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From trauma to treatment:A scoping review of childhood bullying and its role in psychotic disorders
No full textIntroductionChildhood adversities are well-established risk factors for the later development of severe mental illness, and experiences of bullying are frequently reported among individuals with psychotic disorders. Bullying may influence symptom presentation, illness trajectory, and treatment responsiveness. It has been hypothesized that patients with psychosis and trauma could benefit from psychotherapeutic interventions. This scoping review aims to synthesize existing literature on the association between childhood bullying and psychotic disorders, including implications for treatment.MethodsA systematic search was conducted in PubMed and Embase on June 24, 2025, using the terms “bullying” AND “schizophrenia” OR “psychoses.” After removing duplicates, 324 records were screened independently by two reviewers. A total of 42 full-text articles and 4 abstracts met the inclusion criteria and were included in the synthesis.ResultsEvidence consistently indicates that childhood bullying increases the risk of developing psychosis, particularly when combined with other adversities or genetic vulnerability. While biological and psychological pathways—such as HPA axis dysregulation and maladaptive cognitive schemas—have been proposed, empirical support remains limited. Bullying has been associated with more severe paranoid ideation, persistent delusions, more abnormal self-experiences and poorer social cognitive functioning. Patients with bullying histories may also exhibit reduced responsiveness to antipsychotic medication. No studies directly examined the efficacy of psychotherapy in this population, though its potential value is widely acknowledged.ConclusionsDespite consistent evidence linking childhood bullying to psychotic disorders, optimal treatment strategies remain unclear. Future research should prioritize evaluating potential mechanisms and targeted interventions to inform more effective, individualized treatment approaches.INTRODUCTION: Childhood adversities are well-established risk factors for the later development of severe mental illness, and experiences of bullying are frequently reported among individuals with psychotic disorders. Bullying may influence symptom presentation, illness trajectory, and treatment responsiveness. It has been hypothesized that patients with psychosis and trauma could benefit from psychotherapeutic interventions. This scoping review aims to synthesize existing literature on the association between childhood bullying and psychotic disorders, including implications for treatment.METHODS: A systematic search was conducted in PubMed and Embase on June 24, 2025, using the terms "bullying" AND "schizophrenia" OR "psychoses." After removing duplicates, 324 records were screened independently by two reviewers. A total of 42 full-text articles and 4 abstracts met the inclusion criteria and were included in the synthesis.RESULTS: Evidence consistently indicates that childhood bullying increases the risk of developing psychosis, particularly when combined with other adversities or genetic vulnerability. While biological and psychological pathways-such as HPA axis dysregulation and maladaptive cognitive schemas-have been proposed, empirical support remains limited. Bullying has been associated with more severe paranoid ideation, persistent delusions, more abnormal self-experiences and poorer social cognitive functioning. Patients with bullying histories may also exhibit reduced responsiveness to antipsychotic medication. No studies directly examined the efficacy of psychotherapy in this population, though its potential value is widely acknowledged.CONCLUSIONS: Despite consistent evidence linking childhood bullying to psychotic disorders, optimal treatment strategies remain unclear. Future research should prioritize evaluating potential mechanisms and targeted interventions to inform more effective, individualized treatment approaches.</p
Social Inequality in Health as a political topic in Denmark in the 21st century
No full textThis study traces the evolution of the ‘(in)equality in health’ concept in parliament debates in Denmark from 1998 until 2024, exploring how the social determinants of health framework has been translated into policy discourse. We analyzed all parliament speeches employing the (in)equality in health concept between 1998 and 2024, and other significant documents of political intent during this period, including government platform papers, party programs and major political agreements. We then quantified the relative dominance of two distinct framings of health inequality by coding the parliament speeches using a large language model. We show that while health inequalities have increasingly been framed ‘broadly’ as a complex issue that notes the importance of social determinants, the practical policy issues connected with health inequalities have increasingly ‘narrowed’ in on the issue of healthcare access and quality. In a paradoxical translation of the social determinants framework, policymakers increasingly frame health inequalities as a complex phenomenon to undermine the use of legislation for structural prevention. The Danish case is illustrative of a dilemma that warrants strategic consideration among proponents of the social determinants of health framework, namely how to simultaneously broaden the policy conversation on health inequalities and prevent this broadness from being instrumentalized against action. We argue that one element of this balancing act could be to engage in more context-specific arguments for particular leverage points and to challenge the pursuit of evidence on ‘what works’ within politically defined boundaries of social change
Performance measures for endoscopic ultrasound:a European Society of Gastrointestinal Endoscopy (ESGE) Quality Improvement Initiative - Update 2025
No full textThe European Society of Gastrointestinal Endoscopy (ESGE) recommends that endoscopy services across Europe adopt the following six key performance measures for endoscopic ultrasound (EUS) for monitoring and evaluation in daily practice at center and endoscopist level: (1: ) informed patient consent (100 % of procedures); (2: ) adequate documentation of landmarks (≥ 90 % of procedures); (3: ) structured training and supervision for trainees, preferably using assessment tools (≥ 20 %); (4: ) standardized description of pancreatic cystic lesions (≥ 85 %); (5: ) diagnostic tissue acquisition with EUS-guided fine-needle aspiration/fine-needle biopsy for solid lesions (≥ 85 %); (6: ) adverse events (< 5 % in cystic and < 3 % in solid lesions). A recommendation to administer antibiotics for EUS-guided puncture of cystic lesions, included in the previous ESGE quality improvement document, has been omitted in the current version based on recent evidence.</p
Educational inequalities in smoking-attributable mortality in Europe: Understanding trends between 2000 and 2020
No full textMeasurement of the g Factor of Ground-State <sup>87</sup>Sr at the Parts-per-Million Level Using Co-Trapped Ultracold Atoms
No full textWe demonstrate nuclear magnetic resonance of optically trapped ground-state ultracold 87Sr atoms. Using a scheme in which a cloud of ultracold 87Rb is co-trapped nearby, we improve the determination of the nuclear g factor, gI, of atomic 87Sr by more than two orders of magnitude, reaching accuracy at the parts-per-million level. We achieve similar accuracy in the ratio of relevant g factors between Rb and Sr. This establishes ultracold 87Sr as an excellent linear in-vacuum magnetometer. More generally, our Letter demonstrates how ultracold neutral atoms can be used for the precise determination of highly relevant atomic and nuclear magnetic properties. These results are important for ongoing efforts toward quantum simulation, quantum computation and optical atomic clocks employing 87Sr, and other neutral alkaline-earth and alkaline-earth-like atoms
Assessment of competence in antegrade intramedullary nail osteosynthesis of femoral shaft fractures: A global Delphi consensus study
No full textIntroductionAntegrade intramedullary nailing of femoral shaft fractures (FSF) is a core competency in orthopedic surgery. However, trainees’ skills acquisition is hindered due to reduced exposure to the procedure. Competency-based medical education (CBME) and simulation-based training (SBT) offer an alternative to traditional time-based residency models; however, their implementation in FSF fixation requires assessment tools supported by validity evidence. This study aimed to use the Delphi method to establish consensus regarding assessment parameters for antegrade FSF nailing.Materials and methodsA modified Delphi study was conducted with a global panel of AO trauma faculty educators. In round 1, panelists proposed key technical skills and common errors during FSF fixation. Round 2 involved rating parameter importance on a 5-point Likert-like scale. In Round 3, specific score ranges were determined for a specific fracture model; these results are not presented in this study. In the final round, each parameter was assigned a weight from 1 to 10. Pearson's correlation coefficient was calculated between round 2 and the final round.ResultsOf 98 panelists included, 87 actively participated. Round 1 yielded 37 parameters. Consensus was reached for 34 after round 2. The mean importance rating in round 2 was 4.04 (SD 0.34), and the mean weight rating in the final round was 8.56 (SD 0.62). A strong correlation was found between importance and weight ratings (r = 0.94, p < 0.001). The final 34 parameters cover the entire fixation process, with 2 relating to fracture reduction, 6 to guidewire placement and entry point, 4 to reaming, 3 to nail choice, 6 to nail placement, 9 to interlocking, and 4 to the end of the procedure.DiscussionThis study defined 34 expert-derived parameters for intramedullary FSF fixation. They are well-suited for implementation in CBME programs and simulators, ensuring content validity and supporting structured skills training
Measuring attitudes toward self-harm among mental health care staff:psychometric evaluation of the Self-Harm Antipathy Scale (SHAS) in Denmark
No full textBackgroundNegative attitudes among mental health professionals toward individuals who self-harm can impact the quality of care and contribute to antipathy and stigma. This study aimed to investigate the psychometric properties of a Danish version of the Self-Harm Antipathy Scale (SHAS-DR), designed to measure mental health professions attitudes toward patients who self-harm.MethodsThe SHAS-D was administered to 261 mental health professionals. Confirmatory factor analysis (CFA) was used to examine dimensionality and structural validity. Internal consistency was evaluated using Cronbach’s alpha reliability and McDonald’s omega coefficients, and discriminant validity was assessed via factor intercorrelations.ResultsNeither a unidimensional global factor nor the originally proposed six-factor model, based on all 30 items, were supported. Consistent with a previous study, a 17-item three-factor solution and a 19-item five-factor solution showed acceptable model fit. Internal consistency was acceptable for most subscale scores. The three-factor model was superior to the five-factor model in terms of internal consistency and discriminant validity.ConclusionsThe 17-item form of the SHAS-DR, capturing three subscales, is a structurally valid and reliable tool for assessing attitudes toward self-harm in Danish mental health care. The three factors of ‘Sympathy and Support’, ‘Judgmental Perception’, and ‘Acceptance and Understanding’ point to central areas of antipathy and may be important targets for future training and stigma-reduction efforts among mental health care staff working with patients who engage in self-harm.Background: Negative attitudes among mental health professionals toward individuals who self-harm can impact the quality of care and contribute to antipathy and stigma. This study aimed to investigate the psychometric properties of a Danish version of the Self-Harm Antipathy Scale (SHAS-DR), designed to measure mental health professions attitudes toward patients who self-harm. Methods: The SHAS-D was administered to 261 mental health professionals. Confirmatory factor analysis (CFA) was used to examine dimensionality and structural validity. Internal consistency was evaluated using Cronbach’s alpha reliability and McDonald’s omega coefficients, and discriminant validity was assessed via factor intercorrelations. Results: Neither a unidimensional global factor nor the originally proposed six-factor model, based on all 30 items, were supported. Consistent with a previous study, a 17-item three-factor solution and a 19-item five-factor solution showed acceptable model fit. Internal consistency was acceptable for most subscale scores. The three-factor model was superior to the five-factor model in terms of internal consistency and discriminant validity. Conclusions: The 17-item form of the SHAS-DR, capturing three subscales, is a structurally valid and reliable tool for assessing attitudes toward self-harm in Danish mental health care. The three factors of ‘Sympathy and Support’, ‘Judgmental Perception’, and ‘Acceptance and Understanding’ point to central areas of antipathy and may be important targets for future training and stigma-reduction efforts among mental health care staff working with patients who engage in self-harm.</p
Emergency parastomal hernia repair - a systematic review
No full textPurpose: Parastomal hernia is a common complication that may require emergency repair (ePHR). Although 20% of PHRs are performed in an emergency setting, treatment strategies and outcomes are poorly documented. This systematic review aimed to determine the optimal strategy and surgical technique for ePHR. Methods: A literature search was conducted in PubMed, Embase, Web of Science, CINAHL, Cochrane Library and Google Scholar for original studies reporting on ePHR. Primary outcome was rate of reoperation within 90 days. Secondary outcomes were length of stay (LOS) as well as 90-day rates of surgical site infection (SSI), other complications, and mortality. Results: The search identified 328 studies of which 10 was included totalling 21,877 patients undergoing ePHR. Mean rates for short-term reoperation, SSI, other complications and mortality were 39% (95%-confidence interval 31–49%), 24% (15–37%), 44% (30–59%) and 12% (8–16%), respectively. Median LOS varied between 7 and 13 days. Insufficient data precluded meta-analysis for comparison of (1) open and laparoscopic repair, (2) local repair, relocation and reversal, as well as (3) mesh and suture repair. Conclusion: Besides considerable LOS, ePHR was associated with high morbidity and mortality. The limited available literature and conflicting data did not entitle recommendation of a specific surgical approach for this patient group. There was no evidence that suggested mesh should be avoided in ePHR. Future studies should investigate a two-stage approach with initial damage control versus one-stage definitive repair. Moreover, studies are warranted to compare open and minimally invasive surgery for ePHR.</p
Inhibitory role of activin A during luteinization of follicular and lutein granulosa cells from small antral and preovulatory human follicles
No full textLuteinization is a vital process in female reproduction, where granulosa cells differentiate into progesterone-secreting luteal cells. While luteinizing hormone (LH) and human chorionic gonadotropin (hCG) are established promoters of luteinization, the regulatory role of activin A remains incompletely understood. This study aimed to investigate whether activin A can prevent or reverse luteinization in granulosa cells from small antral and preovulatory follicles using an in vitro model. Granulosa cells were collected from women undergoing either IVF treatment or ovarian tissue cryopreservation. Cells were cultured for 48 h with FSH, hCG, or activin A. Hormone secretion (progesterone and estradiol) and content of steroidogenic markers (CYP19A1, STAR, 17βHSD1, 3βHSD2, FSHR, and LHCGR) were analyzed via ELISA, RT-qPCR, and Western blot. RESULTS: demonstrated that activin A suppressed luteinization markers and progesterone production while promoting estrogen synthesis and maintaining granulosa cell features. Conversely, hCG increased luteinization marker expression and progesterone secretion, consistent with its known role in luteal transformation. Notably, granulosa cells from small antral follicles showed a distinct, stage-specific response to activin A compared to those from preovulatory follicles, indicating a temporal regulation of luteinization competence. These findings support a regulatory role for activin A in maintaining granulosa cell identity and delaying luteinization. Understanding the differential responsiveness of granulosa cells across follicular development stages may inform new therapeutic approaches for luteal phase deficiencies and fertility preservation strategies.</p