Predicting Suicidal Behavior: Are We Really that Far Along? Comment on “Discovery and Validation of Blood Biomarkers for Suicidality”

A recent publication focused on biomarkers of future suicidal behaviors identifies several genes expressed in high-risk states among four samples. We discuss the implications of this study as well as the current state of research regarding biomarkers of suicidal behavior

Diferencias en la conducta suicida: estudio comparativo entre los intentos de suicidio y suicidio consumado

Tesis doctoral inédita realizada en la Universidad Autónoma de Madrid. Departamento de Psiquiatría. Fecha de lectura: 25 de Noviembre de 2010

Borderline personality disorder: The challenge of crisis management

El manejo del trastorno límite de personalidad puede ser un reto para el clínico, especialmente en elservicio de urgencias hospitalarias, donde se hacen necesarias decisiones rápidas que deben ser ademáslas más beneficiosas y en conjunto con el paciente, favoreciendo su autonomía y participación en laresolución de la crisis.En este artículo pretendemos revisar el manejo de la crisis de una forma práctica y, basándonos enlas guías clínicas más recientes, proporcionar una serie de pautas a los clínicos que se enfrentan a estassituaciones para manejar adecuadamente las crisis con recomendaciones basadas en la evidencia cientí-fica que tenemos hasta ahora y claves para la valoración de la conducta suicida, que es uno de los motivosmás frecuentes por lo que estos pacientes acuden a los servicios de urgencias. Finalmente revisaremos losdiferentes manejos y encuadres, repasando las indicaciones de ingreso hospitalario, así como los objetivosdel mismo.Managing patients with borderline personality disorder can pose a substantial challenge for psychia-trists. This is especially the case when patients with this disorder are seen in the emergency room, asclinicians must make rapid decisions that balance clinical benefit and the will of the patient, fosteringtheir autonomy and participation.A review is presented in this article of the strategies for practical management of crises. Based on themost recent clinical guidelines, a series of insights are provided for facing these situations, includingrecommendations based on scientific evidence, as well as the key steps for assessing suicidal behaviour,which is one of the most frequent causes behind visits to the emergency department in this patientpopulation. Finally, a review is presented on the different management approaches and frameworks,analysing the indications and aims of hospital admission.Instituto de Salud Carlos III PI16/01852Delegación del Gobierno para el Plan Nacional de Drogas 20151073American Foundation for Suicide Prevention LSRG-1-005-1

Impulsivity in fatal suicide behaviour: A systematic review and meta-analysis of psychological autopsy studies

Our aim is to review and perform a meta-analysis on the role of impulsivity in fatal suicide behaviour. We included papers who used psychological autopsy methodology, assessed adult death by suicide, and included assessment of impulsivity. We excluded papers about assisted suicide, terrorist suicide, or other cause of death other than suicide or postmortem diagnosis made only from medical records or database. 97 articles were identified. 33 were included in the systematic review and nine in the meta-analysis. We found that people who die by suicide with high impulsivity are associated with younger age, substance abuse, and low intention to die, whereas those with low impulsivity were associated with older age, depression, schizophrenia, high intention to die and low social support. In the meta-analysis, suicide cases had higher impulsivity scores than living controls (Hedges' g = 0.59, 95 % CI [0.28, 0.89], p=.002). However, studies showed heterogeneity (Q = 90.86, p<.001, I2=89.0 %). Impulsivity-aggressiveness interaction was assessed through meta-regression (β=0.447, p=.045). Individuals with high impulsivity would be exposed to a higher risk of fatal suicide behaviour, aggressiveness would play a mediating role. People who die by suicide with high and low impulsivity display distinct characteristics, which may reflect different endophenotypes leading to suicide by different pathways

Personality Disorders and Health Problems Distinguish Suicide Attempters from Completers in a Direct Comparison

Background Whether suicide attempters and completers represent the same population evaluated at different points along a progression towards suicide death, overlapping populations, or completely different populations is a problem still unresolved. Methods 446 Adult suicide attempters and knowledgeable collateral informants for 190 adult suicide probands were interviewed. Sociodemographic and clinical data was collected for both groups using semi-structured interviews and structured assessments. Univariate analyses and logistic regression models were conducted to explore the similarities and differences between suicide attempters and completers. Results Univariate analyses yielded significant differences in sociodemographics, recent life events, impulsivity, suicide intent, and distribution of Axis I and II disorders. A logistic regression model aimed at distinguishing suicide completers from attempters properly classified 90% of subjects. The most significant variables that distinguished suicide from attempted suicide were the presence of narcissistic personality disorder (OR=21.4; 95% CI=6.8–67.7), health problems (OR=20.6; 95% CI=5.6–75.9), male sex (OR=9.6; 95% CI=4.42–20.9), and alcohol abuse (OR=5.5; 95% CI=2.3–14.2). Limitations Our study shares the limitations of studies comparing suicide attempters and completers, namely that information from attempters can be obtained from the subject himself, whereas the assessment of completers depends on information from close family or friends. Furthermore, different semi-structured instruments assessed Axis I and Axis II disorders in suicide attempters and completers. Finally, we have no data on inter-rater reliability data. Conclusions Suicide completers are more likely to be male and suffer from alcohol abuse, health problems (e.g. somatic illness), and narcissistic personality disorder. The findings emphasize the importance of implementing suicide prevention programs tailored to suicide attempters and completers

Trifoliata hybrids rootstocks for 'Lane Late' navel orange in Spain

Carrizo citrange [Citrus sinensis (L.) Osb. × Poncirus trifoliata (L.) Raf.] and Cleopatra mandarin (C. reshni Hort. ex Tan.) are the most important rootstocks used in Spain, but they are problematic and it is necessary to search for new rootstocks with better all-round performance. The performance of 'Lane Late' navel orange [Citrus sinensis (L.) Osb] on ten rootstocks was determined in the South of the province of Alicante (Spain). They are Carrizo citrange, Cleopatra mandarin and eight new hybrids obtained at the Instituto Valenciano de Investigaciones Agrarias in Valencia (Spain): 020324 [Troyer citrange (C. sinensis × P. trifoliata) × Cleopatra mandarin], Forner-Alcaide 418 (F&A 418) [Troyer citrange × common mandarin (C. deliciosa Ten.)], Forner-Alcaide 13 (F&A 13), 030118, 030127 and 030131 (Cleopatra mandarin × P. trifoliata) and 030212 and 030230 (Cleopatra mandarin × Troyer citrange). Soil is clay loam, with pH 8.5 and electric conductivity in the saturation extract at 25ºC of 5.79 mS cm-1. Yield was weighed during the first nine harvests, fruit quality was determined in the last three. Pre-harvest fruit-drop was controlled for the 4th until 9th harvests. The trees of 'Lane Late' navel budded on Cleopatra mandarin were the tallest (2.5 m) and F&A 418 (1.6 m) the shortest of all rootstocks tested. Trees on 030131 hybrid and Carrizo citrange rootstocks had the highest mean yield (81.2 and 80.3 kg per tree per year respectively), while trees on F&A 418 produced the lowest mean yield (22.3 kg per tree per year). Trees on 030131, 020324 and 030212 had the highest yield efficiency as total cumulative yield per cubic meter of canopy volume (62.1, 58.7 and 55.9 kg m-3 respectively) whereas trees on 030127, F&A 418 and Cleopatra mandarin had lower yield efficiencies (45.0, 44.4 and 38.6 kg m-3, respectively). Pre-harvest fruit-drop was lower in trees grafted on Cleopatra mandarin (24.62 %) and on 030212 (26.61 %), and was also low on F&A 418 (27.76 %), 020324 (28.14 %) and 030230 (29.18 %) rootstocks. Trees on Carrizo citrange and 030127 experienced important fruit-drop (40.24 % and 38.27 % respectively). Trees on F&A 418 had the highest fruit weight and fruit size whereas trees on 030118 induced the lowest ones. The ripeness index was the highest on F&A 13 (18.3) and lowest on F&A 418 (15.3), 030212 (15.3)

Guía para el diseño de andamios de plataformas suspendidas de nivel variable (andamios colgados)

En este artículo docente se pretende entrar en detalle en el estudio de los andamios compuestos por plataformas suspendidas de nivel variable accionadas manualmente, sistema conocido de forma coloquial como andamio colgado manual. Para ello, en primer lugar, estableceremos el fundamento normativo y teórico de la actuación para, posteriormente, plantear y resolver un caso práctico que pueda servir de ejemplo para la resolución de casos posteriores.Monfort Signes, J.; Fuentes Giner, MB.; Oliver Faubel, I.; Vidal Lucas, MJ. (2014). Guía para el diseño de andamios de plataformas suspendidas de nivel variable (andamios colgados). http://hdl.handle.net/10251/3783

Guía para el diseño de andamios tubulares

En este artículo docente se pretende entrar en detalle en el estudio del andamio tubular normalizado. Para ello, en primer lugar, estableceremos el fundamento normativo y teórico de la actuación para, posteriormente, plantear y resolver un caso práctico que pueda servir de ejemplo para la resolución de casos posteriores.Monfort Signes, J.; Fuentes Giner, MB.; Oliver Faubel, I.; Vidal Lucas, MJ. (2014). Guía para el diseño de andamios tubulares. Universitat Politècnica de València. http://hdl.handle.net/10251/37834Premio Calidad Docencia en re

Nos vamos a África II: inventario, clasificación y catalogación (página web incluida) del Museo de Antropología Giner Abati (MAGA), en San Cristóbal de la Cuesta (Salamanca)

Memoria ID2022-... Ayudas de la Universidad de Salamanca para la innovación docente, curso 2022-2023

Brote nosocomial de sarampión

Desde 2010, España y el resto de la Unión Europea presentan niveles de incidencia de sarampión no observados en las dos últimas décadas. En la Comunidad Valenciana en junio del 2011 se notifica el primer caso de sarampión confirmado correspondiente al brote epidémico iniciado en la ciudad de Valencia. El 15 de agosto se produce la transmisión al personal sanitario iniciándose un brote nosocomial. Se diseñó un estudio longitudinal, anidado en el seguimiento de la situación epidémica, para casos incidentes vinculados al territorio hospitalario. Desde el 26 de junio hasta el cierre del brote nosocomial se produjeron 177 notificaciones de sarampión, que permitieron confirmar 151 casos. Cincuenta casos correspondieron al brote comunitario que dio origen a la situación epidémica; al brote nosocomial, 21 casos. El genotipo obtenido fue Paramixovirus D4. El estado inmunitario frente al sarampión era desconocido en el 52,38%. El personal afectado pertenecía al área de urgencias. La finalización de la situación epidémica fue consecuencia más de la eliminación natural de población susceptible que de medidas activas de protección. En nuestra opinión este brote pone de manifiesto que la extensión a la población general se produjo, en gran parte, como consecuencia del brote nosocomial