Cingulate to septal circuitry facilitates the preference to affiliate with large peer groups.

Despite the prevalence of large-group living across the animal kingdom, no studies have examined the neural mechanisms that make group living possible. Spiny mice, Acomys, have evolved to live in large groups and exhibit a preference to affiliate with large over small groups. Here, we determine the neural circuitry that facilitates the drive to affiliate with large groups. We first identify an anterior cingulate cortex (ACC) to lateral septum (LS) circuit that is more responsive to large than small groups of novel same-sex peers. Using chemogenetics, we then demonstrate that this circuit is necessary for both male and female group investigation preferences but only males' preference to affiliate with larger peer groups. Furthermore, inhibition of the ACC-LS circuit specifically impairs social, but not nonsocial, affiliative grouping preferences. These findings reveal a key circuit for the regulation of mammalian peer group affiliation.

Harnessing the power of language to enhance patient experience of the NHS complaint journey in Northern Ireland: a mixed-methods study.

Background: Good communication is consistently recognised as essential for effective complaint handling, while failures in communication correlate with risk of escalation. Nonetheless, communication in National Health Service complaint handling remains underexamined. Objectives: To examine complainants' lived experience of the complaints journey through (1) micro-analysis of their communication with National Health Service representatives; (2) their self-reported expectations and experiences throughout the complaints journey; to survey patient perceptions of the culture of the National Health Service; to develop 'Real Complaints' - an evidence-based communication training resource. Design: The project triangulates microlevel conversation analysis and discourse analysis of spoken and written complaints encounters with complainants' appraisals of those encounters in longitudinal case studies. This is underpinned by an audit of patient views of the cultural-institutional context of the National Health Service. Setting and participants: Data were gathered in the complaints-handling services of two National Health Service trusts and a Patient Advocacy Service in Northern Ireland. Twenty-three complainants consented to longitudinal data collection and 58 to initial encounter recording; 115 members of the Patient Advocacy Service mailing list completed the cultural audit; 3 trust complaint handlers, 1 Patient Advocacy Service complaint handler and 2 trust complaints managers were interviewed. Data sources: This yielded 1155 minutes of recorded calls, 113 written encounters, 36 diaries, 6 meetings, 23 interviews and 115 cultural audit responses collected over a period of 24 months. Results: Our analysis illuminates the dual nature of complaints: as personal expressions of dissatisfaction and as systemic critiques. The complaint experience is a dynamic journey with evolving narratives reflecting complainants' shifting perceptions, expectations and experiences of the 'system', both moment-by-moment and encounter-by-encounter in the overall journey. Key interpersonal priorities for complainants significantly affected complaint outcomes, most important of which was the need to be respected as a 'reasonable complainant'. Also key is the conversation analytic concept of affiliation, which involves taking a stance towards the event(s) being described that matches the complainant's stance. Use of affiliation by call handlers supported effective and efficient person-centred complaints handling, while absence of affiliation typically led to escalation of the scope, scale and emotional intensity of the complaint, sometimes to the point of an expressed intention to litigate (particularly in the case of written responses). Viewed holistically, successful complaints communication requires person-centredness, and affiliative interactions framed by shared expectations. These findings were applied in the development of Real Complaints Training and Guidance for spoken and written complaints communication. Limitations: The COVID pandemic significantly constrained trust participation, particularly the participation of front-line clinical staff, and one trust introduced 'telephone resolution' to which we were not given access. Additionally, calls viewed by staff as 'challenging' and ethnic minority communities are both under-represented in the final data set. Conclusions: Addressing the complainant's desire to be perceived as reasonable was revealed as crucial for fostering a more person-centred approach to handling complaints and addressing the gap between expectations and experience. This finding holds particular significance for recommendations, guidance and training relating to both spoken and written communication. Future work: Direct extensions of the project include the piloting and evaluation of Real Complaints Training and further primary research involving communication between complainants and front-line service/clinical staff and complaint handling by ombudsman complaints investigators. An emerging question relates to social exclusion and access to complaints procedures. Study registration: This study is registered as Research Registry: researchregistry5049. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR127367) and is published in full in Health and Social Care Delivery Research Vol. 12, No. 33. See the NIHR Funding and Awards website for further award information.

The aim of this project was to make the experience of complaining to the National Health Service better for patients and their families and improve the outcomes for the National Health Service. Complaints can be positive for the National Health Service because they help improve services for other patients. However, if a complaint escalates, it could be costly for the National Health Service and stressful for the patient. We analysed phone calls and letters between the National Health Service and patients or their family. Some patients took part in the study over a long period of time: from when their complaint was lodged until it was complete. We also used online diaries and interviews to analyse how this communication affected the hopes and expectations of the patient throughout the complaints journey. Our research found that people making complaints have particular needs: to be listened to, to tell their whole story (including how the bad experience has impacted on their lives), to be treated as reasonable and for their complaint to be taken seriously. If they feel that these needs are not being met, the complaint often becomes more serious; the patient may even talk about pursuing legal action. We observed that call handlers can use communication skills to ensure that patients feel listened to and taken seriously when they make a complaint. We also found that receiving written responses to their complaint (often at the end of the complaint journey) is when patients feel most dissatisfied. We identified which responses to a complaint are viewed negatively (avoiding blame, insincere apologies) and which are viewed positively (accepting responsibility, recognising the impact of the events). Our findings were then used to develop training materials using real examples from our data. This will help complaint handlers reflect on how their communication impacts on patients making complaints and will lead to a better experience of the complaints process.

Anatomical traits explain drought response of seedlings from wet tropical forests.

Water availability regulates plant community dynamics but the drought response of seedlings remains poorly known, despite their vulnerability, especially for the Asian tropics. In particular, discerning how functional traits of seedlings mediate drought response can aid generalizable predictions of tree responses to global environmental change. We assessed interspecific variation in drought response explained by above- and below-ground seedling traits. We conducted a dry-down experiment in the greenhouse using 16 tree species from the humid forests of Western Ghats in southern India, chosen to represent differences in affinity to conditions of high and low seasonal drought (seasonality affiliation). We compared survival, growth, and photosynthetic performance under drought and well-watered conditions and assessed the extent to which species' responses were explained by seasonality affiliation and 12 traits of root, stem and leaf. We found that the species from seasonally dry forest reduced photosynthetic rate in drought compared with well-watered conditions, but seasonality affiliation did not explain differences in growth and survival. Performance in drought vs well-watered conditions were best explained by anatomical traits of xylem, veins and stomata. Species with larger xylem reduced their growth and photosynthesis to tolerate desiccation. In drought, species with smaller stomata correlated with lower survival even though photosynthetic activity decreased by a larger extent with larger stomata. Overall, anatomical traits of xylem and stomata, directly related to water transport and gas-exchange, played a more prominent role than commonly used traits (e.g., specific leaf area, leaf dry matter content) in explaining species response to drought, and may offer a good proxy for physiological traits related to drought tolerance of seedlings.

Social capital, education, and subjective well-being in Ecuador.

The study examines the interaction between social capital, education, and subjective well-being in Ecuador, highlighting its impact on economic development. The study aims to understand the situation of social capital and subjective well-being and how the identified factors explain the impact on subjective well-being in the Ecuadorian population, using a descriptive and analytical approach with information from the World Value Survey database of waves 6 and 7. The main results show a significant relationship between social capital and subjective well-being, with positive influences such as justice and union membership, and negative effects of public administration and media. In conclusion, the importance of strengthening social capital and improving public services and communication to promote the well-being of the Ecuadorian population is emphasized.

Longitudinal associations between deviant peer affiliation and externalizing behavior in Chinese preadolescence: Differentiating between-person effects from within-person effects.

The present study employed the cross-lagged panel model and the random intercepts cross-lagged panel model to investigate the longitudinal association between deviant peer affiliation and externalizing behavior in Chinese preadolescents. A sample of 1987 students, comprising 56.10% male participants with a mean age of 12.32 years (SD = 0.53), from Guangdong and Shandong provinces, completed the Deviant Peer Affiliation Scale and the Externalizing Behavior Scale in biannual surveys. The surveys were conducted in the autumn semester of 7th grade, the spring semester of 7th grade, and the autumn semester of 8th grade. The cross-lagged panel model illustrated a bidirectional association between adolescents' involvement with deviant peers and externalizing behavior. Conversely, the random intercepts cross-lagged panel model indicated a positive association between deviant peer affiliation and externalizing behavior at the between-person level. At the within-person level, a significant predictive correlation was identified between the association with deviant peers and subsequent externalizing behavior, whereas the reverse pathway was determined to be statistically insignificant. To comprehend the connection between deviant peer association and externalizing behavior in preadolescence, it is essential to differentiate between between-person and within-person effects and utilize a sophisticated research methodology.

Age-related reproductive effort in male chimpanzees: terminal investment or alternative tactics?

Because senescence impairs the ability of older males to compete successfully for mates, male reproductive strategies are expected to change with age. The terminal investment hypothesis proposes that older males, who could die soon, should take greater risks to obtain mating opportunities. Another possibility is that older males avoid such risks, adopting alternative reproductive tactics, such as increased affiliation with females, increased reliance on coalitions or sexual coercion to continue to compete with younger animals. We tested these hypotheses in wild chimpanzees, Pan troglodytes schweinfurthii, of the Kanyawara community, Kibale National Park, Uganda, where old males sire offspring at relatively high rates. Our data set included >40 000 incidents of male aggression and >5800 copulations observed between 2005 and 2017. We found that, even as their dominance status declined, old males maintained relatively high copulation rates, especially with established mothers. There was no evidence for terminal investment in response to ageing. Males became generally less aggressive as they aged. Neither did old males form affiliative bonds with females, nor use sexual coercion more frequently, as alternative reproductive tactics. Old males did, however, participate in coalitionary aggression at higher rates than young males and increased the proportion of their aggression that was coalitionary over time. Coalitions were positively associated with mating success, particularly for low- and middle-ranking males. These results support the hypothesis that ageing male chimpanzees use coalitions as an alternative reproductive tactic. The lack of evidence for terminal investment in response to ageing appears to reflect a broader mammalian pattern in which males who rely on fighting to secure mating opportunities avoid excessive risk taking as their formidability wanes.

Realization of affiliation goals, interpersonal identity development, and well-being: effects of the implicit affiliation motive among German and Zambian adolescents.

Introduction: Across various cultural contexts, success in goal realization relates to individuals' well-being. Moreover, commitment to and successful pursuance of goals are crucial when searching for a meaningful identity in adolescence. However, individuals' goals differ in how much they match their implicit motive dispositions. We hypothesized that successful pursuance of affiliation goals positively relates to commitment-related dimensions of interpersonal identity development (domain: close friends) that, in turn, predict adolescents' level of well-being. However, we further assumed that the links between goal success and identity commitment are particularly pronounced among adolescents who are characterized by a high implicit affiliation motive. Methods: To scrutinize the generalizability of the assumed relationships, data were assessed among adolescents in individualistic (Germany) and collectivistic (Zambia) cultural contexts. Results: Regardless of adolescents' cultural background, we found that commitment-related dimensions of interpersonal identity development mediate the link between successful attainment of affiliation goals and well-being, particularly among adolescents with a pronounced implicit affiliation motive; that is, the strength of the implicit affiliation motive moderates the association between goal success and identity commitment. Conclusion: We discuss findings concerning universal effects of implicit motives on identity commitment and well-being.

The impact of political partisanship, certificate of need, Medicaid expansion, and area deprivation index on total shoulder arthroplasty prices in the United States.

BACKGROUND: Recent mandates from the Center for Medicare and Medicaid Services require United States hospitals to disclose health care service pricing. Yet, there's a gap in understanding how state-level factors affect hospital service pricing, like total shoulder arthroplasty (TSA). Comprehending these influences can help policymakers and health care providers manage costs and improve care access for vulnerable populations. The purpose of this study was to examine the effect of state characteristics such as partisan lean, certificate of need (CON) status, and Medicaid expansion on TSA price. METHODS: TSA price data was extracted from the Turquoise Health Database using Current Procedural Terminology code 23472. State partisan lean was determined by evaluating each state during the 2020 election year for its legislature (both senate and house), governor, presidential vote, and Insurance Commissioner Affiliation, categorizing states as either "Republican-leaning" or "Democratic-leaning." CON status, Medicaid expansion, Area Deprivation Index (ADI), and population density information was obtained from publicly available sources. Multivariable regression models were used to assess the relationship between these factors and TSA price. RESULTS: The study included 2068 hospitals nationwide. The median (interquartile range) price of TSA across these hospitals was $12,607 ($9,185). In the multivariable analysis, hospitals in Republican-leaning states were associated with a significantly greater price of +$210 (P = .0151), while Medicaid expansion was also associated with greater price +$1,878 (P < .0001). CON status was associated with a significant reduction in TSA prices of -$2,880 (P < .0001). In North Carolina an ADI >85 was associated with a reduction in price (P = .0045), while urbanization designation did not significantly impact TSA price (P = .8457). CONCLUSION: This cross-sectional observational study found that Republican-leaning states and Medicaid expansion were associated with increased TSA prices, while an ADI >85 and CON laws were associated with reduced TSA prices.

Dataset for the long-term trade (1900-2021) and GDP (1960-2021) statistics of small island economies.

This historical dataset regarding island and coastal economies has been built with the intent of making up for the gaps and shortcoming of the economic literature on long-term island development. This dataset gathers Imports, Exports, GDP, Population and Exchange Rate data on a yearly basis. The idea was to gather as much data as possible, with the reference period being 1900-2021 for foreign trade and 1960-2021 for GDP data. This dataset is relevant as it opens up new possibilities of long-term systematic comparisons between a great number of territories. Data were collected from international databases (UNCTAD, UN Statistics Division, UN Statistical Yearbook) when available. Some scholarly works were also used, most notably Mitchell [4] and Bulmer-Thomas [2]. When these sources were exhausted, the author went himself to the French Archives (INSEE) and the British National Archives (at Kew) to consult physical copies of colonial reports in order to find data prior to the 1950's. Other islands' data were reconstructed by contacting the local archives or statistical offices. For the foreign trade dataset, data are expressed in local currencies, then transformed to current USD, to constant 2005 USD equivalent and finally to constant 2005 USD per capita equivalent. These different levels of disaggregation are voluntarily left for each reader to use. For the GDP dataset, data are presented in current USD, current USD per capita and constant 2015 USD per capita equivalent. Different datasets have different levels of disaggregation. Some territories could not be included for practical reasons. The Italian islands are not included as the author could not go to the National Institute of Statistics (ISTAT) to consult the data in person. German island colonies in the Pacific could not be studied as the author does not understand the older German. Also, the India Office of the British Colonial Archives has been transferred to Qatar National Library, which scans and makes documents progressively available. Finally, the Western Pacific Archives were transferred to the University of Auckland Special Collections since 2002 and the author could not consult them. A coordinated effort by the research community could resolve these issues.

Examining Audiences' Psychological Reactance to Christian-Sourced Excessive Alcohol Consumption Messages in the United States.

This study experimentally investigated the effect of dogmatic and suggestive language in Christian-sourced excessive alcohol consumption messages among college-aged participants who identify as Christians or non-Christians, as well as the role of perceived similarity with the message source, on their self-reported freedom-threat, psychological reactance, and behavioral intentions to consume alcohol. The results from this study support psychological reactance theory and demonstrate the various message strategies to effectively communicate the negative health effects of excessive alcohol consumption to individuals who identify either as Christians or non-Christians.

Social tension after grooming in wild Japanese macaques (Macaca fuscata yakui) is sex specific and sensitive to social relationships.

Changes in the rate of self-directed behavior-a proxy for social tension-offer valuable insights into individuals' experiences of social interactions. Many studies have tested the tension-reduction hypothesis, whereby grooming is expected to reduce social tension in the grooming partners. However, it is still unclear whether responses to grooming are affected by social factors such as an individual's role or social relationship with their partner, and whether responses are similar for females and males. Focussing on same-sex grooming in Yakushima Japanese macaques (Macaca fuscata yakui), we analyzed the effects of two social factors on the change in the rate of self-scratching after receiving grooming: sitting in contact with their partner outside of grooming contexts (as a measure of relationship strength) and rank distance. We collected 10-min postgrooming and matched-control focal samples on recipients of grooming. After controlling for postinhibitory rebound effects, grooming reduced scratching in females (suggesting that grooming was relaxing for the receiver), but not in males. In females, this reduction was associated with increased sitting in contact and increased rank distance: being groomed was more tension-reducing if the grooming partners spent time together outside of grooming contexts, or if their difference in rank was greater and therefore more conspicuous. The reduction effect was mediated by sitting in contact only when females had a higher-ranking-that is, more dominant and potentially aggressive-groomer. Our findings suggest that not all grooming interactions are perceived as equal, which has implications for its use as an index of relationship quality. To our knowledge, this represents the first study of postgrooming social tension in male Japanese macaques and our results highlight the need for caution when generalizing findings from only one sex to the species level.

Parental phubbing and mobile phone addiction among Chinese adolescents: a moderated mediation model.

It has been reported that parental phubbing is a significant predictor of mobile phone addiction (MPA) among adolescents. However, the mechanisms underlying this association remain largely unclarified. On the basis of the social learning theories and ecological systems, this study assessed the mediating effect of deviant peer affiliation and the moderating effect of sensation seeking in the association between parental phubbing and MPA among Chinese adolescents. A total of 786 Chinese adolescents (mean age = 13.17 years, SD = 1.35) completed the questionnaires anonymously about parental phubbing, MPA, deviant peer affiliation and sensation seeking. After controlling for study variables, deviant peer affiliation could partially mediate the association between parental phubbing and MPA among adolescents and this indirect path could be moderated by sensation seeking. Notably, the effect of deviant peer affiliation on MPA was more pronounced in adolescents with higher sensation seeking than in those with lower sensation seeking.

Adverse childhood experiences and deviant peer affiliation among Chinese delinquent adolescents: the role of relative deprivation and age.

Background: Deviant peer affiliation is considered a potential risk factor for adolescent delinquency. Due to the serious situation of adolescent delinquency in China, it is necessary to investigate the mechanisms by which adolescents associate with deviant peers. Objectives: The purpose of this study was to examine the association between adverse childhood experiences (ACEs) and deviant peer affiliation, the mediating effect of relative deprivation, and the moderating effect of age in a sample of Chinese delinquent adolescents. Methods: Five hundred and forty-two Special School students aged 11-18 years were interviewed and completed questionnaires, including demographics, adverse childhood experiences, deviant peer affiliation, and relative deprivation. Results: (1) After controlling for gender, adverse childhood experiences and deviant peer affiliation were significantly and positively associated among delinquent adolescents. (2) The effect of ACEs on deviant peer affiliation was mediated by relative deprivation. (3) Age played a moderating role not only in the relationship between ACEs and relative deprivation, but also in the indirect relationship in which ACEs influence deviant peer affiliation through relative deprivation; specifically, the indirect effect of ACEs influencing deviant peer affiliation through relative deprivation was stronger in early adolescence compared with late adolescence. Conclusion: Overall, early ACEs play an important role in deviant peer affiliation among delinquent adolescents and relative deprivation is an important mediating variable. The results of the present study emphasize the importance of cognitive interventions for delinquent adolescents who experience ACEs in early adolescence, which may be instructive for the prevention of adolescent delinquency.

Sequential organization and interactional functions of patient loyalty in routine chronic encounters.

Doctor-patient communication is pivotal for the delivery of effective health care, patient satisfaction and retention, and the development of patient loyalty to the provider. However, the interactional dynamics of loyalty in real-life communication are left underexplored. In this regard, this study aims to examine and analyze loyalty in naturally occurring routine chronic encounters. Based on audio-recordings collected in a state-run tier-three hospital in China, the study uses conversation analysis to examine the sequential placement of loyalty display and its interactional functions in different environments. The findings report two sequential environments where loyalty display emerges: the opening and closing phases. The findings also show that loyalty is mainly produced by the patient to display affiliation and commitment, indicate their preferred treatment options, and rekindle a disconnected relationship. This work contributes to a more nuanced understanding of loyalty display in service and institutional encounters.

Sex and stress interactions in fear synchrony of mouse dyads.

Socially coordinated threat responses support the survival of animal groups. Given their distinct social roles, males and females must differ in such coordination. Here, we report such differences during the synchronization of auditory-conditioned freezing in mouse dyads. To study the interaction of emotional states with social cues underlying synchronization, we modulated emotional states with prior stress or modified the social cues by pairing unfamiliar or opposite-sex mice. In same-sex dyads, males exhibited more robust synchrony than females. Stress disrupted male synchrony in a prefrontal cortex-dependent manner but enhanced it in females. Unfamiliarity moderately reduced synchrony in males but not in females. In dyads with opposite-sex partners, fear synchrony was resilient to both stress and unfamiliarity. Decomposing the synchronization process in the same-sex dyads revealed sex-specific behavioral strategies correlated with synchrony magnitude: following partners' state transitions in males and retroacting synchrony-breaking actions in females. Those were altered by stress and unfamiliarity. The opposite-sex dyads exhibited no synchrony-correlated strategy. These findings reveal sex-specific adaptations of socio-emotional integration defining coordinated behavior and suggest that sex-recognition circuits confer resilience to stress and unfamiliarity in opposite-sex dyads.

The impact of affiliation naming proximity on the retrieval efficiency of Chinese universities-affiliated retractions in the Retraction Watch Database.

The Retraction Watch Database (RWDB) is widely used to retrieve retraction data. However, its lack of affiliation normalization hinders the retrieval efficiency of retraction data for specific research-performing organizations. A query for a university name in the RWDB may yield retraction data entries for other universities with similar names, giving rise to the issue of affiliation naming proximity. This study assessed the impact of this issue on the retrieval efficiency of retraction records for 2,692 Chinese university names in English. The analysis revealed that the retrieval efficiency of retraction records for 206 Chinese university names can be influenced by 408 university names. As of 2022, the retrieval efficiency of retraction records for 96 Chinese university names was compromised by the involvement of 402 university names, resulting in an overall retraction inflation rate of 37.9% and an average rate of 45.0%. The findings highlight the importance of curating retraction data through affiliation-specific queries in the RWDB, adhering to the official English names of Chinese universities for scholarly publishing, and adopting the Research Organization Registry system for affiliation disambiguation. Given the significance of this issue concerning the English names of universities in non-English-speaking countries, the identified causes of the problem and proposed solutions can offer valuable insights for improving the retrieval of retraction records for non-Chinese universities in the RWDB.

Main Biological Models of Resilience.

Objective: Resilience is a complex process of adaptation to new conditions that would permit a positive outcome after adversities, traumas or other sources of stress. However, despite the growing interest in this topic, there is no universally accepted definition and no comprehensive bio-behavioural model. This systematic review aims to provide an overview of the main biological models that have been theorized to date, with a focus on new alternative theories to improve our understanding of the mechanisms underlying the development and strengthening of resilience, with potential implications for the prevention of some psychopathological disorders. Method: This review was conducted according to PRISMA guidelines and includes 185 studies published in English in PubMed and Embase up to December 2023. Results: Most studies use the stress-related model, which conceptualizes resilience as the absence of symptoms after the stressful event and mainly deal with the differences between stress-prone and resilient phenotypes in animals exposed to stress. However, the results of this search seem to suggest that resilience might be an independent construct with biological bases rooted in the stress system and the social brain, and widely sculptured by individual and environmental factors, especially early life events and affiliation. Conclusions: This work contributes to ongoing efforts to understand the intricate mechanisms of resilience, while highlighting the potential of improving social relationships since our birth to promote coping strategies towards stress and traumas, and even a peaceful world.

Lung cancer patients with anaplastic lymphoma kinase rearrangement lose affiliation with labor market at diagnosis.

Aim: The main purpose of the present study was to investigate the labor market affiliation of ALK+ NSCLC patients in long-term treatment as well as overall survival and incidence/prevalence. Materials & methods: Nationwide retrospective study of all patients with ALK+ NSCLC in Denmark diagnosed between 2012 and 2018. Results: During the study period ALK+ NSCLC patients had a median overall survival of 44.0 months and a 7.8-fold increase in disease prevalence. Six months prior to diagnosis, 81% of ALK+ NSCLC patients ≤60 years of age were employed. At the end of the 18-month follow-up period, 36% were employed. Conclusion: ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market.

The purpose of this study was to examine the employment status and survival of patients with ALK+ NSCLC who are undergoing long-term treatment. The researchers conducted a study analyzing data from all such patients diagnosed between 2012 and 2018 in Denmark. The results showed that ALK+ NSCLC patients had a median overall survival of 44.0 months and a that the number of patients increased almost eightfold during the study period. Prior to diagnosis, 81% of ALK+ NSCLC patients who were 60 years of age or younger were employed. However, at the end of the 18-month follow-up period, only 36% of these patients were still employed. In conclusion, ALK+ NSCLC patients tend to have prolonged survival after diagnosis. However, a considerable proportion of these patients lose their affiliation with the labor market, indicating the impact of the disease on employment status.

ALK+ NSCLC patients have prolonged survival following diagnosis, but a large fraction of patients lose affiliation with the labor market following diagnosis. #alkpositive #lcsm.

The relationship between religious affiliation and menopause symptoms and attitudes in United States women.

OBJECTIVES: This study's aim is to examine patterns of menopause symptoms and attitudes among United States women from different religious affiliations. STUDY DESIGN: We used data from a national sample of midlife and older adults. For this analysis, we included only women who were postmenopausal or had undergone hysterectomy. We constructed univariate and multivariate logistic regression models to examine the relationship between religious affiliation and menopause symptoms and attitudes while adjusting for potential confounders. MAIN OUTCOME MEASURES: Menopause symptoms (hot flashes, pain in sexual interactions, pleasure in sexual interactions, trouble falling asleep) and attitudes (relief on periods stopping, regret on periods stopping, worry about becoming less attractive) measured by self-report on Likert scales. RESULTS: Across denominations, 47 % of women experienced hot flashes, 48 % experienced pain in sexual interactions, 95 % experienced pleasure, and 88 % had trouble falling asleep. Regarding attitudes towards menopause and aging, 62 % felt relief in their periods stopping, while 56 % expressed worry about becoming less attractive with aging. Baptist women were more likely to experience hot flashes and trouble falling asleep compared to Catholic women. However, when adjusted for smoking status, this relationship did not persist. Unaffiliated and Spiritual women were less likely to experience trouble falling asleep and more likely to report pleasure in sexual interactions compared to Catholic women. Spiritual women were significantly more likely to feel regret on periods stopping compared to Catholics. CONCLUSIONS: There is a relationship between religious affiliation and the menopause experience. These findings demonstrate the importance of considering social influences on women's health.

Contratos y recontratos / Contracts and recontracts / Contrats et recontrats / Contratos e recontratos

Este trabajo se apoya en los conceptos contrato narcisista primario y secundario para dar cuenta del proceso de filiación y afiliación de la paciente (caso de Agustina) AU

This work relies on the concepts of primary and secondary Narcissistic Contract to understand the process of affiliation and filiation of the patient (Agustina ́s case) AU

Ce travail s'appuie sur les concepts de contrat narcissique primaire et secondaire pour rendre compte du processus de filiation et du processus d ́adhésiondu patient (cas d ́Agustina) AU

Este trabalho baseia-se nos conceitos de contrato narcísico primário e secundário para dar conta do processo de filiação e afiliaçãodo paciente (caso de Agustina) AU