Moderate Levels Research Articles

Exploring the Levels of Undergraduate University Students' Study Skills

The ability to study well is crucial to students' academic performance. The aims of this research were to investigate the study skills levels of undergraduate students, to determine the correlation between academic performance and the study skills of undergraduate students, and to identify any noteworthy variations in study skills based on gender and location. Multi-stage stratified random sampling technique was used to select representative sample of 2207 undergraduate students from Punjab, Pakistan's general public universities. With the author's consent, a modified version of the study skills evaluation questionnaire was adapted, and the academic performance scale was created, verified, and subjected to a reliability coefficient of .094 and 0.85. Four research hypotheses were developed and put to the test using the t-test, Pearson r, mean, and standard deviation. The results indicated a substantial difference in terms of gender and location, as well as a favorable link between study skills and academic performance. Moreover, the majority of undergraduate students employed study skills at a moderate level; therefore, it is recommended to design and incorporate study skills in educational courses for students in academic curricula.

The Unspoken Wounds: Understanding the Psychological Impact on Healthcare Professionals Fighting COVID-19 in Pakistan

During the COVID-19 pandemic, hospital staff faced numerous mental health challenges. However, limited research focused on anxiety and stress specifically among hospital workers during this time. Therefore, this study aimed to investigate the anxiety levels of healthcare workers during the COVID-19 pandemic. A multidimensional, cross-sectional survey was distributed to healthcare workers and staff at hospitals, COVID-19 laboratories, and healthcare settings. The survey included a total of 625 frontline healthcare workers, with 445 (71.2%) being male and 180 (28.8%) female. There were 405 (64.8%) lab professionals, 90 (14.0%) doctors, and 130 (20.8%) others, including nursing staff, administrative personnel, and supporting staff crucial to the functioning of healthcare settings. Among the lab professionals, 37.0% reported moderate depression levels and 16.0% reported severe depression levels during the pandemic. For doctors, 22.2% experienced mild depression and 33.33% experienced severe depression. Several factors were significantly associated with depression and anxiety among frontline healthcare workers, including physiological and social factors, fear of infection, risk of infecting family members and colleagues, lack of personal protective equipment (PPE), long working hours, untrained staff, social issues, and cooperation problems. These factors collectively contributed to reduced work efficacy during the pandemic. Frontline health workers played a critical role in the fight against COVID-19. The findings from this study have important implications for developing strategies to improve the mental health of healthcare workers during the pandemic and implementing policies that enhance work efficacy, ultimately leading to the improved outcomes.

THE IMPACT OF EMOTIONAL CONTAGION IN NURSES ON MISSED NURSING CARE: A CROSS-SECTIONAL STUDY

Nurses encounter various situations in their work that can affect their emotional status, and they can contagion these emotions to others. These emotions experienced by nurses can influence nursing care. The study used a cross-sectional, descriptive, and correlational design to explore the impact of emotional contagion among nurses on unmissed nursing care. The research was conducted with 304 volunteer nurses through an online survey. Data were collected using a survey form consisting of a Demographic Information Form, Emotional Contagion Scale, and Missed Nursing Care Needs Scale. The data were analyzed by the researchers. The study revealed that nurses had a moderate level of emotional contagion. Differences in emotional contagion levels were found based on gender, age, educational level, type of institution, marital status, working hours, institutional experience, unit of work, and voluntary choice of job (p < 0.05). Additionally, the study showed that the level of missed nursing care among nurses was low. "Communication" was identified as the most significant factor causing missed nursing care. The level of missed nursing care varied according to gender, age, educational status, type of institution, professional and institutional experience, marital status, working hours, unit of work, and duration of employment (p < 0.05). Emotional contagion had a negative impact on the need for missed nursing care (β = -0.150, t = -2.636, R2 = 0.022, p < 0.05), its causes (β = -0.193, t = -3.411, R2 = 0.037, p < 0.05), especially workforce resources (β = -0.249, t = -4.470, R2 = 0.062, p < 0.05), and material resources (β = -0.271, t = -4.898, R2 = 0.074, p < 0.05). To reduce the level of missed nursing care, fostering positive emotions among nurses and promoting their transmission can be utilized as a strategy.

Prevalence of noise-induced health hazards and occupational safety practices among welders in Mysuru city: a cross-sectional study

Background: Occupational exposure to noise is a significant concern in the welding industry, posing potential health hazards to workers. This study aimed to assess the prevalence of noise-induced health hazards, knowledge regarding these hazards, and the practice of preventive measures among welders in Mysuru City. Methods: A cross-sectional study was conducted and data was collected from welders in Mysuru City, including noise exposure levels, perceived stress levels, insomnia prevalence, and demographic characteristics. The association between the number of years of noise exposure and auditory/non-auditory health effects was analysed. Participants' awareness of noise-induced health hazards and the use of protective equipment were also evaluated. Results: The study included male participants, predominantly below 30 years of age, with a majority (74.3%) belonging to the Muslim community. Decreased hearing (11.5%) and sleep disorders (3%) were reported by participants. About half (53.7%) were aware of noise-induced health hazards, with a high usage of safety glasses but limited use of earplugs. Most had exposure to noise for less than 5 years. Moderate levels of perceived stress and low prevalence of insomnia were observed. Significant associations were found between the number of years of noise exposure and both auditory/non-auditory health hazards, as well as between age category and auditory health effects. Conclusions: The study reveals the prevalence of noise-induced health hazards among welders in Mysuru City and highlights the importance of promoting occupational health and safety measures. Raising awareness and encouraging the use of protective measures are crucial to mitigate the adverse effects of noise exposure in the welding industry.

Grading system for assessing the confidence in the epileptogenic zone reported in published studies: A Delphi consensus study.

This study was undertaken to develop a standardized grading system based on expert consensus for evaluating the level of confidence in the localization of the epileptogenic zone (EZ) as reported in published studies, to harmonize and facilitate systematic reviews in the field of epilepsy surgery. We conducted a Delphi study involving 22 experts from 18 countries, who were asked to rate their level of confidence in the localization of the EZ for various theoretical clinical scenarios, using different scales. Information provided in these scenarios included one or several of the following data: magnetic resonance imaging (MRI) findings, invasive electroencephalography summary, and postoperative seizure outcome. The first explorative phase showed an overall interrater agreement of .347, pointing to large heterogeneity among experts' assessments, with only 17% of the 42 proposed scenarios associated with a substantial level of agreement. A majority showed preferences for the simpler scale and single-item scenarios. The successive Delphi voting phases resulted in a majority consensus across experts, with more than two thirds of respondents agreeing on the rating of each of the tested single-item scenarios. High or very high levels of confidence were ascribed to patients with either an Engel class I or class IA postoperative seizure outcome, a well-delineated EZ according to all available invasive EEG (iEEG) data, or a well-delineated focal epileptogenic lesion on MRI. MRI signs of hippocampal sclerosis or atrophy were associated with a moderate level of confidence, whereas a low level was ascribed to other MRI findings, a poorly delineated EZ according to iEEG data, or an Engel class II-IV postoperative seizure outcome. The proposed grading system, based on an expert consensus, provides a simple framework to rate the level of confidence in the EZ reported in published studies in a structured and harmonized way, offering an opportunity to facilitate and increase the quality of systematic reviews and guidelines in the field of epilepsy surgery.

Public Value and Level of e-Government in Sri Lanka: Problems and Prospects

Public Value and Level of e-Government in Sri Lanka: Problems and Prospects

Disparity of serum uric acid threshold for CKD among hypertensive and non-hypertensive individuals

Introduction Hypertension and rising serum uric acid (sUA) played a pivotal role in the development of Chronic Kidney Disease (CKD). This study investigates the interactive effect of sUA and hypertension on CKD and identifies the optimal threshold of sUA among individuals with and without hypertension in the Chinese community population. Materials and methods The study included 4180 individuals aged 45–85 years, derived from the China Health and Retirement Longitudinal Study (CHARLS) between 2011 and 2015. Additionally, a hospital-based study enrolled subjects in the Department of Nephrology at Zhongshan Hospital, China from January 1, 2019, to December 31, 2021. The interaction effect analysis were used to assess the impact of sUA and hypertension on CKD. We also compared the distribution of sUA and the CKD risk in community populations, distinguishing between those with and without hypertension. For the hospital-based population, kidney injury was marked by a KIM-1 positive area. Results Our results indicate a higher prevalence of CKD in the community population with hypertension (10.2% vs. 3.9%, p < .001). A significant additive synergistic effects of the sUA and hypertension on the CKD risk were found. When the sUA level was < 4.55 mg/dL in the hypertensive population and < 5.58 mg/dL in the non-hypertensive population, the risk of CKD was comparable (p = .809). In the propensity score matched (PSM) population, the result remained roughly constant. Conclusion Therefore, even moderate levels of sUA was associated with a higher risk of CKD in middle-aged hypertensive patients, who warrant stricter sUA control.

Female School Teachers' Knowledge Regarding Cervical Cancer

Cervical cancer is a globally leading cause of mortality and morbidity in females. It is a curable cancer if diagnosed in the early stage. Lack of awareness of screening methods, risk factors, and early symptoms may lead to a late diagnosis. This study aimed to assess the knowledge regarding cervical cancer among female school teachers. A cross-sectional study design was adopted to assess the knowledge regarding cervical cancer among 106 female teachers. A non-probability purposive sampling technique was used to select the sample. Data was collected using a structured self-administered questionnaire and subsequently entered into IBM SPSS version 22 for analysis. The findings of the study revealed that the mean age was 30.45±3.911 and the majority of respondents were married (95.3%). Similarly, 72.6% of respondents had bachelor-level education, and 12.3% respondents had a family history of cervical cancer. Regarding the level of knowledge, the majority (64.2%) had a good level of knowledge, 25.5% had moderate level of knowledge, and 10.4% had poor level of knowledge. There was a significant association between levels of knowledge and religion (p=0.006). Findings indicate that a substantial percentage of respondents possess a good level of knowledge on cervical cancer.

The non-mevalonate pathway requires a delicate balance of intermediates to maximize terpene production

Terpenes are valuable industrial chemicals whose demands are increasingly being met by bioengineering microbes such as E. coli. Although the bioengineering efforts commonly involve installing the mevalonate (MVA) pathway in E. coli for terpene production, the less studied methylerythritol phosphate (MEP) pathway is a more attractive target due to its higher energy efficiency and theoretical yield, despite its tight regulation. In this study, we integrated an additional copy of the entire MEP pathway into the E. coli genome for stable, marker-free terpene production. The genomically integrated strain produced more monoterpene geraniol than a plasmid-based system. The pathway genes’ transcription was modulated using different promoters to produce geraniol as the reporter of the pathway flux. Pathway genes, including dxs, idi, and ispDF, expressed from a medium-strength promoter, led to the highest geraniol production. Quantifying the MEP pathway intermediates revealed that the highest geraniol producers had high levels of isopentenyl pyrophosphate (IPP) and dimethylallyl pyrophosphate (DMAPP), but moderate levels of the pathway intermediates upstream of these two building blocks. A principal component analysis demonstrated that 1-deoxy-D-xylulose 5-phosphate (DXP), the product of the first enzyme of the pathway, was critical for determining the geraniol titer, whereas MEP, the product of DXP reductoisomerase (Dxr or IspC), was the least essential. This work shows that an intricate balance of the MEP pathway intermediates determines the terpene yield in engineered E. coli. The genetically stable and intermediate-balanced strains created in this study will serve as a chassis for producing various terpenes.Key points• Genome-integrated MEP pathway afforded higher strain stability• Genome-integrated MEP pathway produced more terpene than the plasmid-based system• High monoterpene production requires a fine balance of MEP pathway intermediates

Comparative cross-sectional study on sexual function of couples during pregnancy: Assisted reproductive techniques versus spontaneous conceptions.

This study aims to compare the sexual functions of couples undergoing assisted reproductive techniques (ART) with those conceiving spontaneously during pregnancy. A total of 102 couples participated in this cross-sectional study, with 68 couples in the spontaneous conception group and 34 couples in the ART group. Data collection was conducted face-to-face in the antenatal clinic using separate "Descriptive Information Form" for women and men, "Female Sexual Function Index (FSFI)" for women, and "Libido Scoring System (LSS)" for men. Descriptive statistical methods, Chi-square and Fisher exact tests, t-test, and Pearson correlation test were used for data analysis. It was observed that the mean FSFI total scores of women who conceived spontaneously and through ART during pregnancy were at a good level (≥30), while the mean LSS scores of their partners were at a moderate level (5-7). No statistically significant distinction existed among the groups. Further research is advisable by adjusting the sample selection criteria, such as gravida, duration of ART treatment, and gestational age.

Geogebra Software as A Guideline for Meaningful Learning of Mathematical Content for Ninth- Grade Students in Ecuador – A Secondary Publication

The introduction of the GeoGebra software led to a considerable increase in the interactivity of the didactic sequence of learning mathematical contents, a scenario that highlighted the inclusion of the meaningful learning model as the basis of pedagogical proposals. In this sense, the objective of this article was to determine the relationship of the GeoGebra software in the learning of mathematics in ninth-grade students in the General Education (GE) of the Yaruquí Public Educational Unit. Relational research with a non-experimental and transversal design was carried out to measure the variables in 44 ninth-grade students through the collection of data using valid and reliable instruments. The results indicated that a large number of students deemed the interface and interactivity of the GeoGebra software as “appropriate” (&gt; 60%) and showed high levels of information acquisition and incorporation of new knowledge (68.2%). The correlational analysis revealed positive directions and moderate levels between the dimensions of the two variables (0.430 &lt; Rho &lt; 0.515); overall, a direct and moderate correlation was observed between GeoGebra software and mathematical learning (Rho = 0.549, R2 = 0.301). Finally, it was concluded that higher scores in the dimensions of GeoGebra software would manifest in high scores for meaningful learning of mathematical content.

Levels of Records Keeping and Records Management among Basic Schools in Zamfara State

This research paper was conducted purposely to determine the levels of record keeping and record management among basic schools in Zamfara State, Nigeria. To achieve this objective, two research questions were establish to guide the study. This study used survey design. A descriptive research design of survey type was employed in the study. The study population comprised all teachers in 126 government-owned basic schools in Bungudu Local Government Area of Zamfara State, Nigeria. 230 teachers were sampled through a random sampling technique using Krejie and Morgan’s Sample Size Determining Table. A structured questionnaire was developed as an instrument for data collection. Data analysis was made using descriptive statistics. The study observed that both levels of school records keeping and that of school records management was at moderate level among basic schools in Bungudu Local Government Area, Zamfara State. Based on findings, it is recommended that government should provide all the relevant/essential materials required for record keeping at the disposal of in-service teachers and other school personnel deployed in the basic schools. Also, head teachers should be exposed to modality of keeping and management the school records which should be done through workshops, effective supervisions and mentoring.

EVALUATION OF SURGICAL OUTCOMES OF OSTEOPOROTIC VERTEBRAL COMPRESSION FRACTURE PATIENTS TREATED BY KYPHOPLASTY, AT MILITARY HOSPITAL 105

Purpose: To evaluate the surgical outcomes of osteoporotic vertebral fracture patients treated by kyphoplasty at Military Hospital 105. Subjects and Methods: A descriptive, retrospective study of 34 osteoporotic fractures patients who were treated by kyphoplasty at Military Hospital 105 from January 2021 to December 2021. Results: Immediately post operation, 100% of patients had significant pain relief compared to preoperation (average VAS score after surgery 1.91 ± 1.22); 100% of patients had vertebral body height restored (with moderate level 36.4%, good level 39.4%); The kyphosis corrected spine has statistical significance compared to before treatment (with p &lt; 0.05).

경제성평가자료제출생략 트랙으로 진입한 약제에 대한 외국의 치료적 이익 평가 결과 비교

This study assessed the additional health benefits of the drugs listed through the Economic Evaluation Exemption Procedure (EEEP) in Korea. We conducted a comparative review of 32 EEEP drugs listed between May 2015 and July 2022, comparing how they were assessed in France, Germany, and Canada. To collect the data, we reviewed the evaluations conducted by the relevant agency in each country and identified if the additional benefit exists and how significant it is. Additionally, the size of the benefit gains assessed by each agency was categorized as “High” or “Low,” allowing us to evaluate the consistency among these countries. In France, only 38% of the 34 drugs compared demonstrated moderate or higher levels of additional benefit. Germany acknowledged substantial benefit improvement in 27% of the 30 drugs assessed, while 73% showed minor, unquantifiable, or no additional benefits. In Canada, 5 out of 22 cases have been identified as providing significant additional benefit. The level of inter-country consistency in the assessment results from these three countries was somewhat limited. Based on the evaluation results in France, Germany, and Canada, the additional benefits of EEEP drugs over existing treatments were not substantial in many cases. Even though the EEEP was introduced to improve accessibility to high-cost drugs for medical conditions with unmet needs, it is necessary to reconsider whether to allow exceptions for drugs with low therapeutic value.

Psychometric evaluation and medication usage pattern in Covid-19 patients: A retrospective study

Aim and objective: Assessing and evaluating Psychometric and medication usage patterns in COVID-19 patients retrospective study. assessing the post-COVID-19 subjects, evaluating the drug report in a post-COVID-19 subject, and measuring psychological status. Evaluation of the serious adverse reaction on the south-Indian population of the post-COVID-19 subject. Methodology: In which 150 subjects were taken and 127 participated. Inclusion criteria COVID-19 subject with adult age group, Patient was admitted and discharged before 3 months and above for COVID-19 with positive RT-PCR Report exclusion criteria patient who is recently tested for COVID-19 and pregnant women and lactating women and who are below the adult age group. Where follow-up is done to assess the psychometric evaluation it is a retrospective study with follow-up. Result: 127 patients were analyzed, in that there are 49 female subjects and 78 male subjects, therefore a total of 1 of 27 patients. The vaccination status of the subjects was analyzed with the data depleted. In that, 118 subjects were affected by Covid-19 before vaccination and only 9 subjects were affected after vaccination. In this pandemic, many subjects were Mentally stressed by their Neighborhood and 32 subjects were not stressed. The generalized anxiety disorder score shows that 15 subjects were currently experiencing low risk, 58 subjects were in the mild range, 32 subjects were in the moderate range and 22 subjects were in the mild range. The discharge medication data shows Vitamin C and Multivitamin tablets were prescribed nearly for 114-116 subjects, secondly, Pantoprazole was prescribed for 96 subjects, thirdly Prednisolone was prescribed for 96 subjects and Paracetamol was prescribed for 68 subjects. At last, other drugs are prescribed according to the Co-Morbidities of the subject. Conclusion: 127 patients were analyzed, in that there are 49 female subjects and 78 male subjects. 85 subjects were affected between ages 18-60 years whereas 42 subjects were affected above the age of 60 years. The vaccination and the non-vaccination status report shows that non-vaccinated people are affected more than vaccinated people. The Generalized Anxiety Disorder (GAD) category depletes that the patients experienced mild to moderate levels of anxiety. The Pearson Chi-square value is 23.271 and the P value is &lt;0.001. This shows the association between anxiety with COVID-19 patients. The Major Depression Inventory (MDI) score depletes severe depression which might be due to the pandemic situation, economic situation, and local restrictions. The Pearson Chi-square value is 70.572 and the P-value is &lt;0.001 showing that there is an association between depression and COVID in patients. This shows that post-COVID-19 affected subjects are experiencing Psychological effects in many terms. These Psychological effects are due to COVID-19 and the intake of Steroids during the treatment and after discharge.

The Relationship between Resilience and Overthinking in Adolescents

The aim of this research is to 1) Find out whether there is a relationship between resilience and overthinking in adolescents. 2) See how high the level of resilience is in adolescents. 3) See how high the level of overthinking is in adolescents. 4) Find out which resilience level scale items are identified as not optimal or low; which can be proposed as guidance topics. 5) Find out which overthinking scale items are identified as not optimal or high; which can be proposed as a guidance topic. This research method is quantitative correlational research. This research was aimed at adolescents at Charitas Jakarta High School. The respondents in this study were 218 adolescents. The measuring instruments used are surveys and data collection instruments for two variables, namely the resilience and overthinking. Items are declared valid with the validity coefficient value, namely r ≥ 0.30 and p value 0.05, and the item is declared reliable when the reliability coefficient is greater than 0.70 (r1 0.70). The results of this study prove that: 1) There is a negative relationship with a high level of significance because the Pearson's r value is -0.688 and p .001. 2) The level of resilience possessed by young students at Charitas Jakarta High School is classified as moderate and tends to be high. This is shown by a total of 218 respondents or adolescents who answered the questionnaire. It shows that there are 134 adolescents indicated to be at a moderate level of resilience, 49 others are at a high level of resilience and 6 adolescents are indicated to have very high resilience. 3) The level of overthinking among adolescents is in the medium position. This is proven by a total of 218 adolescents or 48.17% of respondents who are at the level of medium overthinking tends to be low. 4) The items from the resilience variable that were indicated to be low were found and 4 guidance themes were proposed. 5) The items from the overthinking variables that were indicated as high were obtained and 3 guidance topics were proposed.

Synthesis, Spectral Characterization, Antibacterial and Anticancer Evaluation of Novel Isoniazid based Schiff Base Ligand derived Transition Metal Complexes

A novel isoniazid based Schiff base ligand was synthesized by the condensation of 5-acetyl-N-(adamantan-2-yl)thiophene-2-carboxamide (1 mmol) and isoniazid (1 mmol). Metal complexes were prepared by reacting the Schiff base with metal(II) chloride (M = Ni2+, Cu2+ and Co2+), formed the novel metal coordination compound. The synthesized ligand and metal complexes were characterized by 1H NMR, mass spectral, UV-visible, IR &amp; EPR spectral studies, themogravimetric analysis, cyclic voltametry and were screened with both Gram-positive and Gram-negative bacterias to evaluate the antibacterial activity by disc diffusion method. The zone of inhibition of the antibacterial assay demonstrated that all the three metal(II) complexes are active against the four bacterias, showed increased activity with increase in concentration and is more active against S. aureas at all concentrations. The systhesized complexes were also evaluated for its anticancer activities, only Ni(II) and Co(II) complexes showed the moderate levels of cytotoxicity activity.

Exploring Crowd Funding as a Sustainable Financing Option among MSME in Odisha: A Case Study in Khurda District

The Micro, Small, and Medium Enterprises (MSMEs) sector is an essential and dynamic part of the Indian economy. However, these small businesses often face challenges when it comes to raising funds. Crowd funding has become a revolutionary concept in the field of finance, transforming how people and organisations raise money for their endeavours. This study aims to assess the factors affecting crowd funding as a sustainable financing option among Micro, Small, and Medium Enterprises (MSMEs) in Odisha. It also focuses on understanding the level of awareness and knowledge about crowd funding as a new and innovative financial model among the Populace of Odisha. Based upon review of literature and further interviews with the managers of MSME the five key variables which affects the adoption of crowd funding was identified. The survey involved 385 MSMEs from various industrial clusters across Khurda district in Odisha and the samples were selected using the convenience sampling technique. The findings of the study revealed that there is a moderate level of awareness of crowd funding among MSMEs in Odisha. By understanding the current perceptions and attitudes of people of MSMEs in Odisha towards crowd funding, various stakeholders such as investors, regulators, and policymakers can make more informed decisions that can potentially empower the MSME sector and drive economic growth in the region.

Analisis Kemampuan Berpikir Kreatif Matematis Siswa Kelas VII SMP Pada Materi Persamaan Dan Pertidaksamaan Linear Satu Variabel Dengan Menggunakan Hands on Activity

Analisis Kemampuan Berpikir Kreatif Matematis Siswa Kelas VII SMP Pada Materi Persamaan Dan Pertidaksamaan Linear Satu Variabel Dengan Menggunakan Hands on Activity

Influence of affective instability on suicidal ideation beyond traumatic brain injury and posttraumatic stress disorder in veterans

ObjectiveMild traumatic brain injury (TBI) is associated with long-term consequences, including greater risk for posttraumatic stress disorder (PTSD) and suicidal ideation. Affective instability is also independently related to PTSD and suicidality, which may explain why some individuals continue to experience chronic psychiatric complaints following mild TBI. The purpose of the present study was to evaluate affective instability as a key factor for PTSD and suicidal ideation among Veterans with and without TBI. MethodParticipants (N = 299 Veterans; 86.96% male) completed the Personality Assessment Inventory (PAI) and structured clinical interviews for TBI and psychiatric diagnoses. Hierarchical linear regression was used to evaluate main and interaction effects. ResultsThere were no significant differences in affective instability (p = 0.140) or suicidal ideation (p = 0.453) between Veterans with or without TBI. Individuals with TBI were more likely to have a PTSD diagnosis (p = 0.001). Analyses evaluating PTSD diagnosis as an outcome indicated a main effect of affective instability (p < 0.001), but not TBI (p = 0.619). Analyses evaluating suicidal ideation as an outcome demonstrated an interaction effect between PTSD and affective instability beyond the effects of TBI (p = 0.034). ConclusionsSevere Affective instability appears to be a key factor in suicidal ideation among Veterans beyond TBI or PTSD history. PTSD was more strongly associated with suicidality at lower and moderate levels of affective instability. At severe levels of affective instability, however, Veterans with and without PTSD experienced suicidal ideation at similar rates. Findings suggests that high levels of affective instability not better explained by other psychiatric conditions confers similar suicidality risk to that of PTSD in a Veteran population.