Parasuicide: The value of suicidal intent and various motives as predictors of future suicidal behaviour

Abstract

The main aim of the study was to examine whether various aspects of suicidal intent or various motives for an index parasuicide can predict nonfatal or fatal repetition of suicidal behaviour. 776 parasuicide patients from 5 Nordic regions participating in the WHO/EURO Multicentre Study on Parasuicide were followed for one year. The Suicide Intent Scale (SIS) and the Motives for Parasuicide Questionnaire (MPQ) were used as predictor variables. A low level of suicidal intent predicted nonfatal repetition. The motive “make things easier for someone” differentiated female repeaters From male repeaters. The report of an unclear motive was the only significant predictor of fatal repetition. Suicidal intent and various motives for a parasuicide have some value in predicting repetition of suicidal behaviour. but should, perhaps. in future studies be combined with other variables in order to increase the predictive value.     

Treatment of undifferentiated embryonal sarcoma of the liver in children—single center experience

Background

Undifferentiated embryonal sarcoma of the liver (UESL) represents less than 5% of all malignant hepatic tumors in childhood. It is considered an aggressive neoplasm with an unfavorable prognosis. The aim of this paper is to present a single center experience in the treatment of children with UESL.

Materials and methods

Ten children with UESL were treated between 1981 and 2012. Age at diagnosis ranged from 4 months to 17 years (median age, 6 years and 9 months). Surgery after neoadjuvant chemotherapy (CHT) was performed in 7 patients, and in 3 patients primary surgery was done. Adjuvant chemotherapy was administered in all 10 patients (CYVADIC, CAV, CAV/ETIF/IF + ADM, CDDP/PLADO). Right hemihepatectomy was performed in 1 patient, extended right hemihepatectomy in 6, and partial resection of the right lobe (segments V-VI, segment V) in 2 patients. One patient with unresectable tumor affecting both lobes was listed for liver transplantation (LTx).

Results

Follow-up from diagnosis ranged from 50 to 222 months (mean 138 months). Among 9 patients treated with partial liver resection, distant metastases/local recurrence was not observed in any, and disease-free survival in this group is 100% (9 patients alive). The patient that underwent liver transplantation died of multiorgan failure 4 months postoperatively.However, this patient was misdiagnosed as having hepatoblastoma (HBL) and received PLADO chemotherapy. The overall survival rate is 90%.

Conclusion

Excellent results with long-term survival can be achieved in children with UESL with conventional therapy, including a combination of neoadjuvant and adjuvant chemotherapy and surgery, even in large extensively growing tumors.     

The processing of compounds in bilingual aphasia: A multiple‐case study

Background: While converging evidence has led to the view that people with aphasia exploit compositional procedures when producing compound words, the issue of what compound‐internal characteristics are at play during these procedures is still under debate. It has been argued that constituent position and/or morphosyntactic prominence, i.e., being the head constituent of a compound, may influence the manner in which compounds are accessed. However, findings obtained from patient performances are thus far inconclusive, because positional and headedness effects are frequently confounded in a language.

Aims: In order to disentangle position‐in‐the‐string and headedness effects in compound production in aphasia, the main objective of this study is to investigate the performance of bilingual patients speaking languages in which these effects can be teased apart. Our secondary goal is to probe the roles of grammatical category (adjectives vs nouns) and of between‐language phonological similarity, as both these factors have been demonstrated to influence compound processing.

Methods & Procedures: Three English–French bilingual persons with aphasia participated in the study. Three experimental tasks, reading, repetition, and translation of isolated compound words, were administrated in each language. We contrasted French and English compounds that differ in the position of the head constituent: left for French and right for English.

Outcomes & Results: Two participants showed a similar pattern—a significantly reduced number of errors for the head (or first) constituent as compared to the non‐head (or second) constituent in French and an equivalent number of errors for both constituents in English—pointing to the cumulative effects of headedness and first‐position‐in‐the‐string in French, and to the mutual cancelling out of these effects in English. The third participant exhibited a non‐head constituent advantage in both languages, indicating that semantic modification of the head constituent by the non‐head constituent plays a prominent role in her accessing procedures. For all three participants phonological similarity influenced production, while grammatical category did not.

Conclusions: Our results reveal that headedness and position interact in the processing of compounds. They also demonstrate that compound constituents are processed asymmetrically across and within languages, thus confirming that people with aphasia are sensitive to compound‐internal structure. Moreover, they show that patients rely on varying structural information when accessing compounds.