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The term metagenomics refers to the use of sequencing methods to simultaneously identify genomic material from all organisms present in a sample, with the advantage of greater taxonomic resolution than culture or other methods. Applications include pathogen detection and discovery, species characterisation, antimicrobial resistance detection, virulence profiling, and study of the microbiome and microecological factors affecting health. However, metagenomics involves complex and multistep processes and there are important technical and methodological challenges that require careful consideration to support valid inference. We co-ordinated a multidisciplinary, international expert group to establish reporting guidelines that address specimen processing, nucleic acid extraction, sequencing platforms, bioinformatics considerations, quality assurance, limits of detection, power and sample size, confirmatory testing, causality criteria, cost, and ethical issues. The guidance recognises that metagenomics research requires pragmatism and caution in interpretation, and that this field is rapidly evolving.

Research demonstrates that children exposed to domestic violence experience a myriad of internalising and externalising symptoms. The current study examines this pathway within a Cambodian sample, specifically determining if the effect of witnessing domestic violence on the child's tendency to bully or to be bullied is mediated by symptoms of posttraumatic stress disorder (PTSD). The PTSD Checklist-Civilian Version, a revised version of a 12-item bullying and victimisation questionnaire, and the Revised Conflict Tactics Scale were administered to 206 high school students in Phnom Penh. A significant mediational effect of PTSD symptoms was found for victimisation (being bullied); no such mediational model was supported for bullying as the outcome variable. However, controlling for emotional, physical, and sexual child abuse resulted in the mediation effect being non-significant. Implications and directions for future research are discussed.

This study examined the relationship among projective drawings and mental health symptomatology to determine if projective drawings provide clinical utility in pet bereavement. Projective drawings, standardized questionnaires, and clinical interview results were collected from 33 adults grieving the loss of a pet. Drawings were coded into a psychosocial adjustment score based on formal artistic elements, specific indicators (e.g., placement of figure), subject portrayal, and use of space. Results showed that those with greater severity of grief and/or somatization displayed poorer psychosocial adjustment. In conjunction with behavioral observations and verbal reflections, projective drawings add clinical utility by introducing a nonverbal form of expression helpful in understanding the severity of grief and in opening up shared communication with those experiencing loss.

The authors investigated the importance of dreams of the deceased in the experiencing of prolonged grief (PG) and posttraumatic stress disorder (PTSD) among Cambodian refugees who survived the Pol Pot genocide (1975-1979). Such dreams were frequent in the last month (52% of those surveyed), and most often involved a relative who died in the Pol Pot period. Past month frequency was correlated with PG severity ("r" = 0.59) and PTSD severity ("r" = 0.52). The dreams were almost always deeply upsetting because the dreams indicated the deceased to be in a difficult spiritual state. Dreams of the deceased as a central component of PG and PTSD among Cambodian refugees is discussed. (Contains 3 figures and 2 tables.)

The present study examined the effects of attachment style and continuing bonds, defined as the extent to which a bereaved individual feels that the deceased remains a part of his/her life, on post bereavement adjustment among 71 conjugally bereaved individuals. It was shown that bereaved individuals with an anxious attachment style tended to show more externalized continuing bonds as well as more grief symptoms. An anxious attachment style played a direct and significant role in post bereavement adjustment over and above the contribution of externalized continuing bonds. Interventions to facilitate restoration tasks and to reduce externalized continuing bonds would be discussed. (Contains 5 tables.)

This study examined type of continuing bonds (CB) expression in relation to risk factors for complicated grief and measures of bereavement-related adjustment. Externalized CB expressions involving illusions and hallucinations with the deceased were distinguished from internalized CB expressions involving use of the deceased as an autonomy promoting secure base. 502 bereaved participants completed over the internet a CB measure assessing externalized and internalized CB along with various known risk-factor measures that included cause of death (i.e., violent vs. non-violent death), responsibility for the death, and attachment style as well as measures of psychological adjustment that included complicated grief symptoms, perceived physical health, and personal growth. As predicted, externalized CB was positively associated with violent death and responsibility for the death, whereas internalized CB was negatively associated with these risk factors as well as uniquely positively linked to personal growth. The implications of the findings for the role of CB in adjustment are discussed. (Contains 4 tables and 1 figure.)

This study examined the impact of attachment on grief severity following the death of a pet. Seventy-one participants who had lost a dog or cat within the past year completed a set of measures that included an attachment measure assessing individual differences in attachment anxiety and avoidance, strength of the past attachment to the pet, the continuing bond with the deceased pet, social support, and complicated grief symptoms. Attachment anxiety and strength of the past attachment to the pet were each uniquely predictive of more severe grief. Furthermore, the continuing bond to the deceased pet partially mediated the impact of strength of the past attachment to the pet on grief severity. No significant mediators of the effect of attachment anxiety on grief were found, however. The results highlight the importance of distinguishing strength of attachment from attachment security in examining the effect of attachment on response to pet loss. (Contains 7 tables and 1 figure.)

This study examined the impact of telling one's story of childhood sexual abuse and its relationship with the survivor's self-capacities and history of other child maltreatment. The baseline data were collected from 134 female CSA survivors who were participating in a large intervention study. Participants were given 10 minutes to describe their childhood sexual abuse and completed a post-interview questionnaire assessing post-traumatic stress symptoms and their emotional response. The distress in response to their narrative was both predicted and mediated by the survivors' self-capacities and other forms of child maltreatment beyond child sexual abuse. (Contains 5 tables and 1 note.)

Much of the contemporary bereavement literature on the continuing bond to the deceased (CB) has emphasized its adaptiveness and given limited attention to when it may be maladaptive. The attachment literature on disorganized-unresolved attachment classification in relation to loss, or "unresolved loss," is informative in identifying CB expressions that are indicative of failure to integrate the death of a loved one. In this article, an important linkage is identified between a prominent indicator of unresolved loss that involves a lapse in the monitoring of reasoning implying disbelief that the person is dead and the clinical writings of J. Bowlby (1980) and V. D. Volkan (1981) on maladaptive variants of CB expression. The aim is to highlight the value of the attachment literature on unresolved loss in clarifying the conditions under which CB is likely to be maladaptive.

An attachment theory based perspective on the continuing bond to the deceased (CB) is proposed. The value of attachment theory in specifying the normative course of CB expression and in identifying adaptive versus maladaptive variants of CB expression based on their deviation from this normative course is outlined. The role of individual differences in attachment security on effective versus ineffective use of CB in coping with bereavement also is addressed. Finally, the moderating influence of type of loss (e.g., death of a spouse vs. child), culture, and religion on type of CB expression within an overarching attachment framework is discussed.

This study examined the continuing bond (CB) to the deceased in coping with the death of a husband. Fifteen early-bereaved widows whose husband had died 4 months previously and 15 later-bereaved widows whose husband had died more than 2 years ago were electronically signaled every 3 hours to complete a set of measures that included the PANAS positive and negative mood scales and CB coping. Participants completed these measures 4 times each day for 14 successive days. Following from an attachment theory perspective on the role of CB in providing felt security, it was hypothesized that CB would be effective as a way of coping in mood regulation, but that its effectiveness would be moderated by time since the death. Consistent with predictions, a positive within-person relationship was found between CB coping and positive mood for the later-bereaved group, but not for early-bereaved widows. CB coping was also positively related to negative mood for both early, and later-bereaved widow groups, however. Finally, in a lagged analysis, greater use of CB was predictive of a shift toward more negative mood among early-bereaved widows, but not for later-bereaved widows. The results were discussed in the context of previous literature on the function of CB in adaptation to bereavement.

Twenty-seven self-identified female survivors of childhood sexual abuse completed measures designed to elicit symptoms and self-descriptions. Discrepancies in views of current self when compared to ideal or future selves were positively correlated with all symptom measures. Self integration was negatively correlated with symptoms. (Author/DB)

Objectives: Outbreaks of bacterial enteric pathogens (BEPs) in men who have sex with men (MSM) associated with antimicrobial resistance are a public health concern. We investigated the prevalence and risk factors of BEPs in MSM to inform infection control.Methods: We conducted a cross-sectional study at a London sexual health clinic between 20/12/2017 and 06/02/2018. Residual rectal swabs from MSM attending for sexually transmitted infection (STI) testing were anonymously tested for a range of BEPs using real-time PCR. A sub-set of samples were tested for the mphA gene (a marker of azithromycin resistance). Results were linked to electronic health records.Results: BEPs were detected in 207 of 2116 participants, giving an overall prevalence of 9.8% (95% CI 8.5%-11.1%) ranging from 0.8% (0.4%-1.2%) for Shigella to 4.9% (4.0%-5.9%) for Enteroaggregative E. coli. MSM with BEPs were more likely to have a history of bacterial STIs (p = 0.010), to report more sexual partners (p<0.001), and among HIV-negative MSM, to report current HIV pre-exposure prophylaxis use (p<0.001). Gastrointestinal symptoms were rare (1.7%) and not associated with BEPs. 41.3% of MSM with BEPs and 14.1% of those without BEPs carried mphA (p<0.001). Among the former, this was associated with a history of bacterial STIs (51.5% vs 31.1%, p = 0.003).Conclusions: One in ten MSM had a BEP detected and most did not report symptoms. MphA carriage was common, particularly among those with BEPs. Bacterial STI treatment might contribute to selection of resistant gut organisms, emphasising the need for better antimicrobial stewardship. [ABSTRACT FROM AUTHOR]

Background: Crimean-Congo haemorrhagic fever (CCHF) is a widespread tick-borne viral infection, present across Africa and Eurasia, which might pose a cryptic public health problem in Uganda. We aimed to understand the magnitude and distribution of CCHF risk in humans, livestock and ticks across Uganda by synthesising epidemiological (cross-sectional) and ecological (modelling) studies.Methods: We conducted a cross-sectional study at three urban abattoirs receiving cattle from across Uganda. We sampled humans (n = 478), livestock (n = 419) and ticks (n = 1065) and used commercially-available kits to detect human and livestock CCHF virus (CCHFV) antibodies and antigen in tick pools. We developed boosted regression tree models to evaluate the correlates and geographical distribution of expected tick and wildlife hosts, and of human CCHF exposures, drawing on continent-wide data.Findings: The cross-sectional study found CCHFV IgG/IgM seroprevalence in humans of 10·3% (7·8-13·3), with antibody detection positively associated with reported history of tick bite (age-adjusted odds ratio = 2·09 (1·09-3·98)). Cattle had a seroprevalence of 69·7% (65·1-73·4). Only one Hyalomma tick (CCHFV-negative) was found. However, CCHFV antigen was detected in Rhipicephalus (5·9% of 304 pools) and Amblyomma (2·9% of 34 pools) species. Modelling predicted high human CCHF risk across much of Uganda, low environmental suitability for Hyalomma, and high suitability for Rhipicephalus and Amblyomma.Interpretation: Our epidemiological and ecological studies provide complementary evidence that CCHF exposure risk is widespread across Uganda. We challenge the idea that Hyalomma ticks are consistently the principal reservoir and vector for CCHFV, and postulate that Rhipicephalus might be important for CCHFV transmission in Uganda, due to high frequency of infected ticks and predicted environmental suitability.Funding: UCL Global Challenges Research Fund (GCRF) and Pan-African Network on Emerging and Re-Emerging Infections (PANDORA-ID-NET) funded by the European and Developing Countries Clinical Trials Partnership (EDCTP) under the EU Horizon 2020 Framework Programme for Research and Innovation. [ABSTRACT FROM AUTHOR]

The study attempts to evaluate whether posttraumatic stress disorder (PTSD) is associated with disability with perceived justice, desire for revenge, and knowledge of and attitudes towards the trials among Cambodians. The results indicate that PTSD is associated with disability in the case of Cambodians.

This article presents findings from a study on the impact of a child's death on parents. We explored the prominence and adaptiveness of parents' continuing bonds expressions, psychological adjustment, and grief reactions. A qualitative case study methodology was used to describe six cases. Participants were classified into two groups based on scores on the Inventory of Complicated Grief. Commonalities in themes on the Continuing Bonds Interview and projective drawings were assessed. Those in the Non-Complicated Grief Group reported internalization of positive qualities and identification with the deceased child as a role model, whereas participants in the Complicated Grief Group did not report these experiences. In addition, the drawings of those in the Non-Complicated Grief Group were evaluated as more adaptive than those in the Complicated Grief Group. doi: 10.2190/OM.60.1.a

The role of the continuing bond to the deceased in adjustment to bereavement has been given considerable attention in the bereavement literature. It is increasingly recognized that it is a normative part of adjustment to the loss of a loved one and that it can be adaptive. It may be the case however that a continuing bond to the deceased may also be maladaptive under certain conditions. In this special topic series of articles, the implications of a continuing bond for ajustment to bereavement is addressed. Conceptually and empirically focused papers as well as clinically oriented papers on the continuing bond to the deceased have been included in order to provide the reader with a broad sampling of contemporary work in this area. The aim is to inspire further thinking and research on this topic as well as to promote greater awareness among grief counselors and practitioners on the importance of the continuing bond to the deceased in working with the bereaved.

Thirty-nine bereaved individuals completed the Continuing Bonds Scale (CBS), assessing various aspects of the ongoing attachment to the deceased, at 60 months postloss in a longitudinal conjugal bereavement study. They also completed symptom measures at 6, 14, 25, and 60 months postloss. Higher CBS scores were associated with a more elevated grief-specific symptom pattern over the 5-year postloss period. Moreover, those who expressed greater helplessness and less blame toward the deceased during a monologue role-play involving their deceased spouse at 6 months postloss had higher CBS scores. Finally, greater satisfaction in the past relationship with the spouse was predictive of higher CBS scores. The results were discussed in relation to existing literature on the adaptiveness of continuing bonds.

In a challenge to traditional views of mental health, Taylor and Brown argued that an overly positive or enhanced perception of the self was adaptive, particularly in conditions of extreme adversity. Researchers have tempered this view with evidence linking self-enhancing biases to negative social consequences. This article reports studies examining self-enhancement in the context of civil war in Bosnia (Study 1) and premature conjugal loss (Study 2). In both studies, mental health experts rated self-enhancing individuals as better adjusted than other participants. Self-enhancement proved particularly salutary for bereaved participants who suffered more adverse losses. These effects were evidenced regardless of whether global judgments or structured clinical interviews were used, whether ratings were collected cross-sectionally or longitudinally, and when negative affect was statistically controlled. However, consistent with previous studies, self-enhancers also evoked negative impressions among untrained observers. Limitations and implications for future research are discussed.

The role of continuing attachment in adjustment to conjugal loss was examined. At 6 months postloss, 70 midlife bereaved participants were interviewed to assess different forms of continuing attachment. They also engaged in a monologue role-play with their deceased spouse, providing a behavioral measure of grief-related distress. In addition, they completed general and grief-specific symptom inventories at 6 months and again at 14 and 25 months postloss. The results indicated that use of the deceased's possessions to gain comfort was positively correlated with concurrent distress in the role-play and predictive of less of a decrease in grief-specific symptoms over time in a growth curve analysis. In contrast, attachment through fond memories was related to less distress in the role-play. The results, therefore, suggest that whether continuing attachment is adaptive or not depends on its form.

In this study the Gestalt empty-chair technique was applied in a research context to assess unresolved grief and its relation to later adjustment. Bereaved individuals who experienced the death of a spouse on average 6 months ago participated in an empty-chair monologue task in which they were instructed to speak to their deceased spouse, imagining that they had one last opportunity to do so. They completed a questionnaire at the end of their monologue speech assessing their affective experience during the monologue. It contained items associated with unresolved grief (e.g., anger, guilt, helplessness, nonacceptance). Near the time of the monologue session, bereaved participants also completed the Beck Depression Inventory (BDI) (Beck and Steer 1987) and the Impact of Event Scale (IES) (Horowitz, Wilner, and Alvarez 1979). At 14 months postloss, bereaved participants again were administered the BDI and IES. As hypothesized, the extent of unresolved grief as assessed by the monologue questionnaire at 6 months postloss was predictive of 14-month postloss symptoms, even when statistically controlling for 6-month postloss symptoms in hierarchical regression analyses.

This article describes a semantic space model of personality. According to the model, representations of facets of the self (e.g., actual self, ideal self) and of others are arrayed in a semantic space, with proximities among representations predicted to be associated with mood, self-evaluation, and broad personality dimensions. The relation of proximities among pairs of representations to personality and mood measures was found to be mediated by the spatial proximity of other representations, indicating that the representations constitute dynamic systems. Proximities among representations were shown to predict self-esteem and self-evaluative moods even after controlling for the contribution of the personality dimensions of Neuroticism, Extraversion, and Agreeableness. Generally, the semantic space model led to better predictions than did several related models concerning representations of self and other.

In non-Western societies, two-way communication between the bereaved and deceased is important in distinguishing adaptive versus maladaptive continuing bonds (CBs). We examined CBs expressed in dreams among Cambodian survivors during the Pol Pot era. Participants completed measures addressing dreams of the deceased, complicated grief (CG), and post-traumatic stress disorder (PTSD) symptoms. Participants who reported distressing dreams were more likely to have witnessed violent deaths of loved ones during the Pol Pot era and reported more severe CG and PTSD symptoms relative to those reporting other types of dreams. Distressing visitation dreams were shown to mediate the effect of violent loss on CG but not on PTSD. [ABSTRACT FROM AUTHOR]

The utility of whole genome sequencing (WGS) to inform sexually transmitted infection (STI) patient management is unclear. Timely WGS data might support clinical management of STIs by characterising epidemiological links and antimicrobial resistance profiles. We conducted a systematic review of clinical application of WGS to any human pathogen that may be transposable to gonorrhoea. We searched six databases for articles published between 01/01/2010–06/02/2023 that reported on real/near real-time human pathogen WGS to inform clinical intervention. All article types from all settings were included. Findings were analysed using narrative synthesis. We identified 12,179 articles, of which eight reported applications to inform tuberculosis (n = 7) and gonorrhoea (n = 1) clinical patient management. WGS data were successfully used as an adjunct to clinical and epidemiological data to enhance contact-tracing (n = 2), inform antimicrobial therapy (n = 5) and identify cross-contamination (n = 1). WGS identified gonorrhoea transmission chains that were not established via partner notification. Future applications could include insights into pathogen exposure detected within sexual networks for targeted patient management. While there was some evidence of WGS use to provide individualised tuberculosis and gonorrhoea treatment, the eight identified studies contained few participants. Future research should focus on testing WGS intervention effectiveness and examining ethical considerations of STI WGS use. • WGS was used as part of TB clinical management to enhance contact tracing and inform treatment. • WGS was used as part of gonorrhoea clinical management to enhance contact tracing. • We identified few studies on WGS use for individual patient management with very few participants. [ABSTRACT FROM AUTHOR]

The current study examined Posttraumatic Growth (PTG) experienced by bereaved pet owners in the United States, French-Canada, Japan, and Hong Kong following the death of their pet. Using qualitative methodology, we analyzed responses of participants who answered "yes" to a question about experiencing PTG and explored to what extent the cross-cultural responses mapped onto the five factors of the Posttraumatic Growth Inventory (PTGI). For the U.S. sample, 58% of responses mapped onto the PTGI. For French-Canada, 72% of responses mapped onto the PTGI. For Japan, 50% of responses mapped onto the PTGI and for Hong Kong, 39% of responses mapped onto the PTGI. We also explored emergent categories related to PTG for individuals who have lost a pet and discerned the unique aspects for PTG across cultures. [ABSTRACT FROM AUTHOR]

This study examined the relationship between sexual revictimization and interpersonal problems in a sample of adult survivors of childhood sexual abuse diagnosed with post-traumatic stress disorder. Fifty-two treatment-seeking women participated in this study. Research participants completed the Sexual Experiences Survey to assess sexual revictimization within the past 6 months and completed the Inventory of Interpersonal Problems (IIP). Revictimized participants reported overall greater interpersonal problems compared with nonrevictimized participants. Post hoc analyses showed significantly higher interpersonal problem scores for revictimized participants on the Hard to Be Assertive and Too Responsible subscales. On the circumplex IIP, revictimized participants were more socially avoidant, nonassertive, and overly nurturant.