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Suicide is in Austria one of the most causes of death in the age group 15–54. World wide every year 1.000.000 of people die by suicide, in Europe the number of total suicide per year is 40.000, approxymately 13.500 young man and women aged 15–24 years die by suicide. Suicidology is a science which automatically leads to active work in prevention. Preventive strategies of the last two decades results in a marked decrease of Suicide rates in most countries of the world. However different preventive concepts seems to show similar results in reducing suicide rates. So it is not easy to identify the right way in suicide prevention. We analyzed the publications of the last years and tried to find out what are the characteristics approaches of the the countries with a successful suicide prevention. It seems that countries which istitutionalized suicide prevention by creating institutes on an university level had a good fundament for research and applied research is the best groundwork for establishing preventive projects. Applied research is as well the best ground base for establishing educational programs which are the start in all well functioning national suicide prevention programs.
This study explores psychopathological aspects of acute and transient psychotic disorders (ATPD), a diagnostic category introduced with ICD-10, to elucidate its relationship with schizophrenia and schizoaffective psychoses.
We recruited all consecutive inpatients fulfilling the ICD-10 criteria of ATPD (F23) during a 5-year period as well as control groups with “positive” schizophrenia (PS) and bipolar schizoaffective disorder (BSAD) matched for gender and age at index episode. For the evaluation of psychopathological parameters during index episode a standardized symptom list was used. Prepsychotic (prodromal) symptoms were also assessed.
During the prepsychotic period few differences between the groups were detected. The most important difference between ATPD and the other two other psychotic disorders regarding phenomenology of the full-blown episodes was a higher frequency of “rapidly changing delusional topics”, “rapidly changing mood” and anxiety in ATPD.
ATPD show a characteristic psychopathological picture consistent with earlier concepts such as cycloid psychoses and bouffée délirante. Nevertheless, psychopathology alone is not enough to establish ATPD as an independent nosological entity.
Peer relationships play a critical role in the development of adolescents, not only for the acquisition of social skills but also for the sense of personal identity and competence. Thus the quality of peer relationships influences actual and future mental health of the adolescent.
SEYLE (Saving and Empowering Young Lives in Europe) is a randomized controlled trial, funded by the EU, evaluating interventions for mental health promotion and suicide prevention. The study comprised 12,395 high-school students from 11 European countries.
We investigated the differences on psychological problems between students with poor and good peer relationships.
1,195 adolescents (mean age 15.3 ± 0.6; 68% females) from the Molise region constituted the Italian sample. Adolescents were identified as with poor peer relationships if they never or just sometimes get along with people of their age, feel that peers like having them in the group and feel that peers were kind and helpful. Psychometric measures were used to assess mental health problems such as depression (Beck Depression Inventory II), anxiety (Zung Self-Assessment Anxiety Scale), well-being (WHO-5) and suicidal ideation (Paykel Suicide Scale).
Adolescents who reported poor peer relationships scored significantly higher (p < .005) on the scales assessing depression, anxiety and suicidal ideation and significantly lower (p < .001) on the WHO-5.
Particularly in adolescence peer relationships may influence psychological well-being and vice versa mental health influences the openness to the others. So promoting mental health and contemporary improve social skills could lead adolescents to a better life.
Smoking among adolescents is still a major public health problem and a global concern. Early onset and long-term smoking are associated with physical and psychological health problems.
To identify risk factors and comorbidities for occasional and daily smoking among European adolescents.
In the context of the Europe-wide 'Saving and Empowering Young Lives in Europe” (SEYLE) study we surveyed 12,328 youths at the age of 13 to 17 from 11 countries. We applied questions from the Global School-Based Student Health Survey to determine nicotine consumption as well as other risk behaviors. Psychiatric symptoms were assessed by the Strengths and Difficulties Questionnaire, the Becks Depression Inventory-II, the Zung Self-Rating Anxiety Scale,the Deliberate Self-Harm Inventory and the Paykel Suicide Scale.
On average 30.9% of adolescents reported daily smoking and the onset of smoking was reported by 35.3% between the age of 12 and 13 already. Multinomial logistic regression model showed significant correlations between adolescent smoking and migration background, living in single parent households, no physical activity, parental smoking and physical fights. Further it revealed significant associations of adolescent smoking with alcohol consumption, illegal drug use, anxiety, conduct problems, hyperactivity, suicidal ideation, self-injury and internet-dependence.
Our data show that adolescent smoking is associated with psychosocial factors, especially family setting and parental behaviors. Further, smoking and psychiatric problems are highly correlated. Therefore, early preventive measures are necessary and essential not only for adolescents but also for their parents.
Bipolar disorder is characterized by depressive and manic episodes, each with its own specific outcomes. To guarantee the best therapy it is important and necessary to assess the episodes of the disease and its exact degree of severity at an early stage.
During a time period of 12 weeks, 9 patients suffering from bipolar disorder were provided with a commercially available smartphone in order to collect behavioral patterns by the phone's internal sensors. These sensors included acceleration, GPS-traces, phone-call behavior and sound. During the trial the patients were also asked to fill out a daily self-assessment questionnaire that included a self-rating. Additionally, to gain ground truth psychological state examinations were performed every three weeks.
The sensor traces are very similar to the diagnosed scores and thus clearly provide an accurate representation of the patient's state. Further, our data suggest a strong empirical evidence that the sensor based data are, on average, a more reliable and objective way of monitoring the mental state and mood than the patient's self-assessment.
The MONARCA system introduces new opportunities for the treatment of patients with bipolar disorder. The acquired data allow for identifying changes in the patient's condition at an early stage and therefore support the timely intervention by psychiatrists.
According to previous studies the prevalence of adolescent depression is 4–8% both in the USA and Europe. the aim of the current study was to investigate the prevalence of adolescent depression separately in several European countries.
Data were drawn from the Saving and Empowering Young Lives in Europe (SEYLE) study, which included 11 countries (Austria, Estonia, France, Germany, Hungary, Ireland, Italy, Israel, Romania, Slovenia and Spain) and Sweden served as the coordinating centre. Depression was measured by the Beck Depression Inventory-II (BDI-II). Adolescents with a score of 20 or greater on the BDI-II were defined as depressed. Multiple imputations were conducted to address missing data.
Out of 14,115 students who consented to participate, finally 12,395 adolescents (5,568 (44.92%) boys and 6,827 (55.08%) girls) were enrolled into the study. the mean age of the students was 14.81 years (SD = .83). Significant differences were detected in the ratio of non-depressed and depressed adolescents among countries (χ2(20) = 385.352 p = .000). the prevalence of depressed adolescents ranged from 7.1% to 19.4%. the prevalence of depressed adolescents according to country in increasing order is: Hungary: 7.1%, Austria: 7.6%, Romania: 7.6%, Estonia: 7.9%, Ireland: 8.5%, Spain: 8.6%, Italy: 9.2%, Slovenia: 11.4%, Germany: 12.9%, France: 15.4%, Israel: 19.4%.
Based on a screening tool our data underlines the importance of taking account country specific prevalence rates of adolescent depression.
Glyphosate-resistant (GR) Palmer amaranth continues to be challenging to control across the U.S. cotton belt. Timely application of POST herbicides and herbicides applied at planting or during the season with residual activity are utilized routinely to control this weed. Although glyphosate controls large Palmer amaranth that is not GR, herbicides such as glufosinate used in resistance management programs for GR Palmer amaranth must be applied when weeds are small. Dicamba can complement both glyphosate and glufosinate in controlling GR and glyphosate-susceptible (GS) biotypes in resistant cultivars. Two studies were conducted to determine Palmer amaranth control, weed biomass, and cotton yield, as well as to estimate economic net return when herbicides were applied 2, 3, 4, and 5 wk after planting (WAP). In one experiment POST-only applications were made. In the second experiment PRE herbicides were included. In general, Palmer amaranth was controlled at least 98% by herbicides applied at least three times regardless of timing of application or herbicide sequence. Glyphosate plus dicamba applied at 4 and 5 WAP controlled Palmer amaranth similarly compared to three applications by 8 WAP; however, yield was reduced 23% because of early-season interference. The inclusion of PRE herbicides benefited treatments that did not include herbicides applied 2 or 3 WAP. Glyphosate plus dicamba applied as the only herbicides 5 WAP provided 69% control of Palmer amaranth. PRE herbicides increased control to 96% for this POST treatment. Economic returns were similar when three or more POST applications were applied, with or without PRE herbicides.
Psychiatric patients constitute a high-risk population for suicide. In-patient status and the period after discharge are of particular interest concerning risk assessment.
To assess risk factors for in-patient and post-discharge suicides.
The Tyrol suicide register was linked with the registers of three psychiatric departments/hospitals of the region. Suicides were categorized according to whether the suicide was committed during a hospital stay or within 12 weeks after discharge or whether the suicide subject had not recently been hospitalized. Groups were compared with regard to demographic and clinical variables. Further, case-control comparisons were performed for the in-patient and post-discharge groups.
During the study period (2004–2011) 30 in-patients, 89 post-discharge and 592 not recently hospitalized suicides were identified. Groups differed in terms of gender distribution, history of suicide attempts, warning signals and suicide methods. Compared with controls matched for a number of variables, in-patient suicides were significantly more suicidal and depressed at admission, reported more often a recent life event and showed less often aggressive behavior and plans for the future. Post-discharge suicides had more often a history of attempted suicide, depressive and thought disorder symptomatology, a ward change and an unplanned discharge and less often a scheduled appointment with a non-psychiatric physician.
Suicide victims differ with regard to whether they die during, shortly after or not associated with a hospitalization. Compared to controls there are specific risk factors for those who commit suicide during a hospital stay and within 12 weeks after discharge.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
There is a growing interest in low-grade inflammatory and metabolic alterations in patients with chronic schizophrenia (SCH).
Inflammatory (tumor-necrosis factor-α [TNF-α], interferon-γ [IFN-γ], interleukins [IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-8, IL-10], monocyte chemo-attractant protein-1 [MCP-1]) and growth factors (vascular endothelial growth factor [VEGF], epidermal growth factor [EGF]) were measured in blood serum samples of 105 SCH patients and 148 control subjects (CS). Simultaneously the clinical biomarkers (C-reactive protein [CRP], triglycerides [TG], low-density lipoprotein [LDL-c] and high-density lipoprotein [HDL-c] cholesterol, glycated hemoglobin [HbA1c]) were measured, and body mass index (BMI) was calculated for patients.
Several cyto-/chemokines (IFN-γ, MCP-1, IL-2, IL-6, IL-8 and IL-10) were significantly (P < 0.0000001) elevated in SCH patients compared to CS. Odds ratios, obtained from logistic regression analyses, were significantly elevated for IL-2, IL-6, IL-10, INF-γ, and decreased for TNF-α in SCH group. Among the patients, higher IL-2, IL-6, INF-γ and lower MCP-1 levels as well as male gender were together significant (P < 0.000001) predictors of higher HbA1c levels, and TG/HDL-c parameter was associated with ratios of INF-γ/IL-10 (P = 0.004), and INF-γ/IL-4 (P = 0.049), HbA1c (P = 0.005), INF-γ (P = 0.009), as well as LDL-c (P = 0.02) levels.
IL-2, IL-6, IL-10 and IFN-γ were the most significant SCH-related markers among the measured cytokines in our patient group. Furthermore, significant associations between pro-/anti-inflammatory imbalance and HbA1c as well as cardio-metabolic risk marker (TG/HDL-c) were observed, indicating higher risks of diabetes and cardiovascular diseases among SCH patients.
In analogy with the lower Assouad dimensions of a set, we study the lower Assouad dimensions of a measure. As with the upper Assouad dimensions, the lower Assouad dimensions of a measure provide information about the extreme local behaviour of the measure. We study the connection with other dimensions and with regularity properties. In particular, the quasi-lower Assouad dimension is dominated by the infimum of the measure’s lower local dimensions. Although strict inequality is possible in general, equality holds for the class of self-similar measures of finite type. This class includes all self-similar, equicontractive measures satisfying the open set condition, as well as certain “overlapping” self-similar measures, such as Bernoulli convolutions with contraction factors that are inverses of Pisot numbers.
We give lower bounds for the lower Assouad dimension for measures arising from a Moran construction, prove that self-affine measures are uniformly perfect and have positive lower Assouad dimension, prove that the Assouad spectrum of a measure converges to its quasi-Assouad dimension and show that coincidence of the upper and lower Assouad dimension of a measure does not imply that the measure is s-regular.
Re-planning mid-treatment, with the adjustment of target volumes, has been performed as part of the normal workflow at our institution. We sought to quantify the benefit of this approach and identify factors to optimise plan adaptive strategies.
Materials and methods:
Patients with locally advanced oropharyngeal cancer treated to 70 Gy with concurrent chemoradiation (CCRT) on TomoTherapy® who underwent re-planning during the treatment were eligible. Survival and prognostic factors were evaluated with Kaplan–Meier and Cox proportional hazards, two-side p-value <0·05 significant.
Forty-two patients were identified with Stage III (n = 5), IVA (n = 34) and IVB (n = 3) [AJCC 7th] disease. Median re-planning dose was 40 Gy (14–60 Gy). Median change in mean total parotid dose was reduction of 1 Gy (range –7·5 Gy to +13·9 Gy). The volume of PTV70 and PTV60 receiving 99% of the prescribed (V99) dose was increased by 2·2% (–3·3 to +16·6%) and 1·9% (–11·5 to +12·6%) by re-planning. As a continuous variable, increasing per cent nodal regression was associated with the improved disease control in a multivariate model including stage, pack years smoking and human papilloma viral (HPV) status (HR: 0·85, 0·71–0·99, p = 0·05).
Adaptive planning generates a superior plan for the majority of patients, but there is modest overall parotid gland sparing.
Recent work has pioneered the use of expert surveys to estimate cross-national party positions in a common ideological space. In this paper, we report findings from an original dataset designed to evaluate bridging strategies between European and American party placements. Specifically, we compare the use of “anchoring vignettes” (fictional party platforms) with an alternative approach that asks comparativist scholars who live in the US (whom we call transatlantic or TA experts) to place parties and parties in their country of expertise on a series of issues scales. The results provide an optimistic assessment of the ability of TA experts to serve as valid bridges across the Atlantic. The resulting cross-comparable estimates of party positions show instances of both convergence and divergence between American and European party systems, including parallels between systems on the cross-cutting issue of international economic integration.
Despite an increasing awareness of the importance of spirituality in mental health contexts, a ‘religiosity gap’ exists in the difference in the value placed on spirituality and religion by professionals compared with service users. This may be due to a lack of understanding about the complex ways people connect with spirituality within contemporary society and mental health contexts, and can result in people's spiritual needs being neglected, dismissed or pathologised within clinical practice. The aim of this qualitative systematic review is to characterise the experiences of spirituality among adults with mental health difficulties in published qualitative research.
An electronic search of seven databases was conducted along with forward and backward citation searching, expert consultation and hand-searching of journals. Thirty-eight studies were included from 4944 reviewed papers. The review protocol was pre-registered (PROSPERO:CRD42017080566).
A thematic synthesis identified six key themes: Meaning-making (sub-themes: Multiple explanations; Developmental journey; Destiny v. autonomy), Identity, Service-provision, Talk about it, Interaction with symptoms (sub-themes: Interactive meaning-making; Spiritual disruption) and Coping (sub-themes: Spiritual practices; Spiritual relationship; Spiritual struggles; Preventing suicide), giving the acronym MISTIC.
This qualitative systematic review provides evidence of the significant role spirituality plays in the lives of many people who experience mental health difficulties. It indicates the importance of mental health professionals being aware of and prepared to support the spiritual dimension of people using services. The production of a theory-based framework can inform efforts by health providers to understand and address people's spiritual needs as part of an integrated holistic approach towards care.
CVD is common in older adults. Consumption of ‘meat’ (beef, pork, lamb, game, poultry, seafood, eggs) and dairy foods (milk, cheese, yoghurt) is encouraged in older adults as these foods provide protein and nutrients such as essential fatty acids, Ca, Fe, Zn and vitamins A, D and B12 required for healthy ageing. However, these foods also contain saturated fats considered detrimental to cardiovascular health. To determine the effect of their consumption on CVD risk we assessed associations between fat intake from ‘meat’ and dairy foods and serum cholesterol levels in 226 aged-care residents (mean age 85·5 years, 70 % female). Dietary intake was determined over 2 d using visual estimation of plate waste. Fat content of foods was determined using nutrition analysis software (Xyris, Australia). Fasting serum total cholesterol (TC), LDL-cholesterol and HDL-cholesterol were measured, and the TC:HDL-cholesterol ratio calculated. Associations were determined using random-effect models adjusted for CVD risk factors using STATA/IC 13.0. Total fat and saturated fat from ‘meat’ and dairy foods were associated with higher serum HDL-cholesterol levels, and dairy fat intake and number of servings were associated with a lower TC:HDL-cholesterol ratio. Every 10 g higher intake of fat and saturated fat from dairy products, and each additional serving was associated with a −0·375 (95 % CI −0·574, −0·175; P = 0·0002), a −0·525 (95 % CI −0·834, −0·213; P = 0·001) and a −0·245 (95 % CI −0·458, −0·033; P = 0·024) lower TC:HDL-cholesterol ratio, respectively. Provision of dairy foods and ‘meat’ in recommended amounts to institutionalised older adults potentially improves intakes of key nutrients with limited detriment to cardiovascular health.
Four on-road studies were conducted in the Clifton area of Nottingham, UK, aiming to explore the relationships between driver workload and environmental engagement associated with ‘active’ and ‘passive’ navigation systems. In a between-subjects design, a total of 61 experienced drivers completed two experimental drives comprising the same three routes (with overlapping sections), staged one week apart. Drivers were provided with the navigational support of a commercially-available navigation device (‘satnav’), an informed passenger (a stranger with expert route knowledge), a collaborative passenger (an individual with whom they had a close, personal relationship) or a novel interface employing a conversational natural language ‘NAV-NLI’ (Navigation Natural Language Interface). The NAV-NLI was created by curating linguistic intercourse extracted from the earlier conditions and delivering this using a ‘Wizard-of-Oz’ technique. This term describes a research experiment in which subjects interact with a computer system that they believe to be autonomous, but which is actually being operated or partially operated by an unseen human being. The different navigational methods were notable for their varying interactivity and the preponderance of environmental landmark information within route directions. Participants experienced the same guidance on each of the two drives to explore changes in reported and observed behaviour. Results show that participants who were more active in the navigation task (collaborative passenger or NAV-NLI) demonstrated enhanced environmental engagement (landmark recognition, route-learning and survey knowledge) allowing them to reconstruct the route more accurately post-drive, compared to drivers using more passive forms of navigational support (SatNav or informed passenger). Workload measures (the Tactile Detection Task (TDT) and the National Aeronautical and Space Administration Task Load Index (NASA-TLX)) indicated no differences between conditions, although SatNav users and collaborative passenger drivers reported lower workload during their second drive. The research demonstrates clear benefits and potential for a navigation system employing two-way conversational language to deliver instructions. This could help support a long-term perspective in the development of spatial knowledge, enabling drivers to become less reliant on the technology and begin to re-establish associations between viewing an environmental feature and the related navigational manoeuvre.
In his seminal work on Sidon sets, Pisier found an important characterization of Sidonicity: A set is Sidon if and only if it is proportionally quasi-independent. Later, it was shown that Sidon sets were proportionally “special” Sidon in several other ways. Here, we prove that Sidon sets in torsion-free groups are proportionally
-degree independent, a higher order of independence than quasi-independence, and we use this to prove that Sidon sets are proportionally Sidon with Sidon constants arbitrarily close to one, the minimum possible value.