Caribbean health research has overwhelmingly employed measures developed elsewhere and rarely includes evaluation of psychometric properties. Established measures are important for research and practice. Particularly, measures of stress and coping are needed. Stressors experienced by Caribbean people are multifactorial, as emerging climate threats interact with existing complex and vulnerable socioeconomic environments. In the early COVID-19 pandemic, our team developed an online survey to assess the well-being of health professions students across university campuses in four Caribbean countries. This survey included the Perceived Stress Scale, 10-item version (PSS-10) and the Brief Resilient Coping Scale (BRCS). The participants were 1,519 health professions students (1,144 females, 372 males). We evaluated the psychometric qualities of the measures, including internal consistency, concurrent validity by correlating both measures, and configural invariance using confirmatory factor analysis (CFA). Both scales had good internal consistency, with omega values of 0.91 for the PSS-10 and 0.81 for the BRCS. CFA suggested a two-factor structure of the PSS-10 and unidimensional structure of the BRCS. These findings support further use of these measures in Caribbean populations. However, the sampling strategy limits generalizability. Further research evaluating these and other measures in the Caribbean is desirable.

The categorisation of personality pathology into discrete disorders has been an enduring standard. However, dimensional models of personality are becoming increasingly prominent, in part owing to their superior validity and clinical utility. We contend that dimensional models also offer a unique advantage in treating mental illness. Namely, psychotherapy approaches and the components of dimensional models of personality can both be arranged hierarchically, from general to specific factors, and aligning these hierarchies provides a sensible framework for planning and implementing treatment. This article begins with a brief review of dimensional models of personality and their supporting literature. We then outline a multidimensional framework for treatment and present an illustrative fictitious clinical case before ending with recommendations for future directions in the field.

There are increasing calls for coverage of medicine during the Holocaust in medical school curricula. This article describes outcomes from a Holocaust and medicine educational program featuring a study trip to Poland, which focused on physician complicity during the Holocaust, as well as moral courage in health professionals who demonstrated various forms of resistance in the ghettos and concentration camps. The trip included tours of key sites in Krakow, Oswiecim, and the Auschwitz-Birkenau concentration camps, as well as meeting with survivors, lectures, reflective writings, and discussions. In-depth interviews and reflective writings were qualitatively analyzed. Resulting themes centered on greater understanding of the relationship between bioethics and the Holocaust, recognizing the need for moral courage and social awareness, deeper appreciation for the historical roles played by dehumanization and medical power and their contemporary manifestations, and the power of presence and experiential learning for bioethics education and professional identity formation. These findings evidence the significant impact of the experience and suggest broader adoption of pedagogies that include place-based and experiential learning coupled with critical reflection can amplify the impact of bioethics and humanism education as well as the process of professional identity formation of medical students.

Rising rates of suicide fatality, attempts, and ideations among adolescents aged 10–19 over the past two decades represent a national public health priority. Theories that seek to understand suicidal ideation overwhelmingly focus on the transition from ideation to attempt and on a sole cognition: active suicidal ideation – the serious consideration of killing one’s self, with less attention to non-suicidal cognitions that emerge during adolescence that may have implications for suicidal behavior. A large body of research exists that characterizes adolescence not only as a period of heightened onset and prevalence of active suicidal ideation and the desire to no longer be alive (i.e., passive suicidal ideation), but also for non-suicidal cognitions about life and death. Our review synthesizes extant literature in the content, timing and mental imagery of thoughts adolescents have about their (1) life; and (2) mortality that may co-occur with active and passive suicidal ideation that have received limited attention in adolescent suicidology. Our “cognition-to-action framework for adolescent suicide prevention” builds on existing ideation-to-action theories to identify life and non-suicidal mortality cognitions during adolescence that represent potential leverage points for the prevention of attempted suicide and premature death during this period and across the life span.

PSR J0837$-$2454 is a young 629 ms radio pulsar whose uncertain distance has important implications. A large distance would place the pulsar far out of the Galactic plane and suggest it is the result of a runaway star, while a short distance would mean the pulsar is extraordinarily cold. Here we present further radio observations and the first deep X-ray observation of PSR J0837$-$2454. Data from the Parkes Murriyang telescope show flux variations over short and long timescales and also yield an updated timing model, while the position and proper motion (and, less strongly, parallax) of the pulsar are constrained by a number of low-significance detections with the Very Long Baseline Array. XMM-Newton data enable detection of X-ray pulsations for the first time from this pulsar and yield a spectrum that is thermal and blackbody-like, with a cool blackbody temperature $\approx$$70\ \mbox{eV}$ or atmosphere temperature $\approx$$50\ \mbox{eV}$, as well as a small hotspot. The spectrum also indicates the pulsar is at a small distance of $\lesssim$$1\ \mbox{kpc}$, which is compatible with the marginal VLBA parallax constraint that favours a distance of $\gtrsim$330 pc. The low implied luminosity ($\sim7.6\times10^{31}\mbox{erg\, s}^{-1}$ at 0.9 kpc) suggests PSR J0837$-$2454 has a mass high enough that fast neutrino emission from direct Urca reactions operates in this young star and points to a nuclear equation of state that allows for direct Urca reactions at the highest densities present in neutron star cores.