The role of demoralization and hopelessness in suicide risk in schizophrenia: a review of the literature

Background and Objectives: Demoralization has been defined by hopelessness and helplessness attributable to a loss of purpose and meaning in life. Demoralization is a meaningful mental health concern, frequently associated with suicide risk in medical and psychiatric patients. The aim of this systematic review was to synthesize the recent empirical evidence on demoralization in patients with schizophrenia and to better understand the relationship between demoralization and suicide risk in patients with schizophrenia. Methods: A comprehensive literature search using key words and subject headings was performed following PRISMA guidelines with several bibliographic databases, resulting in the identification of 27 studies. Results: The findings suggested that demoralization is prevalent in patients with schizophrenia and supported the hypothesis that the association between depression and suicide is moderated by hopelessness. In clinical practice, it is important to recognize symptoms of demoralization using appropriate psychological tools to better understand the suffering of patients with schizophrenia and to implement suicide prevention programs

Effect of Cereals and Legumes Processing on In Situ Rumen Protein Degradability: A Review

The determination of the ruminal degradability rate of feeds, mainly starch and crude protein, is one of the most common methods to evaluate the nutritional value of ruminant feed. The protein requirements for ruminants are met from microbial protein and undegraded dietary protein digested in the small intestine. In order to reach maximum productivity, high-quality proteins are needed, and the requirement for undegraded dietary protein increases with the performance of the animal. This protein can be supplied by reducing the ruminal degradation to increase the amount of protein digested post-rumen, but the form in which a feed is administered influences degradability, and grain processing, especially, is a common practice to improve feed efficiency. Despite these aspects, studies on the effects of feed processing methods on protein degradability are limited, even though more and more ruminants are fed with processed feeds. For these reasons, this review investigated the protein degradability of different processed cereals and legumes in ruminants based on the analysis of available literature in order to take stock of the state of the art on this topic. Results showed that: First, the majority of the papers are focused on the energy aspects mainly due to carbohydrate-rich feeds; second, the majority of the studies in the literature are quite old, probably because the changes occurred in the animal testing legislation that made in vivo studies more and more difficult in the last 20 years; third, as a consequence, the few data available in recent years concern in vitro experiments; fourth, we found a high variability of the experimental conditions thus affecting protein degradability and making it quite difficult to compare the different results

Nutritional Characteristics of Corn Silage Produced in Campania Region Estimated by Near Infrared Spectroscopy (NIRS)

In formulating balanced rations for ruminants, knowing the chemical composition of forage and feeds in general is crucial to create adequate nutritional plans that meet animals’ feed requirements. From July to December of 2020, a total of 175 samples of corn silage hybrid PR31Y43 grown (135 days of maturity class) in three sites (Piana del Sele, Vallo di Diano and Caserta) of the Campania region (South Italy) were collected and analysed by using a portable Near Infrared Spectroscopy (NIRS). The area of cultivation/storage of corn silage highly (p < 0.05) affected the nutritional characteristics of the analysed samples. The silages produced in the Vallo di Diano showed the significantly highest (p < 0.05) DM content compared to those from the other sites (349.3 vs. 323.4 and 328.1 g/kg as feed from Caserta and Piana del Sele, respectively). The structural carbohydrates were significantly higher (p < 0.05) in Piana del Sele feed than those in both Caserta and Vallo di Diano feeds (420.1 vs. 396.7 and 397.6 g/kg as feed), whereas the non-fibrous carbohydrates were significantly higher in Caserta and Vallo di Diano feeds (p < 0.05; 469.6 and 471.8 g/kg as feed); intermediate values were registered in the corn silages produced in Piana del Sele (446.6 g/kg as feed). No differences were detected for protein levels. The NIRS technology could be useful to obtain fast and accurate picture of silage quality. The knowledge of the nutritional characteristics of silages can improve the formulation of balanced rations, contributing to guarantee animal welfare and good productive performances

Job satisfaction mediates the association between perceived disability and work productivity in migraine headache patients

Migraine headache is the cause of an estimated 250,000,000 lost days from work or school every year and is often associated with decreased work productivity. The aim of this cross-sectional study was to assess the relationship between perceived disability, job satisfaction and work productivity in patients affected by chronic migraineurs. Participants were 98 consecutive adult outpatients admitted to the Regional Referral Headache Centre of the Sant’Andrea Hospital in Rome, Italy. Patients were administered the Italian Perceived Disability Scale, The Quality of Life Enjoyment and Satisfaction Questionnaire-Work Subscale and The EndicottWork Productivity Scale. Perceived disability is significantly associated with job satisfaction and work productivity. Job satisfaction is significantly related to work productivity and mediates the association between perceived disability and work productivity in patients affected by chronic migraineurs. Our results confirm that patients suffering from migraine headaches who have negative perceptions © 2019 by the authors. Licensee MDPI, Basel, Switzerland

End-stage heart failure in congenitally corrected transposition of the great arteries:a multicentre study

BACKGROUND AND AIMS: For patients with congenitally corrected transposition of the great arteries (ccTGA), factors associated with progression to end-stage congestive heart failure (CHF) remain largely unclear. METHODS: This multicentre, retrospective cohort study included adults with ccTGA seen at a congenital heart disease centre. Clinical data from initial and most recent visits were obtained. The composite primary outcome was mechanical circulatory support, heart transplantation, or death. RESULTS: From 558 patients (48% female, age at first visit 36 ± 14.2 years, median follow-up 8.7 years), the event rate of the primary outcome was 15.4 per 1000 person-years (11 mechanical circulatory support implantations, 12 transplantations, and 52 deaths). Patients experiencing the primary outcome were older and more likely to have a history of atrial arrhythmia. The primary outcome was highest in those with both moderate/severe right ventricular (RV) dysfunction and tricuspid regurgitation (n = 110, 31 events) and uncommon in those with mild/less RV dysfunction and tricuspid regurgitation (n = 181, 13 events, P &lt; .001). Outcomes were not different based on anatomic complexity and history of tricuspid valve surgery or of subpulmonic obstruction. New CHF admission or ventricular arrhythmia was associated with the primary outcome. Individuals who underwent childhood surgery had more adverse outcomes than age- and sex-matched controls. Multivariable Cox regression analysis identified older age, prior CHF admission, and severe RV dysfunction as independent predictors for the primary outcome. CONCLUSIONS: Patients with ccTGA have variable deterioration to end-stage heart failure or death over time, commonly between their fifth and sixth decades. Predictors include arrhythmic and CHF events and severe RV dysfunction but not anatomy or need for tricuspid valve surgery.</p

In the context of a daycare center: nursing and their representations of child care as an educational act

This study aimed to analyze the social representations in the professionals of technical staff, who work with children at USP daycare centers. Eight professionals of the nursing field underwent a semi-structured interview. The interviews were recorded and transcribed in their entirety and the content of the discourse was subjected to thematic-categorical analysis. The categories were transformed into variables and processed by the software Classification Hiérarchique Classificatoire et Cohésitive (CHIC®) and analyzed by the hierarchical similarity tree. The results indicate that actions to promote health are reported as educational and transformative, in which health care gains new meaning through contextualized conceptions in the field of child education. We conclude that professionals attribute new meanings to their practices in the health care environment of daycare centers as their representations shifts from the logic of the biomedical field to a logic of educational care. In this sense, they perceive themselves as being challenged to establish an interaction with the children in terms of their activities related to the promotion of health and in an educational act

Impairment of circulating endothelial progenitors in Down syndrome

<p>Abstract</p> <p>Background</p> <p>Pathological angiogenesis represents a critical issue in the progression of many diseases. Down syndrome is postulated to be a systemic anti-angiogenesis disease model, possibly due to increased expression of anti-angiogenic regulators on chromosome 21. The aim of our study was to elucidate some features of circulating endothelial progenitor cells in the context of this syndrome.</p> <p>Methods</p> <p>Circulating endothelial progenitors of Down syndrome affected individuals were isolated, <it>in vitro </it>cultured and analyzed by confocal and transmission electron microscopy. ELISA was performed to measure SDF-1α plasma levels in Down syndrome and euploid individuals. Moreover, qRT-PCR was used to quantify expression levels of <it>CXCL12 </it>gene and of its receptor in progenitor cells. The functional impairment of Down progenitors was evaluated through their susceptibility to hydroperoxide-induced oxidative stress with BODIPY assay and the major vulnerability to the infection with human pathogens. The differential expression of crucial genes in Down progenitor cells was evaluated by microarray analysis.</p> <p>Results</p> <p>We detected a marked decrease of progenitors' number in young Down individuals compared to euploid, cell size increase and some major detrimental morphological changes. Moreover, Down syndrome patients also exhibited decreased SDF-1α plasma levels and their progenitors had a reduced expression of SDF-1α encoding gene and of its membrane receptor. We further demonstrated that their progenitor cells are more susceptible to hydroperoxide-induced oxidative stress and infection with Bartonella henselae. Further, we observed that most of the differentially expressed genes belong to angiogenesis, immune response and inflammation pathways, and that infected progenitors with trisomy 21 have a more pronounced perturbation of immune response genes than infected euploid cells.</p> <p>Conclusions</p> <p>Our data provide evidences for a reduced number and altered morphology of endothelial progenitor cells in Down syndrome, also showing the higher susceptibility to oxidative stress and to pathogen infection compared to euploid cells, thereby confirming the angiogenesis and immune response deficit observed in Down syndrome individuals.</p