Frequency Of Attempts Research Articles

Management of self-harm, suicidal ideation and suicide attempts.

The strategic location of primary care providers (PCPs) in clinics, private general practices and emergency departments is critical to the detection and appropriate management of patients with suicidal behaviour. Their position within the primary care setting and responsibility for preventive and promotive care require PCPs to possess good clinical skills and evidence-based knowledge to assist patients presenting with suicidal ideation and behaviour. The objective of this article is to provide guidelines for the management of suicidal behaviour within the primary care setting, with the goal of reducing deaths from suicide, and the frequency and intensity of suicide attempts. The priority in the management of patients presenting at health facilities following suicide attempts is medical resuscitation and stabilisation. As soon as the patient is medically stable, a thorough suicide risk assessment, which evaluates suicidal ideation/intent, preceding circumstances, predisposing and protective factors, should be conducted. An assessment of current and ongoing suicide risk will assist in determining the safest place to manage the patient. For those with a low level of suicide risk, outpatient management may be considered in the presence of a good social support system at home and a well-documented safety plan. Measures should be put in place to address the modifiable psychosocial risk factors for suicide, whilst appropriate pharmacotherapy is instituted for co-existing mental illness. Post-discharge care such as referral to psychologist, psychiatrist or social worker should be initiated by the primary care practitioner to ensure continuity of care. Support and psycho-education should also be extended to immediate family members of patients with suicidal behaviour for their own well-being and their ability to support the patient.

Advice of General Practitioner, of Surgeon, of Endocrinologist, and Self-determination: the Italian Road to Bariatric Surgery.

Bariatric surgery (BS) is considered the most efficient treatment for severe obesity. International guidelines recommend multidisciplinary approach to BS (general practitioners, endocrinologists, surgeons, psychologists, or psychiatrists), and access to BS should be the final part of a protocol of treatment of obesity. However, there are indications that general practitioners (GPs) are not fully aware of the possible benefits of BS, that specialty physicians are reluctant to refer their patients to surgeons, and that patients with obesity choose self-management of their own obesity, including internet-based choices. There are no data on the pathways chosen by physicians and patients to undergo BS in the real world in Italy. An exploratory exam was performed for 6months in three pilot regions (Lombardy, Lazio, Campania) in twenty-three tertiary centers for the treatment of morbid obesity, to describe the real pathways to BS in Italy. Charts of 2686 patients (788 men and 1895 women, 75.5% in the age range 30-59years) were evaluated by physicians and surgeons of the participating centers. A chronic condition of obesity was evident for the majority of patients, as indicated by duration of obesity, by presence of several associated medical problems, and by frequency of previous dietary attempts to weight loss. The vast majority (75.8%) patients were self-presenting or referred by bariatric surgeons, 24.2% patients referred by GPs and other specialists. Self-presenting patients were younger, more educated, more professional, and more mobile than patients referred by other physicians. Patients above the age of 40years or with a duration of obesity greater than 10years had a higher prevalence of all associated medical problems. The majority of patients referred to a tertiary center for the treatment of morbid obesity have a valid indication for BS. Most patients self-refer to the centers, with a minority referred by a GP or by specialists. Self-presenting patients are younger, more educated, more professional, and more mobile than patients referred by other physicians. Older patients and with a longer duration of obesity are probably representative of the conservative approach to BS, often regarded as the last resort in an endless story.

Preliminary Evidence That the Short Allele of 5-HTTLPR Moderates the Association of Psychiatric Symptom Severity on Suicide Attempt: The Example in Obsessive-Compulsive Disorder.

BackgroundThe severity of symptoms represents an important source of distress in patients with a psychiatric disease. However, the extent to which this endogenous stress factor interacts with genetic vulnerability factors for predicting suicide risks remains unclear.MethodsWe evaluated whether the severity of symptoms interacts with a genetic vulnerability factor (the serotonin transporter gene-linked promoter region variation) in predicting the frequency of lifetime suicide attempts in patients with a psychiatric disease. Symptom severity and 5-HTTLPR polymorphism were collected from a sample of 95 patients with obsessive-compulsive disorder (OCD). Lifetime suicide attempt was the primary outcome, and antecedent of multiple suicide attempts was the secondary outcome.ResultsThe gene-by-symptoms interaction was associated with an excess risk of suicide attempts (OR = 4.39, 95CI[1.44, 13.38], p < 0.009) and of multiple suicide attempts (OR = 4.18, 95CI[1.04, 16.77], p = 0.043). Symptom severity (moderate, severe, or extreme) was associated with an approximately five-fold increase in the odds of a lifetime suicide attempt in patients carrying one or two copies of the short allele of 5-HTTLPR. No such relationship was found for patients carrying the long allele.ConclusionThis study provides preliminary evidence for the gene-by-stress interaction on suicide attempt when stress is operationalized as symptom severity. Progress in suicide research may come from efforts to investigate the gene-by-symptoms interaction hypothesis in a variety of diseases.

Combined rectal indomethacin and intravenous saline hydration in post-ERCP pancreatitis prophylaxis

Background and study aimAcute pancreatitis (AP) is a potentially life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). There is a lack of effective measures to prevent post-ERCP pancreatitis (PEP), except NSAIDs. Aggressive hydration for AP can be considered, given the frequency of hemoconcentration, hypovolemia, and hypoperfusion in pancreatitis. We aimed to clarify the clinical utility of combined indomethacin and saline hydration for preventing PEP. Patients and methodIn this cross-sectional study, 120 patients undergoing ERCP for the first time at the Gastrointestinal Endoscopy Unit and Liver Unit Kasralainy (GIELUKA) were enrolled and then randomly allocated into two groups: indomethacin and indomethacin-hydration groups. Intravenous (IV) saline was given to the latter at a rate of 10 ml/kg/h after the ERCP for 2 h. ResultsThe age of the studied patients was 43.8 ± 14.9 years, with 55% of them being female. The patient-related risk factors for PEP were older age (p = 0.039), higher pre-ERCP urea level (p = 0.032), and less choledocholithiasis (p = 0.028). The patients with PEP had a higher frequency of biliary cannulation attempts (p = 0.004) and accidental pancreatic duct cannulation (p = 0.003), required a longer cannulation time (p = 0.021), had undergone precut knife and transpancreatic sphincterotomy at a higher rate (p = 0.032; and p = 0.001, respectively), and had a significantly longer procedure time (p = 0.006).PEP occurred in only five patients in the indomethacin group, while it did not occur in the indomethacin-hydration group (8% vs. 0%, p = 0.022). Serum amylase and lipase elevation 2 h after ERCP were predictors of PEP. However, serum amylase only was significantly lower 2 h post-ERCP in the indomethacin-hydration group than in the indomethacin group (p = 0.045). Moreover, abdominal pain and vomiting on the first day of ERCP were good predictors of PEP. ConclusionAggressive IV saline hydration with rectal indomethacin can more effectively prevent PEP than indomethacin alone.

Emergency Department Adolescent Suicidality: A Pilot Study to Determine How Common Actual Attempts Are.

Adolescent mental health is a rapidly escalating presentation to emergency departments in the United States with depression and suicidal thoughts being the most prevalent condition. Much of the research and focus has been on preventing future attempts. However, one outcome that may be very important in addition to focus on is the impact of presentations for thoughts without self-injury. The aim was to evaluate outcomes of interest for a larger prospective observational adolescent suicidal trial including frequency of suicide attempts versus thoughts and factors associated with each outcome. This is a prospective pilot study of adolescents at a single pediatric emergency department between December 2016 and September 2017 with acute suicidality. We used descriptive statistics to compare chief complaint, medical history, Patient Health Questionnaire-9 (PHQ-9), and outcomes including final disposition and total emergency department length of stay (LOS). We used t tests for continuous outcomes, χ2 test for categorical data, and Fisher exact tests for categorical and sparse data (20% of cell sizes of <5). Forty-one patients were enrolled, with 43.9% having an attempt; 72.2% of attempts were the result of an ingestion, and approximately 54% were over-the-counter medications. The average (SD) LOS was 30.8 (31.2) hours, and 63% were discharged home to outpatient services. There were no significant differences in age, chief complaint (except overdose), medical history, final disposition, total LOS in the ED, and the PHQ-9. Scores of the PHQ-9 were, on average (SD), 18.51 (4.7) across the entire cohort, 18.06 (5.75) in patients with an attempt, and 18.87 (3.77) in patients without an attempt (P = 0.59). Adolescent mental health is a growing issue for pediatric emergency departments nationally. Prospective research to identify factors associated with worsening outcomes is important to identify and potentially modify if possible. This study did not find any specific factors associated with a suicide attempt, but found that less than half of patients presenting with suicidality actual made an attempt. Future research should focus on not only limiting suicide attempts but also using decreased emergency department visits for worsening thoughts as an outcome of interest.

Трудная ларингоскопия в плановой анестезиологии

Введение. Обеспечение проходимости дыхательных путей — одна из ключевых задач плановой анестезиологии. Почти треть всех случаев анестезиологической смертности связана с трудностями при вентиляции пациентов после индукции в наркоз. Причем большинство из них обусловлены непосредственно интубацией трахеи и трудностями последующей вентиляции. Причиной 80 % закрытых исков Американской ассоциации анестезиологов по поводу повреждения гортани были повторные попытки интубации трахеи во время плановой анестезии. Цель исследования: повышение эффективности и уменьшение частоты осложнений обеспечения проходимости дыхательных путей при трудной ларингоскопии в плановой анестезиологии. Материалы и методы исследования. Нами проанализированы результаты 66 случаев трудной ларингоскопии при плановых оперативных вмешательствах на базе Полтавской областной клинической больницы за 2013–2015 годы. У всех пациентов во время прямой ларингоскопии на фоне миоплегии голосовая щель не визуализировалась. Пациентам I группы применялся клинический протокол оказания медицинской помощи больным с трудной интубацией трахеи, пациентам II группы после неудачной попытки интубации сразу устанавливалась ларингеальная маска соответствующего размера. Исследовалась частота удачных попыток восстановления проходимости дыхательных путей методом интубации трахеи и с помощью ларингеальной маски, частота и причины осложнений. Результаты исследования. У пациентов I группы вторая попытка интубации трахеи была удачной в 43,8 % случаев. Со следующими попытками интубации трахеи эффективность манипуляции прогрессивно уменьшалась до 6,2 % с четвертой попытки. Эффективность последующего использования ларингеальной маски составила 45,4 %; причины несостоятельности: травматизация слизистой, гиперсаливация, бронхорея, ларинго- и бронхоспазм. У пациентов II группы в 91,2 % случаев постановка ларингеальной маски обеспечила герметичность дыхательного контура и адекватную вентиляцию во время оперативного вмешательства. Осложнений практически не наблюдалось. Выводы. Использование клинического протокола оказания медицинской помощи больным с трудной интубацией трахеи в плановой анестезиологии менее эффективно и имеет высокую частоту осложнений, связанных с прямой ларингоскопией, по сравнению с единственной попыткой интубации трахеи и последующим использованием ларингеальной маски.

Is age of self-harm onset associated with increased frequency of non-suicidal self-injury and suicide attempts in adolescent outpatients?

BackgroundSelf-harm in adolescents is an increasing public health concern and an important risk factor for suicide. We aimed to examine how age of self-harm onset in adolescents was associated with frequency of subsequent suicidal and non-suicidal self-harm (NSSI) episodes, and how age of onset and duration of self-harm may influence the frequency of self-harm.MethodsData from 103 adolescents with recurrent self-harm recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports, and analysed with negative binomial and hurdle models.ResultsA lower age of self-harm onset and a longer duration of self-harm were both significantly associated with increased frequency of subsequent episodes of NSSI and risk of a first suicide attempt. There was an increase in repeated suicide attempts when the age of onset of self-harm decreased and the duration increased, and dramatically more for long duration of NSSI before first suicide attempt.ConclusionInitiating self-harm behaviour at the youngest age had the highest risk of increased frequency of NSSI and suicide attempts. Longer duration of self-harm behaviour increased this risk. This underlines the importance of early identification of self-harm behaviour in adolescents, and the use of effective interventions.

Associations between weight loss history and factors related to type 2 diabetes risk in the Stop Diabetes study

BackgroundFrequent weight loss attempts are related to maladaptive eating behaviours and higher body mass index (BMI). We studied associations of several type 2 diabetes (T2D) risk factors with weight loss history, defined as the frequency of prior weight loss attempts, among Finnish adults at increased risk for T2D.MethodsThis study (n = 2684, 80% women) is a secondary analysis of the 1-year StopDia lifestyle intervention with digital intervention group, digital intervention + face-to-face counselling group, or control group. The frequency of prior weight loss attempts was categorized into five groups: no attempts/no attempts to lose weight, but trying to keep weight stable/1–2 attempts/3 or more attempts/ continuous attempts. Data on emotional eating and social/emotional nutrition self-efficacy were collected with a digital questionnaire. We assessed baseline differences between categories of weight loss history as well as the intervention effects.ResultsAltogether 84% of participants had attempted weight loss. Those with one or more weight loss attempts had higher BMI, larger waist circumference, and more emotional eating compared to ‘no attempts’ and ‘no attempts to lose weight, but trying to keep weight stable’ categories. The ‘no attempts’ category had the highest baseline fasting insulin, whereas it showed the largest decrease in this measure with the intervention. This change in fasting insulin in the ‘no attempts’ category was significantly different from all the other categories. Emotional nutrition self-efficacy slightly improved in the ‘no attempts’ category, which was significantly different from its concomitant decrease in the categories ‘1-2 attempts’ and ‘3 or more attempts’. The intervention group assignment did not affect the results.ConclusionsMultiple attempts to lose weight may unfavourably affect T2D risk factors as well as lifestyle intervention outcomes. More research is needed on how weight loss frequency could affect T2D risk factors and how to design lifestyle interventions for individuals with frequent previous weight loss attempts.

Frequency of suicide ideation and attempts and its correlates among inpatients with depressive disorders at a tertiary care center in North India.

ABSTRACTBackground:Suicidal ideation is higher in psychiatric patients, particularly in those with depressive disorders. It tends to be a precursor to suicide attempts.Aim:To estimate the frequency of suicide ideation and attempts and their sociodemographic and clinical correlations among the inpatients with depressive disorders at a tertiary care center in North India.Methods:A cross-sectional descriptive survey was carried out among 128 participants diagnosed with depressive disorders who were admitted from September 2019 to April 2021 at a tertiary care hospital, India, using a total enumerative sampling technique. The sociodemographic and clinical data (particularly on suicide) were supplemented with the Modified Scale of Suicide Ideation (to evaluate suicidality) and the Hamilton Depression Rating Scale (for the severity of depression).Results:The median suicide ideation score was 11 inter quartile range (IQR: 19), and the overall mean depression score of the sample was 22.74 standard deviation (SD = 6.24). About 87% reported moderate to severe suicidal ideas. Occupation (farmer) (P < 0.01), current medications (tricyclic antidepressant) (P < 0.05), and history of suicide (P < 0.05) were significantly associated with the severity of depression. However, only a history of suicide was significantly associated with the current suicidal ideation (P < 0.05). About 48% had a history of suicide attempts, and among those who were more severely depressed, intoxicated during a suicide attempt (P < 0.01), taken precautions against being interrupted (P < 0.05), and had an intention to die (P < 0.05) had a significant association with their suicide attempts.Conclusion:Among hospitalized patients with depressive disorders, suicidal ideation is common. The study reiterates the importance of screening for suicide, particularly in those with more severe depression in the inpatient setting.

Comparison of the Clinical Characteristics of Pediatric Poisoning Patients Who Visited Emergency Department Before and During the COVID-19 Pandemic.

We aimed to investigate changes in the clinical characteristics of pediatric poisoning patients who visited the emergency department (ED) before and during the coronavirus disease 2019 (COVID-19) pandemic. Poisoning cases below age 18 who visited the ED from January 2018 to December 2021 were retrospectively analysed. The study period was then divided into pre-COVID-19 and COVID-19 pandemic to compare poisoning patterns. During the study period, 86,153 visits to the pediatric ED had been recorded, with 625 patients being included the final analysis. During the COVID-19 period, the proportion of poisoned patients increased from 0.62% to 0.98%. The average age of the patients was higher in the COVID-19 period, with 53.4% of the cases being intentional (pre-COVID-19, 32.5%; P < 0.001). Moreover, 70.4% of poisoning cases during the COVID-19 period were caused by drugs (pre-COVID-19, 60.6%; P = 0.038). More patients underwent decontamination and laboratory investigation during the COVID-19 period than during the previous period (P = 0.007 and P < 0.001, respectively). The length of ED stay and the proportion of hospitalisation were significantly greater during the COVID-19 period. After analysing accidental poisoning cases, we found that antipyretics/nonsteroidal anti-inflammatory drugs and respiratory drugs were more common in the pre-COVID-19 group, whereas iron/vitamins, cardiovascular drugs and hormones were more common in the COVID-19 group. After analysing intentional poisoning cases, we found that 73.6% and 76.4% of the patients in the pre-COVID-19 and COVID-19 group had a history of psychiatric disease, respectively. Although no difference was observed in the frequency of previous first suicide attempts, 19.0% of the patients in the COVID-19 group attempted suicide more than three times. During the COVID-19 pandemic, intentional poisoning cases, especially in adolescence, increased and were treated more. Many of the patients with intentional poisoning had a history of mental illness or suicide in the past. Therefore, it seems that policy consideration for mentally vulnerable adolescents during this new pandemic period is necessary.

CHILDHOOD TRAUMA EXPERIENCES IN MERSIN UNIVERSITY FACULTY OF MEDICINE STUDENTS

Objective: This study aimed to investigate whether the students studying at Mersin University Faculty of Medicine experienced neglect or abuse, and to examine the factors affecting this situation while investigating the relationship between the frequency of thoughts and attempts of suicide and the experience of abuse, and their knowledge level regarding the types of sexual abuse. Method: The population of the cross-sectional research is 1458 students. A sample size of 616 participants was calculated with 50% prevalence, 95% confidence interval, and 3% margin of error. 650 students were targeted and reached. Childhood Trauma Questionnaire-Short Form was applied. Descriptive statistics, student's t-test, one-way ANOVA, Welch, Bonferroni post-hoc tests, Games Howell, and Pearson correlation tests were used. Statistical significance level was accepted as p≤0.05. Results: Scale total scores were higher for males(p<0.01), for those living in an extended family(p<0.01), for those whose mother is not working(p=0.03), and for those who stated they have economic difficulties(p<0.01). Scale total score(p<0.01) and sexual abuse score(p<0.01) of those with suicidal thoughts were higher. Scale total scores of students who attempted suicide were higher than those who did not(p<0.01). Conclusions: Considering that students with higher trauma and sexual abuse scores also have higher suicidal thoughts and attempts, it is important to carry out a qualified monitoring in child adolescent care as a primary health care service.

Atomistic simulation of the diffusion behavior in Al-Fe

• As Al block was attached to Fe block, Al atoms penetrated Fe block and vice versa on simulation. • Al atoms diffused massively into the Fe lattice, whereas Fe atoms moved deeper inside Al block. • The diffusion coefficient of Al was 2 times the diffusion coefficient of Fe. • Activation energy is 0.83 and 0.72 eV for Al and Fe, respectively. • Pre-exponentials is 1.03 × 10 −6 m 2 /s for Al and 5.83 × 10 −8 m 2 /s for Fe. The diffusion behavior of the Al-Fe system was investigated by a classical molecular dynamics simulation for simulating the Al coating process on Fe. Two bulks were built as the model: one bulk contained Al atoms and the other was made from Fe atoms. The diffusion was studied at four different temperatures for 6 ns by utilizing a MEAM potential. The mean square displacement (MSD) and potential energy of Al and Fe atoms were recorded during the simulation. Fe atoms penetrated inside the Al lattice in low quantities and at a slower rate compared with the fast and large number of diffusing Al atoms that did not penetrate inside the Fe lattice. The diffusion coefficient was estimated by the fitting of the linear region from the MSD and time curves. The Arrhenius equation was used to find the activation energy and the frequency of attempts. The activation energy of Al was 0.83 eV, whereas that of Fe was 0.72 eV. The frequency of attempts for the Al and Fe atoms were 1.03 × 10 - 6 and 5.83 × 10 - 8 m 2 /s, respectively. The diffusing mechanisms were studied, and it was found that the Fe atoms diffused into the Al lattice by the first-neighbor hopping mechanism. The potential energy of the Fe atoms increased as the Fe atoms penetrated the Al lattice.

Associations between plumage colour and fear behaviour in young Nigerian indigenous turkeys (Meleagris gallopavo)

The effects of plumage colour on different behaviours have been reported in several avian species, but there are only few studies for Nigerian indigenous turkeys (NIT). Fear is a negative affective state that is indicative of suffering and associated with adverse effects on welfare and productivity of livestock species. This study compared fear behaviours in NIT with different plumage colours during early life (first 16 days of life). Seventy-five birds (25 each of white, black and lavender) were used in this study. The three colour phenotypes were derived from the same genetic line. Tonic immobility, emergence, open field, inversion and attention bias tests were done at 7, 9, 12, 14 and 16 days old, respectively. Data were analysed with Kruskal-Wallis tests. The durations of tonic immobility and freezing during the attention bias test were not significantly associated with plumage colour (χ2 =1.7592, df=2, p = 0.42 and χ2 =3.9421, df=2, p = 0.14, respectively). The latency to emerge from a dark box was significantly related to plumage colour (χ2 =8.9229, df=2, p = 0.01), with the shortest emergence latency observed in black NIT. There was a significant plumage colour effect on the duration of ambulation (χ2 =9.6013, df=2, p = 0.01) and a significant effect on the percentage of floor squares explored by the birds in the open field test (χ2 =6.1191, df=2, p = 0.05). The least ambulation time was observed in black NIT (p = 0.02). Lavender turkeys explored fewer floor squares compared to black and white NIT (p = 0.04). The frequency of escape attempts was significantly associated with the plumage colour of the birds (χ2 =11.6810, df=2, p = 0.00). The highest frequency of escape attempts during the open field test was observed in black birds, while there was no significant difference in the frequency of escape attempts of white and lavender birds. There were no plumage colour effects on the duration of preening (χ2 =1.5896, df=2, p = 0.45), wall pecking (χ2 =3.3346, df=2, p = 0.19) and floor pecking (χ2 =1.7483, df=2, p = 0.42) of NIT in the open field test. The results from this study applied to the early life stage. It can be concluded that plumage colour influenced the level of fear in young NIT, with lavender turkeys being the most fearful in three out of the four statistically significant fear indicators (longer emergence duration, lower number of escape attempts and lower percentage of floor squares explored in an open field test), followed by white, whereas black turkeys were least fearful.

Implementing an Evidence-Based Feeding Protocol: Impact on Nurses' Knowledge, Perceptions, and Feeding Culture in the NICU.

Evidence-based feeding practices are often variable among neonatal providers due to lack of knowledge and neonatal intensive care unit (NICU) feeding culture norms. To evaluate changes in NICU nurses' knowledge, perceptions, feeding practices and culture following education about, and implementation of, an evidence-based Infant-Driven Feeding (IDF) protocol. A pre-/postprospective comparative design was used to survey 120 registered nurses employed in a level 3 NICU about feeding practices, knowledge, and culture prior to IDF education and 1 to 2 months after IDF implementation. The preeducation survey yielded 59 respondents; of these, 30 responded to the same survey after IDF implementation. Postimplementation responses were significant for fewer nurses making decisions to begin oral feedings ( P = .035), greater use of gestational age to increase frequency of oral feeding attempts ( P = .03), less reliance on weight loss to decrease oral feeding attempts ( P = .018), an increase in use of combination interventions to prepare infants for oral feeding ( P = .001), and greater willingness to allow a rest period or stop the feeding if an infant falls asleep after completing 70% of the feeding ( P = .03). Trends in several survey categories following the education program and implementation of IDF support the use of evidence-based practices (EBPs) such as IDF. Future research focused on nurses' perceptions of how education influences integration of specific EBPs into practice is needed. Evaluating EBP mentorship combined with education about EBPs can provide insights on how best to integrate EBPs into practice.

Genetic liability to suicide attempt, suicide death, and psychiatric and substance use disorders on the risk for suicide attempt and suicide death: a Swedish national study.

How does genetic liability to suicide attempt (SA), suicide death (SD), major depression (MD), bipolar disorder (BD), schizophrenia (SZ), alcohol use disorder (AUD), and drug use disorder (DUD) impact on risk for SA and SD? In the Swedish general population born 1932-1995 and followed through 2017 (n = 7 661 519), we calculate family genetic risk scores (FGRS) for SA, SD, MD, BD, SZ, AUD, and DUD. Registration for SA and SD was assessed from Swedish national registers. In univariate and multivariate models predicting SA, FGRS were highest for SA, AUD, DUD, and MD. In univariate models predicting SD, the strongest FGRS were AUD, DUD, SA, and SD. In multivariate models, the FGRS for SA and AUD were higher in predicting SA while the FGRS for SD, BD, and SZ were higher in predicting SD. Higher FGRS for all disorders significantly predicted both younger age at first SA and frequency of attempts. For SD, higher FGRS for MD, AUD, and SD predicted later age at SD. Mediation of FGRS effects on SA and SD was more pronounced for SD than SA, strongest for AUD, DUD, and SZ FGRS and weakest for MD. FGRS for both SA and SD and for our five psychiatric disorders impact on risk for SA and SD in a complex manner. While some of the impact of genetic risk factors for psychiatric disorders on risk for SA and SD is mediated through developing the disorders, these risks also predispose directly to suicidal behaviors.

Prevalence and Factors Associated With Youth Vaping Cessation Intention and Quit Attempts.

This study sought to examine the prevalence and factors associated with youth vaping cessation behaviors. Current (past 30-day) electronic-cigarette (e-cigarette) users from the 2020 National Youth Tobacco Survey (n = 1660, typically aged 11-18 years) were analyzed to examine the prevalence of youth intention to quit vaping, past-year quit attempts, and the frequency of quit attempts. Multivariable logistic or linear regressions were performed to assess the correlates with youth vaping cessation behaviors. In 2020, 53.4% of current e-cigarette users reported intention to quit vaping and 67.4% reported having tried to quit vaping. Intention to quit was lower among female individuals (versus male individuals, adjusted odds ratio [aOR] = 0.7, P = .0004), users of a modifiable system (versus disposable e-cigarettes, aOR = 0.4, P = .0204), and dual or poly users (versus sole e-cigarette use, aOR = 0.7, P = .0144). e-cigarette harm perception was positively associated with intention to quit (aOR = 2.2, P < .0001) and past-year quit attempts (aOR = 1.6, P = .0037). Reasons for e-cigarette use were related to cessation behaviors. Adolescents who vaped because of curiosity had higher odds of past-year quit attempts (aOR = 1.4, P = .0306), whereas users to disguise vaping had a lower likelihood of intention to quit (aOR=0.4, P < .0001) and past-year quit attempts (aOR = 0.7, P = .0126). The average number of past-year quit attempts was 5.3, and it was lower among female individuals (versus male individuals), users of e-cigarettes with prefilled pods or cartridges (versus disposable e-cigarettes), and those with nicotine cravings (versus no nicotine craving). Intention to quit vaping and past-year quit attempts are prevalent among US adolescent e-cigarette users. The study findings inform the development of multifaceted vaping cessation programs to take sex, e-cigarette devices, vaping reasons and patterns, harm perception, and nicotine dependence into account.

Sub-Lethal Effects of λ-Cyhalothrin on Behavior and Development of the ParasitoidAphidius colemani(Hymenoptera: Braconidae) onkdr-Resistant and Susceptible Green Peach Aphid,Myzus persicae(Hemiptera: Aphididae)

The green peach aphid, Myzus persicae (Sulzer), is a pest mainly controlled with insecticides, and it can acquire resistance through different mechanisms. Pyrethroids can select the knock down resistance (kdr) mutation in M. persicae and can also produce lethal and sub-lethal effects on its main parasitoid, Aphidius colemani Viereck. However, kdr-resistant M. persicae exhibits a reduced response to alarm pheromone and increased vulnerability to natural enemies. To study the effects of sub-lethal concentrations of a pyrethroid on the aphid-parasitoid interaction, kdr-resistant and susceptible M. persicae were confronted with A. colemani with residual sub-lethal concentrations of λ-cyhalothrin. The behavior, survival, and development of parasitoids were evaluated after exposure to λ-cyhalothrin LC20 for adult parasitoids (0.52 mg/liter) for susceptible (Mp-SS, 0.56 mg/liter) and kdr-resistant M. persicae (Mp-RR, 12.15 mg/liter). The foraging and oviposition behaviors of the parasitoids were not affected by the lower parasitoid or Mp-SS LC20. Conversely, the higher Mp-RR LC20 significantly reduced parasitoid walking, the frequency of sting attempts, and successful stings, as well as aphid defensive behaviors, such as walking, kicking, and jerking. Therefore, the higher vulnerability of kdr-resistant M. persicae could not be capitalized by A. colemani parasitoids under a high concentration of λ-cyhalothrin. Similarly, the parasitism rate, survival of progeny, productivity, sex ratio (proportion of females), longevity, and adult body mass were reduced, and the development time increased with a higher Mp-RR LC20. Our results suggest that A. colemani could efficiently control kdr-resistant and susceptible M. persicae only at lower λ-cyhalothrin concentrations.

Results from the blood donor competence, autonomy, and relatedness enhancement (blood donor CARE) randomized trial.

This study aimed to promote competence, autonomy, and relatedness among first-time whole blood donors to enhance intrinsic motivation and increase retention. Using a full factorial design, first-time donors (N=2002) were randomly assigned to a no-treatment control condition or to one of seven intervention conditions designed to promote donation competence, autonomy, relatedness, a combination of two (e.g., competence and autonomy), or all three constructs. Participants completed donor motivation measures before the intervention and 6 weeks later, and subsequent donation attempts were assessed for 1 year. There was no significant group difference in the frequency of donation attempts or in the number of days to return. Significant effects of group were observed for 10 of the 12 motivation measures, although follow-up analyses revealed significant differences from the control group were restricted to interventions that included an autonomy component. Path analyses confirmed direct associations between interventions involving autonomy and donor motivation, and indirect mediation of donation attempts via stronger donation intentions and lower donation anxiety. Among young, first-time, whole blood donors, brief interventions that include support for donor autonomy were associated with direct effects on donor motivation and indirect, but small, effects on subsequent donation behavior.

An investigation on the frequency of thoughts, readiness and suicide attempt in individuals with thalassemia

Background and Aim: Thalassemia major is one of the most common chronic genetic diseases in the world and in Iran that can impose many adverse effects on the self and society. Psychologically, patients with thalassemia are under stress. According to the World Health Organization (WHO), suicide is one of the leading causes of death worldwide. It is important to identify the people who have the highest risk factors for suicide. The present research investigates the frequency of thoughts, readiness and suicide attempts in people with thalassemia. Methods: This was a cross-sectional study. Its sample was 150 patients with thalassemia in the age range of 10 to 46 years whom we selected through census by sampling at convenience. We gave to patients a standardized Beck Suicide Thought Assessment Questionnaire. We analyzed the research data using descriptive and inferential statistical tests. Results: From among 150 patients with thalassemia in this study, 57.3% of the respondents were male and 42.7% were female. The results showed that there was a negative and significant relationship between suicide thoughts and attempts and age (-0.234) (P &lt;0.05). The mean prevalence of suicide in men (1.89) was significantly higher compared to women (0.79) (P &lt;0.05). We did not observe significant difference in prevalence of suicide thoughts and attempts between married and single groups with a mean difference (0.69) (P &lt;0.05) and, in different educational groups, no significant difference was reported (P&gt; 0.05). Conclusion: The findings of this research showed that among patients with thalassemia, the prevalence of suicidal ideation has a significant percentage. Since suicidal ideation provides a platform for preparation and attempt to commit suicide, so by providing mental health services and regular screening, we can take an effective step to prevent this problem among patients with thalassemia. Keywords: Thalassemia, Suicidal ideation, Suicide.

The impact of the COVID-19 pandemic on suicide ideation and suicide attempts in a sample of psychiatric inpatients

There has been little research reported regarding both suicide ideation and suicide attempts during the COVID-19 pandemic and government lockdown restrictions in Italy, one of the countries most affected by the pandemic. We investigated whether the frequency of suicide ideation and suicide attempts differed between psychiatric patients admitted to a psychiatric unit before and during the COVID-19 pandemic and government lockdown restrictions. We also assessed psychiatric diagnosis, length of hospitalization, and types of admission. We collected data on 632 psychiatric patients admitted to a public psychiatric clinic. Patients were divided into two different groups according to their admission before or during the COVID-19 pandemic. Our results showed that only suicide attempts, but not suicide ideation, were more frequent in psychiatric patients admitted during the COVID-19 pandemic than before. Furthermore, mood disorder diagnoses were more frequent during the COVID-19 pandemic than before the pandemic. The types of admission and the mean length of hospitalization did not differ between the two groups. In conclusion the present study results adds consistent knowledge on the phenomenon of suicide during the challenging time of the pandemic, pointing to continuing effort in suicide prevention measures.