Suicide—A Challenge in Modern Greenland

The incidence of youth suicides has increased dramatically among the Inuit in Greenland since the modernization started in the 1950s. Suicides currently peak at age 15–24 Men: 400–500, Women: 100–150 per 100,000 person-years. The methods are drastic: shooting or hanging. An early peak was seen in the capital, a later peak in the rest of West Greenland, and high and increasing rates in remote East Greenland. Suicidal thoughts occur more often in young people who grew up in homes with a poor emotional environment, alcohol problems and violence. There is a definite correlation with several aspects of the modernization process but it is hard to pinpoint causal relationships. It is rather the “modernization package” that should be regarded as risk factors for suicides.     

Appetitive Violence: A New Phenomenon?

Youth violence has long been regarded as a major social issue. The past decade has, however, seen the scrutiny which encompasses this violence intensify, largely due to a recent media focus on an apparently increasing tendency amongst some young people to engage in acts of ‘appetitive’ or ‘thrill-seeking’ violence. This is reported to be a new form of violence, in which young people act in an excitable state, rather than the more common form of anger-mediated violence. Whilst incidents of appetitive violence are overly represented in the news media and are presented as a major public concern, there is presently no empirical research exploring the validity of this phenomenon and no systematic analysis of the frequency and severity of this form of violent behaviour. Furthermore, the underlying causes of this type of violence are not understood. As such, preventative practices, risk assessment, treatment requirements and targeted management strategies are lacking. The purpose of this review is to examine the current literature on youth violence, particularly youth involvement in ‘thrill-seeking’ acts of violence, as well as describing a range of contemporary factors highlighted as integral to youth violence; specifically, gang involvement, alcohol use and the possession of weapons. This review will also examine an array of international strategies implemented in response to this form of youth violence. Finally, the General Aggression Model (GAM) will be considered to determine whether its framework can assist in advancing our understanding of appetitive violence, by elucidating those characteristics of the individual and their environment that contribute to its expression.     

Violence: innate or acquired? A survey and some opinions

Freud's psychoanalysis and Lorenz's ethology consider human aggressiveness to be innate. According to recent archaeological excavations and evolutionary studies, human groups in the Upper Paleolithic and Early Neolithic were peaceful and cooperative. This culture was replaced ten thousand years ago by a predatory hierarchical structure, which is here viewed as a cultural variant.     

Focal myositis – A neurogenic phenomenon?

We report four cases of focal myositis. The patients, three men and one woman, had painful muscle hypertrophy, affecting four different sites. MRI confirmed the muscle enlargement and oedema. Electromyography revealed evidence of acute and chronic denervation in all four cases. Muscle biopsy was available in three and confirmed features suggestive of focal myositis. Based on our patient material, we suggest that chronic nerve irritation, such as compression, can lead to muscle hypertrophy which, when prolonged, provokes fibre necrosis and secondary inflammation. Our finding in four patients having hypertrophy involving four different sites, leads us further to suggest that this may be the common mechanism behind focal myositis.     

Bilateral carpal tunnel syndrome – A review

Carpal tunnel syndrome (CTS) is the most common upper extremity compressive neuropathy, with a prevalence of 3%–5% in the general population, and 6% in the group of females over the age of 40. It occurs about five times more common in females, with 2 peaks observed, in the 6th and 8th decades of life. Bilateral manifestation is more common than unilateral (60%), but significantly more often begins or is more strongly expressed in the dominant hand. Possible anatomical abnormalities underlying the development of CTS account for about 5% of cases. More and more scientific data confirm the significant role of central nervous system processes (including central sensitization) in the development of carpal tunnel syndrome, and changes in central nervous system body somatotopic representation, resulting from prolonged median nerve pathology, are described in consistence with the brain plasticity concept. This central involvement of bilateral CTS may explain that a proportion of patients following surgery for one hand experience improvement also in the non-operated hand.     

Leptin in adolescent idiopathic scoliosis – A meta-analysis

To compare the serum levels of leptin and soluble leptin receptor (sOB-R) with adolescent idiopathic scoliosis (AIS) girls and controls through meta-analysis. The MEDLINE via PubMed, Cochrane, Scopus, and EMBASE database, from the earliest available date of indexing between January 2010 and January 2019, were searched for comparative studies evaluating serum levels of leptin and sOB-R in AIS girls. Two authors performed the data extraction independently. Any discrepancies were resolved by a consensus. Six comparative studies were identified. There was no statistically significant difference in terms of leptin between AIS girls and control [p = 0.19, WMD = −2.06 (−5.14, 1.03) ng/mL]. However, the sOB-R level was significantly higher [p < 0.00001, WMD = 2.85 (1.81, 3.88) ng/mL] and the free leptin index was significantly lower [p = 0.0006, WMD = −0.12 (−0.19, −0.05)] in AIS girls than those of healthy control girls. The body mass index was significantly lower in AIS girls [p = 0.03, WMD = −1.53 (−2.95, −0.12) kg/m²]. The current meta-analysis showed that the level of sOB-R is higher in AIS patients than controls, while the concentration of leptin remains unchanged in AIS patients. Further well-designed studies would be necessary to substantiate our results.     

PG-13 Rated Movie Violence and Societal Violence: is there a Link?

Psychiatric Quarterly - Recent scholarship has suggested that the frequency of violence in PG-13 rated movies has increased in recent years. Although some scholars have expressed concern that such...     

Volumetric growth of residual meningioma – A systematic review

Surgical resection of meningioma leaves residual solid tumour in over 25% of patients. Selection for further treatment and follow-up strategy may benefit from knowledge of volumetric growth and factors associated with re-growth. The aim of this review was to evaluate volumetric growth and variables associated with growth in patients that underwent incomplete resection of a meningioma without the use of adjuvant radiotherapy. A systematic review was conducted in accordance with the PRISMA statement and registered a priori with PROSPERO (registration number: CRD42020177052). Six databases were searched up to May 2020. Full text articles analysing volumetric growth rates in at least 10 patients who had residual meningioma after surgery were assessed. Four single-centre, retrospective studies totalling 238 patients were included, of which 99% of meningioma were WHO grade 1. The absolute tumour growth rate ranged from 0.09 to 4.94 cm³ per year. The relative growth rate ranged from 5.11 to 14.18% per year. Varying methods of volumetric assessment and definitions of growth impeded pooled analysis. Pre-operative and residual tumour volume, and hyperintensity on T2 weighted MRI were identified as variables associated with residual meningioma growth, however this was inconsistent across studies. Risk of bias was high in all studies. Radiological regrowth occurred in 42–67% of cases. Our review identified that volumetric growth of residual meningioma is scarcely reported. Sufficiently powered studies are required to delineate volumetric growth and prognostic factors to stratify management.     

International military operations and mental health – A review

Background: Volunteering in international military missions has been scrutinized for its effects on mental health. Different kinds of exposures to traumatic events are associated with a variety of mental disorders, mainly heightened rates of post-traumatic stress disorder (PTSD) and alcohol abuse. Aims: Based on the literature we discuss risk and protective factors concerning the psychological well-being of soldiers attending to international military operations. Methods: A systematic literature search was carried out using relevant search terms to identify the articles for this review. Results and conclusions: The ability to recognize and treat acute stress reactions during deployments is important. Post-deployment psychosocial support and services have a role in lowering barriers to care, diminishing stigma and also in recognizing individuals who suffer from psychological distress or psychiatric symptoms, to connect them with appropriate care. Further investigation of gender differences and the role of stigmatization is warranted. Most of those participating in international military operations are repatriated without problems, but repeated exposure to combat situations and other stressors may affect mental health in various ways. Stigmatization is still a barrier to care.     

Recurrent Ischemic Stroke – A Systematic Review and Meta-Analysis

ObjectivesRecurrent stroke remains a challenge though secondary prevention is initiated immediately post-stroke. Stroke subtype may determine the risk of recurrent stroke and require specific preventive measures. We aimed to identify subtype-specific stroke recurrence and associated risk factors over time.Methods and materialsA systematic review was performed using PubMed and Embase for studies including adults >18 years, first-ever ischemic stroke in population-based observational studies or registries, documented TOAST-criteria and minimum 1-year follow-up. Meta-analysis on stroke recurrence rate was performed. Final search: November 2019.ResultsThe search retrieved 26 studies (between 1997 and 2019). Stroke recurrence rate ranged from 5.7% to 51.3%. Recurrent stroke was most frequent in large artery atherosclerosis (LAA) and cardioembolic (CE) stroke with recurrent stroke similar to index stroke subtype. We identified a lower recurrence rate for small vessel occlusion (SVO) stroke with recurrence frequently of another stroke subtype. Based on a meta-analysis the summary proportion recurrence rate of recurrent stroke in studies using TOAST-criteria = 0.12 and = 0.14 in studies using TOAST-like criteria. Hypertension, diabetes mellitus, atrial fibrillation previous transient ischemic attack, and high stroke severity were independent risk factors for recurrence.ConclusionStroke recurrence rates seem unchanged over time despite the use of secondary prevention. The highest recurrence rate is in LAA and CE stroke eliciting same subtype recurrent stroke. A lower recurrence rate is seen with SVO stroke with a more diverse recurrence pattern. Extensive workup is important in all stroke subtypes - including SVO stroke. Future research needs to identify better preventive treatment and improve compliance to risk factor prevention to reduce stroke recurrence.     

Neuroeducation – A Critical Overview of An Emerging Field

In the present article, we provide a critical overview of the emerging field of ‘neuroeducation’ also frequently referred to as ‘mind, brain and education’ or ‘educational neuroscience’. We describe the growing energy behind linking education and neuroscience in an effort to improve learning and instruction. We explore reasons behind such drives for interdisciplinary research. Reviewing some of the key advances in neuroscientific studies that have come to bear on neuroeducation, we discuss recent evidence on the brain circuits underlying reading, mathematical abilities as well as the potential to use neuroscience to design training programs of neurocognitive functions, such as working memory, that are expected to have effects on overall brain function. Throughout this review we describe how such research can enrich our understanding of the acquisition of academic skills. Furthermore, we discuss the potential for modern brain imaging methods to serve as diagnostic tools as well as measures of the effects of educational interventions. Throughout this discussion, we draw attention to limitations of the available evidence and propose future avenues for research. We also discuss the challenges that face this growing discipline. Specifically, we draw attention to unrealistic expectations for the immediate impact of neuroscience on education, methodological difficulties, and lack of interdisciplinary training, which results in poor communication between educators and neuroscientists. We point out that there should be bi-directional and reciprocal interactions between both disciplines of neuroscience and education, in which research originating from each of these traditions is considered to be compelling in its own right. While there are many obstacles that lie in the way of a productive field of neuroeducation, we contend that there is much reason to be optimistic and that the groundwork has been laid to advance this field in earnest.     

A Review of: “The Oxford Textbook of Suicidology and Suicide Prevention: A Global Perspective”

Abstract

This study provides data on the characteristics and management of all prisoners identified at risk of suicidal behaviour over a 12 month period in all Scottish prisons. From a total of 44,093 admissions, 1,984 (4.5%) prisoners were identified at time of reception as ‘at risk’ while 857 (1.9%) inmates were classified as ‘at risk’ at some other point during custody. Of those identified ‘at risk’ at time of reception, 19.1% were retained on suicidal supervision, while 58.2% of those identified ‘at risk’ during custody were maintained on some form of suicidal supervision. Average length of time kept on strict suicidal supervision for those identified at time of reception was 1.87 days, and for those identified at some other point during custody was 2.59 days. Results are discussed in relation to the problems associated with suicide prediction and prevention in prison settings and the tendency for risk assessment to create significant numbers of false positives at time of reception.