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Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24-71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. The total distance covered by deletions crossing over known neurodevelopmental CNV regions was significant (beta = 0.029, SE = 0.005, P = 6.3 × 10-8). The genome-wide neurodevelopmental CNV burden identified explains 0.034% of the variation in PTSD symptoms. The 15q11.2 BP1-BP2 microdeletion region was significantly associated with PTSD (beta = 0.0206, SE = 0.0056, P = 0.0002). No individual significant genes interrupted by CNV were identified. 22 gene pathways related to the function of the nervous system and brain were significant in pathway analysis (FDR q

Background\ud Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWAS).\ud Methods\ud GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European Ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with LD-score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program (MVP) GWAS of PTSD total symptoms.\ud Results\ud GWAS of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four out of these 9 PTSD loci were independently replicated in MVP.\ud Conclusion\ud Through using a quantitative trait measure of PTSD, we identify novel risk loci not previously identified using prior case/control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods.

Prvi svetski rat se smatra prelomnim događajem XX veka i periodom koji je označio kraj jedne faze moderne svetske istorije i najavio početak naredne. Kada se na globalnom planu analizira geopolitička, ekonomska, društvena i umetnička situacija pre i nakon završetka sukoba, jasno je da su u pitanju dve potpuno drugačije slike sveta koje su se, očekivano, reflektovale i na stanje svesti ljudi koji su preživeli taj period.Shodno tome, komparativna analiza predratne i poratne književnosti objašnjava kako su pisci doživeli taj trusni period i u kom kontekstu se njihovo osećanje stvarnosti i umetnosti menja tokom ratnih godina. Kao taoci slučaja u kojem su se našli, različiti pisci manifestuju različita ponašanja na osnovu iskustava koje nose iz rata. Književno stvaralaštvo inspirisano ratom mora se povezati sa biografijom pisaca, učešćem ili neučešćem u sukobima i snalaženjem u poratnom svetu, ali i sa njihovim poetičkim načelima, opusom i odnosom prema poziciji umetnika i umetnosti uopšte.Srpski i angloamerički pisci obezbeđuju potrebnu širinu da se uvidi sveobuhvatnost književnosti o Prvom svetskom ratu jer su među njima direktni učesnici sukoba, oni koji su rat preživali daleko od fronta, pisci ratnih putopisa i memoara, kao i spisateljice koje su u ratu imale specifičnu ulogu, dok su njihova iskustva dovoljno sadržajna i obimna da predstave sve aspekte rata. Sa druge strane, među njima postoje određena razdvajanja uslovljena istorijskim prilikama i, kako se istraživanje zasniva na analizi biografskog predloška, bitno je pronaći i objasniti različita ratna iskustva, zbog čega se pripadnici srpske, engleske i američke književnosti nameću kao adekvatan izbor usled tri različite pozicije svojih zemalja pre i tokom rata. Autori koje obrađuje disertacija su Miloš Crnjanski, Stanislav Krakov, Dušan Vasiljev, Dragiša Vasić, Rastko Petrović, Isidora Sekulić, Ernest Hemingvej, Vilijam Fokner, Virdžinija Vulf, Rebeka Vest, Džon Dos Pasos i Ford Madoks Ford.

Key Points Question Which mechanisms underlie the negative association of posttraumatic stress disorder (PTSD) with traits related to educational attainment (EA)? Findings In this mendelian randomization study based on large-scale genomic data sets, including data from more than 1 million individuals, EA was negatively associated with PTSD, also supporting the role of economic status as a mediator in this association. Meaning This study suggests that economic status may mediate the association of EA with PTSD independent of the brain mechanisms associated with EA., This mendelian randomization study investigates the association of posttraumatic stress disorder and traits associated with educational attainment., Importance There is a well-established negative association of educational attainment (EA) and other traits related to cognitive ability with posttraumatic stress disorder (PTSD), but the underlying mechanisms are poorly understood. Objectives To investigate the association of PTSD with traits related to EA. Design, Setting, and Participants Genetic correlation, polygenic risk scoring, and mendelian randomization (MR) were conducted including 23 185 individuals with PTSD and 151 309 control participants from the Psychiatric Genomics Consortium for PTSD and up to 1 131 881 individuals assessed for EA and related traits from UK Biobank, 23andMe, and the Social Science Genetic Association Consortium. Data were analyzed from July 3 through November 19, 2018. Main Outcomes and Measures Genetic correlation obtained from linkage disequilibrium score regression, phenotypic variance explained by polygenic risk scores, and association estimates from MR. Results Summary association data from multiple genome-wide association studies were available for a total of 1 180 352 participants (634 391 [53.7%] women). Posttraumatic stress disorder showed negative genetic correlations with EA (rg = −0.26; SE = 0.05; P = 4.60 × 10−8). Mendelian randomization analysis, conducting considering a random-effects inverse-variance weighted method, indicated that EA has a negative association with PTSD (β = −0.23; 95% CI, −0.07 to −0.39; P = .004). Investigating potential mediators of the EA-PTSD association, propensity for trauma exposure and risk-taking behaviors were observed as risk factors for PTSD independent of EA (trauma exposure: β = 0.37; 95% CI, 0.19 to 0.52; P = 2.57 × 10−5; risk-taking: β = 0.76; 95% CI, 0.38 to 1.13; P = 1.13 × 10−4), while income may mediate the association of EA with PSTD (MR income: β = −0.18; 95% CI, −0.29 to −0.07; P = .001; MR EA: β = −0.23; 95% CI, −0.39 to −0.07; P = .004; multivariable MR income: β = −0.32; 95% CI, −0.57 to 0.07; P = .02; multivariable MR EA: β = −0.04; 95% CI, −0.29 to 0.21; SE, 0.13; P = .79). Conclusions and Relevance Large-scale genomic data sets add further evidence to the negative association of EA with PTSD, also supporting the role of economic status as a mediator in the association observed.

Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way .

The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, p

The retrospective autopsy study included 98 adults who died because of laryngeal choking on a bolus of food: 67 men and 31 women (χ(2)=6.843, p0.01), average age 58.61±15.87 years (range 26-92 years). Most of the subjects had poor dentition (χ(2) =34.327, p0.01). Twenty individuals died in medical institutions, and 78 were nonhospitalized individuals. More than a third of the nonhospitalized individuals were under the influence of ethanol at the moment of death: average blood concentration 8.3g/dL (SD=11.0), ranged from 5.0 to 36.0. Nonhospitalized persons were at the moment of event more often under influence of ethanol than the subjects in control group (χ(2)= 38.874, p0.01), and at the same time significantly more intoxicated (z=-7.126, p0.01). Our study pointed out that poor dentition and impairment of the swallowing reflex, as a consequence of ethanol intoxication in individuals without mental disorders, were the most important risk factors for bolus death.

Background While shared clinical decision-making (SDM) is the preferred approach to decision-making in mental health care, its implementation in everyday clinical practice is still insufficient. The European Psychiatric Association undertook a study aiming to gather data on the clinical decision-making style preferences of psychiatrists working in Europe. Methods We conducted a cross-sectional online survey involving a sample of 751 psychiatrists and psychiatry specialist trainees from 38 European countries in 2021, using the Clinical Decision-Making Style - Staff questionnaire and a set of questions regarding clinicians' expertise, training, and practice. Results SDM was the preferred decision-making style across all European regions ([central and eastern Europe, CEE], northern and western Europe [NWE], and southern Europe [SE]), with an average of 73% of clinical decisions being rated as SDM. However, we found significant differences in non-SDM decision-making styles: participants working in NWE countries more often prefer shared and active decision-making styles rather than passive styles when compared to other European regions, especially to the CEE. Additionally, psychiatry specialist trainees (compared to psychiatrists), those working mainly with outpatients (compared to those working mainly with inpatients) and those working in community mental health services/public services (compared to mixed and private settings) have a significantly lower preference for passive decision-making style. Conclusions The preferences for SDM styles among European psychiatrists are generally similar. However, the identified differences in the preferences for non-SDM styles across the regions call for more dialogue and educational efforts to harmonize practice across Europe., European Psychiatry Association (EPA); NIHR Nottingham Biomedical Research Centre, This research received no grant funding from any external agency, commercial or not-for-profit sector, but was financially supported by the European Psychiatry Association (EPA). M.S. acknowledges the support of the NIHR Nottingham Biomedical Research Centre.