A Six Year Experience of a National Leadership Fellowship in Northern Ireland: Achieve, Develop, Explore Programme for Trainees (ADEPT).

Introduction: The Achieve, Develop, Explore Programme for Trainees (ADEPT) Clinical Leadership Fellowship Programme was established in response to growing recommendations to underpin healthcare reconfiguration in Northern Ireland with a collective leadership strategy. The fellowship combines a leadership development programme with a project carried out within a host organisation. With the fellowship now in its sixth year, a need was identified to assess its impact on the fellows' leadership skills, career choices, achievements, and views on both the fellowship and how to develop future leaders. Methods: Demographic data for all ADEPT fellows was held centrally through Northern Ireland Medical and Dental Training Agency (NIMDTA) and assessed anonymously. A mixed-methods questionnaire was composed using Smart Survey. Likert scale questions were designed to determine the extent to which participants believed ADEPT supported their development of strong and exemplary elements of the nine dimensions of the NHS Healthcare Leadership Model. The questionnaire was distributed electronically to all ADEPT alumni in November 2021 and remained open for 4 weeks. Results: There have been 46 ADEPT fellows to date (72% female; all fellows were white). ADEPT fellows were most commonly from Psychiatry (33%), Paediatrics (17%) and Obstetrics and Gynaecology (15%). There were 19 responses from the alumni cohort of 46 (41%). 75% of respondents reported that their project resulted in publication, presentation or award. Leadership skill development was identified as best in "Evaluating Information" and "Engaging the Team", whereas skills in "Sharing the Vision" and "Developing Capability" saw less improvement. The majority felt that the fellowship had been useful in securing their position as a consultant or general practitioner and 50% went on to pursue senior leadership positions. Conclusion: The ADEPT Clinical Leadership Fellowship delivers effective leadership training as measured by the nine domains of the NHS Healthcare Leadership Model. It provides value for host organisations through the projects undertaken and by developing doctors who are more likely to engage in future formal leadership roles. ADEPT alumni saw the value in their leadership experience and felt it should be embedded in standard postgraduate training schemes to reach a wider audience.

Is competitive body-building pathological? Survey of 984 male strength trainers.

OBJECTIVES: Hundreds of thousands, if not millions, of individuals worldwide engage in competitive body-building. Body-building often attracts derogatory characterisations such as as 'bizarre' or 'narcissistic,' or a 'freak show', seemingly implying that it is associated with pathology. Few studies have compared psychological features in competitive bodybuilders versus recreational strength trainers. METHODS: Using logistic regression with adjustment for age and race, we compared 96 competitive bodybuilders ('competitors') with 888 recreational strength trainers ('recreationals'), assessed in a prior internet survey, regarding demographics; body image; use of anabolic-androgenic steroids (AAS), other appearance-enhancing and performance-enhancing drugs (APEDs), and classical drugs of abuse; history of psychiatric diagnoses; and history of childhood physical/sexual abuse. RESULTS: Competitors reported a higher lifetime prevalence of AAS (61 (63.5%) vs 356 (10.1%), p<0.001) and other APED use than recreationals but showed very few significant differences on other survey measures. AAS-using competitors were more likely than AAS-using recreationals to have disclosed their AAS use to a physician (31 (50.8%) vs 107 (30.0%), p=0.003). Both groups reported high levels of body image concerns but did not differ from one another (eg, 'preoccupation with appearance' caused significant reported distress or impairment in important areas of functioning for 18 (18.8%) competitors vs 132 (15.4%) recreationals, p=0.78). No significant differences were found on the prevalence of reported childhood physical abuse (9 (9.4%) vs 77 (8.8%), p=0.80) or sexual abuse (4 (4.2%) vs 39 (4.5%), p=0.83). Competitors reported a lower lifetime prevalence of marijuana use than recreationals (38 (39.6%) vs 514 (57.9%), p=0.001). CONCLUSION: Aside from their APED use, competitive bodybuilders show few psychological differences from recreational strength trainers.

Competitive Bodybuilding: Fitness, Pathology, or Both?

The sport of competitive bodybuilding requires an intense regimen of weightlifting and dieting, often aided with muscle-building or fat-burning drugs, and culminating in an on-stage posing competition. Despite these rigorous demands, competitive bodybuilding is popular, with thousands of competitions performed annually around the world. Although many studies have addressed the psychological features of various sports and the athletes who compete in them, few have examined the psychological aspects of bodybuilding. Even fewer studies have specifically examined competitive bodybuilders, as opposed to the much larger group of "recreational" bodybuilders who do not compete. The limited available literature suggests that competitive bodybuilders may show an increased risk for four categories of psychopathology: muscle dysmorphia, eating disorders, abuse of appearance- and performance-enhancing drugs, and exercise dependence. However, in each of these categories, one must carefully distinguish between the planned and dedicated behaviors required for success in the sport, as opposed to frankly pathological behaviors that impair social or occupational function, cause subjective distress, or lead to adverse health consequences. Future work should attempt to better assess the nature and prevalence of these conditions among competitive bodybuilders, with perhaps greatest attention to the issue of drug use.

Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety.

Consensus Report of the 2015 Weinman International Conference on Mesothelioma.

On November 9 and 10, 2015, the International Conference on Mesothelioma in Populations Exposed to Naturally Occurring Asbestiform Fibers was held at the University of Hawaii Cancer Center in Honolulu, Hawaii. The meeting was cosponsored by the International Association for the Study of Lung Cancer, and the agenda was designed with significant input from staff at the U.S. National Cancer Institute and National Institute of Environmental Health Sciences. A multidisciplinary group of participants presented updates reflecting a range of disciplinary perspectives, including mineralogy, geology, epidemiology, toxicology, biochemistry, molecular biology, genetics, public health, and clinical oncology. The group identified knowledge gaps that are barriers to preventing and treating malignant mesothelioma (MM) and the required next steps to address barriers. This manuscript reports the group's efforts and focus on strategies to limit risk to the population and reduce the incidence of MM. Four main topics were explored: genetic risk, environmental exposure, biomarkers, and clinical interventions. Genetics plays a critical role in MM when the disease occurs in carriers of germline BRCA1 associated protein 1 mutations. Moreover, it appears likely that, in addition to BRCA1 associated protein 1, other yet unknown genetic variants may also influence the individual risk for development of MM, especially after exposure to asbestos and related mineral fibers. MM is an almost entirely preventable malignancy as it is most often caused by exposure to commercial asbestos or mineral fibers with asbestos-like health effects, such as erionite. In the past in North America and in Europe, the most prominent source of exposure was related to occupation. Present regulations have reduced occupational exposure in these countries; however, some people continue to be exposed to previously installed asbestos in older construction and other settings. Moreover, an increasing number of people are being exposed in rural areas that contain noncommercial asbestos, erionite, and other mineral fibers in soil or rock (termed naturally occurring asbestos [NOA]) and are being developed. Public health authorities, scientists, residents, and other affected groups must work together in the areas where exposure to asbestos, including NOA, has been documented in the environment to mitigate or reduce this exposure. Although a blood biomarker validated to be effective for use in screening and identifying MM at an early stage in asbestos/NOA-exposed populations is not currently available, novel biomarkers presented at the meeting, such as high mobility group box 1 and fibulin-3, are promising. There was general agreement that current treatment for MM, which is based on surgery and standard chemotherapy, has a modest effect on the overall survival (OS), which remains dismal. Additionally, although much needed novel therapeutic approaches for MM are being developed and explored in clinical trials, there is a critical need to invest in prevention research, in which there is a great opportunity to reduce the incidence and mortality from MM.

One-dimensional decavanadate chains in the crystal structure of Rb4[Na(H2O)6][HV10O28]·4H2O.

New decavanadate minerals, the products of the leaching or metasomatic processes, are possible in nature via Na/Rb removal/inclusion reactions. As part of our search for novel vanadate phases with varying functionalities, a new phase, tetrarubidium hexaaquasodium hydrogen decavanadate tetrahydrate, Rb4[Na(H2O)6][HV10O28]·4H2O, has been synthesized by the hydrothermal technique at 553 K. Ten shared edges of V-centred octahedra form monoprotonated decavanadate cages, which are joined together via hydrogen bonds into one-dimensional chains parallel to the [101] direction. Within these chains, H atoms are sandwiched between neighbouring polyanions. Na and Rb atoms and H2O molecules occupy interstices flanked by the anionic chains providing additional crosslinking in the structure. This compound is the second decavanadate with P2/n symmetry. Structural relationships among protonated and deprotonated decavanadates with inorganic cations, including minerals of the pascoite group, are discussed.

Thermally induced single crystal to single crystal transformation leading to polymorphism.

The robust complex [La(1,10-phen)2(NO3)3] (1,10-phen=1,10-phenanthroline) exhibits thermally induced single crystal to single crystal transformation from one polymorphic phase to another. The complex crystallizes in monoclinic C2/c space group with C2 molecular symmetry at 293K while at 100K it shows P21/c space group with C1 molecular symmetry. Supramolecular investigation shows that at 100K the complex forms 2D achiral sheets whereas at 293K forms two different homochiral 2D sheets. Low temperature DSC analysis indicates that this structural transformation occurs at 246K and also this transformation is reversible in nature. We have shown that thermally induced coherent movement of ligands changes the molecular symmetry of the complex and leads to polymorphism. Photoluminescence property of complex has been studied in both solid state and in methanolic solution at room temperature. The effect of the presence low-lying LUMO orbital of π-character in the complex is elucidated by theoretical calculation using DFT method.

Erionite exposure in North Dakota and Turkish villages with mesothelioma.

Exposure to erionite, an asbestos-like mineral, causes unprecedented rates of malignant mesothelioma (MM) mortality in some Turkish villages. Erionite deposits are present in at least 12 US states. We investigated whether increased urban development has led to erionite exposure in the United States and after preliminary exploration, focused our studies on Dunn County, North Dakota (ND). In Dunn County, ND, we discovered that over the past three decades, more than 300 miles of roads were surfaced with erionite-containing gravel. To determine potential health implications, we compared erionite from the Turkish villages to that from ND. Our study evaluated airborne point exposure concentrations, examined the physical and chemical properties of erionite, and examined the hallmarks of mesothelial cell transformation in vitro and in vivo. Airborne erionite concentrations measured in ND along roadsides, indoors, and inside vehicles, including school buses, equaled or exceeded concentrations in Boyali, where 6.25% of all deaths are caused by MM. With the exception of outdoor samples along roadsides, ND concentrations were lower than those measured in Turkish villages with MM mortality ranging from 20 to 50%. The physical and chemical properties of erionite from Turkey and ND are very similar and they showed identical biological activities. Considering the known 30- to 60-y latency for MM development, there is reason for concern for increased risk in ND in the future. Our findings indicate that implementation of novel preventive and early detection programs in ND and other erionite-rich areas of the United States, similar to efforts currently being undertaken in Turkey, is warranted.

A supramolecular spin crossover Fe(III) complex and its Cr(III) isomer: stabilization of water-chloride cluster within supramolecular host.

The metal complexes, [M(Hdammthiol)(2)]Cl·3H(2)O [M = Cr(III) (1), Fe(III) (2)] [where H(2)dammthiol is the thiol form of the ligand, diacetylmonoxime morpholine N-thiohydrazone] were synthesized by metal template reactions of diacetylemonoxime with morpholine N-thiohydrazide in the presence of CrCl(3)·6H(2)O and FeCl(3)·6H(2)O. Both the complexes (1 and 2) were characterized by single crystal X-ray crystallography, spectroscopic (IR and UV-vis), Mössbauer and TGA analyses. The single crystal X-ray studies of both complexes show that the supramolecular hosts, constructed by the discrete mononuclear complexes, form supramolecular channels along the c-axis which are filled up by water-chloride clusters. In both complexes, the 1D water-chloride chain with chair-like architecture within the supramolecular hosts presents novelty. The magnetic measurement study of Fe(III) complex shows a spin crossover from S = 1/2 at 2.5 K to S = 5/2 at 300 K. At very low temperature, the presence of strong cooperative hydrogen bonding interactions stabilizes the S = 1/2 state.

12-Membered borophosphate rings in KNi5[P6B6O23(OH)13].

The title compound, potassium pentanickel hexaborophosphate tridecahydroxide, was synthesized under hydrothermal conditions from the NiCl(2)-K(3)PO(4)-B(2)O(3)-K(2)CO(3)-H(2)O system. The crystal structure was determined using single-crystal X-ray diffraction at 100 K. The KNi(5)[P(6)B(6)O(23)(OH)(13)] phase is cubic. For the three crystallographically distinct Ni centers, two occupy sites with 3 symmetry, while the third Ni and the K atom are located on 3 sites. The structure is built from alternating borate and phosphate tetrahedra forming 12-membered puckered rings with K(+) ions at the centers. These rings are arranged as in cubic dense sphere packing. A novel feature of the new crystal structure is the presence of linear trimers of face-sharing [NiO(6)] octahedra occupying the octahedral interstices of this sphere packing, and of single [NiO(6)] octahedra in the tetrahedral interstices. All oxygen corners of the Ni octahedra are linked to phosphate or borate tetrahedra of the 12-membered rings to form a mixed anionic framework.

A new type of mixed anionic framework in microporous rubidium copper vanadyl(V) phosphate, Rb2Cu(VO2)2-(PO4)2.

In dirubidium copper bis[vanadyl(V)] bis(phosphate), Rb(2)Cu(VO(2))(2)(PO(4))(2), three different oxo complexes form an anionic framework. VO(5) polyhedra in a trigonal bipyramidal configuration and PO(4) tetrahedra share vertices to form eight-membered rings, which lie in layers perpendicular to the a axis of the monoclinic unit cell. Cu atoms at centres of symmetry have square-planar coordination and link these layers along [100] to form a three-dimensional anionic framework, viz. [Cu(VO(2))(2)(PO(4))(2)](infinity)(2-). Intersecting channels in the [100], [001] and [011] directions contain Rb(+) cations. Topological relations between this new structure type and the crystal structures of A(VO(2))(PO(4)) (A = Ba, Sr or Pb) and BaCrF(2)LiF(4 )are discussed.

A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomes.

In Cappadocia, Turkey, an unprecedented mesothelioma epidemic causes 50% of all deaths in three small villages. Initially linked solely to the exposure to a fibrous mineral, erionite, recent studies by scientists from Turkey and the United States have shown that erionite causes mesothelioma mostly in families that are genetically predisposed to mineral fibre carcinogenesis. This manuscript reports, through the eyes of one of the researchers, the resulting scientific advances that have come from these studies and the social improvements that were brought about by both the scientists and members of the Turkish Government.

Protonmotive force: development of electrostatic drivers for synthetic molecular motors.

Ferrocene has been investigated as a platform for developing protonmotive electrostatic drivers for molecular motors. When two 3-pyridine groups are substituted to the (rapidly rotating) cyclopentadienyl (Cp) rings of ferrocene, one on each Cp, it is shown that the (Cp) eclipsed, pi-stacked rotameric conformation is preferred both in solution and in the solid state. Upon quaternization of both of the pyridines substituents, either by protonation or by alkylation, it is shown that the preferred rotameric conformation is one where the pyridinium groups are rotated away from the fully pi-stacked conformation. Electrostatic calculations indicate that the rotation is caused by the electrostatic repulsion between the charges. Consistently, when the pi-stacking energy is increased pi-stacked population increases, and conversely when the electrostatic repulsion is increased pi-stacked population is decreased. This work serves to provide an approximate estimate of the amount of torque that the electrostatically driven ferrocene platform can generate when incorporated into a molecular motor. The overall conclusion is that the electrostatic interaction energy between dicationic ferrocene dipyridyl systems is similar to the pi-stacking interaction energy and, consequently, at least tricationic systems are required to fully uncouple the pi-stacked pyridine substituents.

Genetic predisposition to fiber carcinogenesis causes a mesothelioma epidemic in Turkey.

Malignant mesothelioma in the western world is often associated with asbestos exposure. It is a relatively rare cancer that causes approximately 2,500 deaths yearly in the United States and 1,000 deaths yearly in the United Kingdom. In contrast, among people born in the Cappadocian (Turkey) villages of Tuzkoy, Karain, and "Old" Sarihidir, approximately 50% of deaths are caused by malignant mesothelioma. This epidemic has been attributed to erionite exposure, a type of fibrous zeolite mineral commonly found in this area of Turkey. In these three villages, malignant mesothelioma occurs in certain houses but not in others. The hypothesis was that a unique and more carcinogenic erionite was present in certain houses and caused malignant mesothelioma. We determined the X-ray diffraction pattern and the crystal structure of erionite from malignant mesothelioma villages and compared the results with the erionite samples from nearby non-malignant mesothelioma villages and from the United States. We found the same type of erionite in Cappadocian villages, with or without a malignant mesothelioma epidemic, in households with high or no incidence of malignant mesothelioma and in the United States. Pedigree studies of the three malignant mesothelioma villages showed that malignant mesothelioma was prevalent in certain families but not in others. When high-risk malignant mesothelioma family members married into families with no history of it, malignant mesothelioma appeared in the descendants. Genetically predisposed family members born and raised outside the malignant mesothelioma villages did not seem to develop malignant mesothelioma. In summary, pedigree and mineralogical studies indicate that the malignant mesothelioma epidemic is caused by erionite exposure in genetically predisposed individuals. This is the first time that genetics is shown to influence mineral fiber carcinogenesis.

Supramolecular recognition forces: an examination of weak metal-metal interactions in host-guest formation.

Molecular receptors consisting of two parallel-disposed terpy-M-Cl units (M = Pd2+, Pt2+) are used to form host-guest adducts with aromatic molecules and with neutral square-planar Pt2+ complexes. Host-guest formation is controlled by several factors including pi-pi interactions and, in some cases, weak Pt-Pt interactions between the host and the guest. This latter interaction was examined by comparing the host-guest stability of adducts formed by isoelectronic Pt2+ and Au3+ complexes with the Pt2+ receptor. Consistently, the former is more stable.

Supramolecular recognition: protonmotive-driven switches or motors?

A dicationic molecular receptor bearing two cofacially disposed terpyridyl-Pd-Cl units forms stable 1:1 host-guest complexes with planar, neutral platinum(II) complexes. When the guest is modified to incorporate a pyridine group, the now basic guest is protonated by trifluoroacetic acid in acetonitrile solutions. The basic yellow guest forms a stable, deep red 1:1 host-guest complex with the yellow palladium receptor. Addition of trifluoroacetic acid to this host-guest complex leads to the displacement of the guest from the receptor. It is proposed that the dissociation of the guest is caused by electrostatic repulsion between the dicationic receptor and the positively charged protonated guest. Addition of base restores the host-guest complex. This protonmotive translocation of the guest from the host to the solution is discussed in terms of the mechanisms that drive molecular motors, the power stroke and the Brownian ratchet. It is concluded that the system is best described as a molecular switch that operates by the same mechanism as one stroke of a molecular motor

Tetra-microchloro-1:2kappa(4)Cl;1:3kappa(4)Cl-bis(4,4'-dimethyl-2,2'-bipyridine)-2kappa(2)N,3kappa(2)N-lithium(I)dipalladium(II) tetrakis(pentafluorophenyl)borate dichloromethane 1.196-solvate.

In the crystal structure of the title compound, [LiPd(2)Cl(4)(C(12)H(12)N(2))(2)](C(24)F(20)B).1.196CD(2)Cl(2) or [[(Me(2)bipy)PdCl(2)](2)(micro-Li)](+).B(C(6)F(5))(4)(-).1.196CD(2)Cl(2) (Me(2)bipy is 4,4'-dimethyl-2,2'-bipyridine), an Li(+) cation is stabilized by complexation with two (Me(2)bipy)PdCl(2) units through weak Li-Cl interactions. This compound is thus a rare example of a complex that exhibits an arrested Cl(-) abstraction.