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Purpose: The first assistant (FA) plays an important role in the operating room for bariatric surgery. The aim of this study was to examine the relationship between the type of FA and operative time (OT) and postoperative outcomes comparing robotic and laparoscopic approaches in bariatric surgery. Methods and Materials: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) data for 2016–2019 was queried. Log-normal regression was performed to evaluate the association of FAs and OT variations within and between groups. We used logistic regression to examine the relationship between the type of FA and 30-day outcomes across all procedures and approaches. Results: A total of 691,789 patients who underwent robotic (R), and laparoscopic (L) sleeve gastrectomy (SG), Roux-en-Y gastric-bypass (RYGB), and duodenal switch (DS) were included. The percentage variation of OT was higher in the laparoscopic group (L-SG: 8.18%, L-RYGB: 9.88%, and L-DS: 15.00%) compared to the robotic group (R-SG: 2.43%, R-RYGB: 5.76%, and R-DS: 0.80%). There was not a significant difference in 30-day outcomes between laparoscopic and robotic approaches for the same procedures. Conclusions: The FA was associated with a decreased variability in OT in the robotic cohort compared to the laparoscopic group with no significant difference in complication rates. These results suggest that the robotic approach may decrease the need for skilled FAs in bariatric procedures. [ABSTRACT FROM AUTHOR]

For further understanding of spree killers, we explored fan communities of the same on Tumblr. We aimed to fit their expressed paraphilic desires with earlier typologies of aggressive/passive hybristophiles (women who fetishize killers) and a previously proposed typology of spree killers themselves. Tumblr fan site content (text and pictures) was investigated using a combination of visual and textual content analysis, latent class analysis, and hierarchical cluster analysis, using other celebrity fan sites as controls. The general trend was for hybristophiles to have surprising levels of self-knowledge with a small sub-set expressing worrying tendencies to fetishize the killings themselves over and above sexual desires towards the perpetrators. Although the division of hybristophiles into active and passive has been previously shown, we believe we are the first to link this to spree killers who are more or less explicitly advertising their behaviors to their fan base. Much attention has been directed to issues of so-called toxic masculinity and incels, but it is important to appreciate that they do not exist in a vacuum. This material contributes somewhat to understanding the toxic soil in which killers flourish. [ABSTRACT FROM AUTHOR]

Individuals with binge-eating disorder (BED) often experience emotion regulation deficits, including negative beliefs about emotions and low emotional expressivity. The current exploratory study examined whether emotion-focused therapy (EFT) for BED could change negative beliefs about emotions and emotional expressivity. Twenty participants were randomly allocated to either immediate treatment of 12 weekly one-hour sessions of EFT for BED, or a waitlist control group. Beliefs about emotions and emotional expressivity were assessed before and after 12 sessions of EFT or 12 weeks on the waitlist. A repeated measures ANOVA was used to examine beliefs about emotions and emotional expressivity changes. EFT for BED resulted in significant changes in particular beliefs about emotions (Overwhelming and uncontrollable, shameful and irrational, invalid and meaningless, and total score on the beliefs about emotions questionnaire) but not emotional expressivity treatment outcomes. This pilot study provides preliminary evidence that EFT may be effective in improving maladaptive beliefs about emotions in adults with BED. Trial registration ACTRN12620000563965, 14 May 2020, retrospectively registered. [ABSTRACT FROM AUTHOR]

Tourette syndrome (TS) is a neuropsychiatric disorder with involvement of genetic and environmental factors. We investigated genetic loci previously implicated in Tourette syndrome and associated disorders in interaction with pre- and perinatal adversity in relation to tic severity using a case-only (N = 518) design. We assessed 98 single-nucleotide polymorphisms (SNPs) selected from (I) top SNPs from genome-wide association studies (GWASs) of TS; (II) top SNPs from GWASs of obsessive–compulsive disorder (OCD), attention-deficit/hyperactivity disorder (ADHD), and autism spectrum disorder (ASD); (III) SNPs previously implicated in candidate-gene studies of TS; (IV) SNPs previously implicated in OCD or ASD; and (V) tagging SNPs in neurotransmitter-related candidate genes. Linear regression models were used to examine the main effects of the SNPs on tic severity, and the interaction effect of these SNPs with a cumulative pre- and perinatal adversity score. Replication was sought for SNPs that met the threshold of significance (after correcting for multiple testing) in a replication sample (N = 678). One SNP (rs7123010), previously implicated in a TS meta-analysis, was significantly related to higher tic severity. We found a gene–environment interaction for rs6539267, another top TS GWAS SNP. These findings were not independently replicated. Our study highlights the future potential of TS GWAS top hits in gene–environment studies. [ABSTRACT FROM AUTHOR]

Geotourism as a tool for local and social development requires evaluating how geology is perceived by society and how the geology can contribute to solve society’s needs and perspectives. This research is the result of a survey undertaken in the “Litoral del Biobío” geopark project (Chile) from April to September 2019. This survey consists of over 400 people and is a direct geoturistic demoscopic study on local communities. It covers a large diversity of social setting (ranging from urban to rural indigenous) and also a diverse level of education. Salient points of the results includes more than 80% of the community are aware of the sites of tourist interest in their community, while less than 20% recognize the geology and/or geosites of the territory. The need for economic development (21%) and tourism in natural areas (82.5%) stand out as the main tourism focus and tool for generating sustainable economic resources for the territory. Geodiversity and geotourism play an important role (48.1%), but are subordinate to biodiversity (76.7%) in the territory. Furthermore, geotourism is far from the perceptions of crime (23%), given that it is still a minority tourism sector. Finally, there is a certain level of resignation in the community regarding the medium-term development of its territory (52%), with education on geological and environmental risks (77%) being one of the main priorities. This study shows that, although there are basic needs to be covered in the territory, such as security and public infrastructure, there is also a great interest in developing tourism in natural areas. In this scenario, geotourism becomes relevant as a tool that can contribute to local sustainable economic development, education on geological risks, awareness of the geological value of the territory, as well as the revaluation of the cultural heritage in the study area. [ABSTRACT FROM AUTHOR]

Purpose: Limb immobilization causes local vasculature to experience detrimental adaptations. Simple strategies to increase blood flow (heating, fidgeting) successfully prevent acute (≤ 1 day) impairments; however, none have leveraged the hyperemic response over prolonged periods (weeks) mirroring injury rehabilitation. Throughout a 14-day unilateral limb immobilization, we sought to preserve vascular structure and responsiveness by repeatedly activating a reactive hyperemic response via blood flow restriction (BFR) and amplifying this stimulus by combining BFR with electric muscle stimulation (EMS). Methods: Young healthy adults (M:F = 14:17, age = 22.4 ± 3.7 years) were randomly assigned to control, BFR, or BFR + EMS groups. BFR and BFR + EMS groups were treated for 30 min twice daily (3 × 10 min ischemia–reperfusion cycles; 15% maximal voluntary contraction EMS), 5 days/week (20 total sessions). Before and after immobilization, artery diameter, flow-mediated dilation (FMD) and blood flow measures were collected in the superficial femoral artery (SFA). Results: Following immobilization, there was less retrograde blood velocity (+ 1.8 ± 3.6 cm s−1, P = 0.01), but not retrograde shear (P = 0.097). All groups displayed reduced baseline and peak SFA diameter following immobilization (− 0.46 ± 0.41 mm and − 0.43 ± 0.39 mm, P < 0.01); however, there were no differences by group or across time for FMD (% diameter change, shear-corrected, or allometrically scaled) nor microvascular function assessed by peak flow capacity. Conclusion: Following immobilization, our results reveal (1) neither BFR nor BFR + EMS mitigate artery structure impairments, (2) intervention-induced shear stress did not affect vascular function assessed by FMD, and (3) retrograde blood velocity is reduced at rest offering potential insight to mechanisms of flow regulation. In conclusion, BFR appears insufficient as a treatment strategy for preventing macrovascular dysfunction during limb immobilization. [ABSTRACT FROM AUTHOR]

Purpose: The implantation of flow diverters requires administration of dual anti-platelet therapy, posing the potential for complications. The p48MW HPC (phenox, Bochüm, Germany) hydrophilic-coated flow diverting stent is designed to be anti-thrombotic, thus opening the potential for single anti-platelet therapy. We deploy a novel intravascular high-resolution imaging technique, high-frequency optical coherence tomography (HF-OCT), to study in an animal model the acute thrombus formation on coated p48MW devices versus uncoated control devices. Methods: Three pigs were implanted with 4 flow diverters each, two test hydrophilic-coated devices, and two control uncoated devices (p48MW). Each pig was treated with a different anti-platelet regime: no anti-platelet therapy, aspirin only, aspirin and clopidogrel. Twenty minutes after the flow diverter was implanted, an HF-OCT data set was acquired. Acute clot formed on the flow diverter at each covered side branch was measured from the HF-OCT slices. Factors considered to be important were the device type (pHPC versus bare metal), aspirin, clopidogrel, and vessel location. A linear model was constructed from the significant factors. Results: Both coating (p < 0.001) and aspirin (p = 0.003) were significantly related to reduction in clot burden, leading to an approximate 100-fold and 50-fold reduction in clot, respectively. Conclusions: This study shows the power of HF-OCT not only in the detection of clot but also the quantification of clot burden. In an animal model, the pHPC-coated p48MW significantly reduced acute thrombus formation over jailed side branches as compared to the bare metal p48MW that was nearly eliminated when combined with aspirin administration. [ABSTRACT FROM AUTHOR]

Intravascular imaging has emerged as a valuable tool for the treatment of coronary and peripheral artery disease; however, no solution is available for safe and reliable use in the tortuous vascular anatomy of the brain. Endovascular treatment of stroke is delivered under image guidance with insufficient resolution to adequately assess underlying arterial pathology and therapeutic devices. High-resolution imaging, enabling surgeons to visualize cerebral arteries' microstructure and micron-level features of neurovascular devices, would have a profound impact in the research, diagnosis, and treatment of cerebrovascular diseases. Here, we present a neurovascular high-frequency optical coherence tomography (HF-OCT) system, including an imaging console and an endoscopic probe designed to rapidly acquire volumetric microscopy data at a resolution approaching 10 microns in tortuous cerebrovascular anatomies. Using a combination of in vitro, ex vivo, and in vivo models, the feasibility of HF-OCT for cerebrovascular imaging was demonstrated. High resolution intravascular imaging in the brain is limited by the high tortuosity of the vasculature. Here the authors present a fiber optic imaging technology using high-frequency optical coherence tomography (HF-OCT) to provide volumetric high resolution images in the highly tortuous cerebral vasculature. [ABSTRACT FROM AUTHOR]

Mechanical thrombectomy for the treatment of ischemic stroke shows high rates of recanalization; however, some patients still have a poor clinical outcome. A proposed reason for this relates to the fact that the ischemic infarct growth differs significantly between patients. While some patients demonstrate rapid evolution of their infarct core (fast evolvers), others have substantial potentially salvageable penumbral tissue even hours after initial vessel occlusion (slow evolvers). We show that the dog middle cerebral artery occlusion model recapitulates this key aspect of human stroke rendering it a highly desirable model to develop novel multimodal treatments to improve clinical outcomes. Moreover, this model is well suited to develop novel image analysis techniques that allow for improved lesion evolution prediction; we provide proof-of-concept that MRI perfusion-based time-to-peak maps can be utilized to predict the rate of infarct growth as validated by apparent diffusion coefficient-derived lesion maps allowing reliable classification of dogs into fast versus slow evolvers enabling more robust study design for interventional research. [ABSTRACT FROM AUTHOR]

Antarctic krill (Euphausia superba) is a highly abundant keystone species of the Southern Ocean ecosystem, directly connecting primary producers to high-trophic level predators. Sex ratios of krill vary remarkably between swarms and this phenomenon is poorly understood, as identification of krill sex relies on external morphological differences that appear late during development. Sex determination mechanisms in krill are unknown, but could include genetic, environmental or parasitic mechanisms. Similarly, virtually nothing is known about molecular sex differentiation. The krill genome has to date not been sequenced, and due to its enormous size and large amount of repetitive elements, it is currently not feasible to develop sex-specific DNA markers. To produce a reliable molecular marker for sex in krill and to investigate molecular sex differentiation we therefore focused on identifying sex-specific transcriptomic differences. Through transcriptomic analysis, we found large gene expression differences between testes and ovaries and identified three genes exclusively expressed in female whole krill from early juvenile stages onwards. The sex-specific expression of these three genes persisted through sexual regression, although our regressed samples originated from a krill aquarium and may differ from wild-regressed krill. Two slightly male-biased genes did not display sufficient expression differences to clearly differentiate sexes. Based on the expression of the three female-specific genes we developed a molecular test that for the first time allows the unambiguous sex determination of krill samples lacking external sex-specific features from juvenile stages onwards, including the sexually regressed krill we examined. [ABSTRACT FROM AUTHOR]

Irish Travellers constitute a pre-demographic-shift population living among a post-demographic-shift one. Their socio-medico profile identifies them as largely on fast life-history trajectories. In addition, they are strongly religious (typically using no contraception), highly sexually behaviorally dimorphic, with strong traditions of male-male competition (bare-knuckle fighting) and quasi-symbolic bride capture ("grabbing"). Their male-male competitions thus allow for the comparative testing of a number of interesting theories pertaining to the nature and function of types of violence in society. As a pilot study, we used expert raters (some naive to the hypotheses) to analyze a number of real-life bare-knuckle competitions in terms of the support said spectacles offered to theories of this sort of violence as reinforcing ideas of antisociality, hierarchical promotion, intersexual signaling, or maintenance of within-group equality. We found good evidence to support theories of within-group, prosocial hierarchical functions for these contests. Limitations and implications for future research, such as direct measurement of fitness, are discussed. [ABSTRACT FROM AUTHOR]

Sustained silencing of gene expression throughout the brain using small interfering RNAs (siRNAs) has not been achieved. Here we describe an siRNA architecture, divalent siRNA (di-siRNA), that supports potent, sustained gene silencing in the central nervous system (CNS) of mice and nonhuman primates following a single injection into the cerebrospinal fluid. Di-siRNAs are composed of two fully chemically modified, phosphorothioate-containing siRNAs connected by a linker. In mice, di-siRNAs induced the potent silencing of huntingtin, the causative gene in Huntington's disease, reducing messenger RNA and protein throughout the brain. Silencing persisted for at least 6 months, with the degree of gene silencing correlating to levels of guide strand tissue accumulation. In cynomolgus macaques, a bolus injection of di-siRNA showed substantial distribution and robust silencing throughout the brain and spinal cord without detectable toxicity and with minimal off-target effects. This siRNA design may enable RNA interference-based gene silencing in the CNS for the treatment of neurological disorders. A divalent siRNA architecture enables sustained silencing of gene expression in deep regions of the brain. [ABSTRACT FROM AUTHOR]

Purpose: The objectives of this study were (1) to determine the concentrations and background concentrations of Ba, Co, Cr, Mn, and Ni in the urban soils of Talcahuano (Chile); (2) assess the level of contamination in the urban soils based on different pollution indexes; and (3) to identify natural or anthropogenic sources in order to obtain a spatial distribution of the pollutants.Material and methods: A total of 420 samples were collected from the study area as follows: 140 topsoil samples (TS) (0-10 cm), 140 subsoil samples (SS) (10-20 cm), and 140 deep soil samples (DS) (150 cm). The soils were characterized, and the concentrations of Ba, Co, Cr, Mn, and Ni were analyzed by atomic absorption photospectrometry following aqua regia digestion. Correlations and principal component analysis combined with spatial analysis were implemented in order to distinguish the sources and their classification as geogenic or anthropogenic. Several simple and robust statistical methods were applied to datasets in order to explore their potential in the evaluation of a useful and robust background values. The degree of contamination along with the geoaccumulation index, enrichment factor, and contamination factor were also evaluated.Results and discussion: The median concentrations obtained for various elements includes Ba 461 mg kg−1, Co 82.7 mg kg−1, Cr 134 mg kg−1, Mn 311 mg kg−1, and Ni 56.1 mg kg−1. In general, the concentrations of Ba, Co, Cr, Mn, and Ni decrease with depth. Correlations and principal component analysis suggest that Cr, Mn, and Ni are contributed by external sources. The spatial distribution of Cr, Mn, and Ni in TS displays a spatial pattern extending along industrial environments and emission sources.Conclusions: The estimated background values determined with the iterative 2σ-technique includes 536 mg kg−1 for Ba, 95.9 mg kg−1 for Co, 208 mg kg−1 for Cr, 464 mg kg−1 for Mn, and 90.5 mg kg−1 for Ni. The geochemical index, enrichment factor, and the contamination factor register a moderate to considerable contamination in some soil samples. [ABSTRACT FROM AUTHOR]

Trichotillomania/hair pulling disorder (HPD) and excoriation/skin picking disorder (SPD) are childhood-onset, body-focused repetitive behaviors that are thought to share genetic susceptibility and underlying pathophysiology with obsessive-compulsive disorder (OCD) and Tourette syndrome (TS). We sought to determine the prevalence of DSM-5 HPD and SPD in TS patients, and to identify clinical factors most associated with their co-morbidity with TS. Participants included 811 TS patients recruited from TS specialty clinics for a multi-center genetic study. Patients were assessed using standardized, validated semi-structured interviews. HPD and SPD diagnoses were determined using a validated self-report questionnaire. HPD/SPD prevalence rates were calculated, and clinical predictors were evaluated using regression modeling. 3.8 and 13.0% of TS patients met DSM-5 criteria for HPD and SPD, respectively. In univariable analyses, female sex, OCD, and both tic and obsessive-compulsive symptom severity were among those associated with HPD and/or SPD. In multivariable analyses, only lifetime worst-ever motor tic severity remained significantly associated with HPD. Female sex, co-occurring OCD, ADHD, and motor tic severity remained independently associated with SPD. This is the first study to examine HPD and SPD prevalence in a TS sample using semi-structured diagnostic instruments. The prevalence of HPD and SPD in TS patients, and their association with increased tic severity and co-occurring OCD, suggests that clinicians should screen children with TS and related disorders for HPD/SPD, particularly in females and in those with co-occurring OCD. This study also helps set a foundation for subsequent research regarding HPD/SPD risk factors, pathophysiology, and treatment models. [ABSTRACT FROM AUTHOR]

The Southern Ocean is expected to be significantly affected by future ocean acidification. Antarctic krill (Euphausia superba) is the key species of the Southern Ocean ecosystem. Understanding their behavioural responses to acidification is critical for assessing the impacts of ocean acidification on the ecosystem. Adult Antarctic krill reared in different holding tanks with various CO2 levels for 6 months prior to the experiments were tested for their behavioural responses to different carbon dioxide partial pressures (pCO2) (400, 1000, 1500, 2000, and 4000 μatm pCO2) in a two-channel flume. The time krill occupied either of the flume channels (with high or ambient CO2 levels) was highly variable in all tests. In most cases no significant preference to either side of the flume was found. The krill did not display any systematic discrimination to the sea water with different CO2 levels regardless of the CO2 levels that krill were acclimated for in the 6 months prior to the experiment. Poor ability to discriminate high CO2 waters may have an important implication to their life history in the future as ocean acidification rapidly progresses in parts of Southern Ocean. [ABSTRACT FROM AUTHOR]

Microplastics (plastics <5mm diameter) are at the forefront of current environmental pollution research, however, little is known about the degradation of microplastics through ingestion. Here, by exposing Antarctic krill (Euphausia superba) to microplastics under acute static renewal conditions, we present evidence of physical size alteration of microplastics ingested by a planktonic crustacean. Ingested microplastics (31.5 µm) are fragmented into pieces less than 1 µm in diameter. Previous feeding studies have shown spherical microplastics either; pass unaffected through an organism and are excreted, or are sufficiently small for translocation to occur. We identify a new pathway; microplastics are fragmented into sizes small enough to cross physical barriers, or are egested as a mixture of triturated particles. These findings suggest that current laboratory-based feeding studies may be oversimplifying interactions between zooplankton and microplastics but also introduces a new role of Antarctic krill, and potentially other species, in the biogeochemical cycling and fate of plastic. [ABSTRACT FROM AUTHOR]

Trust is widely recognized as being crucial to the relationship between nonprofit organizations and their donors. However, trust is fragile. It can be easily damaged due to a single mistake. Understanding trust damage is very important for nonprofits in order to restore people’s confidence in their organization. Using a real nonprofit scandal event that occurred in China, this study examines the psychological effects of trust damage and determines the roles that cognitive and emotional perceptions play in it. Results suggest that the mental representation of trust damage is a two-dimensional construct. Both cognitive representation and emotional representation have significantly positive effects on the trust damage of individual donors after a negative event at a nonprofit organization. In order to help people recover from trust damage after a negative event, it is not only necessary to remove people’s cognitive concern but also to address people’s lingering emotional distress. Several important implications for nonprofit practitioners are also discussed. [ABSTRACT FROM AUTHOR]

Guided respiration mindfulness therapy (GRMT) is a manualized intervention that synthesizes a sustained focus on self-regulation of respiration, mindfulness, and relaxation. In our previous publication (in Lalande et al. J Contemp Psychother 46(2):107-116, 2016) we reported an evaluation of a manual-based GRMT therapist training program for the treatment of depression and anxiety. Here we report the outcomes of the manualized treatment program for depression and anxiety with clients. Forty-two participants with a primary diagnosis of depression or anxiety disorder participated in an uncontrolled clinical trial evaluating treatment response using standardised outcome measures with data collected on a session-by-session basis. For the majority of participants, treatment led to statistically and clinically significant reduction in symptoms of depression, anxiety and stress, along with reduced anxiety sensitivity and increases in overall wellbeing. Results suggested GRMT shows promise as an effective brief treatment option that does not rely on cognitive or behavioural techniques. [ABSTRACT FROM AUTHOR]

For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward. The primary outcome was estimated total hospitalization cost (length of stay in days multiplied by the average cost per day). Secondary outcomes were length of stay, in-hospital pain scores, opioid use, maximum ambulatory distance and 30-day readmission, morbidity, and mortality. Of the 262 TKA patients during the study period, 14 were admitted to rehabilitation and were matched to 14 patients admitted to acute care. Estimated total hospitalization cost [median (10th-90th percentiles)] was US$30,755 (US$23,066-38,444) for ward patients compared to US$17,620 (US$13,215-33,918) for rehabilitation patients ( P = 0.006). This difference [mean (95% CI)] was US$10,143 (US$2174-18,112). There were no other differences. For facilities similar to ours, direct postoperative admission of select TKA patients to subacute rehabilitation may be less costly than acute care and may not negatively affect outcomes. [ABSTRACT FROM AUTHOR]

Understanding the role that therapists play in psychotherapy outcome, and the contribution to outcome made by individual therapist differences has implications for service delivery and training of therapists. In this study we used a novel approach to estimate the magnitude of the therapist contribution overall and the effect of individual therapist differences. We conducted a meta-analysis of studies in which participants were randomised to receive the same treatment either through self-help or through a therapist. We identified a total of 15 studies (commencement N = 910; completion N = 723) meeting inclusion criteria. We found no difference in treatment completion rate and broad equivalence of treatment outcomes for participants treated through self-help and participants treated through a therapist. Also, contrary to our expectations, we found that the variability of outcomes was broadly equivalent, suggesting that differences in efficacy of individual therapists were not sufficient to make therapy outcomes more variable when a therapist was involved. Overall, the findings suggest that self-help, with minimal therapist input, has considerable potential as a first-line intervention. The findings did not suggest that individual differences between therapists play a major role in psychotherapy outcome. [ABSTRACT FROM AUTHOR]

This study investigated the relationship between two therapist attributes (reflective functioning and attachment style) and client outcome. Twenty-five therapists treated a total of 1001 clients. Therapists were assessed for reflective functioning and attachment style using the Adult Attachment Interview and the Experiences in Close Relationships Scale. Clinical outcome was measured using the Outcome Questionnaire (OQ-45). Data were analysed using hierarchical linear modelling. Results indicated that therapist reflective functioning predicted therapist effectiveness, whereas attachment style did not. However, there was evidence of an interaction between therapist attachment style and therapist reflective functioning. Secure attachment compensated somewhat for low reflective functioning and high reflective functioning compensated for insecure attachment. Possible implications for the selection of therapy training candidates and therapist training are discussed. [ABSTRACT FROM AUTHOR]

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This article presents the results of a cross-cultural study that examines the relationship between spirituality and a consumer's ethical predisposition, and further examines the relationship between the internalization of one's moral identity and a consumer's ethical predisposition. Finally, the moderating impact of cultural factors on the above relationships is tested using Hofstede's five dimensions. Data were gathered from young adult, well-educated consumers in five different countries, namely the U.S., France, Spain, India, and Egypt. The results indicate that the more spiritual an individual consumer is, the more likely that consumer is to be ethically predisposed. Furthermore, the stronger one's internalization of a moral identity, the more likely one is to be ethically predisposed. These two relationships are further moderated by Hofstede's cultural factors such as the degree of collectivism versus individualism in the culture. However, the strength and direction of the moderation may vary depending upon the specific Hofstede dimension. [ABSTRACT FROM AUTHOR]

All humans must eventually face death at the end of life in this physical world. Nevertheless, sometimes sudden death can be horrendous, especially when associated with what appears to be unbearable pain during those final moments, such as being burned alive or beaten to death. The thought of a loved one having suffered such pain at the moment of death may intensify the degree of grief. However, despite the appearance of what sometimes appears to be conscious somatic suffering in those final moments, a non-pathological dissociation from that pain may have occurred. This paper explores this hypothesis, providing evidence of this occurring from research studies and/or self-reports. It then closes with a suggestion that knowledge of this phenomenon may provide some comfort to those in grief over a loved one who has undergone a horrible death in which extreme suffering seemed to have been present in those final moments. [ABSTRACT FROM AUTHOR]

The present paper describes the development and evaluation of a standardized multi-component therapist training program in guided respiration mindfulness therapy (GRMT). GMRT is a manual-based, experimental clinical intervention involving concentrated focus on sustained self-regulation of breathing, application of mindfulness to emergent somatic experience and relaxation. Therapists ( n = 61) new to the approach attended a 2-day experiential workshop and were evaluated pre-post workshop for change in intervention knowledge, as well as change in mindfulness. These trainees also participated in post-workshop focus group sessions to explore perception of the intervention. A subset of 40 therapists participated in a second training component, and 14 of these were rated for competent delivery of the intervention during participation in a clinical trial. During training, therapists personally received the treatment giving the opportunity to assess treatment session ( n = 283) impact on sense of wellbeing. Results indicated a brief focused training program can equip therapists with basic knowledge and skills required to deliver the standardized manual-based treatment. Qualitative analysis of focus group sessions showed that therapists endorsed the intervention for clinical use and found it personally beneficial. This research provides a foundation for further evaluation of clinical effectiveness of the intervention. [ABSTRACT FROM AUTHOR]

Tourette syndrome (TS) is a neuropsychiatric disorder characterized by recurrent motor and vocal tics, often accompanied by obsessive-compulsive disorder and/or attention-deficit/hyperactivity disorder. While the evidence for a genetic contribution is strong, its exact nature has yet to be clarified fully. There is now mounting evidence that the genetic risks for TS include both common and rare variants and may involve complex multigenic inheritance or, in rare cases, a single major gene. Based on recent progress in many other common disorders with apparently similar genetic architectures, it is clear that large patient cohorts and open-access repositories will be essential to further advance the field. To that end, the large multicenter Tourette International Collaborative Genetics (TIC Genetics) study was established. The goal of the TIC Genetics study is to undertake a comprehensive gene discovery effort, focusing both on familial genetic variants with large effects within multiply affected pedigrees and on de novo mutations ascertained through the analysis of apparently simplex parent-child trios with non-familial tics. The clinical data and biomaterials (DNA, transformed cell lines, RNA) are part of a sharing repository located within the National Institute for Mental Health Center for Collaborative Genomics Research on Mental Disorders, USA, and will be made available to the broad scientific community. This resource will ultimately facilitate better understanding of the pathophysiology of TS and related disorders and the development of novel therapies. Here, we describe the objectives and methods of the TIC Genetics study as a reference for future studies from our group and to facilitate collaboration between genetics consortia in the field of TS. [ABSTRACT FROM AUTHOR]