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Abstract Objective This study aims to investigate the interrelationship of risk factors for suicidal behaviour and their influence on attempt severity in a sample of adolescents who have recently attempted suicide. For it a network analyse was performed. Method Data from a sample of adolescents from 12 to 17 years of age with documented suicide attempts were collected and analysed in the context of a larger study conducted in Spain called SURVIVE. Several factors were examined including age, sex, depression, trauma, impulsivity, and substance abuse. Graph analysis was performed to identify relationships and centrality measures among these factors. Results A total of 267 participants were enrolled: 233 females and 34 males with a mean age of 15.00 years (SD = 1.52). The results indicate that age and sex do not have a notable relationship with attempt severity in adolescents. Emotional and behavioural difficulties, measured by the Strengths and Difficulties Questionnaire (SDQ), have the greatest influence on other variables. Depression and childhood trauma show varying degrees of association with suicidal behaviour, as does motor impulsivity. Substance use does not appear to be strongly related to suicide attempt severity. The number of suicide attempts is strongly correlated with emotional and behavioural difficulties, depression, and childhood trauma. Lethality of suicide attempts and intensity of suicidal ideation do not show significant associations with the other variables. Conclusion This study identifies significant risk factors for adolescent suicide. Emotional and behavioural symptoms, depression, and childhood trauma are strongly linked to suicidal behaviour. However, age, sex, and substance abuse show minimal correlation. Assessing emotional difficulties and depressive symptoms using specific questionnaires could be crucial in evaluating suicidal behaviour in adolescents. more...

Abstract Background One of the most relevant risk factors for suicide is the presence of previous attempts. The symptomatic profile of people who reattempt suicide deserves attention. Network analysis is a promising tool to study this field. Objective To analyze the symptomatic network of patients who have attempted suicide recently and compare networks of people with several attempts and people with just one at baseline. Methods 1043 adult participants from the Spanish cohort “SURVIVE” were part of this study. Participants were classified into two groups: single attempt group (n = 390) and reattempt group (n = 653). Different network analyses were carried out to study the relationships between suicidal ideation, behavior, psychiatric symptoms, diagnoses, childhood trauma, and impulsivity. A general network and one for each subgroup were estimated. Results People with several suicide attempts at baseline scored significantly higher across all clinical scales. The symptomatic networks were equivalent in both groups of patients (p > .05). Although there were no overall differences between the networks, some nodes were more relevant according to group belonging. Conclusions People with a history of previous attempts have greater psychiatric symptom severity but the relationships between risk factors show the same structure when compared with the single attempt group. All risk factors deserve attention regardless of the number of attempts, but assessments can be adjusted to better monitor the occurrence of reattempts. more...

BackgroundChild maltreatment is associated with a higher probability of mental disorders and suicidal behavior in adolescence. Therefore, accurate psychometric instruments are essential to assess this.ObjectiveTo validate the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in adolescents with suicide attempts.MethodsMultisite cohort study of 208 adolescents with suicide attempts using data from the following scales: Mini International Neuropsychiatric Interview (MINI), Columbia Suicide Severity Rating Scale (C-SSRS), Patient Health Questionnaire (PHQ-9), and CTQ-SF. Statistical analysis: CTQ-SF scores analyzed by descriptive statistics. Internal consistency: McDonald’s omega and Cronbach’s alpha. Concurrent validity with PHQ-9 and C-SSRS scores: Spearman correlation coefficient. Structural validity: Confirmatory factor analysis.ResultsFloor and ceiling effects: Physical abuse and neglect as well as sexual abuse demonstrated high floor effects (50.0, 35.1, and 61.1% of adolescents, respectively). No ceiling effects were found. The CTQ-SF had excellent internal consistency (McDonald’s omega = 0.94), as did the majority of its subscales (Cronbach’s alpha 0.925–0.831) except for physical neglect (0.624). Its concurrent validity was modest, and the emotional neglect subscale had the lowest Spearman correlation coefficients (0.067–0.244). Confirmatory factor analysis: Compared with alternative factor structures, the original CTQ-SF model (correlated 5-factor) exhibited a better fit [S-B χ2 = 676.653, p more...

Suicidal behavior and Non-Suicidal Self-Injuries (NSSIs) are a major health problem in the adolescent population. New technologies can contribute to the development of innovative interventions in suicide prevention. Here, we present the SmartCrisis-Teen study protocol. The study consists of a randomized clinical trial which aims to evaluate the effectiveness of a digital safety plan to prevent suicidal behavior and NSSIs in adolescents. This is a multicentric study which will be conducted among the adolescent population, both in clinical and student settings, with a target sample of 1080 participants. The intervention group will receive an Ecological Momentary Intervention (EMI) consisting of a digital safety plan on their mobile phone. All participants will receive their Treatment As Usual (TAU). Participants will be followed for six months, with weekly and monthly telephone visits and face-to-face visits at three and six months. Participants will be assessed using traditional questionnaires as well as Ecological Momentary Assessment (EMA) and Implicit Association Tests (IATs). With this intervention, we expect a reduction in NSSIs through the acquisition of coping strategies and a decrease in suicidal behavior over the course of follow-up. This study provides a novel, scalable digital intervention for preventing suicidal behavior and NSSIs in adolescents, which could contribute to improving adolescent mental health outcomes globally. more...

Abstract Background Suicidal behavior constitutes a multi-cause phenomenon that may also be present in people without a mental disorder. This study aims to analyze suicidal behavior outcomes in a sample of attempters, from a symptom-based approach. Methods The sample comprised 673 patients (72% female; M = 40.9 years) who attended a hospital emergency department due to a suicide attempt. A wide range of clinical factors (e.g., psychopathology symptoms, psychiatric diagnoses, impulsivity, acquired capability), was administered within 15 days after the index attempt. Nine psychopathology domains were explored to identify the profile of symptoms, using latent profile analysis. The relationship between the profile membership and suicide outcome (i.e., intensity of suicidal ideation, number of suicide behaviors, and medical injury derived from index attempt) was also studied, using linear and logistic regression. Results Three psychopathology profiles were identified: high-symptom profile (45.02% of participants), moderate-symptom profile (42.50%), and low-symptom profile (12.48%). High-symptom profile members were more likely to show higher risk of non-suicidal self-injury, acquired capability for suicide, and more severe suicide behavior and ideation. On the other hand, a more severe physical injury was associated with low-symptom profile membership in comparison to membership from the other profiles (OR more...

BackgroundIn recent decades, the relationship between emotional disorders (i.e., depression and anxiety) and alterations in physiological functions (i.e., inflammation or metabolism) have been well supported. However, studies on a symptom-based approach have provided mixed results. Our study aims to gain insight into how subclinical statuses, featured by elevated depressive and/or anxious symptoms, may influence immunometabolic alterations in the concurrent relationship; and the development of metabolic diseases at 10-year follow-up: diabetes, hypertension and hypercholesterolemia.MethodsData from 758 Greek adults [394 men (aged 41 ± 10 years) and 364 women (aged 37 ± 12 years)] were used. Four groups were created according to the levels of depressive and anxiety symptoms: (1) control group (CG), (2) depressive group (DG), (3) anxiety group (AG) and (4) depressive and anxiety group (DAG). Multi-indicator multi-causes (MIMIC) modeling was used to estimate metabolic function and inflammatory response scores, on a wide selection of blood biomarkers. Finally, a binary logistic regression was carried out to study the influence of symptoms on the development of the aforementioned metabolic diseases on a 10-year follow-up.ResultsGroup membership was not associated with metabolic function score. Conversely, DAG membership was related with higher inflammatory response score (B = 0.20, CI95 = 0.01, 0.40), with respect to the CG (p < 0.05). Both age and sex were significant variables in the calculation of both scores. Regarding disease at 10-year follow-up effect, risk of developing diabetes, hypertension and hypercholesterolemia was associated with age and socioeconomic status. Moreover, DG membership was significant for diabetes risk (OR = 2.08, CI95 = 1.00, 4.22) and DAG for hypercholesterolemia (OR = 1.68, CI95 = 1.16, 2.43).LimitationsData on anti-inflammatory drugs and psychopharmacological medication were not collected in this study.ConclusionsElevated symptoms of depression and anxiety accounts for inflammatory alterations at concurrent relationship and a higher risk of 10-year follow-up metabolic diseases. more...

IntroductionOver the last decade, excessive spontaneous mind wandering (MW) has been consistently associated with emotional disorders. The main aims of the present study were (1) to re-examine the factor structure of the Mind Excessively Wandering Scale (MEWS); (2) to validate the Spanish version of the MEWS; and (3) to conduct a cross-cultural validation of the MEWS in Spanish and UK samples.MethodsA forward/backward translation to Spanish was conducted. Data of 391 Spanish and 713 British non-clinical individuals were analysed.ResultsA revised 10-item version of the MEWS (MEWS-v2.0) demonstrated to be a valid instrument to assess MW. A 2-correlated factor structure properly captured the MEWS-v2.0 variance, accounting for two specific but interrelated dimensions (Uncontrolled thoughts and Mental Overactivity).DiscussionThe Spanish MEWS-v2.0 showed adequate internal consistency and construct validity, as well as appropriate convergent/divergent validity. Cross-cultural analyses showed that MEWS-v2.0 captured the same construct in both UK and Spanish samples. In conclusion, both Spanish and English MEWS-v2.0 demonstrated to be reliable measures to capture spontaneous MW phenomenon in non-clinical adult populations. more...

Spinal metastasis may occur in 40–70% of patients with cancer. Symptoms can vary from pain to spinal cord compression (SCC) and can affect their quality of life (QoL). Stereotactic body radiotherapy (SBRT) allows dose escalation of spinal tumor metastases, minimizing doses to organs at risk and improving pain control. The aim of this study is to retrospectively describe our institution’s experience with robotic SBRT (CyberKnife®, Accuray Incorporated, Sunnyvale, CA, USA) for spinal metastases, in terms of feasibility, oncological results, toxicities, and pain relief observed. In total, 25 patients with 43 lesions were assessed, most of them with dorsal metastases (48.8%). The median total dose was 27 Gy (16–35 Gy), the median number of fractions administered was 3 (1–5), and the median dose per fraction was 9 Gy. Pain was evaluated using the visual analogue scale at baseline and at the end of treatment. The statistically significant reduction in pain (p < 0.01) was associated with the total dose of radiotherapy delivered (p < 0.01). Only one patient developed grade 3 dermatitis. Female gender, adenocarcinoma tumors, and lack of previous surgery were associated with better response to SBRT (p < 0.05). Robotic spine SBRT is feasible, well-tolerated, and improves patients’ QoL through a statistically significant reduction in pain, so it should be offered to patients at an early stage in their process. more...

Background: Children age 5–11 became eligible for COVID-19 vaccination in November 2021 in the United States, but vaccine uptake in this age group remains low. Understanding reasons why parents are hesitant to vaccinate their children may provide critical insights to help protect children from COVID-19 infection. This study examines factors associated with parents' willingness to vaccinate their children. Methods: We conducted a cross-sectional survey focusing on the Los Angeles County adult residents between March and June 2021. Our analytic sample focused on a subgroup of participants who self-report having a child. Predictors included parents' vaccination status and beliefs about COVID-19. We used multivariable logistic regression analysis and calculated the predicted probabilities of parents' willingness to vaccinate their children. Results: Parents (n = 401) who worried about catching the virus, had trust in vaccine development and the COVID-19 vaccine approval process, and vaccinated against COVID-19 were more likely to be willing to vaccinate their children. Socio-economic, racial and ethnic differences were no longer statistically significant in the adjusted model. Predicted probabilities of parents who were willing to vaccine their children were 55% among the vaccinated and 36% among the unvaccinated. Conclusions: Parents' intent to vaccinate their children is influenced by their perceived severity of the pandemic, trust in the vaccine development process, and their vaccination status, which can be the potential drivers of hesitancy to vaccinate their children. more...

IntroductionIn chronic low back pain (CLBP), disturbed body image has been highlighted as a contributor to the condition and a potential target for treatment. The Fremantle Back Awareness Questionnaire (FreBAQ) allows its assessment. Following international guidelines for the cross-cultural translation of questionnaires, we aimed to translate the FreBAQ into Spanish (FreBAQ-S) and validate the new questionnaire in a sample of Spanish-speaking people with CLBP.MethodsTwo hundred and sixty-four adults with CLBP (91 males) and 128 healthy controls (34 males) completed an online form including the FreBAQ-S and questionnaires related to the pain experience. All participants were Spanish and no gender identities differing from biological sex were reported. A week later, 113 CLBP participants and 45 healthy controls (41 and 13 males, respectively), re-answered the FreBAQ-S to evaluate test–retest reliability. Confirmatory factor and multigroup analysis assessed the scale consistency on the patient sample. Discriminant and convergent validity were explored by between-group differences and the relationship with clinical characteristics. Reliability relied on Cronbach’s alpha estimates and test–retest (intraclass correlation coefficient, standard error of measurement, minimal detectable change).Results and discussionConfirmatory factor analysis showed a one-factor structure of the questionnaire, without supporting evidence for item deletion (CFI = 0.97; TLI = 0.96; RMSEA = 0.06; SRMR = 0.07; SRMRu = 0.064). Multigroup analyses do not support mean invariance between groups regarding health condition or sex. The FreBAQ-S demonstrated good discriminant and convergent validity, internal consistency (α = 0.82), and test–retest reliability (ICC = 0.78; SE = 3.41; MDC = 5.12). The FreBAQ-S is a valid and reliable tool to assess back awareness in clinical and non-clinical samples. more...

Treatments aimed at increasing self-perception may improve chronic low back pain (CLBP) symptomatology and present novel management approaches. Consequently, it is important to have valid, complete, and reliable tools for its assessment, and to understand which variables influence altered back awareness. We aimed to evaluate the face/content validity of the Spanish version of the Fremantle Back Awareness Questionnaire (FreBAQ-S) among people with and without CLBP, and to explore additional variables suggested to be involved in back awareness. A total of 264 individuals with CLBP and 128 healthy controls (HC) answered an online survey, including the FreBAQ-S, and questions regarding the completeness, comprehensibility, time-to-complete adequacy, and time spent completing it. If participants declared a lack of completeness, they had to report which aspects would be incorporated into the questionnaire to explore additional back-awareness-related variables. A statistically significant difference in completeness emerged between groups (p < 0.01). The questionnaire was comprehensible for more than 85% of participants, regardless of the group (p = 0.45). CLBP participants spent significantly more time in completing the questionnaire than controls (p < 0.01), but no differences were found between groups regarding the time-to-complete adequacy (p = 0.49). Regarding the back-awareness-related variables, 77 suggestions from CLBP group and seven from the HC were received. Most of them were related to proprioceptive acuity such as posture, weight, or movement patterns, among others. The FreBAQ-S demonstrated adequate face/content validity, completeness, comprehensibility, and adequate time of response. The feedback provided will help improve currently available assessment tools. more...

IntroductionAbnormal cortisol suppression in borderline personality disorder has been consistently reported in previous studies, suggesting that a hypersensitivity response of the hypothalamic-pituitary-adrenal (HPA) axis might occur in these patients. In this study, the abnormalities of the cortisol response in borderline personality disorder (BPD) are investigated through the cellular expression of the glucocorticoid receptors (GR) in BPD patients and its relationship with traumatic experiences.MethodologySixty-nine male and female patients diagnosed with BPD and 62 healthy controls were studied. Peripheral blood mononuclear cells were obtained to investigate the expression of glucocorticoid receptors. Western blot was used to measure protein expression. Statistical correlations of GR expression with BPD clinical features and intensity of previous traumatic events were investigated.ResultsA significant decrease in the nuclear expression of glucocorticoid receptors was found in BPD patients compared to healthy controls in a regression analysis controlling for the effect of medication. GR expression decrease correlated significantly with clinical levels of anxiety and depression, but not with previous traumatic experiences in patients.ConclusionsBPD patients had a lower nuclear expression of glucocorticoid receptors than healthy controls, when it was controlled for the effect of medication. The reduced GR expression in BPD patients was not associated with previous traumatic events and might be associated with other aspects of BPD, such as emotional instability; more studies with larger samples of patients are still needed to understand the relevance and the implications of these findings. more...

BackgroundSocial functioning is often impaired in schizophrenia (SZ) and Alzheimer's disease (AD). However, commonalities and differences in social dysfunction among these patient groups remain elusive.Materials and methodsUsing data from the PRISM study, behavioral (all subscales and total score of the Social Functioning Scale) and affective (perceived social disability and loneliness) indicators of social functioning were measured in patients with SZ (N = 56), probable AD (N = 50) and age-matched healthy controls groups (HC, N = 29 and N = 28). We examined to what extent social functioning differed between disease and age-matched HC groups, as well as between patient groups. Furthermore, we examined how severity of disease and mood were correlated with social functioning, irrespective of diagnosis.ResultsAs compared to HC, both behavioral and affective social functioning seemed impaired in SZ patients (Cohen's d's 0.81-1.69), whereas AD patients mainly showed impaired behavioral social function (Cohen's d's 0.65-1.14). While behavioral indices of social functioning were similar across patient groups, SZ patients reported more perceived social disability than AD patients (Cohen's d's 0.65). Across patient groups, positive mood, lower depression and anxiety levels were strong determinants of better social functioning (p's ConclusionsAD and SZ patients both exhibit poor social functioning in comparison to age- and sex matched HC participants. Social dysfunction in SZ patients may be more severe than in AD patients, though this may be due to underreporting by AD patients. Across patients, social functioning appeared as more influenced by mood states than by severity of disease. more...

The coronavirus SARS-CoV-2 generated an alert that became a state of emergency in health issues worldwide, a situation that affected the entire population, including pregnant women. The present study aims to understand the effect of the psychopathological profile of a sample of pregnant women at the time of the COVID-19 pandemic on themselves during childbirth (Phase 1) and after childbirth and the anthropometric measures of the neonate at birth (Phase 2). The total sample comprises 81 pregnant women aged 32.07 years (SD = 5.45) and their neonates. Sociodemographic and obstetric data of the sample were collected. During pregnancy, psychopathology was measured by means of the SCL-90, as well as other psychological measures on stress and social support. Cluster k-means techniques were used to uncover the heterogeneous profiles of psychopathology in Phase 1. Two main psychopathological profiles were found (Cluster 1: High psychopathological symptoms; Cluster 2: Low psychopathological symptoms). The clusters generated show significant differences in all the SCL-90-R subscales used and in the general index at Phase 1. After childbirth, high psychopathology profile membership was associated with a greater probability of having a non-eutocic delivery. On the other hand, the low psychopathological symptoms cluster shows higher levels of depressive symptoms, hostility, paranoid ideation, and psychotic symptoms in Phase 2. In conclusion, there seemed to exist two heterogeneous profiles of psychopathology in pregnant women during the pandemic; the stress related to the pandemic seemed uninfluential on the development of a profile of high psychopathological symptoms and the psychopathology profile may influence delivery and postpartum outcomes. more...

Substance use is a common public health problem among adolescents in low- and middle-income countries (LMICs), however, factors that are associated with this condition are not clearly understood. The aim of the present study was to examine personal and interpersonal factors that contribute to risk for substance use among adolescents in six ASEAN (Association of Southeast Asian Nations) LMICs (i.e., Indonesia, Laos, Malaysia, Myanmar, Philippines and Thailand). Data of 57,825 adolescents (52.64% girls; median age = 14 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After the weighted prevalence was estimated for each country, multilevel models were employed to examine the influence of the risk factors on the prevalence of substance use across the countries. The results indicated a high prevalence of substance use among adolescents in all these six ASEAN LMICs. Alcohol use, smoking and drug use were more prevalent among adolescents in Thailand, Laos and Philippines.Adolescents who were bullied and who had no close friends had a high prevalence of alcohol and drug use. Problematic drinking and smoking were more prevalent among older adolescents, and smoking and drug use were more prevalent among boys. Furthermore, frequent worry, loneliness and regular physical activity were found to predict adolescents’ heavy and binge drinking. This study contributed to knowledge on risk factors for specific substance use among adolescents and drew attention for the urgent need to strengthen the intervention, law policies and professional support for reducing substance use in ASEAN LMICs. more...

Introduction: Adolescence is a critical developmental stage for the initiation of substance use worldwide. However, the prevalence of various types of substances consumed by adolescents living in low- and middle- income countries (LMICs) across different continents is not fully understood.The aims of the present study were to estimate the prevalence of regular and problematic substance use among adolescents in 73 LMICs across different continents and to explore the role of country-specific factors on this prevalence. Method: Data of 314,187 adolescents (52.79% girls; median age = 15 years old) who participated in the Global School-based Student Health Survey (GSHS) were analysed. After estimating the weighted prevalence for each country, multilevel models were used to examine the influence of country-specific factors on the prevalence of substance use across 73 LMICs. Results: The results indicated that problematic alcohol use was more prevalent in LMICs with higher income levels. The prevalence of regular alcohol use was the highest in Zambia. Regular and problematic alcohol use was the least prevalent in Senegal and Myanmar. The findings also revealed that smoking and the consumption of marijuana and amphetamine were the most common among adolescents in Samoa, whereas the prevalences for these substances were the lowest in Laos. Conclusion: Economic wealth, religion and geographical factors seem to have a role in determining the prevalence of substance use among adolescents in LMICs. more...

The Central Andes in northwestern Argentina are characterized by steep topographic and climatic gradients. The humid foreland areas at 1 km asl elevation rapidly rise to over 5 km in the eastern Cordillera, and they form an orographic rainfall barrier on the eastern windward side. This topographic setting combined with seasonal moisture transport through the South American monsoon system leads to intense rainstorms with cascading effects such as landsliding and flooding. In order to better quantify the dynamics of water vapour transport, we use high-temporal-resolution global navigation satellite system (GNSS) remote sensing techniques. We are particularly interested in better understanding the dynamics of high-magnitude storms with high water vapour amounts that have destructive effects on human infrastructure. We used an existing GNSS station network with 12 years of time series data, and we installed two new ground stations along the climatic gradient and collected GNSS time series data for three years. For several stations we calculated the GNSS signal delay gradient to determine water vapour transport direction. Our statistical analysis combines in situ rainfall measurements and ERA5 reanalysis data to reveal the water vapour transport mechanism for the study area. The results show a strong relationship between altitude and the water vapour content, as well as between the transportation pathways and the topography. more...

Summary: Background: The rapid growth of the size of the older population is having a substantial effect on health and social care services in many societies across the world. Maintaining health and functioning in older age is a key public health issue but few studies have examined factors associated with inequalities in trajectories of health and functioning across countries. The aim of this study was to investigate trajectories of healthy ageing in older men and women (aged ≥45 years) and the effect of education and wealth on these trajectories. Methods: This population-based study is based on eight longitudinal cohorts from Australia, the USA, Japan, South Korea, Mexico, and Europe harmonised by the EU Ageing Trajectories of Health: Longitudinal Opportunities and Synergies (ATHLOS) consortium. We selected these studies from the repository of 17 ageing studies in the ATHLOS consortium because they reported at least three waves of collected data. We used multilevel modelling to investigate the effect of education and wealth on trajectories of healthy ageing scores, which incorporated 41 items of physical and cognitive functioning with a range between 0 (poor) and 100 (good), after adjustment for age, sex, and cohort study. Findings: We used data from 141 214 participants, with a mean age of 62·9 years (SD 10·1) and an age range of 45–106 years, of whom 76 484 (54·2%) were women. The earliest year of baseline data was 1992 and the most recent last follow-up year was 2015. Education and wealth affected baseline scores of healthy ageing but had little effect on the rate of decrease in healthy ageing score thereafter. Compared with those with primary education or less, participants with tertiary education had higher baseline scores (adjusted difference in score of 10·54 points, 95% CI 10·31–10·77). The adjusted difference in healthy ageing score between lowest and highest quintiles of wealth was 8·98 points (95% CI 8·74–9·22). Among the eight cohorts, the strongest inequality gradient for both education and wealth was found in the Health Retirement Study from the USA. Interpretation: The apparent difference in baseline healthy ageing scores between those with high versus low education levels and wealth suggests that cumulative disadvantage due to low education and wealth might have largely deteriorated health conditions in early life stages, leading to persistent differences throughout older age, but no further increase in ageing disparity after age 70 years. Future research should adopt a lifecourse approach to investigate mechanisms of health inequalities across education and wealth in different societies. Funding: European Union Horizon 2020 Research and Innovation Programme. more...

Growing evidence supports the hypothesis that temperamental traits are not static throughout adolescence. The known links between both reactive and regulatory temperament and anxiety symptoms should be investigated bearing this hypothesis in mind. This study collected self-reported data on behavioral inhibition system (BIS) sensitivity, attentional control (AC), and anxiety symptomatology, from 296 adolescents (64.2% girls; M = 12.96 years at the first assessment, SD = 0.47) every six months, four times over eighteen months. The relationships between temperament factors (AC and BIS sensitivity), considered longitudinally (by means of their trajectories) and anxiety symptoms were investigated using Multigroup Latent Growth Modeling (MLGM), as well as the mediating effect of sex on trajectories and anxiety. BIS sensitivity decreased over time and showed differential patterns across sexes. AC remained relatively stable and we found no sex influence on its trajectory. On the other hand, we observed that the BIS sensitivity trajectory was a significant predictor of anxiety symptomatology at age 15. In conclusion, temperamental changes between the ages of 13 and 15 seem to play a relevant role in explaining subsequent anxiety symptomatology, under the mediating influence of sex. more...

This retrospective study aimed to provide some clinical outcomes regarding effectiveness, toxicity, and quality of life in PCa patients treated with dose-escalated moderately hypofractionated radiation therapy (HFRT). Patients received HFRT to a total dose of 66 Gy in 22 fractions (3 Gy/fraction) delivered via volume modulated arc therapy (VMAT) in 2011–2016. Treatment effectiveness was measured by the biochemical failure-free survival rate. Toxicity was assessed according to the criteria of the Radiation Therapy Oncology Group (RTOG) and quality of life according to the criteria of the European Organization for Research and Treatment of Cancer (EORTC). In this regard, quality of life (QoL) was measured longitudinally, at a median of 2 and 5 years after RT. Enrolled patients had low-risk (40.2%), intermediate-risk (47.5%), and high-risk (12.3%) PCa. Median follow-up was 75 months. The biochemical failure-free survival rate was 94.2%. The incidence of acute grade 2 or higher gastrointestinal (GI) and genitourinary (GU) toxicity was 9.84% and 28.69%, respectively. The incidence rate of late grade 2 or higher GI and GU toxicity was 1.64% and 4.10%, respectively. Expanded Prostate Cancer Index Composite (EPIC) scores showed that the majority of patients maintained their QoL. HFRT to 66 Gy with VMAT was associated with adequate biochemical control, low toxicity and good reported GU and GI quality of life. more...

During the gestation period, pregnant women experience physical and psychological changes, which represent vulnerability factors that can boost the development of mental health conditions. The COVID-19 pandemic is producing new changes in the routines of the whole society, especially on lifestyle habits. The psychological impact associated with the COVID-19 pandemic and pregnant women remains unclear. A scoping review regarding the psychological impact of the COVID-19 pandemic on pregnant women was conducted. Searchers were conducted using the PubMed, Web of Science and CINAHL databases. Articles in Spanish, English and French were included. The search was conducted between November 2020 and September 2021. We identified 31 studies that evaluated 30,049 expectant mothers during the COVID-19 pandemic. Pregnant women showed high levels of anxiety and depression symptomatology. Fear of contagion and concerns regarding the health of the fetus were identified as the main variables related to psychological distress. An increase of the levels of depression, anxiety and stress during the COVID-19 pandemic amongst pregnant women has been observed. Moreover, an increased vulnerability of the fetus due to placental metabolic alterations is discussed. This review suggests that the COVID-19 pandemic is associated with a negative psychological impact on pregnant women. Thus, high levels of anxiety and depression symptoms suggest the need for a systematic approach. more...

Atmospheric water vapour content is a key variable that controls the development of deep convective storms and rainfall extremes over the central Andes. Direct measurements of water vapour are challenging; however, recent developments in microwave processing allow the use of phase delays from L-band radar to measure the water vapour content throughout the atmosphere: Global Navigation Satellite System (GNSS)-based integrated water vapour (IWV) monitoring shows promising results to measure vertically integrated water vapour at high temporal resolutions. Previous works also identified convective available potential energy (CAPE) as a key climatic variable for the formation of deep convective storms and rainfall in the central Andes. Our analysis relies on GNSS data from the Argentine Continuous Satellite Monitoring Network, Red Argentina de Monitoreo Satelital Continuo (RAMSAC) network from 1999 to 2013. CAPE is derived from version 2.0 of the ECMWF’s (European Centre for Medium-Range Weather Forecasts) Re-Analysis (ERA-interim) and rainfall from the TRMM (Tropical Rainfall Measuring Mission) product. In this study, we first analyse the rainfall characteristics of two GNSS-IWV stations by comparing their complementary cumulative distribution function (CCDF). Second, we separately derive the relation between rainfall vs. CAPE and GNSS-IWV. Based on our distribution fitting analysis, we observe an exponential relation of rainfall to GNSS-IWV. In contrast, we report a power-law relationship between the daily mean value of rainfall and CAPE at the GNSS-IWV station locations in the eastern central Andes that is close to the theoretical relationship based on parcel theory. Third, we generate a joint regression model through a multivariable regression analysis using CAPE and GNSS-IWV to explain the contribution of both variables in the presence of each other to extreme rainfall during the austral summer season. We found that rainfall can be characterised with a higher statistical significance for higher rainfall quantiles, e.g., the 0.9 quantile based on goodness-of-fit criterion for quantile regression. We observed different contributions of CAPE and GNSS-IWV to rainfall for each station for the 0.9 quantile. Fourth, we identify the temporal relation between extreme rainfall (the 90th, 95th, and 99th percentiles) and both GNSS-IWV and CAPE at 6 h time steps. We observed an increase before the rainfall event and at the time of peak rainfall—both for GNSS-integrated water vapour and CAPE. We show higher values of CAPE and GNSS-IWV for higher rainfall percentiles (99th and 95th percentiles) compared to the 90th percentile at a 6-h temporal scale. Based on our correlation analyses and the dynamics of the time series, we show that both GNSS-IWV and CAPE had comparable magnitudes, and we argue to consider both climatic variables when investigating their effect on rainfall extremes. more...

Introducción/Objetivos: Este informe breve tiene por objetivo poner a prueba dos predicciones derivadas de un reciente modelo sobre los resultados en psicoterapia: (a) solo un tratamiento de alta intensidad sería capaz de cambiar de dirección una trayectoria ascendente de ansiedad, y (b) tanto un tratamiento de alta como de baja intensidad podrían influir en una trayectoria noascendente de ansiedad. Método: Setenta y cuatro adolescentes (58,40% chicas; M= 14,65 a˜nos, = 0,53) fueron asignados aleatoriamente a una de estas condiciones: tratamiento de alta intensidad, tratamiento de baja intensidad o lista de espera. Resultados: Solo la aplicación del tratamiento de alta intensidad permitió reducir los niveles de ansiedad en los adolescentes con trayectoria creciente de dicha sintomatología (p < 0,01). Además, ambos tratamientos redujeron de forma equivalente la sintomatología en individuos con trayectoria no ascendente de ansiedad. Conclusiones: Estos resultados apoyan las predicciones teóricas propuestas y subrayan la necesidad de considerar no solamente la magnitud de la sintomatología ansiosa sino también su curso temporal, en contextos clínicos more...

The COVID-19 pandemic has altered the normal course of life, with measures to reduce the virus spread impacting motherhood expectations and, in particular, breastfeeding practices. This study aimed to review evidence regarding the impact of COVID-19 on breastfeeding plans and how these relate to women’s psychological outcomes. Searches were conducted on PubMed and Web of Science for studies in English, Spanish, and Portuguese between January 2020 and January 2021. All study designs and pre-prints were considered. Twelve studies were included. Reports suggest that COVID-19 impacts differently on breastfeeding plans, which in turn leads to distinctive mental health outcomes. Positive breastfeeding experiences have been observed when mothers perceive that they have more time for motherhood, which may be associated with better mental health outcomes. Negative breastfeeding experiences have been observed when mothers are separated from their newborns, when mothers struggle with breastfeeding, or when mothers perceive decreased family and professional support, which seems to be associated with worse mental health outcomes. These preliminary results highlight the need for further research into the association between COVID-19, breastfeeding expectations, and maternal mental health. Filling this gap will foster the development of guidelines and interventions to better support mothers experiencing the obstacles of COVID-19 pandemic. more...

The COVID-19 ongoing pandemic constitutes a major challenge for countries throughout the world due to the rapid spread of SARS-CoV-2 and devastating consequences in health. No one is free from COVID-19 impact. In this regard, pregnant women are not the exception. The COVID-19 outbreak represents a massive source of stressful agents for women and their babies during the perinatal period. The COVID-19 pandemic has been suggested to potentially have short- and long-term detrimental effects on pregnant women and the baby. These adverse consequences range from mental to medical diseases. During the last centuries, several dreadful and fatal incidents have put pregnant women and their babies at higher risk of mortality and health deterioration. For example, it has been informed that women exposed to the 1918 flu pandemic (commonly known as the Spanish flu) while pregnant showed higher rates of premature delivery in the short term. Long-term consequences have also been reported and individuals (both males and females) who were exposed to the 1918 flu pandemic while in utero had a higher risk of developing schizophrenia, diabetes, coronary heart disease or cancer throughout their lifespan. more...

Background: The association between decreased heart rate variability (HRV) and increased internalizing symptoms is well documented. Adolescence is a critical period for the development of mental health problems, in particular internalizing symptoms. Previous research has illustrated sex differences in adolescent HRV, such that females have reduced short-term resting state HRV compared to males. Studies on long-term ecological recordings of HRV in adolescents are scarce. The aims of the present study were, (a) to test if adolescent females show decreased long-term HRV and cardiac complexity (CC) compared to males, and (b) to explore whether sex and HRV and CC measures, as well as their interaction, would predict internalizing symptoms.Materials and Methods: HRV was recorded in n = 166 adolescents (86 girls), on a normal school day. HRV and CC measures were calculated on the interbeat interval time series.Results: Females showed lower HRV and CC in most of the assessed indices. Internalizing symptoms were mainly predicted by HRV whereas sex only predicted symptoms of social anxiety. The interaction between sex and HRV did not predict internalizing symptoms.Conclusions: Results suggest that reduced HRV should be considered as a potential contributor to exacerbating internalizing symptoms in adolescence. Girls with reduced HRV and CC might be prone to the development of internalizing disorders. HRV is a promising tool for the early identification of vulnerability. more...

Este estudio pretende conocer el efecto de los tratamientos psicológicos sobre la calidad de vida de pacientes y supervivientes de cáncer, así como la influencia moderadora de variables médicas y propias del tratamiento sobre dicho efecto. Para ello, se realizó un meta-análisis que incluyó 78 trabajos publicados entre 1970 y 2012. Se analizaron aspectos relacionados con la muestra, el tratamiento y la calidad metodológica de estos estudios. Como resultado, se encontró un tamano˜ del efecto significativo de los tratamientos psicológicos sobre la calidad de vida (g = 0,35). Dicho efecto estaba moderado por el estado clínico del paciente y la adyuvancia del tratamiento psicológico con el médico (p < 0,05). También se observó que mayores reducciones de sintomatología depresiva debidas al tratamiento llevaban a mayores beneficios sobre la calidad de vida según las meta-regresiones ejecutadas (R2 = 0,30). En conclusión, los tratamientos psicológicos pueden mejorar la calidad de vida de pacientes oncológicos, principalmente cuando deben afrontar tratamientos médicos, así como de los supervivientes. Además, cuando se reduce la sintomatología depresiva la calidad de vida suele mejorar. Estos resultados destacan la influencia decisiva de los tratamientos psicológicos para la salud integral en contextos oncológicos. more...

Introducción/Objetivo: Se ha asociado la existencia de sintomatología ansiosa con algunas propiedades lineales de la variabilidad cardiaca (VC), sin prestar demasiada atención a propiedades más esenciales del sistema cardiaco, como su naturaleza fractal. En este trabajo se pretendía evaluar si medidas de fractalidad (exponentes alométricos) y medi - das de VC (potencia en la banda de altas frecuencias, AF) permitían distinguir entre 24 adolescentes con alta sintomatología ansiosa y 26 adolescentes con baja. Además, se perseguía explorar las asociaciones de estas medidas con sensibilidad al castigo (SC), un factor de riesgo para ansiedad. Método: Se tomó la actividad cardiaca de los adolescen - tes en contexto ecológico y se calcularon dichas medidas sobre registros de 90 minutos. Resultados: Se encontraron exponentes alométricos significativamente mayores para los adolescentes con alta ansiedad ( p < 0,05), sin observarse diferencias significativas en potencia de AF ( p = 0,057). Además, sólo se encontraron correlaciones positivas significa - tivas entre los exponentes alométricos con SC, y dichos exponentes con varias escalas de ansiedad. Conclusiones: Estos resultados muestran que propiedades más básicas del sis - tema cardiaco parecen estar alteradas en adolescentes ansiosos más allá de la mera in - fluencia parasimpática. Estas propiedades pueden aportar información relevante para la detección y prevención de trastornos de ansiedad. more...

The interactions between atmosphere and steep topography in the eastern south–central Andes result in complex relations with inhomogenous rainfall distributions. The atmospheric conditions leading to deep convection and extreme rainfall and their spatial patterns—both at the valley and mountain-belt scales—are not well understood. In this study, we aim to identify the dominant atmospheric conditions and their spatial variability by analyzing the convective available potential energy (CAPE) and dew-point temperature ( T d ). We explain the crucial effect of temperature on extreme rainfall generation along the steep climatic and topographic gradients in the NW Argentine Andes stretching from the low-elevation eastern foreland to the high-elevation central Andean Plateau in the west. Our analysis relies on version 2.0 of the ECMWF’s (European Centre for Medium-Range Weather Forecasts) Re-Analysis (ERA-interim) data and TRMM (Tropical Rainfall Measuring Mission) data. We make the following key observations: First, we observe distinctive gradients along and across strike of the Andes in dew-point temperature and CAPE that both control rainfall distributions. Second, we identify a nonlinear correlation between rainfall and a combination of dew-point temperature and CAPE through a multivariable regression analysis. The correlation changes in space along the climatic and topographic gradients and helps to explain controlling factors for extreme-rainfall generation. Third, we observe more contribution (or higher importance) of T d in the tropical low-elevation foreland and intermediate-elevation areas as compared to the high-elevation central Andean Plateau for 90th percentile rainfall. In contrast, we observe a higher contribution of CAPE in the intermediate-elevation area between low and high elevation, especially in the transition zone between the tropical and subtropical areas for the 90th percentile rainfall. Fourth, we find that the parameters of the multivariable regression using CAPE and T d can explain rainfall with higher statistical significance for the 90th percentile compared to lower rainfall percentiles. Based on our results, the spatial pattern of rainfall-extreme events during the past ∼16 years can be described by a combination of dew-point temperature and CAPE in the south–central Andes. more...

In the last years, the use of radio occultation (RO) technique to observe the terrestrial atmosphere and the climate takes advantage of the occultation of the Sun, the Moon, the stars and principally of artificial satellites of low height (LEO). In the latter case, crossed signs between LEO and GPS satellites are used. The application of RO's technology using transmitters of the GPS system in high orbits and recipients on board of low orbit satellites, has provided profiles of atmospheric refractivity very precise. The basic idea of a RO is to observe how waves emitted by a GPS are propagated in the atmosphere. The ray trajectory associated to a radio wave between a GPS and a LEO, while these are hiding themselves mutually due to the interposition of the Earth, is deviated due to refractivity gradients. The ray bending angle is obtained from a change in the phase (Doppler shift) of the signal received by the LEO. Assuming spherical symmetry, the deviation information may be inverted by an Abel transformation to obtain a vertical profile of the index of refraction. From atmospheric profiles of refractivity and an atmospheric model, several parameters are obtained: from temperature (T), pressure, geopotential height and water vapor to minor species as aerosols, cloud liquid water and ionospheric electron density. The enormous advantage offered by the coverage in the whole planet, above the continental and oceanic territories, the 1K T resolution, the long term stability and mainly the absence of any restriction imposed by climatic conditions, makes the GPS RO technique unique among different remote sensing atmospheric systems. Up to now, hundreds of thousands of soundings have been processed, from the first satellites to recent (SAC-C, CHAMP, GRACE, COSMIC, TerraSAR-X, MetOp). In the present work, examples of global and regional water vapor and atmospheric wave energy distributions will be shown. It will be put on special emphasis on the mountainous regions of the Andes Range at middle latitudes and the Antarctic Peninsula and case studies will be analyzed. This analysis will be complemented by WRF model simulations and with measured T profiles in the regions of interest. In particular it will be shown: i) the spatial distribution of stationary gravity waves, ii) their propagation in the lower and middle atmospheres, and iii) the possible relevance of mountain waves as a triggering mechanism of seep convection processes with hail production. Key words: satellite radio occultation, gravity waves. more...

Este artículo explora algunas de las más significativas expresiones de la caricatura republicana durante la época de la Intervención francesa y el Segundo Imperio. Pone particular atención a las representaciones de monstruos y criaturas zoomorfas que habitaban el imaginario de la sátira política de mediados del siglo XIX, analizando los usos de la imagen como elementos cruciales de la propaganda, la lucha política y la confrontación de proyectos de nación. Así, el artículo propone un recorrido iconográfico por una singular galería de deformidades que fungían como retratos bufos de la escena política y de la sociedad, a la vez que exponían un enjuiciamiento moral de la convulsa situación nacional. more...

Aim: Women diagnosed and surgically treated for early-stage breast cancer were studied to determine the influence that sociodemographic variables, type of surgery, amount of social support, and quality of life had on their body image and self-esteem. Method: Subjects n=54; Measures: Self Esteem Scale (Rosenberg, 1965), Body Image Questionnaire (authors´article) and E.O.R.T.C. (Quality of life) (Aaronson et al, 1988) Result and conclusions: Analyses of variance showed that married women reported a more positive body image than non married women, and so did women with a lumpectomy versus those with a mastectomy. These variables did not relate significantly to the patients’ self-esteem, which in turn was found to be higher in women aged 43-55 years old when compared to younger women. Correlational analyses revealed a significant negative correlation between the deterioration of quality of life after surgery and both body image and more...

Los autores destacan la importancia del tema en Latinoamérica, donde muchos pueblos han sido afectados por conflictos armados de larga duración y grandes grupos de población se han desplazado o refugiado. Se detallan algunas investigaciones realizadas y datos epidemiológicos que ponen de manifiesto el significado de las consecuencias psicosociales de eventos traumáticos de esta índole. Además de los trastornos psicopatológicos que aparecen como consecuencia del trauma, es necesario considerar otros fenómenos como el miedo, la aflicción, el desorden social, la violencia y el consumo de sustancias psicoactivas. Se hace referencia a las lecciones aprendidas en los últimos años, así como a los retos enfrentados y a las perspectivas que se tienen para el futuro. Finalmente, se analizan las principales líneas de acción de un plan de salud mental en situaciones de emergencia, que serían: el diagnóstico preliminar, así como el incremento, la descentralización y el fortalecimiento de los servicios públicos de salud mental; también se subraya la atención psicosocial a los trastornos más prevalentes -con énfasis en niñez y juventud- por personal no especializado y la atención que debe desarrollarse por psicólogos o psiquiatras. Otros aspectos a tener en cuenta serían la educación comunitaria, capacitación, comunicación social, organización comunitaria, participación social, coordinación interinstitucional, flexibilidad, sostenibilidad y acciones específicas de acuerdo con las necesidades locales. more...

En los últimos años, el uso del principio de radio ocultamiento (RO) satelital para observar la atmósfera terrestre y el clima aprovecha los ocultamientos bajo el horizonte del sol, de la luna, de las estrellas y principalmente de satélites artificiales de baja altura (LEO). En este último caso, se utilizan señales cruzadas entre satélites LEO y satélites de gran altura GPS. La aplicación de la técnica de RO usando transmisores del sistema de GPS en órbitas altas y receptores a bordo de satélites de baja órbita, ha provisto perfiles de refractividad atmosférica muy precisos. La idea básica de un RO es observar como las ondas de radio emitidas por los GPS se propagan en la atmósfera. La trayectoria del rayo asociado a una onda de radio entre un LEO y un satélite GPS, mientras se están ocultando mutuamente por interponerse la Tierra entre ambos, atraviesa la atmósfera desviándose debido a gradientes de refractividad. El ángulo de desviación del rayo se obtiene a partir de un cambio en el retraso de la fase (corrimiento Doppler) de la señal GPS recibida por el LEO. Suponiendo simetría esférica, la información de la desviación puede ser invertida mediante una transformación de Abel, y así obtener un perfil vertical del índice de refracción. A partir de perfiles atmosféricos verticales de refractividad y de un modelo atmosférico, se obtienen diversos parámetros indirectamente: desde temperatura (T), presión, altura geopotencial y vapor de agua, hasta especies minoritarias como aerosoles, agua líquida de las nubes y densidad electrónica ionosférica. La enorme ventaja ofrecida por la cobertura en todo el planeta, tanto sobre los territorios continentales como oceánicos, la resolución en T menor que 1 K, la estabilidad a largo plazo y fundamentalmente la ausencia de cualquier limitación impuesta por posibles condiciones climáticas, hace a la técnica de RO GPS única dentro de los diferentes sistemas de sensado remoto de la atmósfera. Hasta la actualidad ha sido obtenida y procesada una base de datos con varios cientos de miles de sondeos de este tipo, recogidos por los primeros satélites LEO y posteriores (SAC-C, CHAMP, GRACE, COSMIC, TerraSAR-X, MetOp). En el presente trabajo, se mostrarán ejemplos de resultados, a escala global y regional de la distribución de vapor de agua y de energía asociada a ondas atmosféricas, mediante datos de RO GPS. Se pondrá especial énfasis sobre las regiones montañosas de la cordillera de los Andes a latitudes medias y de la península antártica, para lo cual se analizarán individualmente eventos de RO de interés, a partir de las excepcionales características observables de OIG en dicha región. Dicho análisis será complementado con simulaciones numéricas con el modelo de mesoescala WRF, versión 3.2. y con perfiles de T de RO disponibles en las regiones de interés. En particular, se mostrará: i) la distribución espacial de ondas internas de gravedad (OIG) estacionarias, ii) su propagación en las atmósferas baja y media y iii) la posible importancia relativa de las ondas de montaña como mecanismo de detonación de procesos de convección profunda con generación de granizo. more...