Experiencing discrimination mediates the relationship between victimization and social withdrawal in patients suffering from a severe mental illness:A cross-sectional study

Psychiatric patients are often victims of crime and discrimination and are often socially withdrawn. This has negative consequences for their health and recovery. We examined whether such discrimination mediates the association between victimization and social withdrawal, and whether these associations differ between men and women. We also determined the prevalence of social withdrawal and the discrimination experienced by patients suffering from a severe mental illness. This study is embedded in the Victimization in Psychiatric Patients study. Information on discrimination, social withdrawal and victimization was obtained using structured self-report questionnaires (N = 949). We reported the 12-month prevalence of these phenomena and used path analysis to estimate the direct path between personal and property victimization and social withdrawal, and the indirect path through the discrimination experienced. The impact of gender was assessed by testing interaction terms. Social withdrawal was reported by 20.6% (95%CI 18.1–23.2) of participants, and being discriminated against in the past 12 months by 75.3% (95%CI: 72.6–78.0%). While crime victimization had no direct effects on social withdrawal, personal crime victimization (B = 0.47; 95%CI 0.25-0.72; p < 0.001) and property crime victimization (B = 0.65; 95%CI 0.42-0.93; p < 0.001) had significant indirect effects on social withdrawal, which were mediated by the discrimination experienced. In men we found a direct negative effect of property crime on social withdrawal (B = -0.68; 95%CI: −1.21to −0.11, p = 0.014). We conclude that personal and property victimization, for both men and women, was associated with higher levels of social withdrawal, and this was fully mediated by the discrimination experienced

Toroidal modelling of plasma response and RMP field penetration

The penetration dynamics of the resonant magnetic perturbation (RMP) field is sim- ulated in the full toroidal geometry, under realistic plasma conditions in MAST experiments. The physics associated with several aspects of the RMP penetration - the plasma response and rotational screening, the resonant and non-resonant torques and the toroidal momentum balance - are highlighted. In particular, the plasma response is found to significantly amplify the non-resonant component of the RMP field for some of the MAST plasmas. A fast rotating plasma, in response to static external magnetic fields, experiences a more distributed electro- magnetic torque due to the resonance with continuum waves in the plasma. At fast plasma flow (such as for the MAST plasma), the electromagnetic torque is normally dominant over the neoclassical toroidal viscous (NTV) torque. However, at sufficiently slow plasma flow, the NTV torque can play a significant role in the toroidal momentum balance, thanks to the precession drift resonance enhanced, so called superbanana plateau regime

Unsaturated fatty acids esterified with androgens as active and safer compounds for androgen-required therapy

Unsaturated fatty acids esterified with androgens as active and safer compounds for androgen-required therapy A. Petroni1, F. Aiello2, A. Garofalo2, S. Banni3, M. Blasevich1 and A.M. Aloisi4 [email protected], [email protected], Dipartimento di Scienze Farmacologiche e Biomolecolari, Universita\u300 di Milano, 20133 Milano, Italy; [email protected], [email protected], Dipartimento di Farmacia e Scienze della Salute e della Nutrizione Universita\u300 della Calabria, 87036 Rende (Cs), Italy; [email protected], Dipartimento Scienze Biomediche, Universita' degli Studi Cagliari, Cittadella Universitaria, 09042 Monserrato (CA), Italy; [email protected], Dipartimento di Medicina, Chirurgia e Neuroscienze, via Aldo Moro 2, 53100 Siena, Italy Testosterone and its powerful metabolite dihydrotestosterone can be used in a variety of disorders to improve the symptoms or restore androgen plasma levels. To increase their duration and effects, androgens are administered in different pharmaceutical forms, in particular as esters of carboxylic acids. The goal of our research was to use specific unsaturated fatty acids esterified with androgens to improve the pharmaceutical characteristics of the esters as well as their biological effects and safety. Oleic acid, linoleic acid and the n-3 fatty acids, alpha-linolenic acid, eicosapentaenoic acid and docosahexaenoic acid, were esterified with androgens. Their cytotoxicity was evaluated in mouse NIH3T3 and human astrocyte cell lines. The esters showed good tolerability and no in vitro cytotoxic effects in both cell cultures. Due to the influence of androgens in pain processes and the common opioid- induced hypogonadism, in vivo studies were carried out to investigate their long-term administration in a pain model of persistent pain. Androgen therapy can also be required in neurodegenerative disorders, for instance in X-linked adrenoleukodystrophy, an inherited pathology. Lipid alterations are the major cause of the disorder and hypogonadism can be a secondary event. In this specific disorder and in chronic pathologies with unbalanced lipid and steroid hormone metabolism, the use of the described esters, which are more \u201cphysiological\u201d than the ones currently available, should be carefully considered

Assessing the Acceptability, Feasibility and Sustainability of an Intervention to Increase Detection of Domestic Violence and Abuse in Patients Suffering From Severe Mental Illness: A Qualitative Study

Rationale: Despite interventions to improve detection rates, domestic violence, and abuse (DVA) remains largely undetected by healthcare services. We therefore aimed to examine the acceptability, feasibility, and sustainability of an intervention aiming to improve DVA detection rates, which included a clear referral pathway (i.e., the BRAVE intervention) and to explore the acceptability and feasibility of DVA management and referrals in general, in the context of low detection rates. Methods: Qualitative study design with four focus groups of 16 community mental health (CMH) clinicians from both control and intervention arms. The focus groups discussed managing DVA in clinical practice and staff experiences with the BRAVE intervention in particular. Focus groups continued until saturation of the subject was reached. Interviews were analyzed using a thematic analysis approach. Results: DVA was seen to be highly relevant to mental healthcare but is also a very sensitive subject. Barriers in CMH professionals, institutions, and society meant CMH professionals often refrained from asking about DVA in patients. Barriers included communication difficulties between CMH professionals and DVA professionals, a fear of disrupting the therapeutic alliance with the patient, and a lack of appropriate services to help victims of DVA. Conclusion: The BRAVE intervention was acceptable but not feasible or sustainable. Personal, institutional, and public barriers make it not feasible for CMH professionals to detect DVA in mental healthcare. To increase the detection of DVA, professional standards should be combined with training, feedback sessions with peers and DVA counselors, and routine enquiry about DVA

Дослідження руху індексу Doing Business України

Background: Domestic Violence and Abuse (DVA) is associated with a range of psychosocial and mental health problems. Having a psychiatric illness increases likelihood of being a victim of DVA. Despite the evidence of a high risk for DVA and the serious effects of violent victimization in psychiatric patients, detection rates are low and responses are inadequate. The aim of the BRAVE (Better Reduction trough Assessment of Violence and Evaluation) study is to improve detection of and response to DVA in psychiatric patients. In this article, we present the protocol of the BRAVE study which follows the SPIRIT guidelines. Methods: The BRAVE study is a cluster randomized controlled trial. We will include 24 community mental health teams from Rotterdam and The Hague. Twelve teams will provide care as usual and 12 teams will receive the intervention. The intervention consists of 1) a knowledge and sk

Prognosis and determinants of serum PTH changes over time in 1-5 CKD stage patients followed in tertiary care

International Guidelines for mineral bone disorders recommend that in Non Dialytic-Chronic Kidney Disease (ND-CKD) clinical decisions should be based on the trend of serum PTH changes over time rather than on a single value. However, the prognostic impact of these changes in ND-CKD patients remains unknown. We performed a multicenter cohort study in ND-CKD patients (stage 1-5) followed for 36 months in 24 Italian Nephrology Units. PTH changes (\u394PTH) were defined as the absolute differences between all available PTH measurements following the first control and basal value. Primary endpoint in this subanalysis was renal death (End-Stage Renal Disease (ESRD) or all-causes death before ESRD). Association between renal death and \u394PTH was assessed by time-dependent Cox model for repeated measurements. Out of the original cohort (N = 884), we selected 543 patients (66.3\ub115.4 ys, 58.4% males) with at least two serum PTH measurements. At baseline, eGFR was 36 (IQR: 22.4-56.8) mL/min/1.73m2 and serum PTH 46 (IQR: 28-81) pg/mL. \u394PTH was in median 0 (IQR:-18/18) pg/mL. Basal predictors of longitudinal PTH increments were higher serum phosphate, more advanced CKD stages and lower serum PTH. Fully adjusted Cox model with \u394PTH quartiles as discrete time-dependent covariate showed a significant risk of renal death in the highest quartile (HR: 1.91; 95%CI:1.08-3.38; P = 0.026). Considering \u394PTH, as continuous time-dependent variable, (HR:1.02; 95%C.I.: 1.01-1.04; P = 0.004), risk of renal death progressively rose as \u394PTH increased. An increment in serum PTH over time is associated with a worse prognosis in ND-CKD patients, independently from baseline or any absolute concentration of serum PTH and phosphate

Consensus parameter: research methodologies to evaluate neurodevelopmental effects of pubertal suppression in transgender youth

An international interdisciplinary team of experts achieved consensus around primary methods and domains for assessing neurodevelopmental effects (i.e., benefits and/or difficulties) of pubertal suppression treatment in transgender youth.Pathways through Adolescenc

Enhanced understanding of non-axisymmetric intrinsic and controlled field impacts in tokamaks

An extensive study of intrinsic and controlled non-axisymmetric field (dB) impacts in KSTAR has enhanced the understanding about non-axisymmetric field physics and its implications, in particular, on resonant magnetic perturbation (RMP) physics and power threshold (Pth) for L-H transition. The n = 1 intrinsic non-axisymmetric field in KSTAR was measured to remain as low as delta B/ B0 x 4 x 10(-5) even at high-beta plasmas (beta(N) similar to 2), which corresponds to approximately 20% below the targeted ITER tolerance level. As for the RMP edge-localized-modes (ELM) control, robust n = 1 RMP ELM-crash-suppression has been not only sustained for more than similar to 90 iota(E), but also confirmed to be compatible with rotating RMP. An optimal window of radial position of lower X-point (i. e. R-x = 1.44 +/- 0.02 m) proved to be quite critical to reach full n = 1 RMP-driven ELM-crash-suppression, while a constraint of the safety factor could be relaxed (q(95) = 5 +/- 0.25). A more encouraging finding was that even when Rx cannot be positioned in the optimal window, another systematic scan in the vicinity of the previously optimal Rx allows for a new optimal window with relatively small variations of plasma parameters. Also, we have addressed the importance of optimal phasing (i. e. toroidal phase difference between adjacent rows) for n = 1 RMP-driven ELM control, consistent with an ideal plasma response modeling which could predict phasing-dependent ELM suppression windows. In support of ITER RMP study, intentionally misaligned RMPs have been found to be quite effective during ELMmitigation stage in lowering the peaks of divertor heat flux, as well as in broadening the ` wet&apos; areas. Besides, a systematic survey of Pth dependence on non-axisymmetric field has revealed the potential limit of the merit of low intrinsic non-axisymmetry. Considering that the ITER RMP coils are composed of 3-rows, just like in KSTAR, further 3D physics study in KSTAR is expected to help us minimize the uncertainties of the ITER RMP coils, as well as establish an optimal 3D configuration for ITER and future reactors

Composition of Fluids Responsible for Gold Mineralization in the Pechenga Structure-Imandra-Varzuga Greenstone Belt, Kola Peninsula, Russia.

This study presents the first fluid inclusion data from quartz of albite–carbonate–quartz altered rocks and metasomatic quartzite hosting gold mineralization in the Pechenga structure of the Pechenga– Imandra–Varzuga greenstone belt. A temperature of 275–370°C, pressure of 1.2–4.5 kbar, and the fluid composition of gold-bearing fluid are estimated by microthermometry, Raman spectroscopy, and LA-ICP-MS of individual fluid inclusions, as well as by bulk chemical analyses of fluid inclusions. In particular, the Au and Ag concentrations have been determined in fluid inclusions. It is shown that albite–carbonate–quartz altered rocks and metasomatic quartzite interacted with fluids of similar chemical composition but under different physicochemical conditions. It is concluded that the gold-bearing fluid in the Pechenga structure is similar to that of orogenic gold deposits