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This reflection article presents insights on conducting fieldwork during and after COVID-19 from a diverse collection of political scientists—from department heads to graduate students based at public and private universities in the United States and abroad. Many of them contributed to a newly published volume, Stories from the Field: A Guide to Navigating Fieldwork in Political Science (Krause and Szekely 2020). As in the book, these contributors draw on their years of experience in the field to identify the unique ethical and logistical challenges posed by COVID-19 and offer suggestions for how to adjust and continue research in the face of the pandemic’s disruptions. Key themes include how contingency planning must now be a central part of our research designs; how cyberspace has increasingly become “the field” for the time being; and how scholars can build lasting, mutually beneficial partnerships with “field citizens,” now and in the future.
La prise en charge des patients bipolaires par les stabilisateurs de l’humeur de différentes classes thérapeutiques fait consensus (HAS, 2009). Si les recommandations nationales et internationales fournissent des algorithmes efficients dans le traitement des épisodes aigus maniaques, hypomaniaques et mixtes, la prise en charge des phases dépressives est plus complexe et le clinicien est bien souvent démunis s’il applique « au pied de la lettre » les recommandations. Dans la pratique quotidienne, le recours aux antidépresseurs bien que déconseillé, reste donc largement utilisée par les praticiens, faute de solution alternative efficace à ce jour. Dans cette situation, les recommandations incitent à utiliser les antidépresseurs en association aux stabilisateurs de l’humeur, en cures courtes d’environ 8 à 12 semaines après une réponse thérapeutique satisfaisante, qui ne survient que chez moins de 25 % des patients déprimés bipolaire (HAS, 2009). Le risque de virage de l’humeur induit par les antidépresseurs rapporté dans la littérature est de 3 à 10 % même lorsqu’une association thymorégulatrice est proposée .
Parmi les alternatives thérapeutiques, la rTMS représente une piste prometteuse : le taux de virage de l’humeur induit est faible (0,84 % d’état maniaque dans le groupe actif vs 0,73 % dans le groupe placebo dans une revue de la littérature publiée par Xia et al. , et dans la pratique quotidienne, les déprimés bipolaires semblent répondent plus rapidement que les patients déprimés unipolaires à la rTMS.
Nous proposons de faire une revue de la littérature concernant l’efficacité et la tolérance de la rTMS dans cette indication.
La stimulation transcrânienne par courant continu (tDCS) est une technique de neuro-modulation qui utilise un courant électrique de faible intensité. Simple a mettre en œuvre, non invasive et peu coûteuse, elle fait l’objet de multiples études tant cliniques qu’expérimentales.
À partir des travaux de Priori et al.  qui ont montre qu’un courant de faible intensité applique sur le scalp est capable de moduler l’excitabilité corticale, le rythme des études publiées s’est accéléré depuis 2005. Les résultats des études publiées, des revues de la littérature et des quelques méta-analyses disponibles montrent que la tDCS peut avoir un intérêt dans la stratégie thérapeutique de la dépression, de la schizophrénie et des addictions avec un impact à la fois sur les symptômes de la maladie mais également les troubles connexes tels que la cognition . À partir de ces études, mais également par leur expérience personnelle et leurs travaux les auteurs proposent de discuter de la place de la tDCS dans les stratégies thérapeutiques actuelles, de discuter des mécanismes d’action mis en jeu et des risques d’une utilisation excessive inhérents à sa simplicité d’emploi.
Suicide is a multicausal phenomenon posing a great challenge to medicine and society, yet we still have limited knowledge concerning underlying biochemical, neuroanatomical and genetic factors. Research increasingly points to a role of the serotonergic system, both on the level of suicidal behavior, and such behavioural traits which may serve as important intermedier endophenotypes in suicide research. Although results are conflicting, several studies described an association between the 5-HTTLPR polymorphism and suicide, as well as this polymorphism and certain aggressive traits. Impulsive aggression is also thought to play a major contributory role in suicide. The aim of our research was to investigate the association between the 5-HTTLPR and aggressive traits in depressive patients carrying a higher risk for suicide and healthy controls.
137 major depressive and 164 healthy controls women were recruited. Participants completed the Buss-Durkee Hostility Inventory and were genotyped for 5-HTTLPR. Association of aggressive traits and indeces with 5-HTTLPR genotype in the two groups were analysed using ANCOVA.
Diagnosis and 5-HTTLPR genotype showed a significant association with aggressive traits. The pattern of association was different in the depressed and control groups. The strongest interaction effect between genotype and diagnosis was observable in case of Resentment.
We found a significant association between 5-HTTLPR and several aggressive traits. In case of depressive patients the association was more marked. In depressed women the 5-HTTLPR shows a stronger association with aggressive traits related to aggression turned inward, which may play a role in the background of suicide.
There has been extensive research concerning the role of the serotonin transporter gene (SLC64A) in depression. The STin2 VNTR polymorphism in the second intron has been found to influence the transcriptional activity of the gene, however, its relationship to major depressive disorder (MDD) has so far been less widely investigated.
71 MDD patients and 99 healthy controls participated in a case-control study. In case of the two populations STin2 allele frequencies were compared. The subjects also completed several tests to establish neurocognitive endophenotypes related to MDD.
A significantly higher frequency of the STin2 10/10 homozygous genotype in the MDD patients’ group was found compared to controls (X2=6,01, df=2, P<0.05). The results of neurocognitive tests indicated cognitive dysfunctions in case of MDD patients compared to controls. The clinical subgroup with at least one copy of the 10-repeat allele showed a decreased interference threshold in attention and cognitive interference as compared to patients without the 10-repeat allele. Average performance of the clinical subgroup without the 12-repat allele proved to be significantly weaker in the verbal learning memory and recall tasks compared to patients having at least one copy of the 12-repeat allele.
After further confirmation our results suggest that the presence of STin2.10 and absence of STin2.12 allele may be considered a possible genetic endophenotype for cognitive dysfunctions detected in MDD.
The P2RX7 gene encoding for purinergic receptor P2X has earlier been associated with a susceptibility to anxiety and affective disorders. The aim of our present study was to investigate the association of this polymorphism with different aspects and symptom clusters of major depression.
192 inpatients diagnosed with DSM-IV major depression and bipolar I and bipolar II depression aged 21-69 years (mean=48.2±11.05) participated in our study. All participants were evaluated using the Montgomery-Asberg Depression Rating Scale (MADRS). All patients were genotyped for the P2RX7 Gln460Arg SNP (rs2230912) using PCR. Association between genotype and MADRS scores was analysed with ANOVA controlling for age and gender.
rs2230912 genotype showed a significant association with depression indicated by the total MADRS score. We also found a significant genotype effect in case of the Affective and Cognitive clusters, but not on the Somatic and Psychomotor clusters of MADRS.
We managed to confirm earlier results concerning the association of the P2RX7 rs2230912 with major depressive disorder and bipolar depression. Furthermore, we found that this association is carried by the affective and cognitive symptoms associated with depression. Our results bring us closer to decomposing depression to endophenotypes more suitable for research and also for understanding the nature of affective disorders.
This work was supported by EU-Hungarian fund, GVOP AKF 311 2004 050324/3.0, the Hungarian National fund, OTKA T048576 and Janos Bolyai Research Fellowship of the Hungarian Academy of Science.
The aim of the study was to evaluate the associations between self-reported suicidal behaviours (i.e., ideators, attempters, and multiple attempters) and socio-demographic as well as psychosocial characteristics in the Hungarian population.
Data obtained from two cross-sectional studies performed in 1995 and 2002 with 12,527 and 12,653 respondents, respectively, which were representative of the adult (aged 18 and older) Hungarian population for sex, age, and place of residence.
The prevalence of suicidal behaviours decreased between 1995 and 2002, however, in both studies, suicidal behaviours were significantly more frequent among women, the unemployed, people with no partners (divorced/separated), with lower educational attainment, Protestants, and Jews compared to their respective controls. High levels of depressive symptomatology, maladaptive coping strategies such as excessive eating/drinking, misuse of alcohol or medication, or risk-taking behaviour, as well as previous suicide in the family, hostile attitude (primarily within the family), low levels of perceived social support (from one's partner, parents, children and co-workers) have been associated with suicidal behaviours.
Although suicidal behaviours share several common psychosocial background factors, high level of depressive symptomatology was the most important risk factor, while the order of the other potential risk factors differed considerably among the different forms of self-reported suicidal behaviour.
Altered serum levels of vascular endothelial growth factor (VEGF) and tumor necrosis factor alpha (TNFalpha) have been implicated in therapy response of depression. We analyzed effects of 4 functional SNPs of VEGF and TNF alpha genes on MDD to test their possible role in pathomechanism of MDD.We recruited 293 inpatients diagnosed for major depressive disorder (MDD) and 443 healthy volunteers. MDD was diagnosed by DSM-IV criteria and measured by Montgomery-Asberg Depression Scale (MADRS). DNA was extracted from buccal mucosa samples given by all participants. Likelihood ratio tests for case-control and mutlivariate linear analysis for quantitative phenotype models were performed in SPSS 17.0 software. We identified a protective allele against MDD as the frequency of G allele of rs1800629 (previously associated with lower TNFa serum level) was 2.7 fold higher in the control group compared to MDD group (LRT = 4.197; p = 0.040). Higher frequency of the same allele was found among SSRI responders compared to non-responders (LRT = 6.281; p = 0.012). Significant GxG interactions were shown within MDD group: epistatic effect of allele variants and also genotypes of the four investigated SNPs were significant on MADRS score (for risk alleles: pmodell = 0.024; pinteraction = 0.005; Adj.R2 = 0.259; for genotypes: pmodell = 0.035; pinteraction = 0.007; Adj.R2 = 0.371). These findings suggest that TNFalpha and VEGF genes are associated with MDD and SSRI response. Our results support the molecular crosstalk between VEGF and TNFalpha pathway by a genetic interaction.This study was supported by the Hungarian Scientific Research Fund Grant (OTKA CK 80289/2009).
The suicide rate in Hungary is high in international comparison. The four-level intervention program of the European Alliance Against Depression (EAAD) is designed to improve the care of depression and to prevent suicidal behaviour. Our aim was evaluating the effectiveness of the EAAD on suicide rates in different areas.
The program was implemented in Szolnok, a town in a region of Hungary with exceptionally high suicide rate and in Miskolc, a town in a region with high unemployment and also high suicide rate. Effectiveness was assessed by comparing changes in suicide rates before to after the start of the intervention in the intervention region to corresponding changes of national suicide rates. In addition, changes in suicide rates were compared to those in a control region (Szeged). In Miskolc also the number of suicide attempts was used to measure the effectiveness of the program.
For the duration of the program and the follow-up year, suicide rates in Szolnok were significantly lower than the average of the previous three years (p=.0076). The suicide rate thus went down from 30.1 per 100,000 in 2004 to 13.2 in 2005 (-56.1%), 14.6 in 2006 (-51.4%) and 12.0 in 2007 (-60.1%). This decrease of annual suicide rates in Szolnok after the onset of the intervention was significantly stronger than that observed in Hungary (p=.017). Men had the same decrease in suicide rates as women in Szolnok. In Miskolc we observed changes in the types of suicide attempts, especially among males.
VEGF exerts diverse effects on the cardiovascular system. VEGF and its receptors are also expressed in the central nervous system. Moreover, accumulating data suggest that VEGF is involved in the etiopathogenesis of depression. to date, the association of the −2578 C/A SNP with depression has been investigated only by two research groups but their results are conflicting.
In the present study we tried to assess the potential association of the −2578 C/A polymorphism with mood disorders (MDD and BD).
220 patients (MDD: 140; BP: 80) with a current episode of major depression (MDE) were recruited at our department. HADS was used for the assessment of the severity of depressive symptoms. Control subjects without psychiatric history were also enrolled (n = 410). VEGF −2578 C/A SNP was analyzed with quantitative PCR.
We found no significant differences in allele frequencies between cases and controls (neither in the comparison of whole patient sample vs. controls nor in comparisons of patients with MDD or BP vs. controls). Nevertheless, depression scores of patients with MDD who carry the C allele were significantly higher (p = 0.012).
Our preliminary results suggest that presence of the C allele might predispose to a more severe MDE in patients with MDD. This is in partial agreement with the results of Viiki et al. who found that the CC genotype was more frequent among patients with MDD than in control subjects and also associated with treatment resistant depression.
The study was supported by OTKA 80289 national grant.
The community-based 4-level-intervention concept developed within the “European Alliance against Depression” (http://www.eaad.net/) combines two important aims: to improve the care and treatment of patients with depression and to prevent suicidal behavior. It has been shown to be effective concerning the prevention of suicidal behavior [1–4] and is worldwide the most broadly implemented community-based intervention targeting depression and suicidal behavior. The 4-level intervention concept comprises training and support of primary care providers (level 1), a professional public relation campaign (level 2), training of community facilitators (teacher, priests, geriatric caregivers, pharmacists, journalists) (level 3), and support for self-help of patients with depression and for their relatives (level 4). In order to deepen the understanding of factors influencing the effectiveness of the intervention, a systematic implementation research and process analysis was performed within the EU-funded study “Optimizing Suicide Prevention Programs and Their Implementation in Europe” (http://www.ospi-europe.com/; 7th Framework Programme) . These analyses were based on data from four intervention and four control regions from four European countries. In addition to intervention effects on suicidal behaviour, a variety of intermediate outcomes (e.g. changes in attitude or knowledge in different populations) were considered. Strong synergistic as well as catalytic effects were identified as a result of being active simultaneously at four different levels. Predictable and unpredictable obstacles to a successful implementation of such community-based programs will be discussed. Via the EAAD, the intervention concept and materials (available in eight different languages) are offered to interested region in and outside of Europe.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Despite growing evidence supporting the clinical interest of repetitive transcranial magnetic stimulation (rTMS) in treatment-resistant depression (TRD), little is known regarding the effects of clinical and sociodemographic factors on the clinical outcome in patients.
We retrospectively investigated the effects of clinical (using the 3-factor model of the Montgomery-Åsberg depression rating scale [MADRS] encompassing dysphoria, retardation and vegetative symptoms) and sociodemographic characteristics of participants on clinical outcome in a sample of 54 TRD patients receiving low frequency rTMS (1 Hz, 360 pulses) applied over the right dorsolateral prefrontal cortex combined with sham venlafaxine.
Responders (n = 29) displayed lower retardation baseline scores (13.6 ± 2.9) than non-responders (15.6 ± 2.9; n = 25; P = 0.02). We also observed a significant difference between the numbers of ex-smokers in responders and non-responders groups; all ex-smokers (n = 8) were responders to rTMS (P = 0.005).
Low MADRS retardation factor and ex-smoker status is highly prevalent in responders to low frequency rTMS. Further studies are needed to investigate the predictive value of these factors.
Suicide rate in Hungary is among the highest in the European Union (2015: 18.9/100,000 inhabitant). Although there is no national registration system of suicide attempts in Hungary, according to previous studies Hungarian Romas have three times higher suicide attempt rate than non-Romas.
The aim of this study was to explore socio-demographic and mental health risk factors of multiple suicide attempts in Hungary.
A total of 1547 suicide attempts were assessed via retrospective data analysis using patient records. Data on socio-demographic variables, psychiatric diagnoses, methods and reported reasons of suicide attempts were investigated. Binary logistic regression analyses were performed to identify potential risk factors for multiple suicide attempts.
The ratio of multiple attempters were 37.7% in the sample, with a Roma predominance (Roma: 51.8%, non-Roma: 34.8%, χ2(1) = 27.64; P < 0.001). Of the potential factors examined, Roma ethnicity (OR: 2,03; CI: 1.53–2.70; P < 0.001), economic inactivity (OR: 1.7; CI: 1.36–2.18; P < 0.001), mood disorders (OR: 1.58; CI: 1.25–1.99; P < 0.001), personality disorders (OR: 2.09; CI: 1.45–3.01; P = 0.00), organic mental disorders (OR: 1.76; CI: 1.01–3.07; P = 0.44) and mistreatment as reported reasons (OR: 3.95; CI: 1.17–13.32; P = 0.02) were found as significant risk factors of multiple suicide attempts.
National registration of suicide attempts would be necessary for a more thorough analysis. Beside the more advanced treatment of mental health disorders, increased efforts in prevention are recommended with a special focus of low SES groups and Roma ethnicity. The specific background factors in Roma ethnic group should be further examined.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Metacercariae of various species within the genus Holostephanus Szidat, 1936 (Trematoda: Digenea: Cyathocotylidae) occur in muscles of both farmed and wild fish, including common carp (Cyprinus carpio Linnaeus, 1758). The life cycle includes a snail as first intermediate host, fish as second intermediate host and birds or mammals as final hosts. We studied the zoonotic potential and the viability of Holostephanus metacercariae from common carp following exposure to various physical and chemical treatments. Muscle tissue samples of common carp specimens from a fish farm in the north-eastern part of Hungary were examined and metacercariae recovered. The zoonotic potential was evaluated experimentally by using small mammals as models (albino mice, n = 2; and Syrian hamsters, n = 4) infected per os with Holostephanus cysts. Parallelly, Metagonimus metacercariae were used as positive controls. We could not confirm the zoonotic potential of Holostephanus metacercariae as they did not survive in the mammalian intestine whereas Metagonimus metacercariae developed to the adult stage. We assessed the viability of metacercariae isolated from common carp specimens during exposure to different physical treatments (temperatures of −18°C, +20°C, +40°C and +60°C) and chemical agents (5% and 10% acetic acid and 10% sodium chloride (NaCl)). Metacercariae lost viability by freezing at −18°C (2 h), heating at 60°C (20 min), incubation in 5% and 10% acetic acid (5 min) and 10% NaCl (2 h). These methods served as models to investigate the effectiveness of food preparation techniques (such as cold and hot smoking, freezing, salting and pickling) on the survival of metacercariae.
In the literature, there have been several methods and definitions for working out whether two theories are “equivalent” (essentially the same) or not. In this article, we do something subtler. We provide a means to measure distances (and explore connections) between formal theories. We introduce two natural notions for such distances. The first one is that of axiomatic distance, but we argue that it might be of limited interest. The more interesting and widely applicable notion is that of conceptual distance which measures the minimum number of concepts that distinguish two theories. For instance, we use conceptual distance to show that relativistic and classical kinematics are distinguished by one concept only.
Verification of a groundwater flow model by radiocarbon (14C) data are presented taking into consideration the paleo-hydrogeological changes. Northeastern area of the Great Hungarian Plain was a deep-lying flat area, and its central part (Nyírség) has been uplifted in the last 15,000 years. These geological events have drastically changed the hydrogeological conditions of Nyírség. The groundwater flow system is composed of the Quaternary-Pliocene-Upper Pannonian clastic sediments. Groundwater flow modeling has been performed to define the main lateral and vertical flow directions and velocities controlling the propagation of the environmental radioactive tracer 14C. Solute-transport modeling was used to calculate the 14C activity. The recent steady-state groundwater flow velocity was reduced to a reasonable value characterizing the average flow velocity over the 15 ka simulation period using “trial and error” method. The best fit between the simulated and measured 14C data was achieved by assuming 0.4 flow velocity reduction factor. Results indicate that the present steady-state flow model with this flow velocity reduction factor is capable of reproducing the observed 14C data taking into account the effect of the significant uplift of the part of the land surface in the last 15 ka in NE Hungary.
Currently, two main approaches exist to distinguish differential susceptibility from diathesis-stress and vantage sensitivity in Genotype × Environment interaction (G × E) research: regions of significance (RoS) and competitive-confirmatory approaches. Each is limited by its single-gene/single-environment foci given that most phenotypes are the product of multiple interacting genetic and environmental factors. We thus addressed these two concerns in a recently developed R package (LEGIT) for constructing G × E interaction models with latent genetic and environmental scores using alternating optimization. Herein we test, by means of computer simulation, diverse G × E models in the context of both single and multiple genes and environments. Results indicate that the RoS and competitive-confirmatory approaches were highly accurate when the sample size was large, whereas the latter performed better in small samples and for small effect sizes. The competitive-confirmatory approach generally had good accuracy (a) when effect size was moderate and N ≥ 500 and (b) when effect size was large and N ≥ 250, whereas RoS performed poorly. Computational tools to determine the type of G × E of multiple genes and environments are provided as extensions in our LEGIT R package.