A narrative review: suicide and suicidal behaviour in older adults.

Globally, suicide is a public health concern that claims the lives of many each year. The complex etiology and factors contributing to the risk of suicide make it hard to predict the likelihood of death by suicide. Suicide rates have been increasing over the past 25 years in patients aged 65 years and older, and with the expected increases in the size of the older adult population and the under-detection of suicide risk, these rates may continue to increase. To mitigate and attempt to limit this expected increase, it is important to understand the risk and protective factors of suicide in older adults. This narrative review focuses on individuals above the age of 65 and encompasses relevant peer-reviewed publications from the past 25 years to cover fatal and non-fatal suicidal behaviour. It summarizes several important risk factors for suicide and suicidal behaviors while considering how risk can be detected, assessed, prevented, and mitigated. Screening methods to detect suicide and depression in older adults were examined based on their effectiveness and suitability for use in this population. Lastly, the impacts of the COVID-19 pandemic on suicide rates in older adults were described.

Investigating Patterns of Donor and Recipient Sports of Talent Transfer Paralympians.

Talent transfer has enabled elite athletes to be successful in another sport, with great potential in para-sport. Previous research suggests that similarities between donor and recipient sports may facilitate talent transfer; however, this remains unclear in para-sport. This study investigated patterns between donor and recipient sports' characteristics, identifying the impact on talent transfer in para-sport. An Australian case study utilizing secondary data of 38 Australian Paralympians who competed at the Paralympic Games from 2000 through 2020 was analyzed. Results demonstrated that similarities between sports were not significantly associated with successful talent transfers between Paralympic sports. Understanding patterns associated with successful Paralympic talent transfers offers a foundation of knowledge for designing and developing future talent-transfer pathways and research. Based on this study, it is recommended that sport administrators and practitioners explore greater opportunity for talent transfer in para-sport, rather than limiting talent-transfer opportunities based on athletes' donor sports.

Management Strategies for Borderline Personality Disorder and Bipolar Disorder Comorbidities in Adults with ADHD: A Narrative Review.

This narrative review examines two of the common comorbidities of attention-deficit/hyperactivity disorder, bipolar disorder (BD), and borderline personality disorder (BPD), which each share several common features with ADHD that can make assessment and diagnosis challenging. The review highlights some of the key symptomatic differences between adult ADHD and these disorders, allowing for more careful consideration before establishing a formal diagnosis. When the disorders are found to be comorbid, further complications may arise; thus, the review will also help to provide evidence-based treatment recommendations as well as suggestions on how to minimize adverse events. Incorporating evidence from systematic reviews, journal articles, randomized controlled trials, and case reports, this review highlights that the diagnosis of ADHD and some of its common comorbidities is challenging and requires full, in-depth assessment and management. The management strategies of these comorbidities will also be addressed, with emphasis on achieving mood stabilization for BD prior to initiating appropriate ADHD pharmacotherapy. Medications, specifically mood stabilizers, antipsychotics, and antidepressants, are fundamental in treating symptoms seen in BD and some cases of BPD, alongside psychotherapy and lifestyle modifications when appropriate. The review highlights the effectiveness of specific medications, including psychostimulants, atomoxetine, and bupropion, as add-on therapies to mood-stabilizing treatments for addressing ADHD symptoms in patients with these comorbidities. Despite limited research, the review will address various pharmacological and psychotherapeutic approaches for managing comorbid ADHD and BPD, emphasizing the need for further investigations to better understand the unique needs of this patient population.

Repeated Treadmill Sprints Impair Cognitive Performance in Amateur Team-Sport Athletes When Performed in Normobaric Hypoxia.

This study determined if a single bout of repeated-sprint running under hypoxic (RSH) conditions was associated with impaired cognitive function when compared with repeated-sprint running under normoxic (RSN) conditions. Eleven amateur team-sport athletes performed a repeated-sprint running protocol (4 sets of 4, 4-s all-out sprints; i.e., RSR444) under both conditions (14.5% and 20.9% O2) on a non-motorized treadmill. Changes in SpO2, pre-frontal cortex total haemoglobin (Δ[THb]), oxyhaemoglobin (Δ[O2Hb]), deoxyhaemoglobin (Δ[HHb]) and cognitive function (detection task: DET; identification task: IDN; one card learning task: OCL; performed pre and 20 min post RSR444) were examined. During RSH, SpO2 was lower following each set (p ≤ 0.05), while [HHb] was higher after each set (p ≤ 0.05) compared with RSN. In addition, while there was no effect of condition on DET (p = 0.20) or IDN (p = 0.14), OCL accuracy was lower after, compared with before, RSH (p=0.04), but not RSN (p = 0.52). A significant relationship was observed between Δ[HHB] and ΔOCL accuracy (r = -0.68, p = 0.01). Performance of a single bout of RSH with 14.5% O2 resulted in impaired cognitive function in amateur team-sport athletes. Coaches should be mindful of timing of RSH prescription with regard to other training sessions that challenge speed and movement accuracy.

Arsenic in groundwater in private wells in rural North Dakota and South Dakota: Water quality assessment for an intervention trial.

Elevated exposure to arsenic disproportionately affects populations relying on private well water in the United States (US). This includes many American Indian (AI) communities where naturally occurring arsenic is often above 10 µg/L, the current US Environmental Protection Agency safety standard. The Strong Heart Water Study is a randomized controlled trial aiming to reduce arsenic exposure to private well water users in AI communities in North Dakota and South Dakota. In preparation for this intervention, 371 households were included in a community water arsenic testing program to identify households with arsenic ≥10 µg/L by inductively coupled plasma mass spectrometry (ICP-MS). Arsenic ≥10 µg/L was found in 97/371 (26.1%) households; median water arsenic concentration was 6.3 µg/L, ranging from <1-198 µg/L. Silica was identified as a water quality parameter that could impact the efficacy of arsenic removal devices to be installed. A low-range field rapid arsenic testing kit evaluated in a small number of households was found to have low accuracy; therefore, not an option for the screening of affected households in this setting. In a pilot study of the effectiveness of a point-of-use adsorptive media water filtration device for arsenic removal, all devices installed removed arsenic below 1 µg/L at both installation and 9 months post-installation. This study identified a relatively high burden of arsenic in AI study communities as well as an effective water filtration device to reduce arsenic in these communities. The long-term efficacy of a community based arsenic mitigation program in reducing arsenic exposure and preventing arsenic related disease is being tested as part of the Strong Heart Water Study.

Mindfulness training attenuates the increase in salivary cortisol concentration associated with competition in highly trained wheelchair-basketball players.

This study determined the effect of 8 wk of mindfulness training (MT) on salivary cortisol (sCort) and rate of salivary Immunoglobulin-A (sIgA) secretion in wheelchair-basketball players during a competition period. The mindful group completed 8 weeks of MT in addition to training and competition. sCort and rate of sIgA secretion were measured at baseline, at 2-week intervals, the end and 2 weeks following the intervention. A significant time and group interaction was observed for sCort (F = 3.297, P = 0.040, ES = 0.191); sCort increased in the control group from MT-BL to MT-2wk (P = 0.001) and remained significantly elevated at MT-4wk (P = 0.013) and MT-6wk (P = 0.002). sCort decreased from MT-6wk to MT-8wk (P < 0.001) and concentrations were not different at MT-8wk and Post-2wk to MT-BL (P > 0.05). Mindful group sCort increased from MT-BL to MT-2wk (P = 0.042) but decreased to concentrations no different to MT-BL for the rest of the intervention period (P > 0.05). There were no group differences in rate of sIgA secretion during the intervention (P = 0.810). It was concluded that 8 weeks of MT attenuated the increase in sCort associated with the competition period.

Underreporting of high-risk water and sanitation practices undermines progress on global targets.

Water and sanitation indicators under the Millennium Development Goals failed to capture high-risk practices undertaken on a regular basis. In conjunction with local partners, fourteen rounds of household surveys using mobile phones with a customized open-source application were conducted across nine study geographies in Asia and Africa. In addition to the main water and sanitation facilities, interviewees (n = 245,054) identified all water and sanitation options regularly used for at least one season of the year. Unimproved water consumption and open defecation were targeted as high-risk practices. We defined underreporting as the difference between the regular and main use of high-risk practices. Our estimates of high-risk practices as the main option matched the widely accepted Demographic and Health Surveys (DHS) estimates within the 95% confidence interval. However, estimates of these practices as a regular option was far higher than the DHS estimates. Across the nine geographies, median underreporting of unimproved water use was 5.5%, with a range of 0.5% to 13.9%. Median underreporting of open defecation was much higher at 9.9%, with a range of 2.7% to 11.5%. This resulted in an underreported population of 25 million regularly consuming unimproved water and 50 million regularly practicing open defecation. Further examination of data from Ethiopia suggested that location and socio-economic factors were significant drivers of underreporting. Current global monitoring relies on a framework that considers the availability and use of a single option to meet drinking water and sanitation needs. Our analysis demonstrates the use of multiple options and widespread underreporting of high-risk practices. Policies based on current monitoring data, therefore, fail to consider the range of challenges and solutions to meeting water and sanitation needs, and result in an inflated sense of progress. Mobile surveys offer a cost-effective and innovative platform to rapidly and repeatedly monitor critical development metrics.

The role of packaged water in meeting global targets on improved water access.

Packaged water (as either refill, bottled, or sachet water) has become an important element of water security in many low- and middle-income countries, owing to poor reliability and lack of piped water infrastructure. However, over time and across countries, the Demographic and Health Surveys monitoring program has inconsistently classified packaged water components as either improved or unimproved. Using data collected as part of the Performance Monitoring and Accountability 2020 (PMA2020) surveys on water options in nine study geographies across eight countries, we identified five geographies where packaged water constituted one of several options for 5% or more of users. In this study, four scenarios were designed in which packaged water components were variously classified as either improved or unimproved. Unimproved water use was highest in scenarios where sachet or refill water was classified as an unimproved source. Across the four scenarios, the difference in the use of unimproved water as the main option was highest (65%) in Nigeria (Lagos). That difference increased to 78% when considering all regular options. The development of these scenarios highlights the importance of classifying a source as improved or unimproved in the overall metric that indicates progress at national and international levels.

Reliability of salivary cortisol and immunoglobulin-A measurements from the IPRO® before and after sprint cycling exercise.

BACKGROUND: The purpose of this study was to evaluate the inter-day reliability of the IPRO method for determining resting and postexercise salivary cortisol (sCort) and rate of salivary Immunoglobulin-A (sIgA) secretion. METHODS: Fourteen males (32±11 years) performed two trials (T1 and T2) separated by 7 d, comprising saliva sampling before and 15 min after completion of two, 30-s Wingate Anaerobic Tests separated by 3.5 min (2 x WAnT). sCort increased after the 2 x WAnT in both trials (T1: P<0.001; T2: P<0.001), whereas rate of sIgA secretion decreased in both trials (T1: P=0.002; T2: P=0.002). RESULTS: The intraclass correlation coefficients for resting and postexercise sCort and rate of sIgA secretion ranged from 0.96-0.99. Mean reliability, expressed as the coefficient of variation (%) and the typical error of measurement over the two trials were resting sCort 9.4%, 0.14 ng·mL-1 (9% CI: 0.1-0.2), postexercise sCort 11.9%, 0.44 ng·mL-1 (9% CI: 0.3-0.7), resting rate of sIgA secretion 7.4%, 85.5 µg·mL-1·min-1 (9% CI: 65.2-127.1) and postexercise rate of sIgA secretion 10.5%, 82.9 µg·mL-1·min-1 (9% CI: 63.2-123.1). CONCLUSIONS: The IPRO is a reliable method for determining sCort and rate of sIgA secretion at rest and after sprint-cycling exercise.

Indices of cognitive function measured in rugby union players using a computer-based test battery.

The purpose of this study was to investigate the intra- and inter-day reliability of cognitive performance using a computer-based test battery in team-sport athletes. Eighteen elite male rugby union players (age: 19 ± 0.5 years) performed three experimental trials (T1, T2 and T3) of the test battery: T1 and T2 on the same day and T3, on the following day, 24 h later. The test battery comprised of four cognitive tests assessing the cognitive domains of executive function (Groton Maze Learning Task), psychomotor function (Detection Task), vigilance (Identification Task), visual learning and memory (One Card Learning Task). The intraclass correlation coefficients (ICCs) for the Detection Task, the Identification Task and the One Card Learning Task performance variables ranged from 0.75 to 0.92 when comparing T1 to T2 to assess intraday reliability, and 0.76 to 0.83 when comparing T1 and T3 to assess inter-day reliability. The ICCs for the Groton Maze Learning Task intra- and inter-day reliability were 0.67 and 0.57, respectively. We concluded that the Detection Task, the Identification Task and the One Card Learning Task are reliable measures of psychomotor function, vigilance, visual learning and memory in rugby union players. The reliability of the Groton Maze Learning Task is questionable (mean coefficient of variation (CV) = 19.4%) and, therefore, results should be interpreted with caution.

Anaerobic Energy Production During Sprint Paddling in Junior Competitive and Recreational Surfers.

This study compared determinants of a 30-s all-out paddling effort (30-s sprint-paddling test) between junior surfboard riders (surfers) of varying ability. Eight competitive (COMP) and 8 recreational (REC) junior male surfers performed a 30-s sprint-paddling test for the determination of peak sprint power and accumulated O2 deficit. Surfers also performed an incremental-paddling test for the determination of the O2 uptake-power output relationship that was subsequently used to calculate the accumulated O2 deficit for the 30-s sprint-paddling test. During the 30-s sprint-paddling test, peak sprint power (404 ± 98 vs 292 ± 56 W, respectively, P = .01) and the accumulated O2 deficit (1.60 ± 0.31 vs 1.14 ± 0.38 L, respectively, P = .02) were greater in COMP than in REC surfers, whereas peak O2 uptake measured during the incremental-paddling test was not different (2.7 ± 0.1 vs 2.5 ± 0.2 L/min, respectively, P = .11). The higher peak sprint power and larger accumulated O2 deficit observed in COMP than in REC surfers during a 30-s sprint paddling test suggest that surfing promotes development of the anaerobic energy systems. Furthermore, peak sprint power determined during 30 s of sprint paddling may be considered a sensitive measure of surfing ability or experience in junior male surfers.

Fecal indicator bacteria contamination of fomites and household demand for surface disinfection products: a case study from Peru.

Surface-mediated disease transmission is understudied in developing countries, particularly in light of the evidence that surface concentrations of fecal bacteria typically exceed concentrations in developed countries by 10- to 100-fold. In this study, we examined fecal indicator bacterial contamination of dinner plates at 21 households in four peri-urban communities in the Peruvian Amazon. We also used surveys to estimate household use of and demand for surface disinfectants at 280 households. Despite detecting total coliform, enterococci, and Escherichia coli on 86%, 43%, and 24% of plates sampled, respectively, less than one-third of households were regularly using bleach to disinfect surfaces. Among non-users of bleach, only 3.2% of respondents reported a new demand for bleach, defined as a high likelihood of using bleach within the next year. This study highlights the potential for marketing approaches to increase use of and demand for surface disinfectants to improve domestic hygiene.

Impact of water-vending kiosks and hygiene education on household drinking water quality in rural Ghana.

Innovative solutions are essential to improving global access to potable water for nearly 1 billion people. This study presents an independent investigation of one alternative by examining for-profit water-vending kiosks, WaterHealth Centers (WHCs), in rural Ghana to determine their association with household drinking water quality. WHCs' design includes surface water treatment using filtration and ultraviolet light disinfection along with community-based hygiene education. Analyses of water samples for Escherichia coli and household surveys from 49 households across five villages collected one time per year for 3 years indicate that households using WHCs had improved water quality compared with households using untreated surface water (adjusted incidence rate ratio = 0.07, 95% confidence interval = 0.02, 0.21). However, only 38% of households used WHCs by the third year, and 60% of those households had E. coli in their water. Recontamination during water transport and storage is an obstacle to maintaining WHC-vended water quality.

Enhanced semipermanent dialysis samplers for long-term environmental monitoring in saturated sediments.

The ability to sample in situ natural environmental processes has proven to be challenging when working with redox-sensitive contaminates in saturated sediments in wetland systems, especially within the rhizosphere, where sharp redox gradients are common. Many traditional approaches are invasive and disturb natural sediment chemistry. Through laboratory and field studies, the work presented in this study demonstrates a novel semipermanent dialysis sampler that allows for long-term, anaerobic monitoring of shallow sediments. Dialysis samplers were deployed and tested for over 1 year while being exposed to extremes in climate. These newly designed devices produce statistically reproducible data and capture sensitive redox trends. Results from the newly designed samplers were compared to conventional samplers. Initially, both the new and old designs yielded statistically similar data, but these data diverged over a period of months. The new devices are less invasive, so data gathered from these devices are more likely to be a closer representation of true conditions in the subsurface. By giving reliable data from a consistent location in space, these new samplers represent a significant step forward in capturing spatial and temporal variability in wetland redox chemistry during long-term monitoring.

The role of biomass, electron shuttles, and ferrous iron in the kinetics of Geobacter sulfurreducens-mediated ferrihydrite reduction.

This work presents a new framework for describing biologically mediated reduction of thin layers of poorly crystalline iron oxides. The research here explores the nature of the biomass to surface area relationship and the role of biogenic ferrous iron during Geobacter sulfurreducens-mediated ferrihydrite reduction, with and without an electron shuttle, through experiments and a mathematical model. The results indicate that a saturating function of biomass most accurately describes the rate of iron reduction without electron shuttles, based on the principle of electron transfer via direct contact. This study also finds that the most appropriate model of iron reduction in the presence of electron shuttles includes both a saturating function of biomass for electron transfer via direct contact and a first-order electron transfer to ferrihydrite via the electron shuttle, strongly supporting the idea that G. sulfurreducens uses both pathways simultaneously. In all experiments, G. sulfurreducens reduced less than 60% of the total ferric iron, a phenomenon that has often been explained through the inhibitory effects of biogenic ferrous iron in the dissolved phase. However, through experiments with spikes of ferrous sulfate, this study suggests that the role of dissolved ferrous iron is passive in this case, and does not directly inhibit the extent of iron reduction in ferrihydrite coated sand. These experiments find that solid phase ferrous iron is the most probable primary product of ferrihydrite reduction, and that the conversion of solid ferric iron to solid ferrous iron depletes a fixed pool of bioavailable ferric iron, thereby accounting for the incomplete reduction of ferric iron observed here. This is the first reported model that explicitly treats solid ferrous iron as the primary product of reduction, with aqueous ferrous iron as a passive byproduct. This simple mathematical model readily translates to other systems of microbially mediated iron reduction.