The Feasibility and Potential of Training Correctional Officers in Flexible Styles of Communication to Reduce Burnout: A Multiple Baseline Trial in Real-Life Settings

Background: Burnout is typically high among correctional officers. By a training intervention in the flexible communication style ‘everyday conversations’ as a way to increase job-related resources, this study aimed to reduce burnout in Swedish correctional officers. Methods: In a stepped wedged waiting list design, 13 prison wards with 266 employees were randomized to the everyday conversations intervention at different time points during the study period. Burnout was measured using the Maslach Burnout Inventory-General Survey scales over 16 time points. Results: A significant reduction in cynicism was found. In addition, moderation effects relating to personal motivators and characteristics were found. Conclusion: There is feasibility and potential to implement communication skills to reduce burnout among employees in real-life prison settings

Clinical and societal burden of incident major depressive disorder : A population-wide cohort study in Stockholm

Objective Major depressive disorder (MDD) is a highly prevalent condition and a significant contributor to global disability. The vast majority of MDD is handled by primary care, but most real-life studies on MDD only include data from secondary care. The aim of this study was therefore to estimate the total clinical and societal burden of incident MDD including data from all healthcare levels in a large well-defined western European healthcare region. Methods Population-wide observational study included healthcare data from Region Stockholm, Sweden's largest region with approximately 2.4 million inhabitants. All patients in Region Stockholm having their first unipolar MDD episode between January 1, 2012, and December 31, 2018, were included. The sample also included matched study population controls. Outcomes were psychiatric and non-psychiatric comorbid conditions, antidepressant therapy use, healthcare resource utilization, work loss, and all-cause mortality. Results In the study period, 137,822 patients in Region Stockholm were diagnosed with their first unipolar MDD episode. Compared with matched controls, MDD patients had a higher burden of non-psychiatric and psychiatric comorbid conditions, 3.2 times higher outpatient healthcare resource utilization and 8.6 times more work loss. MDD was also associated with a doubled all-cause mortality compared with matched controls (HR: 2.2 [95% CI: 2.0-2.4]). Conclusions The high mortality, morbidity, healthcare resource utilization, and work loss found in this study confirms that MDD is associated with individual suffering and low functioning leading to substantial costs for patients and society. These findings should motivate additional efforts in improving outcomes for MDD patients.Peer reviewe

Discovery of a novel class of highly conserved vaccine antigens using genomic scale antigenic fingerprinting of pneumococcus with human antibodies

Pneumococcus is one of the most important human pathogens that causes life-threatening invasive diseases, especially at the extremities of age. Capsular polysaccharides (CPSs) are known to induce protective antibodies; however, it is not feasible to develop CPS-based vaccines that cover all of the 90 disease-causing serotypes. We applied a genomic approach and described the antibody repertoire for pneumococcal proteins using display libraries expressing 15–150 amino acid fragments of the pathogen's proteome. Serum antibodies of exposed, but not infected, individuals and convalescing patients identified the ANTIGENome of pneumococcus consisting of ∼140 antigens, many of them surface exposed. Based on several in vitro assays, 18 novel candidates were preselected for animal studies, and 4 of them showed significant protection against lethal sepsis. Two lead vaccine candidates, protein required for cell wall separation of group B streptococcus (PcsB) and serine/threonine protein kinase (StkP), were found to be exceptionally conserved among clinical isolates (>99.5% identity) and cross-protective against four different serotypes in lethal sepsis and pneumonia models, and have important nonredundant functions in bacterial multiplication based on gene deletion studies. We describe for the first time opsonophagocytic killing activity for pneumococcal protein antigens. A vaccine containing PcsB and StkP is intended for the prevention of infections caused by all serotypes of pneumococcus in the elderly and in children

Novel Biochemical Markers of Psychosocial Stress in Women

Background: Prolonged psychosocial stress is a condition assessed through self-reports. Here we aimed to identify biochemical markers for screening and early intervention in women

Routine Analysis of Mercury. A comparative Study between two Methods; neutron activation and flameless atomic absorption

Mercury analysis was performed on purely routine basis om samples of organic origin. The object was to compare the two analytical methods at IVL, neutron activation and flaemless atomic absorption, both available as a routine service. The investigation was based on eight samples, run a striplets, showed: Neutron activation has an excellent accuracy with a coefficient of variation of less than 5 % when mercury level exceeds 2 ppb (ng/g). All of the performed analyses gave good results. - Flameless atomic adsorption samples were digested in either of three media: aqua regia (inorganic matter), sulfuric, nitric an dperchloric acid or dulfuric and nitric acids combined with permangante and persulfate. Two performance with aqua regia was acceptable while no agreement was obtianed with the two other methods Loss of mercury occured compared to the reference values. Digestion with permanganate and persulfate showed the best agreement. The maximun loss was 35 %. Moreover detection limit was high because of the high background. At best is was found to be 5 ppb (ng/g). The comparative study gives neutron activation a very strong hand.Mercury analysis was performed on purely routine basis om samples of organic origin. The object was to compare the two analytical methods at IVL, neutron activation and flaemless atomic absorption, both available as a routine service. The investigation was based on eight samples, run a striplets, showed: Neutron activation has an excellent accuracy with a coefficient of variation of less than 5 % when mercury level exceeds 2 ppb (ng/g). All of the performed analyses gave good results. - Flameless atomic adsorption samples were digested in either of three media: aqua regia (inorganic matter), sulfuric, nitric an dperchloric acid or dulfuric and nitric acids combined with permangante and persulfate. Two performance with aqua regia was acceptable while no agreement was obtianed with the two other methods Loss of mercury occured compared to the reference values. Digestion with permanganate and persulfate showed the best agreement. The maximun loss was 35 %. Moreover detection limit was high because of the high background. At best is was found to be 5 ppb (ng/g). The comparative study gives neutron activation a very strong hand

SOX2 expression is associated with a cancer stem cell state and down-regulation of CDX2 in colorectal cancer

Background: To improve current treatment strategies for patients with aggressive colorectal cancer (CRC), the molecular understanding of subgroups of CRC with poor prognosis is of vast importance. SOX2 positive tumors have been associated with a poor patient outcome, but the functional role of SOX2 in CRC patient prognosis is still unclear. Methods: An in vitro cell culture model expressing SOX2 was used to investigate the functional role of SOX2 in CRC. In vitro findings were verified using RNA from fresh frozen tumor tissue or immunohistochemistry on formalin fixed paraffin embedded (FFPE) tumor tissue from a cohort of 445 CRC patients. Results: Using our in vitro model, we found that SOX2 expressing cells displayed several characteristics of cancer stem cells; such as a decreased proliferative rate, a spheroid growth pattern, and increased expression of stem cell markers CD24 and CD44. Cells expressing SOX2 also showed down-regulated expression of the intestinal epithelial marker CDX2. We next evaluated CDX2 expression in our patient cohort. CDX2 down-regulation was more often found in right sided tumors of high grade and high stage. Furthermore, a decreased expression of CDX2 was closely linked to MSI, CIMP-high as well as BRAF mutated tumors. A decreased expression of CDX2 was also, in a stepwise manner, strongly correlated to a poor patient prognosis. When looking at SOX2 expression in relation to CDX2, we found that SOX2 expressing tumors more often displayed a down-regulated expression of CDX2. In addition, SOX2 expressing tumors with a down-regulated CDX2 expression had a worse patient prognosis compared to those with retained CDX2 expression. Conclusions: Our results indicate that SOX2 expression induces a cellular stem cell state in human CRC with a decreased expression of CDX2. Furthermore, a down-regulated expression of CDX2 results in a poor patient prognosis in CRC and at least part of the prognostic importance of SOX2 is mediated through CDX2 down-regulation