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Seasonal cycles within the marginal ice zones in polar regions include large shifts in temperature and salinity that strongly influence microbial abundance and physiology. However, the combined effects of concurrent temperature and salinity change on microbial community structure and biochemical composition during transitions between seawater and sea ice are not well understood. Coastal marine communities along the western Antarctic Peninsula were sampled and surface seawater was incubated at combinations of temperature and salinity mimicking the formation (cold, salty) and melting (warm, fresh) of sea ice to evaluate how these factors may shape community composition and particulate metabolite pools during seasonal transitions. Bacterial and algal community structures were tightly coupled to each other and distinct across sea-ice, seawater, and sea-ice-meltwater field samples, with unique metabolite profiles in each habitat. During short-term (approximately 10-day) incubations of seawater microbial communities under different temperature and salinity conditions, community compositions changed minimally while metabolite pools shifted greatly, strongly accumulating compatible solutes like proline and glycine betaine under cold and salty conditions. Lower salinities reduced total metabolite concentrations in particulate matter, which may indicate a release of metabolites into the labile dissolved organic matter pool. Low salinity also increased acylcarnitine concentrations in particulate matter, suggesting a potential for fatty acid degradation and reduced nutritional value at the base of the food web during freshening. Our findings have consequences for food web dynamics, microbial interactions, and carbon cycling as polar regions undergo rapid climate change.

Marine eelgrasses are influential to their surrounding environments through their many ecosystem services, ranging from the provisioning of food and shelter for marine life to serving as a natural defense against pollution and pathogenic bacteria. In the marine waters of San Diego, CA, USA, eelgrass beds comprised of Zostera spp. are an integral part of the coastal ecosystem. To evaluate the impact of eelgrass on bacterial and archaeal community structure we collected water samples in San Diego Bay and sequenced the 16S rRNA gene from paired eelgrass-present and eelgrass-absent sites. To test the hypothesis that microbial community structure is influenced by the presence of eelgrass we applied mixed effects models to these data and to bacterial abundance data derived by flow cytometry. This approach allowed us to identify specific microbial taxa that were differentially present at eelgrass-present and eelgrass-absent sites. Principal coordinate analysis organized the samples by location (inner vs. outer bay) along the first axis, where the first two axes accounted for a 90.8% of the variance in microbial community structure among the samples. Differentially present bacterial taxa included members of the order Rickettsiales, family Flavobacteriaceae, genus Tenacibaculum and members of the order Pseudomonadales. These findings constitute a unique look into the microbial composition of San Diego Bay and examine how eelgrasses contribute to marine ecosystem health, e.g., by supporting specific microbial communities and by filtering and trapping potentially harmful bacteria to the benefit of marine organisms.

Traditional media (press, radio and television) in South America have better expectations regarding the process of digital transition faced by communication companies and industries on a global level. This hypothesis is contrasted by comparing two elements. First, the evolution trends of the media sector in Latin America collected by sectorial databases of the World Association of Newspapers and New Publishers, the Eurodata´s general audience report, the Pew State of the News Media and the Global Entertainment & Media Outlook 2016-2020. Second, the results of an own survey to 166 managers from 19 Latin American countries. Media managers from the area confirm that traditional media will grow up to 5% and digital media and advertising could reach 10% and more in the coming years

Abstract Background Over the last decade, significant downward linear time trends in suicide mortality were observed in most Western countries. To date, it is not established whether those favourable time trends developed homogeneously for sex and age groups and how they were affected by the number of undetermined deaths. Methods Data on suicide mortality and undetermined death from 1991 to 2002 in Germany were obtained from the German Federal Statistical Office. For each year, the age-standardised suicide rate (SR), undetermined death rate (UDR) and total rate (SR+UDR) was calculated by direct standardisation separately for men and women. Time trends were analyzed by Poisson regression estimating the average annual percentage change (AAPC) of the rates for sex and four age groups (15–24, 25–44, 45–74, ≥ 75 years). Results A significant decline of the SR was observed in all age groups but was less pronounced among the younger ages, particularly among men aged 15–24 years (AAPC -0.7%, p = 0.041). The SR in the oldest male age group (≥ 75 years) declined much stronger (AAPC -3.5%, p < 0.001). In women, the AAPC of the SR ranged from -1.7% to -4.6%. The average annual percentage changes in the age groups 25 – 74 years did not differ substantially for SR and SR+UDR. In contrast, due to an increase of undetermined deaths for subjects ≥ 75 years, time trends in this age group were affected by the number of undetermined deaths, especially in women. Conclusion Observing downward trends in suicide mortality with lower declines for younger subjects, prevention strategies should focus in particular on younger subjects.

Microbial ecological functions are an emergent property of community composition. For some ecological functions, this link is strong enough that community composition can be used to estimate the quantity of an ecological function. Here, we apply random forest regression models to compare the predictive performance of community composition and environmental data for bacterial production (BP). Using data from two independent long-term ecological research sites-Palmer LTER in Antarctica and Station SPOT in California-we found that community composition was a strong predictor of BP. The top performing model achieved an R2 of 0.84 and RMSE of 20.2 pmol L-1 hr-1 on independent validation data, outperforming a model based solely on environmental data (R2 = 0.32, RMSE = 51.4 pmol L-1 hr-1). We then operationalized our top performing model, estimating BP for 346 Antarctic samples from 2015 to 2020 for which only community composition data were available. Our predictions resolved spatial trends in BP with significance in the Antarctic (P value = 1 × 10-4) and highlighted important taxa for BP across ocean basins. Our results demonstrate a strong link between microbial community composition and microbial ecosystem function and begin to leverage long-term datasets to construct models of BP based on microbial community composition., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Society for Microbial Ecology.)

Background: Technology plays a fundamental role to achieve higher education key learning objectives. Digital competence (DC) is defined as a set of skills, knowledge, abilities, and attitudes in technological aspects. It is necessary to employ an effective training action plan in higher education institutions to advance towards a level of teaching digital competence (TDC). The objective of this study was to validate the COMDID A instrument to assess Teaching Digital Competence (TDC) of active teachers, through a confirmatory factor and internal reliability analysis. Methods: The research was developed within a descriptive-correlational scope and a non-experimental-cross-sectional design to validate the dimensionality and reliability of the COMDID A instrument and evaluate the self-perceived digital competence of active teachers. The population was made up of 690 professors who were part of the teaching staff of the National University of Chimborazo, Ecuador, in the first academic period of the year 2021. The sample was probabilistic, in a simple random scheme, the percentage of potential error admitted was 3%. The representativeness of the sample was 50%, and the confidence level was 97%. A total of 511 teachers completed the questionnaire compared to the 452 individuals needed. Results: The instrument was robust, and it was reliable for the calculated sample. There were correlations between the variables, and the statistical calculation ensured the development of the multivariate analysis to validate the dimensionality of the instrument. Moreover, the correct dimensionality was determined through a confirmatory analysis and high reliability of the instrument. Conclusions: The calculated factorial scores were defined in order for further studies to be carried out. It is important to apply confirmatory factor analysis in educational technology research to validate the dimensionality of data collection instruments., Competing Interests: No competing interests were disclosed., (Copyright: © 2023 Cisneros-Barahona AS et al.)

The Antarctic marine environment is a dynamic ecosystem where microorganisms play an important role in key biogeochemical cycles. Despite the role that microbes play in this ecosystem, little is known about the genetic and metabolic diversity of Antarctic marine microbes. In this study we leveraged DNA samples collected by the Palmer Long Term Ecological Research (LTER) project to sequence shotgun metagenomes of 48 key samples collected across the marine ecosystem of the western Antarctic Peninsula (wAP). We developed an in silico metagenomics pipeline (iMAGine) for processing metagenomic data and constructing metagenome-assembled genomes (MAGs), identifying a diverse genomic repertoire related to the carbon, sulfur, and nitrogen cycles. A novel analytical approach based on gene coverage was used to understand the differences in microbial community functions across depth and region. Our results showed that microbial community functions were partitioned based on depth. Bacterial members harbored diverse genes for carbohydrate transformation, indicating the availability of processes to convert complex carbons into simpler bioavailable forms. We generated 137 dereplicated MAGs giving us a new perspective on the role of prokaryotes in the coastal wAP. In particular, the presence of mixotrophic prokaryotes capable of autotrophic and heterotrophic lifestyles indicated a metabolically flexible community, which we hypothesize enables survival under rapidly changing conditions. Overall, the study identified key microbial community functions and created a valuable sequence library collection for future Antarctic genomics research., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Dutta, Connors, Trinh, Erazo, Dasarathy, Ducklow, Steinberg, Schofield and Bowman.)

Concurrent osmotic and chaotropic stress make MgCl 2 -rich brines extremely inhospitable environments. Understanding the limits of life in these brines is essential to the search for extraterrestrial life on contemporary and relict ocean worlds, like Mars, which could host similar environments. We sequenced environmental 16S rRNA genes and quantified microbial activity across a broad range of salinity and chaotropicity at a Mars-analogue salt harvesting facility in Southern California, where seawater is evaporated in a series of ponds ranging from kosmotropic NaCl brines to highly chaotropic MgCl 2 brines. Within NaCl brines, we observed a proliferation of specialized halophilic Euryarchaeota, which corresponded closely with the dominant taxa found in salterns around the world. These communities were characterized by very slow growth rates and high biomass accumulation. As salinity and chaotropicity increased, we found that the MgCl 2 -rich brines eventually exceeded the limits of microbial activity. We found evidence that exogenous genetic material is preserved in these chaotropic brines, producing an unexpected increase in diversity in the presumably sterile MgCl 2 -saturated brines. Because of their high potential for biomarker preservation, chaotropic brines could therefore serve as repositories of genetic biomarkers from nearby environments (both on Earth and beyond) making them prime targets for future life-detection missions., (© 2021 Society for Applied Microbiology and John Wiley & Sons Ltd.)

A multitude of concurrent biological and physical processes contribute to microbial community turnover, especially in highly dynamic coastal environments. Characterizing what factors contribute most to shifts in microbial community structure and the specific organisms that correlate with changes in the products of photosynthesis improves our understanding of nearshore microbial ecosystem functions. We conducted high frequency sampling in nearshore Southern California in order to capture sub-weekly microbial community dynamics. Microbial communities were characterized by flow cytometry and 16S rRNA gene sequencing, and placed in the context of physicochemical parameters. Within our time-series, season and nutrient availability corresponded to changes in dominant microbial community members. Concurrent aseasonal drivers with overlapping scales of variability were also apparent when we used network analysis to assess the microbial community as subsets of the whole. Our analyses revealed the microbial community as a mosaic, with overlapping groups of taxa that varied on different timescales and correlated with unique abiotic and biotic factors. Specifically, a subnetwork associated with chlorophyll a exhibited rapid turnover, indicating that ecologically important subsets of the microbial community can change on timescales different than and in response to factors other than those that govern turnover of most members of the assemblage., (© 2021 Society for Applied Microbiology and John Wiley & Sons Ltd.)

Mangrove ecosystems provide important ecological benefits and ecosystem services, including carbon storage and coastline stabilization, but they also suffer great anthropogenic pressures. Microorganisms associated with mangrove sediments and the rhizosphere play key roles in this ecosystem and make essential contributions to its productivity and carbon budget. Understanding this nexus and moving from descriptive studies of microbial taxonomy to hypothesis-driven field and lab studies will facilitate a mechanistic understanding of mangrove ecosystem interaction webs and open opportunities for microorganism-mediated approaches to mangrove protection and rehabilitation. Such an effort calls for a multidisciplinary and collaborative approach, involving chemists, ecologists, evolutionary biologists, microbiologists, oceanographers, plant scientists, conservation biologists, and stakeholders, and it requires standardized methods to support reproducible experiments. Here, we outline the Mangrove Microbiome Initiative, which is focused around three urgent priorities and three approaches for advancing mangrove microbiome research., (Copyright © 2020 Allard et al.)

Background: Suicide prediction during psychiatric in-patient treatment remains an unresolved challenge., Aims: To identify determinants of railway suicides in individuals receiving in-patient psychiatric treatment., Method: The study population was drawn from patients admitted to six psychiatric hospitals in Germany during a 10-year period (1997-2006). Data from 101 railway suicide cases were compared with a control group of 101 discharged patients matched for age, gender and diagnosis., Results: Predictors of suicide were change of therapist (OR = 22.86, P = 0.004), suicidal ideation (OR = 7.92, P<0.001), negative or unchanged therapeutic course (OR = 7.73, P<0.001), need of polypharmaceutical treatment (OR = 2.81, P = 0.04) and unemployment (OR = 2.72, P = 0.04). Neither restlessness nor impulsivity predicted in-patient suicide., Conclusions: Suicidal ideation, unfavourable clinical course and the use of multiple psychotropic substances (reflecting the severity of illness) were strong determinants of railway suicides. The most salient finding was the vital impact of a change of therapist. These findings deserve integration into the clinical management of patients with serious mental disease., (Royal College of Psychiatrists.)

Objective: The present study addressed potential harms of a negative working environment for employed subjects. The main aim was to evaluate if adverse working conditions and job strain are related to an increase in suicide mortality., Methods: The study population consisted of 6817 participants drawn from the MONICA/KORA Augsburg, Germany, surveys conducted in 1984-1995, being employed at baseline examination and followed up on average for 12.6 years. Adverse working conditions were assessed by an instrument of 16 items about chronobiological, physical and psychosocial conditions at the workplace, job strain was assessed as defined by Karasek. Suicide risks were estimated by Cox regression adjusted for suicide-related risk factors., Results: A number of 28 suicide cases were observed within follow-up. High levels of adversity in chronobiological/physical working conditions significantly increased the risk for suicide mortality (HR 3.28, 95% CI 1.43-7.54) compared to low/intermediate levels in a model adjusted for age, sex and survey (p value 0.005). Additional adjustment for living alone, low educational level, smoking, high alcohol consumption, obesity and depressed mood attenuated this effect (HR 2.73) but significance remained (p value 0.022). Adverse psychosocial working conditions and job strain, in contrast, had no impact on subsequent suicide mortality risk (p values > 0.200)., Conclusions: A negative working environment concerning chronobiological or physical conditions at the workplace had an unfavourable impact on suicide mortality risk, even after controlling for relevant suicide-related risk factors. Employer interventions aimed to improve workplace conditions might be considered as a suitable means to prevent suicides among employees., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Background: The majority of fatalities on the European Union (EU) railways are suicides, representing about 60% of all railway fatalities. The aim of this study was to compare time patterns of suicidal behaviour on railway tracks in Germany between two observation periods (1995-1998 and 2005-2008) in order to investigate their stability and value in railway suicide prevention., Methods: Cases were derived from the National Central Registry of person accidents on the German railway network (STABAG). The association of daytime, weekday and month with the mean number of suicides was analysed applying linear regression. Potential differences by observation period were assessed by adding observation period and the respective interaction terms into the linear regression. A 95% confidence interval for the mean number of suicides was computed using the t distribution., Results: A total of 7,187 railway suicides were recorded within both periods: 4,102 (57%) in the first period (1995-1998) and 3,085 (43%) in the second (2005-2008). The number of railway suicides was highest on Mondays and Tuesdays in the first period with an average of 3.2 and 3.5 events and of 2.6 events on both days in the second period. In both periods, railway suicides were more common between 6:00 am and noon, and between 6:00 pm and midnight. Seasonality was only prominent in the period 1995-1998., Conclusions: Over the course of two observation periods, the weekday and circadian patterns of railway suicides remained stable. Therefore, these patterns should be an integral part of railway suicide preventive measures, e.g. gatekeeper training courses.

Background: Suicide is strongly associated with mental disorders, particularly with depression. There is insufficient knowledge to what extent sociodemographic and behavioral characteristics contribute to suicide risk., Methods: A population-based cohort study on three independent cross-sectional MONICA/KORA Augsburg surveys with 12,888 subjects (6456 men, 6432 women) was followed up on average for 12.0 years. Information on sociodemographic characteristics, chronic disease conditions, smoking habits, alcohol consumption, depressive symptoms, personality type, and other psychodiagnostic parameters was assessed by standardized interviews. Cox proportional hazards regression analyses were used to compute hazard ratios (HRs) as estimates of relative risks for suicide mortality. Additionally, population-attributable risks were calculated., Results: Within the follow-up period, a total of 1449 persons had died, 38 of them by suicide. Although several variables were associated with increased risk in the basic analyses, only obesity (HR=2.73), smoking (HR=2.23), and living alone (HR=2.19) remained significantly associated with suicide additionally to male sex (HR=3.57) and depressed mood (HR=2.01) in a multivariate analysis., Limitations: The generalization of our findings to countries with different social, economic or cultural conditions may be questioned., Conclusions: Our findings extend the knowledge about sociodemographic and behavioral risk factors for suicide in the general population: Suicide prevention measures should not consider only subjects with mental disorders but also address other adverse conditions., (© 2013 Published by Elsevier B.V.)

Aim: To assess suicide mortality in comparison to traffic accidents and homicide deaths in Germany in the year 2010 and to compare years of life lost (YLL) due to these unnatural deaths., Methods: Mortality data were provided by the Federal Statistical Office giving death rates (related to 100,000 inhabitants) and proportions (related to 100 deaths of individuals) for suicide, traffic accidents and homicide as well as YLL data., Results: A total of 14,441 unnatural deaths (suicide, traffic accidents, homicide) were reported in 2010 in Germany. Of those, 10,021 subjects (69.4%) committed suicide, 3,942 (27.3%) died in traffic accidents, 478 (3.3%) were murdered. Suicide death rates were by far the highest, with rates for men (18.6) three times higher than for women (6.1). For both sexes, suicide rates increased with age, whereas suicide as a proportion of all causes of death was higher in younger age groups. In both sexes, suicide was the leading cause of YLL (men: 314 YLL, women: 90 YLL)., Conclusions: Suicide is the leading cause of unnatural death and YLL. The sex- and age- specific patterns in suicide mortality call for different action plans to target high risk groups.

We report on the intra-Amazonian migration of a pair of Orinoco Geese (Neochen jubata) from Manú National Park, Peru. The species is Critically Endangered in Peru, so a major aim of the study was to aid conservation planning by learning the wet season location of the country's last known breeding population. We captured a breeding pair on October 27, 2010, and fitted the birds with Microwave Telemetry, Inc. GPS/Argos satellite PTT's. The pair migrated ∼655 km from Manú National Park to the Llanos de Moxos, Bolivia (Dept. of Bení) in a predominantly longitudinal migration, reaching their final destination on December 23, 2010. Major movements (>5 km per time period) were almost exclusively at night and were undertaken with and without moonlight. Foraging areas used at stopovers in the Llanos de Moxos were remarkably limited, suggesting the importance of grazing lawns maintained by the geese and other herbivores, possibly including cattle. Orinoco Geese are resident in the Llanos de Moxos year-round, so the Manú geese represent a partial migration from the Bení region. We hypothesize that cavity nest limitation explains the partial migration of Orinoco Geese from the Llanos de Moxos.

Background: Smoking and heavy alcohol use predicts suicidal behaviour. Whether the simultaneous presentation of both conditions induces an amplified effect on risk prediction has not been investigated so far., Methods: In a community-based cohort study, a total of 12,888 subjects (6,456 men, 6,432 women; age range of 25-74 years at assessment) from three independent population-based cross-sectional MONICA surveys (conducted in 1984/85, 1989/90, and 1994/95), representative for the Southern German population, was followed up until 31 December 2002. Standardized mortality ratios (SMR) for deaths from suicide using German population rates were calculated for smoking and high alcohol consumption., Results: After a mean follow-up time of 12.0 (SD 4.4) years and 154,275 person-years at risk, a total of 1,449 persons had died from all causes and 38 of them from suicide. Compared to the general population, mortality from suicide was increased for risky alcohol consumption (SMR = 2.37; 95% CI 1.14-4.37) and for smoking (SMR = 2.30; 95% CI 1.36-3.63). A substantial increase in suicide mortality (SMR = 4.80; 95% CI 2.07-9.46) was observed for smokers with risky alcohol consumption., Conclusions: The approximately fourfold increased relative risk for completed suicide in subjects with smoking and risky alcohol consumption indicates a synergistic effect which deserves an increased alertness.

Current knowledge on behavioural patterns and personal characteristics of subjects who choose the railway as means of suicide is sparse. The aim of this study was to determine the frequency of three distinct behaviour patterns (jumping, lying, wandering) in railway suicides and to explore associated variables. Cases were derived from the National Central Registry of person accidents on the German railway net covering the period from 2002 to 2006. A retrospective analysis of registry protocols of all 4127 suicidal acts allowed classification of behaviour patterns in 1004 cases. Types of suicidal behaviour occurred with nearly equal frequencies; jumping in 32.2%, lying in 32.6% and wandering in 34.2% of cases. Age and sex were not associated with type of suicidal behaviour. The proportion of jumping was highest during 9:01 am to 6:00 pm while at night, lying was used most frequently. Jumping predominated in the station area, while lying and wandering on the open track. Fatality was highest in liers and lowest in jumpers. The frequency of jumping decreased during the study period by 12.6% (p < .05). These findings may help to elucidate differential risk features of this highly lethal suicide method., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Among risk factors for suicide, suicidal ideation (SID) is of paramount importance. This study sought to determine sex- and age-related SID point prevalence rates in the general population. A population-based survey of 3154 subjects, 35 to 84 years, conducted in 2004/05 in southern Germany, identified 170 subjects (5.4%; 95% CI 4.6-6.2) suffering from SID within the last 14 days. Age-adjusted short-term period prevalence in women (6.0%, 95% CI 4.9.-7.2) was higher than in men (4.0%, 95% CI 3.1-5.1). Among 10-year age groups, sex-related differences were only significant in middle-aged subjects (55-64 years). Prevalence increased significantly with age, leading to a prevalence of >10% in the oldest age group (75-84 years). The population-based approach demonstrates a substantial proportion of subjects suffering from SID, particularly in older age groups.

Background: Overall, decreasing suicide mortality rates were observed in the last decades in most Western populations. However, it remains unclear, whether these favourable trends occurred uniformly in particular suicide methods. Therefore, the present study evaluated time trends of suicide mortality by method in Germany over the period 1991-2002., Methods: A total of 145,865 fatal suicide cases of men and women aged >or=15 years and with available suicide method were recorded by the Federal Statistical Office of Germany (suicides coded "death following a suicide attempt" were excluded). Based on these data, seven different suicide methods were defined. Poisson regression was used to estimate the age-adjusted annual percentage change (AAPC) of the number of each suicide method., Results: The most frequently used suicide methods in both sexes were hanging, strangling or suffocation (HSS) with 55.8% in men and 39.9% in women, followed by self-poisoning. Statistically significant declines of the number of suicides were observed, in descending order, for self-poisoning, drowning and HSS in both sexes. In contrast, methods using firearm discharges or stab with a sharp object remained in roughly constant level. Modifications of time trends were observed for several methods by age classes., Conclusions: The present study demonstrates different time trends for suicide methods. Further examinations are recommended in particular concerning possible reasons for the choice of a suicidal method.

Background: Over the last decade, significant downward linear time trends in suicide mortality were observed in most Western countries. To date, it is not established whether those favourable time trends developed homogeneously for sex and age groups and how they were affected by the number of undetermined deaths., Methods: Data on suicide mortality and undetermined death from 1991 to 2002 in Germany were obtained from the German Federal Statistical Office. For each year, the age-standardised suicide rate (SR), undetermined death rate (UDR) and total rate (SR+UDR) was calculated by direct standardisation separately for men and women. Time trends were analyzed by Poisson regression estimating the average annual percentage change (AAPC) of the rates for sex and four age groups (15-24, 25-44, 45-74, > or = 75 years)., Results: A significant decline of the SR was observed in all age groups but was less pronounced among the younger ages, particularly among men aged 15-24 years (AAPC -0.7%, p = 0.041). The SR in the oldest male age group (> or = 75 years) declined much stronger (AAPC -3.5%, p < 0.001). In women, the AAPC of the SR ranged from -1.7% to -4.6%. The average annual percentage changes in the age groups 25 - 74 years did not differ substantially for SR and SR+UDR. In contrast, due to an increase of undetermined deaths for subjects > or = 75 years, time trends in this age group were affected by the number of undetermined deaths, especially in women., Conclusion: Observing downward trends in suicide mortality with lower declines for younger subjects, prevention strategies should focus in particular on younger subjects.

Psychiatric management forms the basis of any integrated psychiatric treatment. It serves to maximize the patient's level of performance, safety and quality of life. It also involves the patient's family members--who are usually indirectly affected by the disorder and may provide support during the course of treatment--in the therapeutic strategy. The psychiatric management of anxiety disorders can be effectively carried out, also by the family doctor familiar with mental disorders, since the GP is usually the first primary care instance to be approached by the patient, who assumes an underlying organic cause rather than a mental problem. Within the framework of psychiatric management, the family doctor should be kept fully informed of the individual steps in the treatment strategy, and coordinate the necessary interventions by other care providers. By taking psychoeducative measures he can already initiate effective treatment, and may create a positive atmosphere in which treatment-requiring anxiety can be openly discussed and perhaps partly resolved. Talking to the patient about early symptoms may help to avoid severe relapses. Psychiatric management as part of the general practitioner's activities helps achieve the goal of integrating the treatment of patients with anxiety disorders in the doctor's office.

The psychophysiological startle response pattern associated with peritraumatic dissociation (DISS) was studied in 103 survivors of a life-threatening cardiac event (mean age 61.0 years, SD 13.95). Mean time period since the cardiac event was 37 (79 IQD) months. All patients underwent a psychodiagnostic evaluation (including the Peritraumatic Dissociative Experiences Questionnaire) and a psychophysiological startle experience which comprised the delivery of 15 acoustic startle trials. Magnitude and habituation to trials were measured by means of electromyogram (EMG) and skin conductance responses (SCR). Thirty-two (31%) subjects were indexed as patients with a clinically significant level of DISS symptoms. High-level DISS was associated with a higher magnitude of SCR (ANOVA for repeated measures p = 0.017) and EMG (p = 0.055) and an impaired habituation (SCR slope p = 0.064; EMG slope p = 0.005) in comparison to subjects with no or low DISS. In a subgroup analysis, high-level DISS patients with severe post-traumatic stress disorder (PTSD; n = 11) in comparison to high-level DISS patients without subsequent PTSD (n = 19) exhibited higher EMG amplitudes during all trials (repeated measures analysis of variance F = 5.511, p = 0.026). The results demonstrate exaggerated startle responses in SCR and EMG measures - an abnormal defensive response to high-intensity stimuli which indicates a steady state of increased arousal. DISS patients without PTSD exhibited balanced autonomic responses to the startle trials. DISS may, therefore, unfold malignant properties only in combination with persistent physiological hyperarousability., (Copyright 2002 S. Karger AG, Basel)

Extracts of the whole plant Acaena magellanica (Rosaceae) were assessed for anti-inflammatory, antipyretic and analgesic activity in animal models. At 600 mg kg(-1), the global ethanolic extract (GEE), dichloromethane (DCM) and defatted methanol (MeOH) fractions showed a mild anti-inflammatory effect in the carrageenan-induced guinea-pig paw oedema. The GEE, DCM and defatted MeOH fractions significantly reduced inflammation by 43.2, 40.5 and 42.1%, respectively. The GEE did not showed any significant antipyretic activity in doses up to 600 mg kg(-1). A 20% w/v infusion administered orally at 16 mL kg(-1) presented analgesic effect in the acetic acid-induced abdominal constriction test in mice. The GEE and MeOH extract of A. magellanica showed free radical scavenging activity in the diphenylpicrylhydrazyl decolouration assay. Assay-guided isolation led to quercetin, Q-3-O-beta-glucoside, Q-3-O-beta-D-galactoside, ellagic acid and catechin as the free radical scavengers. The saponins tormentic acid 28-O-beta-D-galactopyranoside and 28-O-beta-D-glucopyranoside were isolated from the polar extract. The structures were determined by spectroscopic methods.

Despite its enormous medical burden, little is known about the epidemiology of somatization in the community. The present study screened a representative population-based survey of 7,466 subjects in the age range of 25 to 69 years for the occurrence of somatization. A total of 137 (1.84%) individuals experienced six or more symptoms from at least two different body sites without an identifiable organic cause. These patients exhibited a lower quality of life (P < or = 0.0001) and suffered from higher levels of emotional stress (P < or = 0.0001) than their counterparts in the healthy subsample (n=906). Somatization was not associated with a medical diagnosis, but disability days, the use of medical services, and the level of medication was higher in the somatization disorder group (P < or = 0.004). The somatization risk was only 1.6-fold higher for women in comparison to men but escalated for women rapidly to an approximately 4-fold risk when being female was combined with low social class and high emotional distress. Against expectation, the somatization risk for men also mounted 3-fold under the identical risk constellation.

Therapeutic modelling has found little attention in the literature. For the first time, the present article reports about sculptural work in psychiatric art therapy. Since 1994 the Psychiatric Hospital Kilchberg/Zürich is carrying out a sculpture project, in which about 30 patients work with sand- or limestone for 2 1/2 hours daily, cared for by eight therapists and protected by detailed safety regulations. At the beginning and the end of each afternoon the patients stand in a circle to communicate inner mood and ideas about the work. An exposition at the end of the project gives the opportunity to demonstrate the sculptures to family, friends and clinical staff. Until now there have been only positive experiences, which speak in favour of a wider use of sculpture in psychiatric art therapy. Sculptural work stimulates the vitality of the patients, who are challenged to use their willpower adaptedly and rhythmically. Especially on patients with autodestructive tendencies sculptural work seems to exert a beneficial influence.

In a randomized, prospective, multicenter study with an observation period of 2.5 years, the differential prophylactic efficacy of lithium versus carbamazepine was compared in 171 patients fulfilling DSM-IV criteria for bipolar disorder. Serum drug levels were 0.6+/-0.1 mmol/L for lithium and 6.1+/-1.3 microg/mL for carbamazepine. Patients were subdivided into a classical subgroup (bipolar I patients without mood-incongruent delusions and without comorbidity, N = 67) and a nonclassical subgroup including all other patients (N = 104). Classical bipolar patients had a lower rehospitalization rate with lithium than with carbamazepine prophylaxis (p = 0.005). For the nonclassical group, a trend in favor of carbamazepine was found. In the lithium group, there was a positive association between hospitalization rate and number of nonclassical features (bipolar II/not otherwise specified, mood-incongruent delusions, comorbidity; p = 0.035). For carbamazepine, this association was negative (p = 0.033). Analyses including mixed states as an additional nonclassical feature confirmed the results. In conclusion, lithium seems to be superior to carbamazepine in treating classical bipolar cases. Patients with nonclassical features might profit more from prophylaxis with carbamazepine, which seems to have a broader spectrum of activity.

Sleep deprivation or "stay awake"-therapy), given in addition to drug therapy, is seen as an effective anti-depressive treatment with actually no side effects. Nevertheless, it is not regularly and systematically used. A reason for this might be doubts about its feasibility in psychiatric hospitals without specialised depression wards. Only a few reports exist on the practical aspects of sleep deprivation. The present article informs about the "stay awake"-therapy on 101 depressive patients (in the mean 25 patient-nights per month), carried out at the Psychiatric Hospital Sanatorium Kilchberg/Zurich. The patients (age between 19 and 76, mean 47 years) participated on average in 4.4 partial sleep deprivations. 72% participated at least for a set of three nights. One staff person takes care of a group of at most five patients. Indication, organisation, night programme, care and possible strains are reported. A stay awake night (three times a week) consists of breakfast, games, conversations, taking two walks, and discussions about depression and about treatment (psychoeducation), with the aim to avoid naps and to provide a pleasant social event. The experiences made with serial partial sleep deprivation are encouraging.