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Stigma resistance (SR) is defined as one's ability to deflect or challenge stigmatizing beliefs. SR is positively associated with patient's outcomes in serious mental illness (SMI). SR appears as a promising target for psychiatric rehabilitation as it might facilitate personal recovery.
The objectives of the present study are: (i) to assess the frequency of SR in a multicentric non-selected psychiatric rehabilitation SMI sample; (ii) to investigate the correlates of high SR
A total of 693 outpatients with SMI were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluation included standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, and personal recovery and a large cognitive battery. SR was measured using internalized stigma of mental illness – SR subscale.
Elevated SR was associated with a preserved executive functioning, a lower insight into illness and all recovery-related outcomes in the univariate analyses. In the multivariate analysis adjusted by age, gender and self-stigma, elevated SR was best predicted by the later stages of personal recovery [rebuilding; p = 0.004, OR = 2.89 (1.36–4.88); growth; p = 0.005, OR = 2.79 (1.30–4.43)). No moderating effects of age and education were found.
The present study has indicated the importance of addressing SR in patients enrolled in psychiatric rehabilitation. Recovery-oriented psychoeducation, metacognitive therapies and family interventions might improve SR and protect against insight-related depression. The effectiveness of psychiatric rehabilitation on SR and the potential mediating effects of changes in SR on treatment outcomes should be further investigated in longitudinal studies.
The usefulness of the dexamethasone suppression test (DST) in the prediction of treatment response to selective antidepressants was tested in 56 major depressive inpatients. Following DST, patients were randomly assigned to treatment by either nomifensine, a catecholaminergic antidepressant, or zimeldine, a serotonergic antidepressant during a 3-week period and assessed by means of the second part of the Clinical Global Impressions (CGI-2). No significant difference was present between the 27 DST suppressor and the 29 DST non-suppressor patients in their overall clinical outcome. Moreover, no preferential response to nomifensine or zimeldine was noted in any of the two groups defined according to DST status. Therefore, these results do not support the usefulness of the DST in the prediction of the treatment response to antidepressants in general and to selective antidepressants in particular.
Since the 1950s, sexual surgical reassignments have been frequently carried out. As this surgical therapeutic procedure is controversial, it seems important to explore the actual consequences of such an intervention and objectively evaluate its relevance. In this context, we have carried out a review of the literature. After looking at the methodological limitations of follow-up studies, the psychological, sexual, social, and professional futures of the individuals subject to a transsexual operation are presented. Finally, prognostic aspects are considered. In the literature, follow-up studies tend to show that surgical transformations have positive consequences for the subjects. In the majority of cases, transsexuals are very satisfied with their intervention and any difficulties experienced are often temporary and disappear within a year after the surgical transformation. Studies show that there is less than 1% of regrets, and a little more than 1% of suicides among operated subjects. The empirical research does not confirm the opinion that suicide is strongly associated with surgical transformation.
The aim of this open trial was to assess the antidepressant/anxiolytic effects of oxytocin used as an adjunct to antidepressant in treatment-resistant depression. Fourteen patients, who have not responded to 40 mg of escitalopram, received intranasal synthetic oxytocin during 4 weeks, in association with antidepressant. This is the first open trial study suggesting OT in association with escitalopram significantly reduced scores on Hamilton Depression Rating Scale.
is a major issue in serious mental illness (SMI) and is negatively associated with patient outcomes. Most studies have been conducted in schizophrenia (SZ). Less is known about self-stigma in other SMI and autism spectrum disorder (ASD). The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD.
A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive battery, and daily functioning assessment.
31.2% of the total sample had elevated self-stigma. The highest prevalence (43.8%) was found in borderline personality disorder and the lowest (22.2%) in ASD. In the multivariate analysis, elevated self-stigma was best predicted by early stages of personal recovery (moratorium, p = 0.001, OR = 4.0 [1.78–8.98]; awareness, p = 0.011, OR = 2.87 [1.28–6.44]), history of suicide attempt (p = 0.001, OR = 2.27 [1.37–3.76]), insight (p = 0.002, OR = 1.22 [1.08–1.38]), wellbeing (p = 0.037, OR = 0.77 [0.60–0.98]), and satisfaction with interpersonal relationships (p < 0.001, OR = 0.85 [0.78–0.93]).
The present study has confirmed the importance of addressing self-stigma in SMI and ASD patients enrolled in psychiatric rehabilitation. The effectiveness of psychiatric rehabilitation on self-stigma and the potential mediating effects of changes in self-stigma on treatment outcomes should be further investigated.
The mechanical response of modern alloys results from a complex interplay between existing microstructure and its evolution with time under stress. To unravel these processes, in situ approaches intrinsically have a critical advantage to explore the basic mechanisms involving dislocations, grain boundaries (GBs), and their interactions in real time. In this article, we discuss recent findings using in situ nanomechanical testing techniques and refined crystallographic analysis tools. Advancements in in situ nanomechanics not only include multiaxial loading conditions, which bring us closer to real-world applications, but also high strain-rate testing, which is critical to compare experiments and simulations. In particular, unraveling the details of GB-based mechanisms and related microstructural changes will facilitate significant breakthroughs in our understanding of the behavior of materials on macroscopic length scales.
In situ transmission electron microscopy (TEM) nanomechanical
testing has benefited from a number of recent technical developments related to
both how deformation is imaged and how deformation is induced and measured
inside a TEM instrument. These developments have led to new insights into the
deformation mechanisms of a wide range of metals and alloys, as well as
measurements of the unusual mechanical properties of small-scale objects such as
whiskers and nanocrystals. Herein, we describe this recent progress through
selected highlights of recent findings on the dynamic behavior of defects such
as dislocations, twins, and grain boundaries.
Magnetophosphenes are described as flickering lights appearing in the visual field, due
to retinal exposure to time-varying magnetic fields (MF). Human magnetophosphene
perception (MP) serves as a scientific basis for international guidelines intending to
limit exposure to electromagnetic fields in the extremely low frequency range. However,
the flux density threshold at which MP occurs, as well as the dose and frequency responses
of the phenomenon, are not clearly experimentally established. The 50–60 Hz threshold is
extrapolated from data in the lower frequency range. The objective of this paper is to
provide a descriptive anecdotal report of MP from 8 individuals exposed to 50 mT MF at 20,
50 and 60 Hz. They describe variations of flickering light perceptions in the visual
field, matching the description by D’Arsonval (1896). This preliminary testing introduces a new experimental protocol, which will
test the threshold for MP and other associated neurophysiological responses in humans.
This article is devoted to recent progress in the area of in situ electron microscopy (scanning and transmission) and will focus on quantitative aspects of these techniques as applied to the deformation of materials. Selected recent experiments are chosen to illustrate how these techniques have benefited from improvements ranging from sample preparation to digital image acquisition. Known for its ability to capture the underlying phenomena of plastic deformation as they occur, in situ electron microscopy has evolved to a level where fully instrumented micro- and nanomechanical tests can be performed simultaneously.
The primary outcome was staff vaccination status. Independent variables included staff demographic and employment characteristics, health status, attitudes and beliefs about the vaccine, and implications for its use.
The staff vaccination rate was 51%. Leading motivators of vaccine receipt were self-protection (77%) and patient protection (49%). The most common reasons for nonreceipt were concerns about side effects (49%), preventive quality (20%), and inconvenience (14%). Logistic regression results suggested that age of 50 years or older (OR, 1.47; P = .021), male gender (OR, 2.50; P < .001), strong belief in vaccine effectiveness (OR, 19.03; P = .008), and importance of HCW vaccination (OR, 20.50; P = .005) significantly increased the probability of vaccination. Recommending the vaccine to coworkers, patients, or patients' families was also associated with HCW vaccination (OR, 3.20; P < .001). Providers who did not believe the vaccine was protective (P < .001) or effective P < .001) were less likely to recommend it to patients.
Strategies to increase vaccination rates among HCWs should address concerns about side effects, effectiveness, and protective value of the vaccine and access to it. The impact of provider recommendations should be stressed. Vaccination and subsequent prevention of illness may limit morbidity and mortality, thus benefiting HCWs, healthcare facilities, and patients.
We examine the form of the free surface flows resulting from the collision of equal jets at an oblique angle. Glycerol-water solutions with viscosities of 15–50 cS were pumped at flow rates of 10–40 cc/s through circular outlets with diameter 2 mm. Characteristic flow speeds are 1–3 m/s. Figures 2–4 were obtained through strobe illumination at frequencies in the range 2.5–10 kHz.
At low flow rates, the resulting stream takes the form of a steady fluid chain, a succession of mutually orthogonal fluid links, each comprised of a thin oval sheet bound by relatively thick fluid rims (Fig. 1). The influence of viscosity serves to decrease the size of successive links, and the chain ultimately coalesces into a cylindrical stream.
As the flow rate is increased, waves are excited on the sheet, and the fluid rims become unstable (Figs. 2 and 3). Droplets form from the sheet rims but remain attached to the fluid sheet by tendrils of fluid that thin and eventually break. The resulting flow takes the form of fluid fishbones, with the fluid sheet being the fish head and the tendrils its bones. Increasing the flow rate serves to broaden the fishbones.
In the wake of the fluid fish, a regular array of drops obtains, the number and spacing of which is determined by the pinch–off of the fishbones (Fig. 4). At the highest flow rates examined, the flow is reminiscent of that arising in acoustically excited fan-spray nozzles.
We have performed investigations of resonance effects inside a gallium nitride one-dimensional photonic crystal slab in order to enhance the second-harmonic generated from an beam incident on the surface of the slab. Convenient conditions on the incident beam propagation direction and polarization are first identified by experimental or theoretical linear optical studies. Giant enhancements in the second-harmonic conversion have been obtained by comparison with the unpatterned GaN layer. The combined role of the resonant coupling of the fundamental field and of the second-harmonic field has been observed by rotating the polarization of the fundamental beam.
Desde la década de 1950, se han llevado a cabo con frecuencia reasignaciones quirúrgicas de sexo. Como este procedimiento terapéutico quirúrgico es polémico, parece importante explorar las consecuencias reales de esta intervención y evaluar objetivamente su pertinencia. En este contexto, hemos llevado a cabo una revisión de las publicaciones. Después de examinar las limitaciones metodológicas de los estudios de seguimiento, se presenta el futuro psicológico, sexual, social y profesional de los individuos sometidos a una intervención quirúrgica transexual. Por último, se consideran aspectos pronósticos. En las publicaciones, los estudios de seguimiento tienden a mostrar que las transformaciones quirúrgicas tienen consecuencias positivas para los sujetos. En la mayoría de los casos, los transexuales están muy satisfechos con su intervención y cualquier dificultad experimentada es a menudo pasajera y desaparece en un plazo de un año después de la transformación quirúrgica. Los estudios muestran que hay menos de un 1% de arrepentimientos, y un poco más de un 1% de suicidios entre los sujetos operados. La investigación empírica no confirma la opinión de que el suicidio está fuertemente asociado con la transformación quirúrgica.
Tension compression fatigue tests and subsequent TEM observations were conducted on single crystalline silicon in a temperature and strain rate domain where lattice friction is still effective: 800-900°C and 1.5 to 6x10-4s-1. Samples oriented for single slip conditions were cyclically loaded under plastic strain amplitude control. For amplitudes ranging from 6x10-4 to 10-2, cyclic stress-strain curves exhibit two different stages of hardening and pass through a maximum before saturation is reached. TEM observations suggest that strain localization takes place near the maximum cyclic stress and beyond. Before mechanical saturation, edge dislocation dipoles sit mainly in thick rectilinear walls. Once the maximum stress is reached, these thick walls “condense” in much thinner walls that seem to carry out the imposed deformation while other regions become inactive. In this case, the dislocation structure anneals out and a loop structure is created from the dipolar walls.
Plastic deformation due to thermal stresses has been investigated for different metallic films deposited on Si or α-alumina substrates. We conducted post-mortem TEM and SEM investigations of samples that underwent thermal cycles in order to capture the microstructural changes imposed by thermal stresses. The ultimate goal is to determine the dominant plasticity mechanisms responsible for such changes. In-situ thermal cycles performed inside the TEM allowed direct and real-time observations of dislocation behaviour under stress. It is shown that dislocation density drops in Al/Si, Au/Si and in Cu/α-alumina thin film systems. Except in the case of pseudo-epitaxial Cu on sapphire, the interaction of dislocations with the interfaces (passivation, oxide, adhesion layer) is attractive and leads to the disappearance of interfacial dislocations. In this light, the generalized observation of high tensile stresses that arise in metallic films at the end of cooling is explained in terms of insufficient dislocation sources instead of classic strain hardening. Diffusional processes can substitute for a lack of dislocation, but the low relaxation strain rate that would be excpected should lead to high stresses during the cooling stages of thermal cycles.
An oscillatory instability mechanism is identified for a horizontal liquid layer with
undeformable open surface heated from the air side. Although buoyancy and surface
tension gradients are expected to play a stabilizing role in this situation, we show that,
acting together, they may lead to the instability of the motionless state of the system.
The instability is a consequence of the coupling between internal and surface waves,
whose resonant interaction and resulting mode mixing are discussed. Predictions
amenable to experimental test are given together with a thorough analytical and
numerical study of the problem.