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We study a setting where individuals prefer to coordinate with others but they differ on their preferred action. Our interest is in understanding the role of link formation with others in shaping behavior. So we consider the situation in which interactions are exogenous and a situation where individuals choose links that determine the interactions. Theory is permissive in both settings: conformity (on either of the actions) and diversity (with different groups choosing their preferred actions) are both sustainable in equilibrium. We conduct an experiment to understand how link formation affects equilibrium selection. Our experiment reveals the powerful effect of linking on equilibrium selection: with an exogenous complete network, subjects choose to conform on the majority’s preferred action. By contrast, with endogenous linking—irrespective of the costs of linking—subjects always opt for diversity of actions.
Evidence shows that the willingness of individuals to avenge punishment inflicted upon them for transgressions they committed constitutes a significant obstacle toward upholding social norms and cooperation. The drivers of this behavior, however, are not well understood. We hypothesize that ulterior motive attribution—the tendency to assign ulterior motives to punishers for their actions—increases the likelihood of counter-punishment. We exogenously manipulate the ability to attribute ulterior motives to punishers by having the punisher be either an unaffected third party or a second party who, as the victim of a transgression, may be driven to punish by a desire to take revenge. We show that survey respondents consider second-party punishment to be substantially more likely to be driven by ulterior motives than an identical, payoff-equalizing punishment meted out by a third party. In line with our hypothesis, we find that second-party punishment is 66.3% more likely to trigger counter-punishment than third-party punishment in a lab experiment. The loss in earnings due to counter-punishment is 64.6% higher for second-party punishers than third-party punishers, all else equal.
To compare the dosimetric characteristics and treatment delivery efficiency of trigeminal neuralgia (TN) stereotactic radiosurgery (SRS) patients previously treated with a 6 MV-FFF (flattening filter-free; radiation beam obtained by removing the flattening filter) beam versus those re-planned with a 10 MV-FFF beam using a conical collimator on the TrueBeam Novalis STx linear accelerator.
Methods:
Eleven patients with TN previously treated with a 6 MV-FFF beam following the SRS protocol of 90 Gy in a single fraction were selected. Plans were recalculated using 10 MV-FFF beam, maintaining the same dose prescription and beam angle configuration used with 6 MV-FFF beam. The dose gradient, volumes receiving 20 and 10 Gy, maximum dose and dose to 10% of the brainstem were recorded for both the energies. Efficiency was assessed by the average monitor unit (MU) and time per arc. The 10 MV-FFF machine was configured in the treatment planning system (TPS) to measure the tissue phantom ratio (TPR), dose profiles and scatter factors using RAZOR, PTW-60012 diodes and EBT3 radiochromic films.
Results:
Compared to the 6 MV-FFF, the 10 MV-FFF plans exhibit average increments in dose gradient, volume of 20 Gy and volume of 10 Gy of 3.8, 17.1 and 17.8%, respectively. Average increases of 6.5 and 18.1% were obtained for maximum dose and dose to 10% of the brainstem, respectively. An average increase of 31 MU/arc was observed for the 10 MV-FFF plans, with a 40% reduction in treatment time per arc. The TPR for the 10 MV-FFF beams increased by 10%, and a penumbra width of 0.3 mm was observed. Scatter factor increments of 15, 13.5, 12.7 and 10.3% were observed for the 6 MV-FFF over the 10 MV-FFF for cones of 4, 5, 6 and 7 mm, respectively.
Conclusions:
In TN SRS, the utilisation of 10 MV-FFF beams reduces treatment duration but results in an increased brainstem radiation dose. To mitigate this increase in brainstem dose, it is necessary to adjust the isocentre position.
This paper describes four methodological proposals for rescuing from oblivion and highlighting women writers in Graeco-Roman Antiquity. In workshops employing a variety of active methodologies, students become acquainted with Greek writers like Sappho, Diotima of Mantinea and Aspasia, and their Roman counterparts, including Sulpicia and Agrippina the Younger, while also becoming aware of the authorship of these women writers and their lack of visibility. The proposals take the shape of activities aimed at fostering a vocation for science among baccalaureate students in Spain but can also be easily adapted to secondary and even higher education in other educational contexts.
Deportations and the threat of removal are choreographic strategies of the nation-state's ever-growing monopoly of movement through border securitization and immigration enforcement, which persists into the twenty-first century. While literature and the visual arts have received critical and popular attention by considering forced family separations, dance remains overlooked. Analyzing dance performances that relate directly to deportation teaches us not only about the painful impact of forced removal: it instructs us to decode, move and maintain relationships as aliens and citizens amid the increasing control of motion in the United States and the cruel joke offered by a nation of immigrants.
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.
Aims
This 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).
Method
A 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.
Results
The 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.
Conclusions
The 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.
This systematic literature review aimed to provide an overview of the characteristics and methods used in studies applying the disability-adjusted life years (DALY) concept for infectious diseases within European Union (EU)/European Economic Area (EEA)/European Free Trade Association (EFTA) countries and the United Kingdom. Electronic databases and grey literature were searched for articles reporting the assessment of DALY and its components. We considered studies in which researchers performed DALY calculations using primary epidemiological data input sources. We screened 3053 studies of which 2948 were excluded and 105 studies met our inclusion criteria. Of these studies, 22 were multi-country and 83 were single-country studies, of which 46 were from the Netherlands. Food- and water-borne diseases were the most frequently studied infectious diseases. Between 2015 and 2022, the number of burden of infectious disease studies was 1.6 times higher compared to that published between 2000 and 2014. Almost all studies (97%) estimated DALYs based on the incidence- and pathogen-based approach and without social weighting functions; however, there was less methodological consensus with regards to the disability weights and life tables that were applied. The number of burden of infectious disease studies undertaken across Europe has increased over time. Development and use of guidelines will promote performing burden of infectious disease studies and facilitate comparability of the results.
The literature on the internalized stigma (or self-stigma) of mental illness has been expanding rapidly. We review the key findings of two meta-analyses of the correlates and consequences that occurred a decade apart (Livingston & Boyd, 2010, Del Rosal et al., 2020), showing that internalized stigma is related to less self-esteem, quality of life, and hope; and related to greater experienced stigma, perceived stigma, and symptom severity. For empowerment, the relationship of internalized stigma was somewhat weaker in 2020 than in 2010. Neither found significant relationships with sociodemographic variables. Although more longitudinal studies are needed to better test the causal direction of these relationships, the overall findings are consistent with the idea that internalized stigma impedes recovery and adds to the burden of mental illness. While, more work needs to be done to understand the effects of internalized stigma on people with a variety of intersectional identities. we briefly describe the literature on a few contrasting types of marginalized identities: gender (female and transgender), race/ethnicity (African Americans), and profession (mental health professionals with a lived experience of mental illness). These summaries highlight that the consequences of internalized stigma may vary across intersectional identities. We conclude with suggestions for future research.
This article uncovers the connections between the legal and scientific art of searching for human remains and theatrical performances. NAKA Dance Theater, a performance group based in Mexico City and Oakland, California, is at the centre of this intersection of art and forensics. Founded by José Navarrete and Debby Kajiyama, NAKA creates theatrical events to configure a claim for social justice where the official legal–scientific terrain has failed to protect victims of state repression. These artists advance a commitment to what I call forensic performances, and their investigative practices revitalize theatrical experience in a time of debilitated democracies. Forensic performances give theatre a role in violent societies where mass graves are woven into life: they carry out some of the work of investigative journalism, without its dangers. Theatre opens up a space to do a forensics that is orthogonal to a state forensics claiming a certain kind of reality and truth that is dangerous for democratic politics.
Health systems are in the need for novel approaches to tackle the challenges from the demographic transition to ageing populations. An effective approach to face these challenges is integrated care delivery. Implementing Comprehensive Geriatric Assessments (CGAs) in Health Ageing might be highly relevant to incorporate this approach. However, this implementation should be supported by Digital Health Interventions (DHIs) in order to reach their full capacity.
Research Objective:
To identify the DHIs facilitating the administration of CGAs used in long-term care and home care settings and provide an insight on their characteristics and stage of maturity and evaluation.
Method:
A search strategy was conducted in PubMed, CINAHL, and Web of Science, targeting studies evaluating the DHIs facilitating the administration of CGAs used in long-term care and home care settings. Studies in English and Spanish and published up to July 26, 2021 were considered.
Preliminary results of the ongoing study:
A total of four papers describing three digital platforms supporting the administration of the CGAs were identified. Information on implementation reported less completion of some sections affecting the CGAs outcomes, assessments mostly being the responsibility of nurses, and missing data related with less quality of care. Limitations and barriers regarding their usability and feasibility were also identified.
Conclusion:
The inclusion of safe data storage, automatic notifications for assessment completion, automatic calculation of final outcomes, and facilitation of multidisciplinary assessments, were identified as key features to enhance the implementation of digital platforms facilitating the administration of CGAs. Nonetheless, information regarding technical features and hardware information of the digital platforms was scarce.
This project is part of the Marie Skłodowska Curie Actions Innovative Training Network H2020-MSCA-ITN, under grant agreement number 813196
The burden of depression is increasing worldwide, specifically in older adults. Unhealthy dietary patterns may partly explain this phenomenon. In the Spanish PREDIMED-Plus study, we explored (1) the cross-sectional association between the adherence to the Prime Diet Quality Score (PDQS), an a priori-defined high-quality food pattern, and the prevalence of depressive symptoms at baseline (cross-sectional analysis) and (2) the prospective association of baseline PDQS with changes in depressive symptomatology after 2 years of follow-up. After exclusions, we assessed 6612 participants in the cross-sectional analysis and 5523 participants in the prospective analysis. An energy-adjusted high-quality dietary score (PDQS) was assessed using a validated FFQ. The cross-sectional association between PDQS and the prevalence of depression or presence of depressive symptoms and the prospective changes in depressive symptoms were evaluated through multivariable regression models (logistic and linear models and mixed linear-effects models). PDQS was inversely associated with depressive status in the cross-sectional analysis. Participants in the highest quintile of PDQS (Q5) showed a significantly reduced odds of depression prevalence as compared to participants in the lowest quartile of PDQS (Q1) (OR (95 %) CI = 0·82 (0·68, 0·98))). The baseline prevalence of depression decreased across PDQS quintiles (Pfor trend = 0·015). A statistically significant association between PDQS and changes in depressive symptoms after 2-years follow-up was found (β (95 %) CI = −0·67 z-score (–1·17, −0·18). A higher PDQS was cross-sectionally related to a lower depressive status. Nevertheless, the null finding in our prospective analysis raises the possibility of reverse causality. Further prospective investigation is required to ascertain the association between PDQS and changes in depressive symptoms along time.
To analyze the impact of the coronavirus disease 2019 (COVID-19) pandemic in workers of a hospital located in one of the most affected areas in Spain.
Design, settings, and patients:
Cross-sectional study performed between March and May 2020 over all workers of a secondary hospital in Madrid, Spain.
Methods:
We employed polymerase chain reaction (PCR, for symptomatic individuals) and serology (for both PCR-negative symptomatic workers and asymptomatic workers) as diagnostic tests for severe acute respiratory coronavirus virus 2 (SARS-CoV-2). We analyzed the prevalence of the virus in healthcare workers (HCWs) and nonhealthcare workers (nHCWs). We also collected information about the use of personal protective equipment (PPEs) and possible contacts prior to infection.
Results:
In total, 2,963 workers were included: 1,092 were symptomatic, and of these, 539 were positive by PCR (49.4% of symptomatic workers). From the remaining symptomatic workers, 197 (35.6%) were positive by serology. Regarding asymptomatic workers, 345 were positive by serology (31.9% of infected workers). In total, 1,081 (36.5%) presented a positive diagnostic test for SARS-CoV-2. Infection rates were different between HCWs (37.4%) and nHCWs (29.8%) (P = .006). In the multivariate logistic regression analysis, the use of PPE (protective: OR, 0.56; 95% CI, 0.44–0.72; P < .001) and previous contact with COVID-19 patients (risk factor: OR, 1.69; 95% CI, 1.28–2.24; P < .001) were independent factors that were associated with SAS-CoV-2 infection.
Conclusions:
Overall, >36% of our workers became infected with SARS-CoV-2, and the rate of asymptomatic infections accounted for almost 32% of all SARS-CoV-2 infections. We detected differences in the rates of infection between HCWs and nHCWs. The use of PPE and previous contact with COVID-19 patients were associated with SARS-CoV-2 infection.
To propose malnutrition screening methods for the elderly population using predictive multivariate models. Due to the greater risk of nutrition deficiencies in ageing populations, nutritional assessment of the elderly is necessary in primary health care.
Design:
This was a cross-sectional study. Multivariate models were obtained by means of discriminant analysis and binary logistic regression. The diagnostic accuracy of each multivariate model was determined and compared with the Chang method based on receiver operating characteristic curves. The optimal cut-point, sensitivity, specificity and Youden index were estimated for each of the models.
Setting:
The province of Cordoba, Spain.
Participants:
Two hundred fifty-five patients over the age of 65 years from three health centres and three nursing homes.
Results:
Fourteen models for predicting risk of malnutrition were obtained, six by discriminant multivariate analysis and eight by binary logistic regression. Sensitivity ranged from 55·6 to 93·1 % and specificity from 64·9 to 94 %. The maximum and minimum Youden indexes were 0·77 and 0·49, respectively. We finally selected a model which does not require a blood test.
Conclusions:
The proposed models simplify nutritional assessment in the elderly and, except for number 2 of those calculated by binary logistic regression, have better diagnostic accuracy than the Spanish version of the Mini Nutritional Assessment screening tool. The selected model, whose validation is necessary for the future with other different samples, provides good diagnostic accuracy, and it can be performed by non-medical personnel, making it an accessible, easy and rapid tool in daily clinical practice.
We develop a model of strategic network formation of collaborations to analyze the consequences of an understudied but consequential form of heterogeneity: differences between actors in the form of their production functions. We also address how this interacts with resource heterogeneity, as a way to measure the impact actors have as potential partners on a collaborative project. Some actors (e.g., start-up firms) may exhibit increasing returns to their investment into collaboration projects, while others (e.g., established firms) may face decreasing returns. Our model provides insights into how actor heterogeneity can help explain well-observed collaboration patterns. We show that if there is a direct relation between increasing returns and resources, start-ups exclude mature firms and networks become segregated by types of production function, portraying dominant group architectures. On the other hand, if there is an inverse relation between increasing returns and resources, networks portray core-periphery architectures, where the mature firms form a core and start-ups with low-resources link to them.
To review the current knowledge about Diogenes symptoms and organic personality disorder through systematic review of the literature and the analysis of a case.
Methods
Case report. Review. Literature sources were obtained through electronic search in PubMed.gov database of 10 last years.
Results
Background: Diogenes syndrome is a behavioral disorder characterized by severe self-neglect, hoarding, domestic dirt, and lack of shame regarding one's living state. Patients may present due to a range of reasons, few studies has been described hoarding symptoms secondary to brain injury. Early management could reduce their high-mortality condition.
Case presentation
We present a case of a 67-year-old Caucasian female known with a organic personality disorder secondary to a head trauma with obsessive hoarding symptoms. After being hospitalizated, we were authorized to explore her personal items trough photographs. Her handbag and her house were filled with rubbish and rotting food. Our patient had no insight into any self-hygiene or public health problems.
Conclusions
Information of the characteristics of Diogenes syndrome can help in earlier recognition of such persons, in order to decrease their morbidity and mortality.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The aim of this piece of research was to study the existence of clusters based on anger, empathy and cortisol and testosterone measures associated with aggressive behavior in school-aged children. The sample group comprised 139 eight-year-old children (80 boys and 59 girls). Aggressive behavior was measured using the Direct and Indirect Aggression Scale. Both psychological and biological variables were used to determine psychobiological profiles. The psychological variables considered were trait anger, measured using the State-Trait Anger Expression Inventory for Children and Adolescents, and empathy, measured using the Empathy Quotient-Child Version. Testosterone and cortisol concentrations were measured through saliva samples and analyzed using an ELISA (Enzyme-linked immunosorbent assay). A Cluster Analysis revealed three clusters which were clearly different as regards their psychological and biological characteristics. The analysis of variance (ANOVA) revealed that the cluster characterized by having higher anger levels, lower empathy levels and higher testosterone and cortisol levels was more aggressive than the other two (p < .0001, η2 = .19). The results indicate that studying psychological and biological variables together may help establish differentiated aggression patterns among children.
Internalized stigma has a high prevalence in people with mental health problems and is associated with negative consequences in different areas: work, social, personal, etc. Therefore, it is relevant to systematically study the characteristics and effectiveness of the different psychological and psychosocial interventions aimed at reducing it. Through the databases MEDLINE and PsycINFO, among others, controlled studies on specific interventions to reduce internalized stigma in people with severe mental disorders published between 2008 and 2018 were selected and reviewed. Results showed that the interventions can be grouped into four blocks: (a) psychoeducational interventions about stigma; (b) cognitive-behavioral interventions, mainly aimed at modifying self-stigmatizing beliefs; (c) interventions focused on the revelation of mental illness; and (d) multicomponent interventions that combine several of the above. The interventions had an average of 10 sessions and were predominantly applied in group format. In 9 of the 14 studies reviewed, significant results were obtained in the reduction of internalized stigma with small or moderate effect sizes. There were also significant improvements in other variables, such as subjective recovery or coping. The main methodological limitation of the studies reviewed was the absence of information on the rejection rate. We conclude that there are effective interventions aimed at reducing internalized stigma, with psychoeducational interventions on stigma and multicomponent interventions showing the best results. Cognitive-behavioral interventions and interventions based on disclosure have been studied to a lesser extent and their results are inconclusive. Future research should focus on establishing optimal interventions according to characteristics and objectives of individuals.
Earthquakes may lead to a reaction to severe stress and adjustment disorders (RSSAD). On September 7, 19, and 23, 2017, Mexico was struck by many severe earthquakes. The aim of this study was to examine whether there was an increase in the number of consultations and RSSAD in a psychiatric emergency department in Mexico City after these earthquakes.
Methods
We studied retrospectively the diagnosis and triage assessment from a Mexican psychiatric emergency department database from September 1 to November 30, 2017, and analyzed RSSAD and the number of consultations after the earthquakes.
Results
A total of 1,811 psychiatric emergency consultations were registered from the period of study. A total of 141 consultations represented RSSAD. There was a significant increase of RSSAD after the September 23, 2017, earthquake. The triage assessment revealed that the urgency of the consultations was higher immediately after the earthquakes.
Conclusion
Natural disasters, such as earthquakes, may trigger diverse RSSAD leading to increased emergency consultations, especially when those disasters are repetitive. Mental health professionals should be adequately trained and sensitized for possible acute disaster victims. (Disaster Med Public Health Preparedness. 2019;13:686–690).
The advantages and limits of empirical, semi-empirical and thermodynamic methods devoted to the estimation of chlorite-formation temperature are discussed briefly. The results of semiempirical and thermodynamic approaches with different assumptions regarding the redox state of iron in chlorite are compared for a large set of natural data covering a range of pressure conditions from a few hundred bars to 18 kbar and temperature from 100 to 500°C. The T-XFe3+ evolution estimated using the thermodynamic approach of Vidal et al. (2005) shows a systematic increase in XFe3+ with decreasing temperature, which is compatible with the decrease in aO2 buffered by magnetite- or hematite-chlorite equilibrium. This trend as well as the observed increase in vacancies in chlorite with decreasing temperature is interpreted as the incorporation of Fe3+-sudoite. The standard-state properties of this endmember have been derived to reproduce the observed T-aO2-XFe3+ evolutions. It can be used to estimate T-aO2-XFe3 values with a Chl-Qtz-H2O multi-equilibrium approach. When combining our results with those of other studies published recently, it appears that thermodynamic approaches and mapping techniques developed for metamorphic rocks can be used to discuss the conditions of formation of very low-grade rocks where kinetics is much more sluggish than in metamorphic rocks. This requires use of appropriate analytical tools and techniques with a spatial resolution of a few hundred nanometres.