The Association of School Climate, Depression Literacy, and Mental Health Stigma Among High School Students

BACKGROUND

Although school climate is linked with youth educational, socioemotional, behavioral, and health outcomes, there has been limited research on the association between school climate and mental health education efforts. We explored whether school climate was associated with students' depression literacy and mental health stigma beliefs.

METHODS

Data were combined from 2 studies: the Maryland Safe Supportive Schools Project and a randomized controlled trial of the Adolescent Depression Awareness Program. Five high schools participated in both studies, allowing examination of depression literacy and stigma measures from 500 9th and 10th graders. Multilevel models examined the relationship between school-level school climate characteristics and student-level depression literacy and mental health stigma scores.

RESULTS

Overall school climate was positively associated with depression literacy (odds ratio [OR] = 2.78, p < .001) and negatively associated with stigma (Est. = -3.822, p = .001). Subscales of engagement (OR = 5.30, p < .001) and environment were positively associated with depression literacy (OR = 2.01, p < .001) and negatively associated with stigma (Est. = -6.610, p < .001), (Est. = -2.742, p < .001).

CONCLUSIONS

Positive school climate was associated with greater odds of depression literacy and endorsement of fewer stigmatizing beliefs among students. Our findings raise awareness regarding aspects of the school environment that may facilitate or inhibit students' recognition of depression and subsequent treatment-seeking.

The dynamic epigenome and its implications for behavioral interventions: a role for epigenetics to inform disorder prevention and health promotion

The emerging field of behavioral epigenetics is producing a growing body of evidence that early life experience and social exposure can alter the way by which genes are marked with DNA methylation. We hypothesize that changes in DNA methylation as well as other epigenetic markers could generate stable phenotypes. Early life adversity appears to result in altered DNA methylation of genes in the brain and peripheral tissues, and these changes are associated with adverse phenotypic changes. Although the data are still sparse, early epigenetic studies have provided a proof of principle that experiences and the environment leave marks on genes, and thus suggest molecular and physical mechanisms for the epidemiological concept of gene-environment interaction. The main attraction of DNA methylation for type I (TI) translational prevention science is the fact that, different from genetic changes that are inherited from our ancestors, DNA methylation is potentially preventable and reversible and, therefore, there is a prospect of epigenetically targeted interventions. In addition, DNA methylation markers might provide an objective tool for assessing effects of early adverse experience on individual risks as well as providing objective measures of progress of an intervention. In spite of this great potential promise of the emerging field of social and translational epigenetics, many practical challenges remain that must be addressed before behavioral epigenetics could become translational epigenetics.

Video Gaming in a Hyperconnected World: A Cross-sectional Study of Heavy Gaming, Problematic Gaming Symptoms, and Online Socializing in Adolescents

AIMS

Examining online social interactions along with patterns of video gaming behaviors and game addiction symptoms has the potential to enrich our understanding of disorders related to excessive video game play.

METHODS

We performed latent class analysis in a sample of 9733 adolescents based on heavy use of games, social networking and instant messaging, and game addiction symptoms. We used latent class regression to determine associations between classes, psychosocial well-being and friendship quality.

RESULTS

We identified two types of heavy gaming classes that differed in probability of online social interaction. Classes with more online social interaction reported fewer problematic gaming symptoms than those with less online social interaction. Most adolescents estimated to be in heavy gaming classes had more depressive symptoms than normative classes. Male non-social gamers had more social anxiety. Female social gamers had less social anxiety and loneliness, but lower self-esteem. Friendship quality attenuated depression in some male social gamers, but strengthened associations with loneliness in some male non-social gamers.

CONCLUSIONS

In adolescents, symptoms of video game addiction depend not only on video game play but also on concurrent levels of online communication, and those who are very socially active online report fewer symptoms of game addiction.

ADHD and Suicidal Ideation: The Roles of Emotion Regulation and Depressive Symptoms Among College Students

OBJECTIVE

ADHD appears to increase risk for both depression and suicidal ideation, while ADHD and depression are also associated with emotion regulation deficits. Thus, we evaluated the degree to which depression mediated the association between ADHD and suicidal ideation, as well as the degree to which emotion regulation deficits moderated the association ADHD shared with depression and suicidal ideation in a nonclinical sample.

METHOD

Participants were undergraduate psychology students (N = 627; age: M = 20.23, SD = 1.40; 60% female; 47% European American) who completed an online assessment.

RESULTS

Results indicated that ADHD indirectly increased suicidal ideation through depression. Emotion regulation deficits of accepting negative emotions, emotional awareness, and goal-oriented behavior moderated the indirect effect of ADHD on suicidal ideation.

CONCLUSION

Depression appears to play an important mediating role in suicidal ideation for college students with ADHD, and specific emotion regulation deficits appear to amplify the effects of ADHD on depression and suicidal ideation.

Smoking quit success genotype score predicts quit success and distinct patterns of developmental involvement with common addictive substances

Genotype scores that predict relevant clinical outcomes may detect other disease features and help direct prevention efforts. We report data that validate a previously established v1.0 smoking cessation quit success genotype score and describe striking differences in the score in individuals who display differing developmental trajectories of use of common addictive substances. In a cessation study, v1.0 genotype scores predicted ability to quit with P=0.00056 and area under receiver-operating characteristic curve 0.66. About 43% vs 13% quit in the upper vs lower genotype score terciles. Latent class growth analyses of a developmentally assessed sample identified three latent classes based on substance use. Higher v1.0 scores were associated with (a) higher probabilities of participant membership in a latent class that displayed low use of common addictive substances during adolescence (P=0.0004) and (b) lower probabilities of membership in a class that reported escalating use (P=0.001). These results indicate that: (a) we have identified genetic predictors of smoking cessation success, (b) genetic influences on quit success overlap with those that influence the rate at which addictive substance use is taken up during adolescence and (c) individuals at genetic risk for both escalating use of addictive substances and poor abilities to quit may provide especially urgent focus for prevention efforts.

Objectively measured physical activity levels of Venetian adults

AIM

Venice, Italy, provides a unique environment to study physical activity as there are no automobiles, and walking is the most common means of transportation. The purpose of the present investigation was to objectively assess the physical activity (PA) levels of residents in Venice, Italy, using an accelerometer.

METHODS

Twenty-seven Venetians (12 men and 15 women, 48 ± 16 yr, 169.4 ± 6.6 cm, 71.7 ± 11.1 kg) had worn an accelerometer (Lifecorder Ex) for 7 consecutive days in order to determine daily number of steps, time spent in light (LPA), moderate (MPA), or vigorous intensity (VPA) and moderate to vigorous intensity (MVPA) as well as energy expenditure associated with PA (PAEE). The time for all PA and MVPA lasting at least 1 minute, 3 minutes, 5 minutes and 10 minutes were also assessed.

RESULTS

The PAEE, number of steps, LPA, MPA, VPA and MVPA averaged over 7 days of week were 1575 ± 524 kJ∙day⁻¹, 11920 ± 3667 steps∙day⁻¹, 77 ± 23 min∙day 43 ± 19 min∙day⁻¹, and 45 ± 21 min∙day⁻¹. The time for MVPA lasting >10 min was 0.3 ± 0.9 min∙day⁻¹.

CONCLUSION

The amount and intensity of PA in Venetian adults is substantially higher than in most other populations previously evaluated, particularly American adults. The effects of the highly active Venetian lifestyle on important health outcomes remain unclear, but warrant further investigation.

Extracorporeal lithotripsy in ureteral stones: Our experience with Dornier HM3, EDAP LT02, Piezolith 2300 lithotripters

We present our experience with three different lithotriptors: Dornier HM3, EDAP LT02 and Piezolith 2300. Materials and methods: 1876 patients with ureteral stones were treated between 1 January 1988 and 1 January 1996. The above 3 lithotriptors were used. In 925 patients the stones were located in the upper ureter, in 182 in the middle ureter and in 769 in the pelvic ureter. Auxiliary procedures were performed in 37% of patients. A DJ stent was used to catheterise 299 (16%) patients and a nephrostomy was performed in 19 (1%). Catheterisation was carried out in 247 (13.1%) ureters to localise the stones, plus 83 (4.4%) push ups and 52 (2.7%) Dormia baskets. Results: one treatment was sufficient in 1395 (74.3%) patients, 2 treatments in 335 (29.1%), 3 in 114 (6%), 4 in 21 (1.1%), 5 in 10 (0.5%) and 6 in 1 (0.05%). Patients were considered stone-free when they had negative X-ray and sonography two months after treatment; stones smaller than 3 mm, capable of being spontaneously eliminated without retrograde dilatation, were considered as fragments. The results were 1475 (78.6%) stone-free patients, 246 (13.1%) with fragments and 117 (6.2%) failures. 38 patients failed to appear at follow-up. Complications: complications were considered as hyperpyrexia and colics. There was very little hematuria, which regressed spontaneously in any case within the first 24 hours. Conclusion: side effects were few and required no treatment, so in our experience lithotripsy is the first choice treatment for ureteral stones. Particular attention, however, must be paid to the size of the stone in predicting the number of treatments.

Reversal of clinical resistance to LHRH analogue in metastatic prostate cancer by the pineal hormone melatonin: efficacy of LHRH analogue plus melatonin in patients progressing on LHRH analogue alone

OBJECTIVE

Experimental and preliminary clinical studies have suggested that the pineal hormone melatonin (MLT) may stimulate hormone receptor expression on both normal and cancer cells. Moreover, MLT has appeared to inhibit the growth of some cancer cell lines, including prostate cancer, either by exerting a direct cytostatic action, or by decreasing the endogenous production of some tumor growth factors, such as prolactin (PRL) and insulin-like growth factor-1 (IGF-1). On this basis, a study was carried out to evaluate the clinical efficacy of a neuroendocrine combination consisting of the LHRH analogue triptorelin plus MLT in metastatic prostate cancer progressing on triptorelin alone.

MATERIAL AND METHODS

The study including 14 consecutive metastatic prostate cancer patients with poor clinical conditions (median age: 70.5 years; median PS: 50%), refractory or resistant to a previous therapy with the LHRH analogue triptorelin alone. Triptorelin was injected i.m. at 3.75 mg every 28 days, and MLT was given orally at 20 mg/day in the evening every day until progression, starting 7 days prior to triptorelin.

RESULTS AND CONCLUSIONS

A decrease in PSA serum levels greater than 50% was obtained in 8/14 (57%) patients. Moreover, PSA mean concentrations significantly decreased on therapy of triptorelin plus MLT. In addition, a normalization of platelet number was obtained in 3/5 patients with persistent thrombocytopenia prior to study. Mean serum levels of both PRL and IGF-1 significantly decreased on therapy. Finally, a survival longer than 1 year was achieved in 9/14 (64%) patients. This preliminary study would suggest that the concomitant administration of the pineal hormone MLT may overcome the clinical resistance to LHRH analogues and improve the clinical conditions in metastatic prostatic cancer patients.

[Prognostic predictive factors of the clinical response to immunotherapy with subcutaneous interleukin-2, in patients with metastatic renal carcinoma: analysis of 60 cases]

The intravenous immunotherapy with high-dose interleukin-2 (IL-2) would constitute one of the most effective treatments of metastatic renal cell carcinoma (RCC). More recently, IL-2 subcutaneous therapy has also appeared active, either alone or in association with interferon, with results comparable to those found with the intravenous route of injection, but with a lower toxicity. On this basis, we have designed a protocol of treatment with low-dose IL-2 alone given subcutaneously as a first or a second line therapy in metastatic RCC. The study included 60 consecutive patients (pts) (M/F: 39/21, median age 56 years, range 26/74). IL-2 was given at a dose of 3 millions IU twice/day for 5 days/week, for 6 weeks, corresponding to one cycle. In non progressed pts a second cycle was repeated after a 28-day rest period. Dominant metastasis sites were, as follows: soft tissues: 8; bone: 11; lung: 29; liver: 3; liver plus lung: 7; adrenal: 2. The minimum follow-up was 18 months and the median follow-up was 34 months (range 18-48). A complete response (CR) was achieved in 2/60 (3%) pts. A partial response (PR) was obtained in 15/60 (25%). Therefore, tumor objective rate (CR + PR) was 17/60 (28%). The median duration of response was 13 months (4-33).(ABSTRACT TRUNCATED AT 250 WORDS)

[Terazosin in the treatment of benign prostatic hypertrophy]

Benign prostatic hypertrophy provokes clinical manifestations correlated on one hand to a static obstructive component, due to the increase in glandular size, and on the other hand to a dynamic component, controlled by the alpha adrenergic autonomic system which gives the smooth muscular tonus of the prostatic adenoma. The alpha adrenergic receptor block reduces the dynamic component, improves the clinical and urodynamic parameters determined by the infra-bladder obstruction in patients with BPH. The selective alpha 1, long acting antagonists especially, such as terazosin, offer a safe and efficient therapy for selected patients suffering from BPH. They also have the indisputable benefit of mono-administration. In this study the basic concepts of BPH treatment with terazosin are discussed.

Neurogenic urinary dysfunction in AIDS patients

From May 1992 to December 1993 (17 months), 18 patients with AIDS, 15 male and 3 female, age range from 25 to 50, were found to have severe voiding disorders related to neurogenic bladder dysfunction. All patients underwent neurologic, urologic and immunologic evaluation and were staged as AIDS-IVB. The neurological evaluation demonstrated: cryptococcal abscess of the brain in 1 patient, progressive and diffuse leukoencephalopathy in 3 patients, AIDS Dementia Complex in 3 patients and no neurologic abnormalities in 11 patients. The urodynamic tests demonstrated: detrusor areflexia in 5 patients, detrusor hyperreflexia with external sphincter dyssynergia in 5 patients, detrusor hyperreflexia with external sphincter dyssynergia and vesico-ureferai reflux in 1 patient, detrusor hyperreflexia without dyssynergia in 7 patients.

[Andrological complications after pancystoprostatovesiculectomy surgery: utility of the bulbocavernosus reflex]

The technique for radical cystoprostatectomy was modified to avoid injury to the branches of pelvic plexus that innervate the corpora cavernosa (monolateral neurovascular bundle preservation or "Nerve sparing technique"). The studies of Walsh and coll. demonstrated that the branches of pelvic plexus that innervate the corpora cavernosa are situated between the rectum and urethra and penetrate the urogenital diaphragm near to the muscular wall of the urethra. Injuries to the pelvic plexus can occur during 1) division of posterior pedicle of bladder (the seminal vesicle can be used as a landmark intraoperatively to avoid injury to pelvic plexus), 2) during apical dissection of prostate with transection of the urethra. The return of sexual function postoperatively is related to preservation of autonomic innervation; the excision of the neurovascular bundle on one side may prevent impotence in 68% patients. Our study was undertaken to identify the cause of impotence in men undergoing radical cystoprostatectomy with "Nerve sparing technique" using bulbo cavernous reflex. Our results suggest that bulbo cavernosus reflex may not be a sensitive clinical tool to establish a diagnosis of neurogenic erectile dysfunction after pelvic surgery. The Authors examine the recent neuro-uro-physiological diagnostic methods for the study of neurogenic erectile dysfunction.

Trattamento con laser infrarosso endouretrale delle prostatiti croniche abatteriche riacutizzate

The Authors present a new infrared laser device with endourethral atraumatic optic fiber capable of effectively treating patients with newly acute chronic prostatitis. Cost-benefit ratio is excellent and the method is minimally invasive.

Le basi anatomiche della prevenzione dei danni neurogeni in corso di chirurgia radicale pelvica nella donna

Radical pelvic surgery in women is considerably handicapped by serious neurogenic complications, commonly due to lesions in the inferior hypogastric plexus or its branches, which cannot be easily identified in the female pelvic cavity. The pelvic cavities of 42 adult female cadavers were studied and the relations between the nervous structures and the cardinal and utero-sacral ligaments were analysed. The possibility of identifying and recognising in vivo anatomical findings of the pelvic plexus is the fulcrum of nerve sparing pelvic surgery.

[Intracavitary echography with a 12.5 MHz microprobe: a new study method in the pathology of the urinary tract]

Endoluminal sonography performed with 12.5 MHz miniature transducer-containing catheters with diameter of 6 or 9 Fr., is a new technique for the study of urinary tract. We studied: U.S. scan of 10 corpes and 10 operatory specimens (bladders and kidneys) with anatomic measurement in vitro. U.S. scan of 20 patients "in vivo" with pathologies involving bladder and upper urinary tract. We studied the normal anatomy of bladder and ureter by U.S. and we detected the structures beyond the ureteral lumen as: vessels, lymph nodes, muscle. Our indications for the utility of this new U.S. technique are: Detection and staging of superficial T.C.C. of the bladder. Detection of dangerous vessels near the U.P.F before endopielotomy. Excretory tract minus (endoluminal ultrasound is helpful in differentiating such pelvic filling defects as blood clots, no opaque stones and transitional cell carcinoma).

[Pathology of urologic importance associated with acquired immunodeficiency syndrome]

Infection by the HIV virus affects the urogenital system in a minor percentage of cases in comparison to other organs such as the lungs, the central nervous system and the haemolymphopoietic system. In recent years however, with the continued spread of the disease also urologists find themselves dealing with the various urogenital pathologies that are presented in seropositive or fully-blown Aids patients. The Authors present their experience and describe the problems correlated to the dealing with acquired immune deficiency syndrome patients that are affected with urogenital pathologies.

Kidney and Ureteral Disease during HIV Infection

Infection by Hiv virus affects the urogenital system in a minor percentage of cases in comparison to other organs such as the lungs, the central nervous system and the haemolymphopoietic system. In recent years however, with the continued spread of the disease, also urologists find themselves dealing with various urogenital pathologies that are presented in seropositive or fully-blown Aids patients. The Authors present their experience and describe the problems correlated to dealing with acquired immunodeficiency syndrome patients that are affected with urological pathologies.

The use of echo-doppler in the study of renal damage sustained during percutaneous manoeuvres and extracorporeal lithotriptic treatments

The echo-doppler is a non-invasive diagnostic method that makes evaluation of the morphology and the renal intraparenchymal vessel flow possible. Due to the development and spread of percutaneous methods and to the large number of patients who undergo extracorporeal lithotripsy, the renal parenchyma suffers traumas of which neither the short no long term consequences are yet fully understood. We calculated the Resistive Index using echo-doppler in 10 pts. who underwnt extracorporeal lithotripsy and we looked for the possible presence of arteriovenous fistulae in 10 pts. who underwent percutaneous manoeuvres (nephrostomy, litholapaxy and endopyelotomy). The results showed an increased R.I. in all patients at the end of the treatment, and in only one patient was this elevated R.I. maintained at the follow-up after 30 days. Arteriovenous fistulae were not found in any of the other patients.

Semi conductor lasers in the treatment of benign prostate pathologies

Treatment of benign prostate pathology often has no effect on the symptomatology of the patient. For this reason we used an infrared laser ray, of which the biophysical effects on tissue are well noted: stimulation of lymphatic drainage, pain reduction, microcirculation, trophism and tissue elasticity increase. The laser was used on the prostate via an endorectal probe that gave compactness and orthogonality to the ray that is transmitted along 5 optic fibres. Between January 1991 and January 1992 we treated, following a rigorous enforcement of the requirements of the inclusion protocol, 80 patients with ages ranging from 25 to 77 years. Of these 40 suffered from abacterial chronic prostatitis (ACP), and 40 from early symptomatic benign prostatic hypertrophy (BPH) with a prostate diameter of < 4 cm. The preliminary results (with a 3 month follow-up) were satisfactory especially regarding the subjective symptomatology: BPH 75%; ACP 85%. The advantages of this method are: good results in selected cases (follow-up still limited), complete harmlessness, high tolerability, possibility of repeating the treatment, excellent cost-benefit ratio. The limitations are: exclusion from the protocol of neurologic bladders, bladder stones, median lobe of the prostate and the progressive loss of efficiency with the growth of the prostatic diameter.

[Recurrence of acute lymphoid leukemia in the bladder: a rare cause of bilateral hydronephrosis]

While the invasion of the bladder by neoplastic cells during acute lymphatic leukaemia in children has been reported by various authors, the leukaemic invasion of the bladder in adults is extremely rare. We report a case of recurrence of A.L.L. in the bladder presenting colicky symptomatology and obstruction of the excretory tracts.

[Traumatic injuries++ of the external genitalia: a case of avulsion of the penile skin]

The Authors report their recent experience about a penis trauma with a subtotal organ skinning. After the literature analysis, the AA. explain the case, with a particular attention to the surgical repairing technique. The surgical outcomes are discussed and it is re-marked the necessity of a precise diagnostic approach and follow up, also to prevent possible unerectional chains.