24-Hour warning signs for adolescent suicide attempts.

BACKGROUND: Little is known about when youth may be at greatest risk for attempting suicide, which is critically important information for the parents, caregivers, and professionals who care for youth at risk. This study used adolescent and parent reports, and a case-crossover, within-subject design to identify 24-hour warning signs (WS) for suicide attempts. METHODS: Adolescents (N = 1094, ages 13 to 18) with one or more suicide risk factors were enrolled and invited to complete bi-weekly, 8-10 item text message surveys for 18 months. Adolescents who reported a suicide attempt (survey item) were invited to participate in an interview regarding their thoughts, feelings/emotions, and behaviors/events during the 24-hours prior to their attempt (case period) and a prior 24-hour period (control period). Their parents participated in an interview regarding the adolescents' behaviors/events during these same periods. Adolescent or adolescent and parent interviews were completed for 105 adolescents (81.9% female; 66.7% White, 19.0% Black, 14.3% other). RESULTS: Both parent and adolescent reports of suicidal communications and withdrawal from social and other activities differentiated case and control periods. Adolescent reports also identified feelings (self-hate, emotional pain, rush of feelings, lower levels of rage toward others), cognitions (suicidal rumination, perceived burdensomeness, anger/hostility), and serious conflict with parents as WS in multi-variable models. CONCLUSIONS: This study identified 24-hour WS in the domains of cognitions, feelings, and behaviors/events, providing an evidence base for the dissemination of information about signs of proximal risk for adolescent suicide attempts.

Risk assessment of carbofuran residues in fruits and vegetables at the Chinese market: A 7-year survey.

The United Nations designated 2021 as the International Year of Fruits and Vegetables (IYFV), with the goal of educating populations regarding the role of such produce in nutrition, food safety, and overall health. Carbofuran is a highly toxic insecticide and nematocide, and its use to treat fruit trees, vegetables, tea, and medicinal herbs is thus prohibited. However, carbofuran residues are still detectable via LC-Q-TOF/MS in fruit and vegetable samples collected from 138 sites in 31 regions. In the present study, carbofuran levels were sampled at 1388 sampling sites in 31 regions (provinces, autonomous regions, and municipalities) not including Hong Kong, Macao, or Taiwan. In total, over 36,000 samples (including 12,547 samples of 41 kinds of fruits and 23,785 samples of 83 kinds of vegetables) were randomly collected from supermarkets and farmer's markets. These data were used to conduct a risk assessment pertaining to dietary carbofuran exposure through the consumption of fruits and vegetables. In total, carbofuran residues were detectable in 2.0% of fruits and 2.3% of vegetables. Risk assessments indicated that the intake of fruits and vegetables harboring carbofuran residues did not pose a chronic health risk. However, peaches, grapes, sweet peppers, celery, Chinese chives, leaf lettuce, spinach, small rape, mustard greens, cucumbers, watermelons, Chinese wolfberry leaves, wax gourds, snap beans, bitter melons, green Chinese vegetables, lettuce, shallot, cowpeas, eggplants, tomatoes, tangerines, summer squash, oranges, lemons, Chinese cabbage, peppers, and strawberries were associated with an unacceptable acute risk to both children and adults. Moreover, crown daisies, nectarines, citrus fruits, pitayas, melons, kale, cabbages, milk Chinese cabbage, carrots, and melons were associated with an unacceptable acute risk to children. Substantial acute risk to children and adults was observed for fruits and vegetables from surveyed regions other than Inner Mongolia, Yunnan, Liaoning, Fujian, Xinjiang, and Hubei. Together, these data provide a foundation for future research aimed at the management of carbofuran residues in fruits and vegetables in an effort to better protect consumer health.

Validity of the modular assessment of risk for imminent suicide in predicting short-term suicidality.

OBJECTIVE: The Modular Assessment of Risk for Imminent Suicide (MARIS) is a clinical assessment tool, consisting of four modules assessing (1) a pre-suicidal cognitive-affective state (Module 1); (2) patients' attitudes toward suicide (Module 2); (3) clinicians' assessment of suicide risk factors (Module 3); and (4) clinicians' emotional responses to patients (Module 4) that assesses short-term suicide risk. Initial evidence provided evidence for its reliability and concurrent validity. The present study extended these findings by examining the MARIS's predictive validity in relation to suicidal thoughts and behaviors at one-month follow-up. METHODS: A sample of 1039 psychiatric patients (378 inpatients, 661 outpatients) and their clinicians (N = 144) completed a battery of measures at baseline; 670 patients completed the one-month follow-up assessment. RESULTS: MARIS total scores predicted suicidal thoughts and behaviors at one-month follow-up, even after controlling for baseline suicidal thoughts and behaviors. Moreover, both Module 1 and the Distress subscale of Module 4 were uniquely associated with suicidal thoughts and behaviors at one-month follow-up, controlling for baseline suicidal thoughts and behaviors. Modules 2 and 3, on the other hand, exhibited poor internal consistency. CONCLUSION: Overall, both patient- and clinician-rated indices are uniquely predictive of suicidal thoughts and behaviors at one-month follow-up, highlighting the need for integrating clinicians' emotional responses into suicide risk assessment. Pending replication and extension of these findings in external samples, a briefer, two-module version of MARIS (MARIS-2) may be such an integrative, psychometrically sound, and clinically useful instrument that can be utilized to assess short-term suicide risk.

National short-term dietary exposure assessment of a selected group of pesticides in Argentina.

An evaluation of acute dietary exposure to pesticide residues, applying deterministic and stochastic methods, was performed for a selected group of pesticides in two representative age groups from Argentina. Thus, 28 active ingredients (a.i.) and 75 food items were evaluated for the group of 2-5-year-old children, while 9 a.i. and 59 food items were considered for the 10-49-year-old women group. A deterministic assessment was conducting following the Food and Agriculture Organization (FAO) and World Health Organization (WHO) procedure but using the national maximum residue limits (MRLs) as pesticide residue concentration data, while in the stochastic approach, a theoretical distribution modeled with the available information was used. Food consumption data were obtained from the 2004-2005 comprehensive national nutrition and health survey. The risk was estimated by comparing the short-term dietary exposure with the acute reference dose (ARfD) values for each pesticide-food combination evaluated. In the deterministic assessment, 173 (39.1%) and 40 (31.3%) combinations exceeded the ARfD thresholds for the 2-5-year-old children and 10-49-year-old women groups, respectively. This conservative study generated relevant information as a first stage of acute dietary risk assessment in Argentina.

Determinants of Seeking and Avoiding Risk-Related Information in Times of Crisis.

This research is designed to provide insight into the psychological (e.g., threat appraisal or coping appraisal) and other determinants (e.g., information quality judgments or demographics) of risk information seeking or avoidance in times of an acute risk, as part of the process of increasing public resilience through adherence to risk mitigating advice. Data were collected via telephone interviews. A specialized agency interviewed 1,000 Dutch citizens, randomly confronted with one of eight fictitious, but realistic, acute risk and emergency situations. Results indicate that information seeking in an acute situation is anticipated by a less elaborate set of predictors (age and risk perception) than information seeking in a nonacute situation (age and risk perception, as well as educational level and social norm). Although risk perception is a predictor for risk information seeking, its predictive value for acute-risk-related behavior, as one might have assumed based on theories such as protection motivation theory (PMT) or the extended parallel process model (EPPM), appears to be limited. Implications for risk communication are discussed.

Warning signs in a period of acute risk for suicide attempt: The utility of count- and combination-based classification.

OBJECTIVE: This study sought to establish if models involving the specific combinations of identifiable behavioral warning signs (WS; i.e., alcohol use, suicidal communications, preparation of personal affairs, experiencing negative interpersonal life events) for a suicide attempt outperformed a simpler count model of WS to distinguish an acute risk period (the six hours prior to a suicide attempt) from a control period (a matched six-hour period the day prior). METHOD: Generalized linear mixed models tested all logical combinations of four behavioral WS in addition to a count variable of the number of behavioral warning signs. For the count variable, receiver operating characteristic curve analysis was utilized to determine the optimal cut point for the number of endorsed WS. RESULTS: Area under the curve (AUC) compared classification across all models, with the count model demonstrating similar classification performance to the best multivariate model (AUCs of 0.72 and 0.73, respectively), with an optimal cut point of endorsing one or more WS. CONCLUSION: Although determinations of acute risk should be informed by multiple sources of information, this study suggests a relatively simple count-based approach that considers the presence of one (or more) behavioral WS may be used as a potential indication of increased acute risk for suicide attempt.

Pesticides in vegetables and fruits from Brazil and risk assessment.

Levels of 237 pesticides were assessed in 1063 fruit and vegetable samples from 12 São Paulo markets spanning the period May 2015 to December 2022. The QuEChERS method was employed for extraction, followed by GC-MS/MS and LC-MS/MS analysis. Findings indicated that 30% of the samples contained residues below the Maximum Residue Limits (MRLs), while 6% exceeded these. Additionally, 23% exhibited excessive residues for their respective crops and 40% had no detectable residues. Health risk evaluation focused on tomatoes, cabbage and oranges, revealing exposure within 0.002-0.9% of the Acceptable Daily Intake (ADI), indicating no chronic risks. However, pyraclostrobin in orange presented a potential acute risk for adults (112%). These results underscore the necessity for continuous monitoring of pesticide residues in fruits and vegetables to safeguard consumer health, especially considering the significant levels of consumption.

Targeted risk assessment for famoxadone.

In accordance with Article 43 of Regulation (EC) No 396/2005, the European Commission requested EFSA to assess whether existing Codex Maximum Residue Limits (CXLs) for famoxadone are safe for consumers in light of the lowered toxicological reference values established following the non-renewal of approval of the active substance famoxadone. Based on the targeted assessment EFSA identified a potential acute concern for the CXL on table grapes. For the other CXLs consumers intake concern was not identified.

Predictive validity and symptom configuration of proposed diagnostic criteria for the Suicide Crisis Syndrome: A replication study.

OBJECTIVE: The Suicide Crisis Syndrome (SCS) is a new proposed suicide-specific diagnosis. In the present large replication study, we examine SCS diagnostic criteria to determine which configuration of symptoms demonstrates the strongest convergent and predictive validity for near-term suicidal behaviour. METHODS: We conducted confirmatory factor analysis (CFA) to examine the factor structure of the proxy-SCS variables derived from an extensive self-report test battery and administered to 903 psychiatric patients (age (M = 36.70, SD = 13.91); gender (64.0% female)) at intake and 4-8-week follow-up assessments. Convergent and predictive validity of five configurations of the proposed SCS diagnostic criteria for suicidal ideation (SI) and attempts (SA) were examined using regression analyses. The new clinician-rated SCS-Checklist was piloted with 68 participants. RESULTS: Both the one-factor and the five-factor models of proxy-SCS variables exhibited strong model fit, supporting the uni-dimensionality as well as the five-criteria structure of the SCS. All four configurations were uniquely related to the presence of a suicide attempt at follow-up when controlling for intake SI, lifetime SA, age, and gender, but none were significantly associated with intake SA when controlling for intake SI, age, and gender. All bivariate correlations between proxy-assessed and checklist-assessed SCS symptom configurations were significant and positive. CONCLUSION: The proposed five-symptom structure of the SCS diagnostic criteria was supported and appears to describe a clinically meaningful syndrome specifically related to near-term suicidal behaviour. SCS assessment may significantly improve clinical evaluation of imminent suicide risk. Future studies are needed to assess the utility of the syndrome in clinical settings.

Qualitative analysis of hospital patient narratives of warning signs on the day of their suicide attempt.

OBJECTIVE: Research on warning signs, defined as acute risk factors for suicide or suicide attempt, has been slow due to the difficulty of examining the hours and minutes preceding suicidal behavior. This study sought to identify new warning signs and to re-examine warning signs that have been proposed. METHOD: Narrative stories of adult patients with substance use problems hospitalized following a suicide attempt were transcribed. The narrative segments describing the 24-h period prior to suicide attempt were examined with directed qualitative content analysis using codes based on prior literature and new codes developed inductively. RESULTS: The sample (N = 35) was mean age = 40, 51% female, and 49% White non-Hispanic. Analysis of the transcripts of the 24-h periods (M word count = 637) yielded a broad range of cognitive (e.g., cognitive disturbance such as rumination), behavioral (e.g., alcohol use), emotional (e.g., dramatic mood changes), and social (e.g., social withdrawal) warning signs, along with a small number of cognitions and behaviors that appeared to mark a dangerous shift to acute preparation and intent for attempt, for example 'self-persuasion to attempt suicide.' CONCLUSION: We posit that a broad range of cognitive, behavioral, emotional, and social warning signs increase acute risk for suicidal behavior by creating the conditions for a shift to acute preparation and intent, a highly potent category of warning signs.

Statement on the short-term (acute) dietary risk assessment for the temporary maximum residue levels for nicotine in rose hips, teas and capers.

In accordance with Article 43 of Regulation (EC) No 396/2005, the European Commission requested EFSA to assess whether the existing temporary maximum residue levels (MRLs) for nicotine in rose hips, teas and capers are sufficiently protective for European consumers, based on the risk assessment model currently used for pesticide risk assessments (EFSA PRIMo rev. 3.1). In its assessment, EFSA noted potential acute exposure risks for the intake of nicotine through rose hips and tea; EFSA recommended to lower the existing MRLs for these two commodities to levels that do not lead to an exceedance of the ARfD. For capers, EFSA concluded that the existing MRL is unlikely to lead to acute intake concerns. The risk assessment for the three food commodities under assessment is affected by additional, non-standard uncertainties.

Use of Eisenia fetida as a Biological Risk Marker in a Qualitative Eco Assessment Test of a Romanian Watercourse.

The qualitative trials were conducted by exposing earthworms to diverse contaminants sources using standard earthworms' avoidance tests (considered useful ab initio indicators). For two years, we observed the Jiu River pollution points. We observed soil traits in 15 sampling points from two neighboring Romanian counties where Jiu River flows, by evaluating the risk of pollution on Eisenia fetida earthworms. The ISO: 11268-2:2015 acute static test was used, following the ethological and bodily features of E. fetida earthworms for 14 days, and then the results obtained for clean soils vs. those presumed polluted were statistically analyzed. Results disclosed statistically significant values (p < 0.05) for the two-way ANOVA and Tukey multiple comparisons tests used for the soil samples thought to be polluted. The mortality percentages by location/replica/year/county find out a high statistical correlation documenting observations related to soil samples gathered from 10 m (p < 0.01) and 30 m (p < 0.001). Compared with the control, the statistical analysis of Relative Growth Rate (RGR) (p < 0.05) and Specific Growth Rate (SGR) (p < 0.01) confirmed that, in the case of soil samples collected from 10 and 30 m from the Jiu River's axis, the earthworms did not gain weight, qualitatively attesting the pollution suspicion/presence of chemical factors potentially pernicious for earthworms.

The Narrative-Crisis Model of suicide and its prediction of near-term suicide risk.

Despite decades of research, much remains unknown about the transition from chronic to imminent suicidal risk. In the context of COVID-19, this question is even more urgent. The present study tests a novel, stepwise model of this transition, termed the Narrative-Crisis Model. This model proposes that, in people with chronic risk factors, stressful life events can trigger a specific progression of cognitive-affective responses (the suicidal narrative and the suicide crisis syndrome), resulting in increased near-term risk of suicidal thoughts and behavior (STB). Identification of each step in this progression provides opportunities for more precise interventions. Concurrent validity was tested with 732 psychiatric patients and predictive validity with 524 participants, assessed one to two months later. Chronic risk factors were measured with the Childhood Trauma Questionnaire, Relationship Styles Questionnaire, and UPPS-P Impulsive Behavior Scale; acute risk factors with the Stressful Life Events Questionnaire, Suicide Narrative Inventory, and Suicide Crisis Inventory. The Columbia Suicide Severity Rating Scale was administered at the initial research assessment and follow-up. Indirect effects were significant for the full model and most pathways, in both concurrent and prospective analyses. In sum, this study provides empirical support for a novel, stepwise model of the progression from chronic to near-term suicidal risk.

Health risks to dietary neonicotinoids are low for Chinese residents based on an analysis of 13 daily-consumed foods.

Neonicotinoid pesticide residues are ubiquitous in various foodstuffs and may adversely affect human health. We performed a nationwide survey of neonicotinoid residues in foodstuffs collected from Chinese markets and evaluated the risks of chronic and acute exposure in 1-6-year-old children and the general population. Among the 3406 samples of 13 commodities, 62.21% contained neonicotinoids with concentrations ranging from 0.1 to 1471.43 µg/kg, and 37.58% were simultaneously contaminated with 2-7 neonicotinoids. Acetamiprid, thiamethoxam, and imidacloprid were the top three detected neonicotinoids (22.14-34.32% of samples). Chronic and acute cumulative risk assessment using the relative potency factor method revealed that exposure to neonicotinoids was within established safety limits (below 1); however, the acute risk was much greater than the chronic risk (chronic hazard index range, 1.40 × 10-6-2.33 × 10-3; acute hazard index range, 1.75 × 10-6-0.15). A relatively greater acute cumulative risk was found for children with respect to consumption of grapes, mandarins, and cowpeas (acute hazard index range, 0.11-0.15). Despite the low health risk, the potential health hazards of neonicotinoids should be continuously assessed, given their ubiquity and cumulative effects.

Cumulative risk assessment of dietary exposure to triazole fungicides from 13 daily-consumed foods in China.

The agroeconomic benefits of the routine use of triazole fungicides on crops have been evident for more than 40 years. However, increasing evidence shows that residues of triazoles are ubiquitous in various foods and thus could pose a potential health risk to humans. We analyzed 3406 samples of 13 food commodities that were collected from markets in 9 regions across China, and assessed the health risk of both chronic and acute exposure to the triazoles for Chinese children (1-6 years old) and the general population. Among all samples, 55.52% had triazoles in concentrations of 0.10-803.30 µg/kg, and 29.77% of samples contained a combination of 2-7 triazoles. Tebuconazole and difenoconazole were the most commonly found triazoles in the foods, being detected in 33.44% and 30.45% of samples, respectively. Chronic and acute cumulative risk assessment for total triazoles based on a relative potency factor method revealed that exposure to triazoles from these particular commodities was below the levels that might pose a health risk (chronic hazard index range, 5.90×10-7 to 1.83×10-3; acute hazard index range, 7.77×10-5 to 0.39, below 1). Notably, dietary exposure risk for children was greater than that for the general population-particularly for the acute intake of mandarin, grape, and cucumber (acute hazard index values of 0.35-0.39). Despite the low health risk, the potential hazards of exposure to triazoles should raise public concern owing to their ubiquitous presence in common foods and potential cumulative effects.

The Brief Suicide Cognitions Scale: Development and Clinical Application.

The study explored the development of the Brief Suicide Cognitions Scale (B-SCS), a simple and brief measure of suicide risk. The B-SCS provides a brief measure that captures critical aspects of suicide risk embedded in core beliefs about the self as unlovable, one's emotional experience as unbearable, and life problems as unsolvable (i.e., the suicidal belief system), resulting in chronic or enduring suicide risk and heightened vulnerability for acute episodes secondary to internal and external triggers. Data were analyzed from three diverse samples, including a student sample (N = 349), an inpatient psychiatric sample (N = 160), and a sample of emergency department (ED) patients presenting secondary to a suicidal crisis (N = 94). Those in the student and inpatient samples completed additional symptom measures (hopelessness, anxiety, depression) and the ED sample provided 6-month follow-up data for suicide attempts. Reliability (internal consistency, test-retest), concurrent validity, construct (divergent, convergent) validity, factorial, incremental, and predictive validity were evaluated, along with calculation of predictive value of negative and positive tests, sensitivity, and specificity estimates. The B-SCS demonstrated good reliability and validity, a unidimensional factor structure across samples, along with good predictive validity and value in real-world clinical settings. The B-SCS is a brief, reliable and valid measure of suicide risk, with good ability to identify those with enduring risk for subsequent suicide attempts. The B-SCS offers a unique contribution to understanding and assessing the nature of suicide risk over time targeting the suicidal belief system, with easy application across inpatient and outpatient clinical settings, and good predictive value.

Pesticide residues in drinking water and associated risk to consumers in Ethiopia.

Access to safe and reliable drinking water is vital for a healthy population. However, surface water may be contaminated with pesticides because of the nearby agricultural areas as well as from household application. Water samples were collected from water sources in Jimma zone and Addis Ababa, Ethiopia. The extraction and clean up of the samples were undertaken using liquid-solid and liquid-liquid methods. Human exposure was assessed by calculating the estimated daily intake (EDI) of pesticides in water and compared with the acceptable daily intake (ADI) and the acute reference dose (ARfD). The mean concentrations of 2,4-D, malathion, diazinon and fenpropimorph were 1.59-13.90 µg/l and 0.11-138 µg/l in Jimma and Addis Ababa water sources, respectively. The residue level of some of the pesticides were above the European drinking water guide line values, which is an indication of an illegal use of pesticides in the study areas. Concerning human health risk estimation, there was no acute risk (EDI < ARfD). However, chronic risks to human health were observed from exposure to diazinon and fenpropimorph (EDI > ADI) for Jimma and Addis Ababa populations, respectively. A comprehensive monitoring is required to reduce the level of pesticide residues in the water and to minimize particularly the long term human health risks.

Development of Toxicological Risk Assessment Models for Acute and Chronic Exposure to Pollutants.

Alert level frameworks advise agencies on a sequence of monitoring and management actions, and are implemented so as to reduce the risk of the public coming into contact with hazardous substances. Their effectiveness relies on the detection of the hazard, but with many systems not receiving any regular monitoring, pollution events often go undetected. We developed toxicological risk assessment models for acute and chronic exposure to pollutants that incorporate the probabilities that the public will come into contact with undetected pollution events, to identify the level of risk a system poses in regards to the pollutant. As a proof of concept, we successfully demonstrated that the models could be applied to determine probabilities of acute and chronic illness types related to recreational activities in waterbodies containing cyanotoxins. Using the acute model, we identified lakes that present a 'high' risk to develop Day Away From Work illness, and lakes that present a 'low' or 'medium' risk to develop First Aid Cases when used for swimming. The developed risk models succeeded in categorising lakes according to their risk level to the public in an objective way. Modelling by how much the probability of public exposure has to decrease to lower the risks to acceptable levels will enable authorities to identify suitable control measures and monitoring strategies. We suggest broadening the application of these models to other contaminants.

Intimate partner homicide: new insights for understanding lethality and risks.

Research on covictims, family members, and close friends who have lost loved ones to intimate partner homicide (IPH) is a neglected area of study. We conducted phenomenological interviews with covictims to gain insights into risk and lethality, examined affidavits from criminal case files, and reviewed news releases. The data uncovered acute risk factors prior to the homicide, identified changes in the perpetrators' behavior and the perpetrators' perceived loss of control over the victim, and described barriers that victims faced when attempting to gain safety. Findings suggest that recognizing acute risk factors is an important area for future IPH research.