This study aimed to determine the prevalence of substance consumption and mental health problems among Spanish medical students, and their association with sociodemographic factors.
A multicentre ...cross-sectional study was conducted. Self-reported data on sociodemographic and clinical characteristics were collected, including BDI-II, PHQ-9, brief STAI, and single-item academic burnout (IUBA).
Overall, 1265 students (74.2% female) completed the survey. Of them, 37.4% scored positive for depressive symptoms, as measured by the BDI-II, and more than half (53%) by the PHQ-9. Suicidal ideation was reported by about 12% whilst high levels of state and trait anxiety were informed by 28.8% and 29.4% of the students. The prevalence of burnout was 40.2%. Female and pre-clinical students reported significantly (p < 0.01) higher rates of depressive, anxiety, and burnout symptoms. Alcohol, energy drinks, and tobacco were the most frequently used substances. Total scores of self-reported mental health problems negatively correlated (p < 0.001) with objective academic results and positively correlated (p < 0.02) with the number of substances consumed in the last 30 days.
Research-based on self-reported data could favour information bias due to the social desirability effect and memory error.
A high prevalence of substance consumption and several mental health problems was found among medical students, especially females. The relevant influence of academic-related factors on students' well-being may be a call for medical schools to implement initiatives aimed to improve students' ability to detect, address, and seek help for their mental health issues.
•Rates of depressive, anxiety and burnout symptoms were higher among female and pre-clinical medical students.•Lower degree of satisfaction with the previous semester´s academic results associated with higher scores of depressive and burnout symptoms.•The most frequently used substances among medical students were alcohol, energy drinks and tobacco.•A positive correlation was found between self-reported mental health scores and substance consumption.
Structural studies of translating ribosomes traditionally rely on in vitro assembly and stalling of ribosomes in defined states. To comprehensively visualize bacterial translation, we reactivated ex ...vivo-derived E. coli polysomes in the PURE in vitro translation system and analyzed the actively elongating polysomes by cryo-EM. We find that 31% of 70S ribosomes assemble into disome complexes that represent eight distinct functional states including decoding and termination intermediates, and a pre-nucleophilic attack state. The functional diversity of disome complexes together with RNase digest experiments suggests that paused disome complexes transiently form during ongoing elongation. Structural analysis revealed five disome interfaces between leading and queueing ribosomes that undergo rearrangements as the leading ribosome traverses through the elongation cycle. Our findings reveal at the molecular level how bL9's CTD obstructs the factor binding site of queueing ribosomes to thwart harmful collisions and illustrate how translation dynamics reshape inter-ribosomal contacts.
The incubation period of COVID-19 helps to determine the optimal duration of the quarantine and inform predictive models of incidence curves. Several emerging studies have produced varying results; ...this systematic review aims to provide a more accurate estimate of the incubation period of COVID-19.
For this systematic review, a literature search was conducted using Pubmed, Scopus/EMBASE, and the Cochrane Library databases, covering all observational and experimental studies reporting the incubation period and published from 1 January 2020 to 21 March 2020.We estimated the mean and 95th percentile of the incubation period using meta-analysis, taking into account between-study heterogeneity, and the analysis with moderator variables.
We included seven studies (n=792) in the meta-analysis. The heterogeneity (I
83.0%, p<0.001) was significantly decreased when we included the study quality and the statistical model used as moderator variables (I
15%). The mean incubation period ranged from 5.6 (95% CI: 5.2-6.0) to 6.7 days (95% CI: 6.0-7.4) according to the statistical model. The 95th percentile was 12.5 days when the mean age of patients was 60 years, increasing 1 day for every 10 years.
Based on the published data reporting the incubation period of COVID-19, the mean time between exposure and onset of clinical symptoms depended on the statistical model used, and the 95th percentile depended on the mean age of the patients. It is advisable to record sex and age when collecting data in order to analyze possible differential patterns.
Most of the research on psychopathology has provided an incomplete picture of mental health by focusing on vulnerability factors and omitting the transversal processes that may explain human adapted ...functioning. Moreover, research has not sufficiently addressed prospective protective factors for mental health. New theoretical and empirical endeavors aim to incorporate this perspective, particularly in the realm of emotional disorders. A positive view of the future is an indispensable process in attaining desired goals and wellbeing. Openness to the Future is a construct characterized by positive affectivity towards the future, which can be a protective factor for mental health. Although some scales assess future orientations, the complexity of this concept has not yet been captured; therefore, there is a need for new instruments. This study presents the development and validation of a scale for measuring Openness to the Future in clinical (n = 412) and community (n = 890) samples.
Psychometric properties of the OFS were analyzed using Confirmatory Factor Analysis (CFA) and Item Response Theory (IRT) analyses, establishing cut-off points to better classify these two groups. Moreover, convergent and discriminant validity were examined by correlating the OFS with theoretically related constructs.
Results support a unidimensional structure and indicate that the items function similarly across clinical and community samples. Moreover, the Openness to the Future scale shows good convergent and discriminant validity.
These findings suggest that the Openness to the Future scale is a valid and brief measure of openness to the future for use with clinical and community samples, and it could help to fill a gap in the literature regarding attitudes towards the future and their implications. Openness to the Future is presented as an empirically feasible and theoretically consistent construct that includes both prospective and protective factors in the psychopathological chart.
Arginine residues are generally considered poor candidates for the role of general bases because they are predominantly protonated at physiological pH. Nonetheless, Arg residues have recently emerged ...as general bases in several enzymes: IMP dehydrogenase, pectate/pectin lyases, fumarate reductase, and
l-aspartate oxidase. The experimental evidence suggesting this mechanistic function is reviewed. Although these enzymes have several different folds and distinct evolutionary origins, a common structural motif is found where the critical Arg residue is solvent accessible and adjacent to carboxylate groups. The chemistry of the guanidine group suggests unique strategies to lower the p
K
a of Arg. Lastly, the presumption that general bases must be predominantly deprotonated is revisited.
Summary
Background
Many authors have analysed premature mortality in cohorts of type 2 diabetic patients, but no analyses have assessed mortality in hospitalised diabetic patients.
Aim
To construct ...predictive models to estimate the likelihood of all‐cause mortality and cardiovascular mortality in type 2 diabetic inpatients.
Design
Cohort study with follow‐up from 2010 to 2014.
Methods
We evaluated mortality in a randomly selected cohort of 112 type 2 diabetic inpatients at the Hospital of Elda (Spain) in 2010–2012. Outcomes: all‐cause mortality and cardiovascular mortality during the follow‐up. Other variables: gender, age, depression, asthma/chronic obstructive pulmonary disease, hypertension, dyslipidemia, insulin, pills, smoking, walking, baseline blood glucose and creatinine. Predictive tables with risk groups were constructed to estimate the likelihood of all‐cause mortality and cardiovascular mortality. Calculations were made of the area under the ROC curve (AUC).
Results
During the follow‐up, 52 inpatients died (46.4%, 95% CI, confidence interval: 37.2–55.7%), 22 because of cardiovascular causes (19.6%, 95% CI: 12.3–27.0%). The mean follow‐up time was 2.7 ± 1.5 years. The AUC for the all‐cause mortality model was 0.84 (95% CI: 0.77–0.92, p < 0.001). Associated parameters: pills, smoking, walking, gender, insulin and age. The AUC for the cardiovascular mortality model was 0.79 (95% CI: 0.67–0.91, p < 0.001). Associated parameters: age, pills, walking, smoking, depression and insulin.
Conclusions
This study provides tools to predict premature mortality in type 2 diabetic inpatients. However, before their general application they require joint validation by the internal medicine unit, emergency department, primary healthcare unit and endocrinology service to enable better prediction of the prognosis and more adequate decision‐taking.
Background
Studies validating indirect methods to identify nonadherence in chronic patients who visit pharmacies are lacking. The aim of this study was to validate self-reported adherence and assess ...the variables associated with both overestimation and underestimation of good adherence when using this method.
Materials and methods
An observational, cross-sectional study was undertaken to validate self-reported adherence in 132 community pharmacies throughout Spain in 6237 chronic patients. The Morisky-Green test was used as the validation method and through a 2 × 2 table, the validity indicators, predictive values, and likelihood ratios were calculated. To assess the variables associated with both overestimation and underestimation of good adherence, multivariate logistic regression analysis and calculation of the area under the ROC curve were used to evaluate discriminatory capacity.
Results
Sensitivity was 27.8% (95% CI: 26.2–29.4) and specificity was 93.9% (95% CI: 93.1–94.7). Discrepancy analysis obtained a significant overestimation of good adherence (
p
< 0.001). The factors associated with overestimating good adherence were performing a mnemonic trick (
p
< 0.001), not self-medicating (
p
< 0.001), a high level of physical activity (
p
< 0.001), and an older age (
p
= 0.014). Factors associated with underestimation were self-medication (
p
< 0.001), desiring more information (p < 0.001), smoking (
p
= 0.014), not engaging in physical activity in the low (
p
= 0.006) or high (
p
< 0.001) categories, having a younger mean age (
p
= 0.007), and taking two to three (
p
= 0.029) or four or more (
p
< 0.001) chronic treatments.
Conclusion
Self-reported adherence has good specificity but poor sensitivity. The associated profiles of the discrepancies were obtained to identify both good and poor adherence.
Personality disorders (PD) have a serious impact on the lives of individuals who suffer from them and those around them. It is common for family members to experience high levels of burden, anxiety, ...and depression, and deterioration in their quality of life. It is curious that few interventions have been developed for family members of people with PD. However, Family Connections (FC) (Hoffman and Fruzzetti, 2005) is the most empirically supported intervention for family members of people with Borderline Personality Disorder (BPD).
The aim of this study is to explore the effectiveness of online vs face-to-face FC. Given the current social constraints resulting from SARS-CoV-2, interventions have been delivered online and modified.
This was a non-randomized pilot study with a pre-post evaluation and two conditions: The sample consisted of 45 family members distributed in two conditions: FC face-to-face (20) performed by groups before the pandemic, and FC online (25), performed by groups during the pandemic. All participants completed the evaluation protocol before and after the intervention.
There is a statistically significant improvement in levels of burden (η 2 = 0.471), depression, anxiety, and stress (η 2 = 0.279), family empowerment (η 2 = 0.243), family functioning (η 2 = 0.345), and quality of life (μ2 η 2 = 0.237). There were no differences based on the application format burden (η 2 = 0.134); depression, anxiety, and stress (η 2 = 0.087); family empowerment (η 2 = 0,27), family functioning (η 2 = 0.219); and quality of life (η 2 = 0.006), respectively).
This study provides relevant data about the possibility of implementing an intervention in a sample of family members of people with PD in an online format without losing its effectiveness. During the pandemic, and despite the initial reluctance of family members and the therapists to carry out the interventions online, this work shows the effectiveness of the results and the satisfaction of the family members. These results are particularly relevant in a pandemic context, where there was no possibility of providing help in other ways. All of this represents a great step forward in terms of providing psychological treatment.
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