Predictors of suicide and differences in attachment styles and resilience among treatment-seeking first responder subtypes

Objective: To identify the predictors of suicide for firefighters (FFs), emergency medical technicians (EMTs), and law enforcement officers (LEOs). Methods: We used baseline data from FFs/EMTs (n = 69) and LEOs (n = 81) to investigate the unique predictors for both first-responder subtypes. We conducted confirmatory factor analysis on validated assessments of posttraumatic stress disorder (PTSD) and depression.Measures of attachment, resilience, PTSD, depression, generalized anxiety, trauma history, and substance use were the independent variables in two backward stepwise regressions predicting suicide. Results: Substance use and somatic depression were significant predictors for LEOs, whereas affective depression, anhedonia, externalizing behaviors, trauma history, and generalized anxiety were significant predictors for FFs/EMTs. Limitations: These data are cross-sectional and should be modeled longitudinally over the course of treatment. Conclusion: Separate constructs influence suicide for LEOs and FFs/EMTs

Validation of the PCL-5, PHQ-9, and GAD-7 in a Sample of Veterans

Objective: Veterans can present at nongovernment (Department of Defense, Department of Veterans Affairs) mental health agencies with complex symptom constellations that frequently include posttraumatic stress disorder, depression, and generalized anxiety. To date, no veteran study has validated these measures on a treatment-seeking sample of veterans outside the DoD and VA. Methods: We used a treatment-seeking sample of veterans (N = 493) to validate measures that assess these constructs (PTSD Checklist 5, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7). Results: The seven-factor posttraumatic stress disorder hybrid configuration was the best fit. The best fitting model of the depression measure was a two-factor structure, cognitive-affective, and somatic depression. The measure of generalized anxiety was a unidimensional model. Limitations: Follow-up studies should validate these measures on non-treatment-seeking discharged veterans. Conclusions: We interpret these findings within the veteran scholarship and explore clinical implications for providers

Características do Bairro e da Comunidade associados ao Transtorno de Conduta dos Jovens

Objetivo: Estima-se que entre 3% a 5% dos jovens sejam anualmente diagnosticados com o Transtorno de Conduta (DC), tornando-se uma preocupação premente de saúde mental. Embora muitos estudos se tenham focado sobre os aspetos comportamentais do transtorno de conduta, os fatores ambientais e de vizinhança ainda necessitam de ser explorados. O presente estudo examinou as características específicas do bairro e da comunidade associadas ao transtorno de conduta nos jovens. Método: Foi realizada uma análise secundária do Questionário Nacional de Saúde Infantil dos Estados Unidos de 2011-2012. Os participantes incluíram um total de 34.601 adolescentes com idade entre os 12 e os 17 anos (52,3% de sexo masculino e 47,7% de sexo feminino). Resultados: Os resultados do modelo final de regressão logística multivariada revelaram que os fatores de risco significativos para o transtorno de conduta dos jovens foram: os bairros sem parques ou parques infantis, bibliotecas ou veículos, presença de lixo nas calçadas, vandalismo, a impossibilidade de contar com os outros nos bairros e a segurança infantil percecionada. Conclusão: São discutidas as implicações desses resultados e as estratégias futuras para a prevenção do transtorno de conduta

The Related Transcriptional Enhancer Factor-1 Isoform, TEAD4216, Can Repress Vascular Endothelial Growth Factor Expression in Mammalian Cells

Increased cellular production of vascular endothelial growth factor (VEGF) is responsible for the development and progression of multiple cancers and other neovascular conditions, and therapies targeting post-translational VEGF products are used in the treatment of these diseases. Development of methods to control and modify the transcription of the VEGF gene is an alternative approach that may have therapeutic potential. We have previously shown that isoforms of the transcriptional enhancer factor 1-related (TEAD4) protein can enhance the production of VEGF. In this study we describe a new TEAD4 isoform, TEAD4216, which represses VEGF promoter activity. The TEAD4216 isoform inhibits human VEGF promoter activity and does not require the presence of the hypoxia responsive element (HRE), which is the sequence critical to hypoxia inducible factor (HIF)-mediated effects. The TEAD4216 protein is localized to the cytoplasm, whereas the enhancer isoforms are found within the nucleus. The TEAD4216 isoform can competitively repress the stimulatory activity of the TEAD4434 and TEAD4148 enhancers. Synthesis of the native VEGF165 protein and cellular proliferation is suppressed by the TEAD4216 isoform. Mutational analysis indicates that nuclear or cytoplasmic localization of any isoform determines whether it acts as an enhancer or repressor, respectively. The TEAD4216 isoform appears to inhibit VEGF production independently of the HRE required activity by HIF, suggesting that this alternatively spliced isoform of TEAD4 may provide a novel approach to treat VEGF-dependent diseases

Understanding family dynamics in a cross-cultural sample: a multi-national study

The Family Systems Circumplex Model posits that balanced levels of cohesion and adaptability are associated with positive familial outcomes, whereas extremely high or low levels of these factors are associated with deleterious outcomes. Despite the popularity and utility of this model in Western cultures, there is a dearth of empirical data supporting its use in more culturally diverse contexts. The current, preregistered study assessed the Family Circumplex Model, cultural factors, and emerging adult outcomes across seven countries (i.e., China, Iran, Nigeria, Switzerland, Turkey, the United Kingdom, and the United States). Participants were N = 3,593 emerging adults, mostly self-identifying as women (71.3%). Collaborators were participants in Psi Chi’s Network for International Collaborative Exchange (NICE) and administered measures related to family dynamics and cultural orientation to participants in a random order. Results indicated that the Family Circumplex Model did not fit cross-culturally. As such, a new model was adapted, the Expanded Circumplex Model, which demonstrated invariance across samples and between women and men. The Expanded Circumplex Model retained 6 constructs with differences regarding the separation of disengagement into 2 variables and the combining of adaptive flexibility and cohesion. The current study suggests that the cultural context in which family dynamics occur should be taken into consideration when conceptualizing family dynamics theory and measurement. Future work should seek to replicate and further apply the Expanded Circumplex Model to familial outcomes

Efficacious lifestyle interventions for appropriate gestational weight gain in women with overweight or obesity set in the health care system: a scoping review.

Purpose: Health care systems offer opportunities to scale up interventions for appropriate gestational weight gain (GWG); however, GWG interventions in the health care setting remain largely unavailable to women with overweight or obesity. To inform the translation of efficacious lifestyle interventions to health care delivery systems, this scoping review aimed to systematically identify randomized controlled trials for appropriate GWG in women with overweight or obesity that were set in a health care system.Methods: A scoping review allows for the systematic synthesis of knowledge on an exploratory research question aimed at mapping key concepts (e.g. time, location, source, and evidence) and gaps in a specific area of study. The Colquhoun et al. (2014) framework to conducting scoping reviews was used to develop the research question, identify relevant studies, select studies, extract data, and synthesize data. Specifically, two reviewers searched publication databases for English-language articles published from January 2009 to May 2020 using specific keywords/MeSH terms.Results: Eight peer-reviewed journal articles were identified; six trials were based in Europe and two in the U.S. Only four included lifestyle interventions that were efficacious in reducing GWG. Three trials with efficacious interventions were among women with obesity only and encouraged them to gain at or below the lower limit for total GWG (i.e. ≤5 kg) of the Institute of Medicine (IOM) guidelines. The fourth was among women with overweight or obesity and encouraged women to gain within the IOM guidelines with a telehealth behavioral intervention. Efficacious interventions were initiated in the first half of pregnancy and included frequent contact delivered through multiple modalities (i.e. in-person visits, telephone calls, text messages, email) by trained intervention staff (i.e. dietitian, lifestyle coach, and/or physiotherapist). Only one efficacious intervention trial briefly mentioned theoretical components for health promotion (e.g. self-monitoring); likewise, only one included cost-effectiveness analyses.Conclusions: This review systematically identified randomized controlled trials of efficacious lifestyle interventions (i.e. consisting of diet and physical activity components) for appropriate GWG in women with overweight or obesity that were set in the health care system and delivered by non-clinicians. Translation efforts could draw upon aspects of the efficacious lifestyle interventions described in this review. Future studies should examine theory-based telehealth interventions and cost-effectiveness