Alejandro de la Torre-Luque, Wala Ayad-Ahmed, Ana Gonzalez-Pinto, Nathalia Garrido-Torres, Lucia Garrido-Sanchez, Natalia Roberto, Purificación Lopez-Peña, Lorea Mar-Barrutia, Iria Grande, Marti Guinovart, Daniel Hernandez-Calle, Luis Jimenez-Treviño, Clara Lopez-Sola, Roberto Mediavilla, Adrian Perez-Aranda, Miguel Ruiz-Veguilla, Elisa Seijo-Zazo, Alba Toll, Matilde Elices, Victor Perez-Sola, Jose Luis Ayuso-Mateos, the SURVIVE Consortium
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- Psychological Medicine , First View
- Published online by Cambridge University Press:
- 16 April 2024, pp. 1-8
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Background
Suicide is one of the main external causes of death worldwide. People who have already attempted suicide are at high risk of new suicidal behavior. However, there is a lack of information on the risk factors that facilitate the appearance of reattempts. The aim of this study was to calculate the risk of suicide reattempt in the presence of suicidal history and psychosocial risk factors and to estimate the effect of each individual risk factor.
MethodsThis systematic review and meta-analysis were conducted following the PRISMA-2020 guidelines. Studies on suicide reattempt that measured risk factors were searched from inception to 2022. The risk factors studied were those directly related to suicide history: history of suicide prior to the index attempt, and those that mediate the transition from suicidal ideation to attempt (alcohol or drug misuse, impulsivity, trauma, and non-suicidal self-injury).
ResultsThe initial search resulted in 11 905 articles. Of these, 34 articles were selected for this meta-analysis, jointly presenting 52 different effect sizes. The pooled effect size across the risk factors was significant (OR 2.16). Reattempt risk may be increased in presence of any of the following risk factors: previous history, active suicidal ideation, trauma, alcohol misuse, and drug misuse. However, impulsivity, and non-suicidal self-injury did not show a significant effect on reattempt.
ConclusionMost of the risk factors traditionally associated with suicide are also relevant when talking about suicide reattempts. Knowing the traits that define reattempters can help develop better preventive and intervention plans.
P119: The Valladolid Multicenter Study: The Use of Benzodiacepines in the Elderly and Falls Reported By a Liaison Psychiatry Units
- Mª Desamparados D. Perez Lopez, Elena Alonso, Alejandro Compared Sanchez, Eduardo Delgado Parada, Miguel Alonso Sánchez, Leire Narvaiza Grau, Monica Prat Galbany, Andrea Santoro, Maria Iglesias Gonzalez, Cristina Pujol Riera, Eduardo Fuster Nacher
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- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 172-173
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Objective:
The objective of this study is to describe the prevalence of benzodiazepine in a sample of patients (≥65 years) attended by liaison psychiatry units (LPU) in Spain and its possible relation to falls.
Methods:This is an observational., cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to 7 general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.
Results:We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Only 5,45% lived in a nursing home. 65,45% of patients had prescribed at least one psychotropic drug before LPU intervention; mainly (50,9%) benzodiazepines (60%women/40%men). 70,9% of these group of patients had more than one psychotropic drug prescribed before LPU. After LPU intervention in 39,39% at least one drug was withdrawn (in 50,81 % of cases benzodiazepines). Falls in the past 6 months were reported in 24.8% of total patients. Patients under benzodiazepine treatment had fallen in 29% of cases. After LPU intervention benzodiazepines were withdrawn in 56,25% % of them.
Conclusions:Benzodiazepines are widely used in our sample and frequently is associated with polypharmacy. LPU intervention might be a useful tool to reduce the use of them, specially for those who reported falls.
Longitudinal studies might be carried out to study these factors and their possible relationship with falls, given that Benzodiazepines are consistently associated with a higher risk of falls. It is unclear whether specific subgroups such as short-acting benzodiazepines and selective serotonin reuptake inhibitors are safer in terms of fall risk. Ppropriate prescription of medications such as BZDs is an important public health issue.
P112: Valladolid Multicenter Study: Diagnostic agreement between physicians and liaison psychiatry units in an elderly population in 7 hospitals in Spain.
- Leire Narvaiza, Monica Prat Galbany, Ferran Vilalta, Andrea Santoro, Maria Iglesias Gonzalez, Cristina Pujol Riera, Eduardo Fuster Nacher, Mª Desamparados Perez Lopez, Eduardo Delgado Parada, Miguel Alonso Sánchez
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- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 212-213
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Objective:
The objective of this study is to describe the diagnostic agreement between physicians and liaison psychiatry units (LPU) in 7 general hospitals of Spain for elderly patients and to analyze possible factors related to it.
Methods:This is an observational., cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to 7 general hospitals in Spain referred from different departments to each liaison psychiatry unit. Data was collected for a month and a half period. Psychiatric evaluations were performed while the patients were on wards.
Results:We obtained a sample of 165 patients (78 women, 88 men) with a mean age of 76,03 years old (42.10% <75 years, 57,83% ≥ 75 years). Most of them were married and they lived accompanied (67,27%). Only 5,45% lived in a nursing home.
In 55.15% the main reason to referral was anxiety/depression symptoms. 42,42% had no psychiatry medical background. After LPU visit a new diagnosis was done in 56.96%. Main diagnoses were adjustments disorders (26,66%), delirium (20,6%) and no psychiatric pathology (14,54%)
Cohen’s kappa statistics were used to estimate the agreement between the diagnoses made by LPU and the diagnoses considered by the referring doctors. We obtained a moderate global agreement (kappa= 0,4971) between observers (0,424 for <75 years, 0,557 for ≥65 years) Moderate agreement was found for alcohol or substance abuse (kappa= 0,41) and low agreement was found for affective disorders (kappa= 0,3278) and delirium/ psychological and behavioral symptoms in dementia (Kappa= 0,2341).
We analyzed factors which might affect de agreement between physicians and LPU such is group of age, functional impairment, comorbidity by Charlson index and previous diagnosis of dementia.
Conclusions:Further longitudinal studies might help in the future to analyze the factors related to agreement between doctors and might help to establish educational programs
P54: The Valladolid Multicentre Study: Clinical Difference Between Age Groups in a Sample of Geriatiric Patiants Referred to 7 Liaison Psychiatrics
- Eduardo Fuster Nacher, Mª Desamparados D. Perez Lopez, Miguel Alonso-Sánchez, Eduardo Delgado Parada, Leire Narvaiza Grau, Monica Prat Galbany, Maria Iglesias Gonzalez, Cristina Pujol Riera
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- Journal:
- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, pp. 242-243
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Introduction and Objectives:
It is well known that geriatric patients are at increased risk of developing comorbid medical and psychiatric conditions, and a large proportion of them are admitted to psychiatric liaison units (LPUs). The aim of this study is to determine which clinical differences between age groups (65- 74 years and ≥75 years) are statistically significant to potentially warrant special attention when referring to an LPU.
Methods:This is an observational, cross-sectional and comparative multicentre study. We collected data from 165 patients (≥65 years) admitted to 7 Spanish general hospitals and referred to each LPU from different departments. Data were collected over a period of one and a half months. Psychiatric examinations were performed during the patients' stay in the wards. The sample was divided into two age groups of patients and a comparative analysis was done.
Results:We obtained a sample of 165 patients with a mean age of 76.03 years (42.10% < 75 years, 57.83% ≥ 75 years). We analysed several variables between two age groups: the youngest (65- 74 years) and the oldest (≥75 years). In the younger group (mean age 69.87 years), the mean Barthel index before admission was 93.23 (52.1% with independent ambulation) and at the time of our first assessment was 54.62, before 82.71 of the older group (mean age 80.63). The mean Lawton index was 4.44 (6.35 for the older group) and the Charlson index was 6.38 (5.6 for the older group). 21.11% reported falls in the last 6 months, compared to 27.6% in the older group. The most common reason for referral was anxiety/depression symptoms in both groups (52.12% and 56.53%) and agitation (24.46% in the older group). After the LPU visit, the main diagnoses were adjustment disorder in both groups (25.3% and 25.53%) and delirium in the older group (23.4%). Antidepressants and benzodiazepines were the most common psychotropic drugs prescribed before the LPU visit, and benzodiazepines were the most common drugs discontinued after the LPU visit in both groups.
Conclusions:Clinical differences were found between two age groups (65-74 years and ≥75 years) at LPU, which could allow professionals to improve their attention and interventions.
P41: Valladolid Multicenter Study: Factors related to time to referral and length of hospital stay in old psychiatry patients in seven general hospitals in Spain
- Cristina Pujol Riera, Anna Barnés Andreu, Eduardo Fuster Nacher, Mª Desamparados Perez Lopez, Miguel Alonso Sánchez, Eduardo Delgado Parada, Leira Narvaiza Grau, Monica Prat Galbany, Andrea Santora, Maria Iglesias Gonzalez
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- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 201
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Objective:
Older patients (≥65yo) admitted to general hospitals have increased in the past years. This resulted in an increase in hospitalization periods, health costs, and morbi-mortality rates in this group of patients.
Previous evidence points that the reduced time to referral (TTR) to Consultation-Liaison Psychiatry Units (CLP) leads to a reduced length of stay (LOS) in GH improving long-term prognosis of medical conditions.
This study aims to explore whether a prior disability in older patients leads to delay the search for psychiatric help. And to explore whether early referral to CLP is associated with reduced LOS in general hospitals.
Methodology:This is an observational, cross-sectional, multicentre study. We obtained a complete data set from a sample of 152 patients (≥65 years old) admitted to 7 general hospitals in Spain referred to CLP unit for 1,5 months.
Results:Mean age of the sample was 76.3 (±6.4). TTR was 14.5 (±18.0) days. LOS was 26.7 (±22.4) days, and length of stay after consultation was 12.3 (±10.3) days. Barthel Index before admission was 87.3 (±18.0) and Lawton&Brody Index before admission was 5.3 (2.7). We found a significant positive association of Barthel Index (r=0.17, p=0.042) and Lawton&Brody Index (r=0.20, p=0.014) before admission with TTR, which indicates that patients with a worse clinical status were attended earlier. Similarly, antecedents of both falling episodes (r=-0.2, p= 0.013) and walking difficulties (r=-0.24, p= 0.003) were associated with shorter TTR. TTR in Medical Departments was 11.7 (±15.0) days and in Surgical Departments was 24.0 (±22.8) days (t=-3.5, p= 0.001). TTR showed a highly significant positive correlation with LOS (r=0.89, p<0.0001) and a more discrete positive correlation with length of stay after consultation (r=0.20, p=0.016).
Conclusion:We confirm that a shorter TTR to CLP was related to a shorter LOS. Also, patients in medical wards had shorter TTR. In contrast to our hypothesis, we found that a higher disability prior to hospitalization led to earlier referral to CLP, meaning that these patients were assessed and treated earlier leading to better long- term prognosis and lower health costs.
FC6: The Valladolid Multicenter Study: ¿Is there ageism in liaison psychiatry? Referrals of patients over 65 years to 7 Liaison Psychiatric Units (LPU) in Spain
- Miguel Alonso Sanchez, Eduardo Delgado Parada, Leire Narvaiza Grau, Monica Prat Galbany, Andrea Santoro, Maria Iglesias Gonzalez, Cristina Pujol Riera, Eduardo Fuster Nacher, Mª Desamparados Perez Lopez
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- International Psychogeriatrics / Volume 35 / Issue S1 / December 2023
- Published online by Cambridge University Press:
- 02 February 2024, p. 69
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Introduction and objective:
Ageism is defined by the World Health Organization as stereotypes, prejudice, and discrimination towards others or oneself based on age. Ageism is thought to pose a risk to the physical and mental health of older adults, but little is known about how to measure it in LPUs. We propose that a form of ageism can be detected by comparing the referrals made by liaison psychiatry services among patients over age 65 at discharge with functional status and medical comorbidity. Our hypothesis is that the worse the functional index and medical comorbidity, the fewer referrals to psychiatric services and the more referrals to primary care physicians.
Methods:This is an observational, cross-sectional, multicenter study. We obtained data from a sample of 165 patients (≥65 years) admitted to seven general hospitals in Spain referred from different departments to each LPU. Data was collected over a period of one and a half months. Psychiatric evaluations were performed while the patients were in the wards. Sociodemographic, clinical, and care variables were collected. Functional status was measured with the Barthel and Lawton index and comorbidity with the Charlson index.
Results:We obtained a sample of 165 patients with a mean age of 76,03 years old. The mean Barthel index was 87,18 previous admission and 61,15 at the time of our first visit. The mean Lawton index was 5,266667 and the Charlson index was 6,03. The different options for referral were primary care physician, psychiatric facilities, nursing homes, substance use centers, or exitus. Statistical analysis was performed using the nonparametric Kruskal-Wallis test to determine if there were significant differences (p < 0,05) between the indices and referrals. Contrary to our hypothesis, statistical significance was observed only for the Lawton index, but with more referrals to psychiatric facilities among patients with the worst functional scores. No other statistical significance was observed.
Conclusions:Functional status and medical comorbidity did not play a role in the referral of inpatients managed by LPUs. Further studies are needed to clarify whether there is any form of ageism in the referral of elderly inpatients attended by Psychiatric Liaison Units.
Proxy measures for the assessment of psychotic and affective symptoms in studies using electronic health records
- Álvaro López-Díaz, Fernanda Jazmín Palermo-Zeballos, Luis Gutierrez-Rojas, Luis Alameda, Francisco Gotor-Sánchez-Luengo, Nathalia Garrido-Torres, Johann Métrailler, Livia Alerci, Vincent Bonnarel, Pablo Cano-Domínguez, Elma Avanesi-Molina, Miguel Soto-Ontoso, Rocio Torrecilla-Olavarrieta, Leticia Irene Muñoz-Manchado, Pedro Torres-Hernández, Fermín González-Higueras, Juan Luis Prados-Ojeda, Mario Herrera-Cortés, José Miguel Meca-García, Rafael Manuel Gordillo-Urbano, Cristina Sánchez-Robles, Tomás Delgado-Durán, María Felipa Soriano-Peña, Philippe Golay, Philippe Conus, Benedicto Crespo-Facorro, Miguel Ruiz-Veguilla
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- BJPsych Open / Volume 10 / Issue 1 / January 2024
- Published online by Cambridge University Press:
- 05 January 2024, e22
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Background
There is a lack of standardised psychometric data in electronic health record (EHR)-based research. Proxy measures of symptom severity based on patients' clinical records may be useful surrogates in mental health EHR research.
AimsThis study aimed to validate proxy tools for the short versions of the Positive and Negative Syndrome Scale (PANSS-6), Young Mania Rating Scale (YMRS-6) and Montgomery–Åsberg Depression Rating Scale (MADRS-6).
MethodA cross-sectional, multicentre study was conducted in a sample of 116 patients with first-episode psychosis from 12 public hospitals in Spain. Concordance between PANSS-6, YMRS-6 and MADRS-6 scores and their respective proxies was evaluated based on information from EHR clinical notes, using a variety of statistical procedures, including multivariate tests to adjust for potential confounders. Bootstrapping techniques were used for internal validation, and an independent cohort from the Treatment and Early Intervention in Psychosis Program (TIPP-Lausanne, Switzerland) for external validation.
ResultsThe proxy versions correlated strongly with their respective standardised scales (partial correlations ranged from 0.75 to 0.84) and had good accuracy and discriminatory power in distinguishing between patients in and not in remission (percentage of patients correctly classified ranged from 83.9 to 91.4% and bootstrapped optimism-corrected area under the receiver operating characteristic curve ranged from 0.76 to 0.89), with high interrater reliability (intraclass correlation coefficient of 0.81). The findings remained robust in the external validation data-set.
ConclusionsThe proxy instruments proposed for assessing psychotic and affective symptoms by reviewing EHR provide a feasible and reliable alternative to traditional structured psychometric procedures, and a promising methodology for real-world practice settings.
Isoparametric hypersurfaces in symmetric spaces of non-compact type and higher rank
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- Miguel Domínguez-Vázquez, Víctor Sanmartín-López
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- Compositio Mathematica / Volume 160 / Issue 2 / February 2024
- Published online by Cambridge University Press:
- 05 January 2024, pp. 451-462
- Print publication:
- February 2024
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We construct inhomogeneous isoparametric families of hypersurfaces with non-austere focal set on each symmetric space of non-compact type and rank ${\geq }3$. If the rank is ${\geq }4$, there are infinitely many such examples. Our construction yields the first examples of isoparametric families on any Riemannian manifold known to have a non-austere focal set. They can be obtained from a new general extension method of submanifolds from Euclidean spaces to symmetric spaces of non-compact type. This method preserves the mean curvature and isoparametricity, among other geometric properties.
Relational values shape people’s connectedness to nature in a former military protected area of Ecuador
- Christian Oswaldo Asanza-Reyes, Antonio J Castro, Juan Miguel Requena-Mullor, María Dolores López-Rodríguez, Cristina Quintas-Soriano
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- Journal:
- Environmental Conservation / Volume 51 / Issue 1 / March 2024
- Published online by Cambridge University Press:
- 22 December 2023, pp. 17-26
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Relational values are a way of recognizing and valuing the complex and interconnected relationships between people and nature, such as caregiving, place attachment and spiritual meaning, as well as the social and cultural impacts of degradation and environmental and conservation efforts. However, the implications of these values for the management and conservation of protected areas are little known. We explored the role of relational values in shaping local communities’ connectedness to a protected area of Ecuador that had been used by the military in the past and the implications of the values for well-being. Four hundred individual face-to-face surveys in the surroundings of Arenillas Ecological Reserve (south-west Ecuador) indicated high levels of connectedness towards this natural reserve amongst local communities through multiple values of nature. However, relational values were identified as the most prominent value explaining the strength of connectedness to nature, followed by intrinsic and instrumental values. We also showed that combinations of different natural values (instrumental, intrinsic and relational) might explain the support for specific well-being components. Our findings offer understanding of human behaviour towards protected areas with a military past and represent a first step in Ecuador towards comprehending how relational values shape the connectedness of local communities to nature.
Estimating the Genetic Contribution to Astigmatism and Myopia in the Mexican Population
- Talía V. Román-López, Brisa García-Vilchis, Vanessa Murillo-Lechuga, Enrique Chiu-Han, Xanat López-Camaño, Oscar Aldana-Assad, Santiago Diaz-Torres, Ulises Caballero-Sánchez, Ivett Ortega-Mora, Diego Ramírez-González, Diego Zenteno, Zaida Espinosa-Valdés, Andrea Tapia-Atilano, Sofía Pradel-Jiménez, Miguel E. Rentería, Alejandra Medina-Rivera, Alejandra E. Ruiz-Contreras, Sarael Alcauter
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- Journal:
- Twin Research and Human Genetics / Volume 26 / Issue 4-5 / August 2023
- Published online by Cambridge University Press:
- 16 October 2023, pp. 290-298
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Astigmatism and myopia are two common ocular refractive errors that can impact daily life, including learning and productivity. Current knowledge suggests that the etiology of these conditions is the result of a complex interplay between genetic and environmental factors. Studies in populations of European ancestry have demonstrated a higher concordance of refractive errors in monozygotic (MZ) twins compared to dizygotic (DZ) twins. However, there is a lack of studies on genetically informative samples of multi-ethnic ancestry. This study aimed to estimate the genetic contribution to astigmatism and myopia in the Mexican population. A sample of 1399 families, including 243 twin pairs and 1156 single twins, completed a medical questionnaire about their own and their co-twin’s diagnosis of astigmatism and myopia. Concordance rates for astigmatism and myopia were estimated, and heritability and genetic correlations were determined using a bivariate ACE Cholesky decomposition method, decomposed into A (additive genetic), C (shared environmental) and E (unique environmental) components. The results showed a higher concordance rate for astigmatism and myopia for MZ twins (.74 and .74, respectively) than for DZ twins (.50 and .55). The AE model, instead of the ACE model, best fitted the data. Based on this, heritability estimates were .81 for astigmatism and .81 for myopia, with a cross-trait genetic correlation of rA = .80, nonshared environmental correlation rE = .89, and a phenotypic correlation of rP = .80. These results are consistent with previous findings in other populations, providing evidence for a similar genetic architecture of these conditions in the multi-ethnic Mexican population.
TrackAnalyzer: A Fiji/ImageJ toolbox for a holistic analysis of tracks
- Ana Cayuela López, Eva M. García-Cuesta, Sofía R. Gardeta, José Miguel Rodríguez-Frade, Mario Mellado, José Antonio Gómez-Pedrero, Carlos Oscar S. Sorzano
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- Biological Imaging / Volume 3 / 2023
- Published online by Cambridge University Press:
- 11 October 2023, e18
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Current live-cell imaging techniques make possible the observation of live events and the acquisition of large datasets to characterize the different parameters of the visualized events. They provide new insights into the dynamics of biological processes with unprecedented spatial and temporal resolutions. Here we describe the implementation and application of a new tool called TrackAnalyzer, accessible from Fiji and ImageJ. Our tool allows running semi-automated single-particle tracking (SPT) and subsequent motion classification, as well as quantitative analysis of diffusion and intensity for selected tracks relying on the graphical user interface (GUI) for large sets of temporal images (X–Y–T or X–Y–C–T dimensions). TrackAnalyzer also allows 3D visualization of the results as overlays of either spots, cells or end-tracks over time, along with corresponding feature extraction and further classification according to user criteria. Our analysis workflow automates the following steps: (1) spot or cell detection and filtering, (2) construction of tracks, (3) track classification and analysis (diffusion and chemotaxis), and (4) detailed analysis and visualization of all the outputs along the pipeline. All these analyses are automated and can be run in batch mode for a set of similar acquisitions.
Coronavirus disease 2019 is associated with long-term depressive symptoms in Spanish older adults with overweight/obesity and metabolic syndrome
- Sangeetha Shyam, Carlos Gómez-Martínez, Indira Paz-Graniel, José J. Gaforio, Miguel Ángel Martínez-González, Dolores Corella, Montserrat Fitó, J. Alfredo Martínez, Ángel M. Alonso-Gómez, Julia Wärnberg, Jesús Vioque, Dora Romaguera, José López-Miranda, Ramon Estruch, Francisco J. Tinahones, José Manuel Santos-Lozano, J. Luís Serra-Majem, Aurora Bueno-Cavanillas, Josep A. Tur, Vicente Martín Sánchez, Xavier Pintó, María Ortiz Ramos, Josep Vidal, Maria Mar Alcarria, Lidia Daimiel, Emilio Ros, Fernando Fernandez-Aranda, Stephanie K. Nishi, Oscar García Regata, Estefania Toledo, Jose V. Sorli, Olga Castañer, Antonio Garcia-Rios, Rafael Valls-Enguix, Napoleon Perez-Farinos, M. Angeles Zulet, Elena Rayó-Gago, Rosa Casas, Mario Rivera-Izquierdo, Lucas Tojal-Sierra, Miguel Damas-Fuentes, Pilar Buil-Cosiales, Rebeca Fernández-Carrion, Albert Goday, Patricia J. Peña-Orihuela, Laura Compañ-Gabucio, Javier Diez-Espino, Susanna Tello, Ana González-Pinto, Víctor de la O, Miguel Delgado-Rodríguez, Nancy Babio, Jordi Salas-Salvadó
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- Psychological Medicine / Volume 54 / Issue 3 / February 2024
- Published online by Cambridge University Press:
- 05 September 2023, pp. 620-630
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Background
The coronavirus disease 2019 (COVID-19) has serious physiological and psychological consequences. The long-term (>12 weeks post-infection) impact of COVID-19 on mental health, specifically in older adults, is unclear. We longitudinally assessed the association of COVID-19 with depression symptomatology in community-dwelling older adults with metabolic syndrome within the framework of the PREDIMED-Plus cohort.
MethodsParticipants (n = 5486) aged 55–75 years were included in this longitudinal cohort. COVID-19 status (positive/negative) determined by tests (e.g. polymerase chain reaction severe acute respiratory syndrome coronavirus 2, IgG) was confirmed via event adjudication (410 cases). Pre- and post-COVID-19 depressive symptomatology was ascertained from annual assessments conducted using a validated 21-item Spanish Beck Depression Inventory-II (BDI-II). Multivariable linear and logistic regression models assessed the association between COVID-19 and depression symptomatology.
ResultsCOVID-19 in older adults was associated with higher post-COVID-19 BDI-II scores measured at a median (interquartile range) of 29 (15–40) weeks post-infection [fully adjusted β = 0.65 points, 95% confidence interval (CI) 0.15–1.15; p = 0.011]. This association was particularly prominent in women (β = 1.38 points, 95% CI 0.44–2.33, p = 0.004). COVID-19 was associated with 62% increased odds of elevated depression risk (BDI-II ≥ 14) post-COVID-19 when adjusted for confounders (odds ratio; 95% CI 1.13–2.30, p = 0.008).
ConclusionsCOVID-19 was associated with long-term depression risk in older adults with overweight/obesity and metabolic syndrome, particularly in women. Thus, long-term evaluations of the impact of COVID-19 on mental health and preventive public health initiatives are warranted in older adults.
Acknowledgements
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Participating in Peace
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- Bristol University Press
- Published online:
- 24 January 2024
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- 31 July 2023, pp ix-x
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Introduction
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Participating in Peace
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- Bristol University Press
- Published online:
- 24 January 2024
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- 31 July 2023, pp 1-10
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Summary
In August 2022, Colombians elected, for the first time, a left-leaning government. Led by former guerrilla activist Gustavo Petro and his Vice President Francia Márquez, an Afro-Colombian woman and well-known advocate for human rights and environmental justice, the shift in governmental discourse was immediately striking. President Petro used his inauguration speech to promise that he would deliver Paz total (total peace), which would involve entering into talks with a wide range of armed groups to tackle the violence that has continued – indeed, in some areas has increased – in the years since the peace agreement between the government and the Fuerzas Armadas Revolucionarias de Colombia (Revolutionary Armed Forces of Colombia; FARC) was signed in 2016. Essential to total peace would be not only those new negotiations, but also fully implementing the terms of the 2016 agreement itself. Former President Iván Duque's (2018–22) failure to do so had caused widespread disillusionment with the peace process, and had also spurred splinter groups from the FARC to continue in arms.
Hopes for a stable and lasting peace in Colombia will depend in part on Petro's success in persuading the wide range of guerrilla, paramilitary and criminal groups still active in the country to cease the violence and lay down their weapons. But Petro was clear that total peace would also need to be a project for the whole of society:
For peace to be possible in Colombia we need dialogue, a lot of dialogue, to understand each other, seek common paths, and produce change … Our future is not written. We own the pen and we can write the page together, in peace and togetherness. Today, we start the Colombia of the possible.
(Petro, quoted in Emblin, 2022)This book is interested in how, in the years before and since the 2016 peace agreement, communities have been using dialogue as a way of participating in the building of peace, often in relatively unpromising circumstances. Seeking to understand the dynamics of community-level dialogues that aim to deal with the legacies of earlier violence and overcome ongoing conflicts, the book takes a ‘bottom-up’ look at the building of peace.
Notes on the Authors
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Book:
- Participating in Peace
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- Bristol University Press
- Published online:
- 24 January 2024
- Print publication:
- 31 July 2023, pp vii-viii
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One - Peace through Participation: The Colombian Experience
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Book:
- Participating in Peace
- Published by:
- Bristol University Press
- Published online:
- 24 January 2024
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- 31 July 2023, pp 11-35
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Summary
The 2016 Colombian peace agreement was lauded internationally as innovative, multi-layered and comprehensive. It went far beyond a simple commitment to lay down arms, incorporating further provisions on how to deal with various thorny legacies of the conflict, and also new challenges that would arise in response to its implementation. These included issues such as reparations for victims and the reintegration of demobilized FARC combatants, including guarantees for their political participation. Most ambitiously, the agreement sought to provide for the future economic growth of the predominantly rural areas that had been most heavily impacted by the conflict, often among the poorest in the country. In doing so, it incorporated much of the learning from previous peace processes (both those perceived as successful and those less so) that took place around the world in the post-Cold War era, while building upon multiple peacebuilding experiences and traditions developed in Colombia itself over the preceding decades. This unquestionably ambitious project of a participatory peace and geographically targeted development was, nevertheless, criticized widely from within Colombia. In the areas that were ostensibly intended to benefit from it, various social actors pointed to an implementation process that failed to address asymmetric power relations and, above all, the economic injustices that fuelled the armed conflict in the first place.
The discussion in this chapter situates the emergence of new forms of community-led participatory peacebuilding in relation to shortcomings in the peace process. Specifically, the chapter's goal is to contextualize the origins of the diálogos socio-territoriales (DSTs) discussed in Chapter Two and explored empirically in Chapters Three and Four. Particularly notable in the Colombian peace process was the government's use of social dialogue as a form of state-sponsored participatory peacebuilding, which in turn built upon previous civil society-led experiments with peace. The ambitious peace programme aspired to produce peaceful and prosperous futures for conflict-affected areas while involving the entirety of Colombian society in the process. However, it was also rather top-down in its initial composition, and various state–society interactions occurred during both the negotiation and implementation phases, which saw its very constitution and purpose becoming a site of conflict and contestation.
Conclusion
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Book:
- Participating in Peace
- Published by:
- Bristol University Press
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- 24 January 2024
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- 31 July 2023, pp 117-130
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This book has been inspired by two central questions. First, how are communities in Colombia seizing the initiative to build peace in the wake of the historic 2016 peace agreement? And second, what can participatory research contribute to these efforts, both within and beyond Colombia?
As is the case with any project in such a complex and shifting social and political situation, the findings we present and discuss here are necessarily provisional and partial. Colombia's conflict, the changing local and national politics surrounding it and associated efforts to understand and reduce violence – efforts that include local actors, NGOs, governments, international agencies and the research community alike – continue to evolve with dizzying speed. A meaningful or comprehensive peace in Colombia is a long way from being successfully ‘built’. Yet notwithstanding the limitations of our own efforts, we are confident of the significant untapped potential for engaged, immersive and non-extractive research in ‘post-conflict’ scenarios and, however embryonic and limited they may be, it is plainly evident that many communities beyond those we have examined here are constantly engaged in the careful, gradual and difficult business of constructing their own visions of more peaceful lives and futures.
In this concluding chapter, we present a synthesis of the book's central empirical, theoretical and methodological insights. We begin by placing the key findings from the two empirical cases in dialogue with one another and in relation to the wider story of the Colombian peace process, including the ‘territorial peace’ agenda. Here we return to the book's core concept of DST and ask what potential lessons these experiences can offer for other community-based actors. In the second section, we outline our key reflections for peace scholars and practitioners, making the case that DST is not only a descriptive concept describing a particular form of dialogue practice, but also a normative one which provides an entry point for PAR-based research to play a meaningful role in partnering with and supporting communities within and beyond Colombia to overcome the conflict(s) that inhibit their ability to live with dignity. Finally, we offer a brief analysis of recent events in Colombia, specifically the election of President Petro in 2022, and the implications of his early efforts towards a lasting form of ‘total peace’.
Two - Participation through Dialogue: Co-Producing Peace and Research
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Book:
- Participating in Peace
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- Bristol University Press
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- 24 January 2024
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- 31 July 2023, pp 36-56
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Dialogue cannot be a panacea for all conflict challenges, nor did the social leaders and community members engaging with our project expect it to be. Their main priority was to find pragmatic ways of addressing ongoing problems and bringing improvements to their territories, often through de-escalating ongoing violent conflicts and finding strategies to avoid overt confrontation. Many participants shared concerns that latent tensions were being intensified by the failure to implement key parts of the peace agreement. Yet, we found that a broad range of social actors saw value in community-driven peacebuilding through dialogue. The main aim of this chapter is to introduce how methodological approaches and ethical sensibilities from Participatory Action Research (PAR) can open up opportunities for researchers to work alongside social actors in the co-production of such dialogues, instead of merely documenting them. We focus in particular on the format of diálogos socio-territoriales (DSTs), which the chapter also defines in more depth.
We must begin by recognizing that territorially rooted, dialogue-based modes of participation were not, for the most part, created de novo after 2016. Such efforts have been part of communities’ repertoires of ‘peacebuilding from below’ for decades (Jaramillo Marín et al, 2018). Community-based organizations have frequently created and convened participatory spaces when state actors have proved unresponsive or unable to interpret their claims (Archila, 2019). Yet, these dialogues have not been adequately recognized either by the literature on peacebuilding, or by the national peace agreement's promises of citizen involvement in the construction of ‘territorial peace’. In many cases, the invented spaces of dialogue that communities have sustained in the ‘post-conflict’ period have been a continuation of, or have built upon the foundations of, those previous efforts. They have also continued to adapt to changing (post-)conflict circumstances, in doing so producing innovations that have opened up further avenues for participation, the construction of peace and pursuit of life with dignity.
This chapter consists of four sections. The first outlines the Improbable Dialogues project from which this book emerges, situating it in the context of receding violence and increasing political optimism that at first followed the signing of the peace agreement. The second section briefly outlines the project's roots in the Latin American tradition of PAR as developed in the pioneering work of Colombian sociologist Orlando Fals Borda, and explains how we applied these principles critically in our approach to community engagement.
Four - Transforming Buenaventura: Dialogue for Municipal Peacebuilding
- Jefferson Jaramillo-Marín, Pontificia Universidad Javeriana, Colombia, Luz Mery López-Lizarazo, Adriel Ruiz-Galvan, Pontificia Universidad Javeriana, Colombia, Matthew Louis Bishop, University of Sheffield, Juan Mario Díaz-Arévalo, University of Sheffield, Juan Miguel Kanai, University of Sheffield, Melanie Lombard, University of Sheffield, Simon Rushton, University of Sheffield, Anastasia Shesterinina, University of Sheffield, Henry Staples, University of Sheffield, Helen Louise Turton, University of Sheffield
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- Book:
- Participating in Peace
- Published by:
- Bristol University Press
- Published online:
- 24 January 2024
- Print publication:
- 31 July 2023, pp 83-116
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In January 2021, a group of human rights defenders in Buenaventura received death threats and harassment by armed men who followed them as they went to and from their homes and workplaces. While typical of the threats faced by community leaders across Colombia since the 2016 peace agreement, in Buenaventura this also reflected the continuation of local struggles over the San Antonio Estuary. A project to dredge the estuary, led by the Instituto Nacional de Vías (National Roads Institute) and a consortium of private interests, had generated intense opposition from local residents. Although the public and private investors proposing the plan argued that dredging would allow for the expansion of commercial shipping operations, they had failed to persuade community leaders to drop their legal action to prevent the work. One representative of the local administration who was in support of the dredging called his opponents “enemies of the development of Buenaventura”.
For those community leaders, however, opposition to the dredging was not only environmental: they also cited reliable evidence that the estuary was an acuafosa, or watery grave, containing the remains of hundreds of victims of forced disappearance (Avila and Parada, 2021). The dredging project, they argued, threatened families’ hopes of ever recovering the remains of their loved ones; a serious abuse of the rights of victims’ relatives. They demanded a detailed investigation of the area and, in February 2021, a request for protection of the Estuary was submitted to the Jurisdicción Especial para la Paz (Special Jurisdiction for Peace; JEP), who ordered the suspension of the dredging project. In April of that year, the Pact for the Search of the Disappeared in Buenaventura was signed, a commitment from the Public Prosecutor's Office's Disappeared Persons Unit and the Mayor's office to conduct the first ever search for the disappeared in a maritime zone. At the time of writing, that search is about to begin.
This incident perfectly encapsulates many of the issues that residents and social leaders in Buenaventura face: powerful commercial and economic interests pursuing forms of development that conflict with the wishes of local communities, an ongoing struggle to deal with the legacies of the city's turbulent history of violence and continuing threats of violence against those who try to defend the interests of the community and address the city's problems.