Trauma and suicidality in war affected communities.

PURPOSE: The aim was to assess whether experiences of war trauma remain directly associated with suicidality in war affected communities when other risk factors are considered. MATERIALS AND METHODS: In the main sample 3313 participants from former Yugoslavia who experienced war trauma were recruited using a random sampling in five Balkan countries. In the second sample 854 refugees from former Yugoslavia recruited through registers and networking in three Western European countries. Sociodemographic and data on trauma exposure, psychiatric diagnoses and level of suicidality were assessed. RESULTS: In the main sample 113 participants (3.4%) had high suicidality, which was associated with number of potentially traumatic war experiences (odds ratio 1.1) and war related imprisonment (odds ratio 3) once all measured risk factors were considered. These associations were confirmed in the refugee sample with a higher suicidality rate (10.2%). DISCUSSION AND CONCLUSIONS: Number of potentially traumatic war experiences, in particular imprisonment, may be considered as a relevant risk factor for suicidality in people affected by war.

Course of post-traumatic stress disorder following war in the Balkans: 1-year follow-up study.

BACKGROUND: Prevalence rates of post-traumatic stress disorder (PTSD) following the experience of war have been shown to be high. However, little is known about the course of the disorder in people who remained in the area of conflict and in refugees. Method We studied a representative sample of 522 adults with war-related PTSD in five Balkan countries and 215 compatriot refugees in three Western European countries. They were assessed on average 8 years after the war and reinterviewed 1 year later. We established change in PTSD symptoms, measured on the Impact of Events Scale - Revised (IES-R), and factors associated with more or less favourable outcomes. RESULTS: During the 1-year period, symptoms decreased substantially in both Balkan residents and in refugees. The differences were significant for IES-R total scores and for the three subscales of intrusions, avoidance and hyperarousal. In multivariable regressions adjusting for the level of baseline symptoms, co-morbidity with depression predicted less favourable symptom change in Balkan residents. More pre-war traumatic events and the use of mental health services within the follow-up period were associated with less improvement in refugees. CONCLUSIONS: Several years after the war, people with PTSD reported significant symptom improvement that might indicate a fluctuating course over time. Co-morbid depression may have to be targeted in the treatment of people who remained in the post-conflict regions whereas the use of mental health services seems to be linked to the persistence of symptoms among refugees.

Rising popularity of anal intercourse and sexual risk taking: findings from two national probability studies of young Croatian adults.

This study examined the prevalence and correlates of heterosexual anal intercourse in two national probability samples of young Croatian adults aged 18-25 years, which were collected in 2005 and 2010. The lifetime prevalence of anal intercourse increased from 27% to 36%. In multivariate analysis, reporting four or more lifetime sexual partners was the only correlate of the experience of anal intercourse that was significant among both women (odds ratios [ORs] = 1.78-3.27, P < 0.05) and men (ORs = 3.14-4.63, P < 0.01). Information about condom use at most recent anal intercourse was collected in the 2010 study wave only. Age (OR = 0.80, P < 0.05), female gender (OR = 0.29, P < 0.01), holding more negative attitudes towards condoms (OR = 0.28-0.32, P < 0.05) and reporting condom use at most recent vaginal intercourse (OR = 11.45, 95% Confidence interval [CI] = 5.68-23.06) were associated with using a condom at most recent anal intercourse. Given the substantial prevalence of anal intercourse among young heterosexual adults and considerable sexually transmitted infection/HIV risks associated with the practice, sex education programmes should promote the discussion of health risks associated with anal eroticism.

Perception of the form of stimulus increment as a method in assessment of the psychophysical relationship.

Among numerous procedures for determination of the psychophysical relation, one approach has seldom been applied. Essential in this method is to present a set of stimuli whose intensity increases in fixed time following different forms. The objective stimulus increment, which the subjects perceive as linear growth directly, represents the inverse psychophysical relation. In this paper the method was tested in the fields of click frequency and sound pressure. This procedure was named "Perception of the Form of Stimulus Increment in Time". In comparison to other psychophysical approaches, this one has several advantages. The principal ones are the following: (1) In assessing the psychophysical relation it is not necessary to try to measure the perceptual magnitude; and (2) the psychophysical relation is directly determined by its dynamic pattern. In this paper modifications to the method are reported which facilitate the subject's task and avoid some differences in subjects' individual approaches to the task. The modified procedure leads to results satisfactory independent of the influence of the factors irrelevant to the psychophysical relationship.

Influence of the intensity of NaCl solutions on adaptation degree and recovery time course.

The degree of adaptation and the time course of recovery after adaptation to NaCl solutions of various intensities were examined by magnitude estimation and simple sensory reaction time using a test stimulus of constant intensity. The results show that the degree of adaptation increased with the adapting concentration following a negatively accelerated function. Similarly, all recovery curves were negatively accelerated functions of the recovery time. The relation between the recovery constant (time necessary to attain two-thirds of normal responsivity) and adapting concentration approximates with both criteria more or less a linear function. Thus the recovery constant is a positively accelerated function of the degree of adaptation. The relationship between concentration and degree of adaptation can be approximated by Beidler's equation of taste stimulation, while the time course of recovery can be expressed by an exponential equation that can also be related to Beidler's theory. The two criteria used showed similar deteriorating effects of taste adaptation, indicating that reaction time can also be a useful criterion of the level of sensory responsivity.

Central processes in gustatory adaptation.

In two experiments the adapting stimuli at the periphery of the taste system were of a constant objective intensity but, using mixture suppression and spatial summation, their perceived intensity was varied. The results have shown that, in spite of the constancy in stimulus concentration, the adaptation degree changed with the perceived intensity of the stimulus. The adaptation to the compounds when in binary mixtures proved to be significantly less effective than the adaptation to the same equimolar compounds when unmixed. Similarly, the adaptation effects of solutions of a constant concentration, when applied to a small tongue area, were significantly smaller than when applied to a larger area. This adaptation dependence upon the taste sensation intensity suggests that in the gustatory adaptation, peripheral as well as central processes take part.

Psychological well-being of refugee children.

Two groups of refugee families participated in a program aimed at preventing children's mental health problems. The program attempted to gain insight into the character and scope of problems of refugee families and to develop and implement a spectrum of interventions that would meet their specific psychological needs. Data about the family situation and the psychosocial adaptation of refugee children to displacement was gathered during detailed structured interviews with the mothers, while the study families were accommodated either in a shelter or with host families. A considerable range of stress-related reactions among displaced children were identified (e.g., sleeping and eating disorders, separation fears, and withdrawal or aggression). Refugee children exhibited a significantly higher incidence of stress reactions if their mothers had difficulty coping with the stress of displacement. The findings also indicated that children in the collective shelter were at greater mental health risk than their peers housed with host families.

Myoblast transfer in Duchenne muscular dystrophy.

One biceps muscle of 8 patients with Duchenne muscular dystrophy was injected at 55 sites with a total of 55 million viable, purified, and contamination-free normal myoblasts (myoblast transfer). The other biceps of each patient was injected with a placebo to serve as a control. The procedure was blinded to the patients, parents, and investigators. Myoblasts derived from a biopsy specimen of the fathers were cultured and purified under strict conditions and carefully screened for microbial contamination. All patients received cyclophosphamide for immunosuppression for 6 or 12 months. No serious complications were observed after myoblast transfer, indicating that the procedure is safe. The overall therapeutic efficiency of myoblast transfer was poor as judged by the results in maximal voluntary force generation, dystrophin content of the muscle, magnetic resonance imaging of the muscle, and the lack of donor-derived DNA and dystrophin messenger RNA in the injected muscle. An improved efficiency of the take of myoblasts might be achieved by using younger cells and injecting the myoblasts with a myonecrotic agent (to increase the prevalence of regeneration) and a basal laminal fenestrating agent.

Interaction between stimuli with different taste qualities evaluated by reaction time.

The influence of adaptation to taste stimuli of 1 quality on tastants with other qualities was investigated by comparing the reaction time (RT) to a test solution after adapting-solution flow with the RT to the same test solution after water flow. Adapting solutions were strong concentrations of NaCl, HCl, QHCl, and sucrose; test solutions were the same compounds but in lower concentrations. Adaptation to sucrose significantly shortened RT to NaCl and HCl, and to a lesser degree to QHCl. A similar cross-enhancement was found in sucrose when other compounds served as adapting solutions, In all other taste combinations, only a cross-adaptation effect was observed. Results are discussed in relation to some adaptation phenomena, water taste data, and magnitude-estimation data.

University students and AIDS: knowledge, attitudes and behavioral adjustment.

This study addresses the relations between AIDS-related knowledge, attitudes, and behavior change among university students. A questionnaire covering such issues and personal background variables was administered to 750 students at the University of Zagreb. Over-all, 62.7% of the knowledge items were answered correctly, while functional, self-protective aspects of knowledge proved to be much better than general knowledge. On the average, attitudinal responses were moderately liberal. Both self-reported change in risk-reduction behavior and personal concern due to the appearance of AIDS were very small. Correlations of risk-reducing behavior with permissive (.15) and restrictive (.14) attitude orientations and with general and functional knowledge (.08) were modest. The level of personal concern correlated neither with permissive attitudes nor with functional knowledge, while it correlated negatively with restrictive attitudes (-.20) and with general knowledge (-.08). Substantial association was only established between functional knowledge and permissive (.51) and restrictive attitude orientations (-.23). It is concluded that, in addition to knowledge and attitudes, a number of factors which restrain desired behavioral adjustment should be considered in anti-AIDS campaigns, such as perceived level of exposure to HIV in a particular environment, young age-specific illusion of invulnerability, peer norms, and others.

Time course of recovery from gustatory adaptation to NaCl.

Recovery from adaptation to NaCl was tested by comparing some relevant parameters of response to the adapting and test stimuli separated by different recovery intervals. The time course of response was determined using magnitude estimations and using the flow chamber for stimulus delivery. The course of recovery for all parameters used was a negatively accelerated function of the rest time, but the recovery rate of different parameters did not prove to be equal. Recovery was fastest for the initial maximum taste magnitude, followed by the time needed for the taste to disappear. The taste effect summed over time and the time required for the taste magnitude to decrease to 30% of its preadapted maximum were the slowest to recover. Although the recovery processes proceeded at a rapid rate during the initial period, all parameters remained depressed over a rather long period.

Magnitude estimation of adaptation to salt using a flow chamber for stimulus delivery.

Adaptation course to NaCl was estimated using a flow chamber for stimulus delivery and changes in the perceived taste magnitude as the criterion. The adapting stimulus of different durations was applied to one side of the tongue. Magnitude estimates were made by comparing the intensity of taste at the end of each adaptation time with the perceived intensity of the same stimulus applied briefly to the unadapted side of the tongue. The course of adaptation followed a negatively accelerated decreasing function. The relationship between taste magnitude and the duration of the adapting stimulus can be approximated by a logarithmic equation and, somewhat less accurately, also by an exponential equation, which can be related to the Beidler theory of taste stimulation. Some advantages of the closed flow technique and comparison of taste magnitudes on the adapted and unadapted sides of the tongue are discussed.

Individual gustatory reaction times to various groups of chemicals that provoke basic taste qualities.

Reaction times (RTs) to four groups of substances that provoke different taste qualities were measured. Measurements for all substances with the same taste, equalized in perceived intensity and provoking a very strong taste, were made concurrently for each subject. The comparisons were made on the individual level. No significant differences in RTs to substances with the same taste quality were found. When the factor of perceived intensity is kept constant, no effect of the stimulus chemical composition on RTs seems to be present. RTs to stimuli with different tastes differ significantly, the shortest being to salt and the longest to bitter. The difference in RTs for sour and sweet substances is small, and the subjects were not all alike in terms of the order of RTs with respect to these stimuli.

Mechanisms of HIV-associated immunosuppression.

HIV antigens were identified in PBL obtained from HIV-positive patients, using IF and IEM. Studies of the phenotype of HIV-containing lymphocytes showed that OKT4+ cells were the principal target of the virus. Approximately 5% of infected cells were multinucleated. Almost all infected and about 30% of uninfected PBL displayed Ab-C3 complexes on the cell surfaces. Sera from HIV-positive patients contained Ab reacting with cell membranes and intracellular structures of PBL from normal subjects, as demonstrated by IEM. The presence of Ig-C3 complexes on a high percentage of HIV-positive- or negative-PBL suggests that the Ab-C-mediated lympholysis may represent a major mechanism of lymphatic tissue destruction in HIV-infected patients.

Pathogenicity of HIV in lymphatic organs of patients with AIDS.

HIV antigens were searched for in the thymus, lymph nodes, bone marrow, and spleen of AIDS patients, by means of immunofluorescence technique. Human IgG against HIV and monoclonal antibodies against viral gag P24 protein yielded strong cytoplasmic fluorescence of cells in sections of the thymus, lymph nodes and spleen. Some cells containing HIV antigens were morphologically multinucleated giant cells. They reacted with monoclonal antibodies against helper/inducer T-cells (OKT4+), and were complexed with antibody or with complement as demonstrated by double-staining immunofluorescence technique. A large number of inflammatory cells infiltrated the thymus in areas containing cells expressing HIV antigens. These studies demonstrated an association of HIV virus with cytopathic and immunopathogenic reactions in lymphatic organs of AIDS patients, and are consistent with previous results, as well as indicative of a primary aetiologic role for the virus.

The relationship between electrode area and sensory qualities in electrical human tongue stimulation.

The relationship between the size of the stimulated human tongue area, the stimulating electric current intensity and the provoked sensory qualities was examined. Five different electrode areas and four anodal current intensities were used. The observed sensations were of three kinds: sour taste, somatosensory, and undefined ones. At a given current intensity level the proportion of taste increases with the increase in the stimulation area, while somatosensory sensations decrease. These results imply that at the suprathreshold level there is a certain interdependence between the area, current intensity and sensory effects. In order to achieve optimal activation of the taste system alone, it is more effective to use a larger electrode and stronger current, than to use smaller areas and weaker stimuli: in this case the electrical sour taste is satisfactorily clear, since the somatosensory system is still not activated. These findings may have implications in clinical electrogustometry.