Public stigma against family members of people with mental illness: findings from the Gilgel Gibe Field Research Center (GGFRC), Southwest Ethiopia

Background: Public stigma against family members of people with mental illness is a negative attitude by the public which blame family members for the mental illness of their relatives. Family stigma can result in self social restrictions, delay in treatment seeking and poor quality of life. This study aimed at investigating the degree and correlates of family stigma. Methods: A quantitative cross-sectional house to house survey was conducted among 845 randomly selected urban and rural community members in the Gilgel Gibe Field Research Center, Southwest Ethiopia. An interviewer administered and pre-tested questionnaire adapted from other studies was used to measure the degree of family stigma and to determine its correlates. Data entry was done by using EPI-DATA and the analysis was performed using STATA software. Unadjusted and adjusted linear regression analysis was done to identify the correlates of family stigma. Results: Among the total 845 respondents, 81.18% were female. On a range of 1 to 5 score, the mean family stigma score was 2.16 (+/- 0.49). In a multivariate analysis, rural residents had significantly higher stigma scores (std. beta = 0.43, P < 0.001) than urban residents. As the number of perceived signs (std. beta = -0.07, P < 0.05), perceived supernatural (std. beta = -0.12, P < 0.01) and psychosocial and biological (std. beta = -0.11, P < 0.01) explanations of mental illness increased, the stigma scores decreased significantly. High supernatural explanation of mental illness was significantly correlated with lower stigma among individuals with lower level of exposure to people with mental illness (PWMI). On the other hand, high exposure to PWMI was significantly associated with lower stigma among respondents who had high education. Stigma scores increased with increasing income among respondents who had lower educational status. Conclusions: Our findings revealed moderate level of family stigma. Place of residence, perceived signs and explanations of mental illness were independent correlates of public stigma against family members of people with mental illness. Therefore, mental health communication programs to inform explanations and signs of mental illness need to be implemented

Synechococcus in the Atlantic Gateway to the Arctic Ocean

Increasing temperatures, with pronounced effects at high latitudes, have raised questions about potential changes in species composition, as well as possible increased importance of small-celled phytoplankton in marine systems. In this study, we mapped out one of the smallest and globally most widespread primary producers, the picocyanobacterium Synechococcus, within the Atlantic inflow to the Arctic Ocean. In contrast to the general understanding that Synechococcus is almost absent in polar oceans due to low temperatures, we encountered high abundances (up to 21,000 cells mL-1) at 79 °N, and documented their presence as far north as 82.5 °N. Covering an annual cycle in 2014, we found that during autumn and winter, Synechococcus was often more abundant than picoeukaryotes, which usually dominate the picophytoplankton communities in the Arctic. Synechococcus community composition shifted from a quite high genetic diversity during the spring bloom to a clear dominance of two specific operational taxonomic units (OTUs) in autumn and winter. We observed abundances higher than 1,000 cells mL-1 in water colder than 2 °C at seven distinct stations and size-fractionation experiments demonstrated a net growth of Synechococcus at 2 °C in the absence of nano-sized grazers at certain periods of the year. Phylogenetic analysis of petB sequences demonstrated that these high latitude Synechococcus group within the previously described cold-adapted clades I and IV, but also contributed to unveil novel genetic diversity, especially within clade I

Immunology of IL-12

As its first identified member, Interleukin-12 (IL-12) named a whole family of cytokines. In response to pathogens, the heterodimeric protein, consisting of the two subunits p35 and p40, is secreted by phagocytic cells. Binding of IL-12 to the IL-12 receptor (IL-12R) on T and natural killer (NK) cells leads to signaling via signal transducer and activator of transcription 4 (STAT4) and subsequent interferon gamma (IFN-γ) production and secretion. Signaling downstream of IFN-γ includes activation of T-box transcription factor TBX21 (Tbet) and induces pro-inflammatory functions of T helper 1 (TH1) cells, thereby linking innate and adaptive immune responses. Initial views on the role of IL-12 and clinical efforts to translate them into therapeutic approaches had to be re-interpreted following the discovery of other members of the IL-12 family, such as IL-23, sharing a subunit with IL-12. However, the importance of IL-12 with regard to immune processes in the context of infection and (auto-) inflammation is still beyond doubt. In this review, we will provide an update on functional activities of IL-12 and their implications for disease. We will begin with a summary on structure and function of the cytokine itself as well as its receptor and outline the signal transduction and the transcriptional regulation of IL-12 secretion. In the second part of the review, we will depict the involvement of IL-12 in immune-mediated diseases and relevant experimental disease models, while also providing an outlook on potential translational approaches

Floral displays suffer from sulphur deprivation

Nutrient deficiency is known to constrain plant growth in numerous ways, but how it impacts floral displays and pollination success remains unclear. Here we investigate how insufficient availability of sulphur – a vital plant nutrient that is a limiting factor in natural and agricultural regions throughout the world – influences the production of floral displays in Brassica rapa, Physalis philadelphica and three Petunia species with differently coloured flowers. Sulphur deficiency led to a drastic reduction in the number of open flowers, an aberrant flower morphology and smaller pollen with an altered mineral nutrient content. Intriguingly, sulphur deprivation also led to a clear reduction in pigmentation of yellow flowers, but not in flowers with white, purple and red colours. The pale yellow flower colour was due to decreased amounts of violaxanthin, lutein and other carotenoids, suggesting that the carotenoid synthesis pathway is particularly susceptible to sulphur deficiency. Additional experiments with nitrogen and phosphorus depletion confirmed that observed colour and morphological changes were not a general nutrient limitation response, but could be ascribed to sulphur depletion specifically. Taken together, our results showed that (mild) sulphur deficiency deteriorates a suite of floral traits, and that the effects may cascade to pollinators and so have the potential to undermine (agro-)ecosystem functioning.<br/

A concise revised myeloma comorbidity index as a valid prognostic instrument in a large cohort of 801 multiple myeloma patients

With growing numbers of elderly multiple myeloma patients, reliable tools to assess their vulnerability are required. The objective of the analysis herein was to develop and validate an easy to use myeloma risk score (revised Myeloma Comorbidity Index) that allows for risk prediction of overall survival and progression-free survival differences in a large patient cohort. We conducted a comprehensive comorbidity, frailty and disability evaluation in 801 consecutive myeloma patients, including comorbidity risks obtained at diagnosis. The cohort was examined within a training and validation set. Multivariate analysis determined renal, lung and Karnofsky Performance Status impairment, frailty and age as significant risks for overall survival. These were combined in a weighted revised Myeloma Comorbidity Index, allowing for the identification of fit (revised Myeloma Comorbidity Index ≤3 [n=247, 30.8%]), intermediate-fit (revised Myeloma Comorbidity Index 4-6 [n=446, 55.7%]) and frail patients (revised Myeloma Comorbidity Index >6 [n=108, 13.5%]): these subgroups, confirmed via validation analysis, showed median overall survival rates of 10.1, 4.4 and 1.2 years, respectively. The revised Myeloma Comorbidity Index was compared to other commonly used comorbidity indices (Charlson Comorbidity Index, Hematopoietic Cell Transplantation-Specific Comorbidity Index, Kaplan-Feinstein Index): if each were divided in risk groups based on 25% and 75% quartiles, highest hazard ratios, best prediction and Brier scores were achieved with the revised Myeloma Comorbidity Index. The advantages of the revised Myeloma Comorbidity Index include its accurate assessment of patients' physical conditions and simple clinical applicability. We propose the revised Myeloma Comorbidity Index to be tested with the “reference” International Myeloma Working Group frailty score in multicenter analyses and future clinical trials

A concise revised Myeloma Comorbidity Index as a valid prognostic instrument in a large cohort of 801 multiple myeloma patients

With growing numbers of elderly multiple myeloma patients, reliable tools to assess their vulnerability are required. The objective of the analysis herein was to develop and validate an easy to use myeloma risk score (revised Myeloma Comorbidity Index) that allows for risk prediction of overall survival and progression-free survival differences in a large patient cohort. We conducted a comprehensive comorbidity, frailty and disability evaluation in 801 consecutive myeloma patients, including comorbidity risks obtained at diagnosis. The cohort was examined within a training and validation set. Multivariate analysis determined renal, lung and Karnofsky Performance Status impairment, frailty and age as significant risks for overall survival. These were combined in a weighted revised Myeloma Comorbidity Index, allowing for the identification of fit (revised Myeloma Comorbidity Index ≤3 [n=247, 30.8%]), intermediate-fit (revised Myeloma Comorbidity Index 4-6 [n=446, 55.7%]) and frail patients (revised Myeloma Comorbidity Index >6 [n=108, 13.5%]): these subgroups, confirmed validation analysis, showed median overall survival rates of 10.1, 4.4 and 1.2 years, respectively. The revised Myeloma Comorbidity Index was compared to other commonly used comorbidity indices (Charlson Comorbidity Index, Hematopoietic Cell Transplantation-Specific Comorbidity Index, Kaplan-Feinstein Index): if each were divided in risk groups based on 25% and 75% quartiles, highest hazard ratios, best prediction and Brier scores were achieved with the revised Myeloma Comorbidity Index. The advantages of the revised Myeloma Comorbidity Index include its accurate assessment of patients' physical conditions and simple clinical applicability. We propose the revised Myeloma Comorbidity Index to be tested with the "reference" International Myeloma Working Group frailty score in multicenter analyses and future clinical trials. The study was registered at the German Clinical Trials Register (DRKS-00003868)

DGK and DZHK position paper on genome editing: basic science applications and future perspective

For a long time, gene editing had been a scientific concept, which was limited to a few applications. With recent developments, following the discovery of TALEN zinc-finger endonucleases and in particular the CRISPR/Cas system, gene editing has become a technique applicable in most laboratories. The current gain- and loss-of function models in basic science are revolutionary as they allow unbiased screens of unprecedented depth and complexity and rapid development of transgenic animals. Modifications of CRISPR/Cas have been developed to precisely interrogate epigenetic regulation or to visualize DNA complexes. Moreover, gene editing as a clinical treatment option is rapidly developing with first trials on the way. This article reviews the most recent progress in the field, covering expert opinions gathered during joint conferences on genome editing of the German Cardiac Society (DGK) and the German Center for Cardiovascular Research (DZHK). Particularly focusing on the translational aspect and the combination of cellular and animal applications, the authors aim to provide direction for the development of the field and the most frequent applications with their problems

Lateinisch-griechisch-arabische Begegnungen

Das spätmittelalterliche Mediterraneum war geprägt von komplexen Gesellschaften mit einem hohen Grad kultureller Heterogenität. Menschen mit unterschiedlichen ethnischen, religiösen und linguistischen Hintergründen lebten zum Teil schon seit Generationen, zum Teil erst kurzfristig mit- oder nebeneinander und kamen auf unterschiedlichen Ebenen miteinander in Kontakt. Die Erforschung dieser spätmittelalterlichen mediterranen "hotspots" kultureller Diversität verspricht wichtige Erkenntnisse über die Konstruktion von sozialen und kulturellen Identitäten und über die integrativen und desintegrativen Prozesse in komplexen pluralen Gesellschaften. Dieser international und interdisziplinär zusammengestellte Sammelband behandelt Aspekte interkultureller Kommunikation, wie sie in Architektur, Bildkunst, Handwerksproduktion und Schrifttum reflektiert werden, untersucht die Genese hybrider Kunstformen sowie Kulturpraktiken und fragt nach der Rolle und Selbstverortung spezifischer Personen und Korporationen in interkulturellen Kontaktsituationen

Training in psychosomatic medicine and psychotherapy for medical doctors in China: A field report

BackgroundThe high prevalence rates of mental disorders in China contrast a comparatively low care capacity from qualified trained medical doctors in the mental health field. The main objective of our cooperation project was to develop and implement advanced postgraduate training for medical doctors for their acquisition of knowledge, skills, and attitudes in the field of psychosomatic medicine and psychotherapy in China.MethodsMonitoring and evaluation as part of the advanced training in Beijing were conducted following the Kirkpatrick training approach using four levels of evaluation: reaction, learning, behavior and results. We performed a continuous course evaluation, assessed the respective learning goal attainment, conducted a pre-post evaluation of reasons and goals for participation in the training, and measured the treatment effects on the patient side.ResultsThe implementation of training standards in the field of psychosomatic medicine and psychotherapy for medical doctors and the transfer of didactic knowledge and skills for Chinese lecturers were achieved. A total of 142 mainly medical doctors attended the 2-year training. Ten medical doctors were trained as future teachers. All learning goals were reached. The content and didactics of the curriculum were rated with an overall grade of 1.23 (1 = very good to 5 = very bad). The highest rated elements were patient life interviews, orientation on clinical practice and communication skills training. The achievement of learning objectives for each block (depression, anxiety disorders, somatic symptom disorder, coping with physical diseases) was rated between 1 and 2 (1 = very well achieved to 5 = not achieved) for all items from participants’ perspectives. On the patient side (n = 415), emotional distress decreased and quality of life and the doctor–patient alliance improved significantly.DiscussionAdvanced training in psychosomatic medicine and psychotherapy was successfully implemented. The results of the evaluation show high participant satisfaction and the successful achievement of all learning objectives. A more detailed and extensive evaluation of the data, such as an analysis of the development of the participants as psychotherapists, is in preparation. The continuation of the training under Chinese guidance is guaranteed

Predatory arthropods in apple orchards across Europe: Responses to agricultural management, adjacent habitat, landscape composition and country

Local agri-environmental schemes, including hedgerows, flowering strips, organic management, and a landscape rich in semi-natural habitat patches, are assumed to enhance the presence of beneficial arthropods and their contribution to biological control in fruit crops. We studied the influence of local factors (orchard management and adjacent habitats) and of landscape composition on the abundance and community composition of predatory arthropods in apple orchards in three European countries. To elucidate how local and landscape factors influence natural enemy effectiveness in apple production systems, we calculated community energy use as a proxy for the communities’ predation potential based on biomass and metabolic rates of predatory arthropods. Predator communities were assessed by standardised beating samples taken from apple trees in 86 orchards in Germany, Spain and Sweden. Orchard management included integrated production (IP; i.e. the reduced and targeted application of synthetic agrochemicals), and organic management practices in all three countries. Predator communities differed between management types and countries. Several groups, including beetles (Coleoptera), predatory bugs (Heteroptera), flies (Diptera) and spiders (Araneae) benefited from organic management depending on country. Woody habitat and IP supported harvestmen (Opiliones). In both IP and organic orchards we detected aversive influences of a high-quality surrounding landscape on some predator groups: for example, high covers of woody habitat reduced earwig abundances in German orchards but enhanced their abundance in Sweden, and high natural plant species richness tended to reduce predatory bug abundance in Sweden and IP orchards in Spain. We conclude that predatory arthropod communities and influences of local and landscape factors are strongly shaped by orchard management, and that the influence of management differs between countries. Our results indicate that organic management improves the living conditions for effective predator communities.info:eu-repo/semantics/acceptedVersio