BACKGROUND: Tiredness, poor concentration, disturbed sleep and poor appetite can all be caused by depression, which is a common mental disorder and a leading cause of disability worldwide. This study aimed to assess the prevalence of major depressive disorder, suicidal ideation, and risk factors in Sudanese children and adolescents during the Sudanese army conflict.
METHODS: A descriptive cross-sectional community-based study was carried out among Sudanese children between 11 and 17 years old who living in Sudan at the start of the conflict by using a self-administered questionnaire under the guidance of parents, if necessary. The questionnaire was adapted from the Patients Health Questionnaire-9 (PHQ-9) checklist for the assessment of major depression disorder symptoms according to the Diagnostic and Statistical Manual Edition 5th Edition (DSM-5). The questionnaire was translated into Arabic by two expert translators, and its validity and reliability were confirmed. Data analysis was performed using Statistical Package for the Social Sciences version 25 software, and descriptive analysis and any appropriate statistical tests were performed.
RESULTS: Among the 963 participants, the mean age was 15.18 ± 2.1 years, 65.5% were female, and 67.7% had major depressive disorder. There was a significant relationship between MDD score, age, sex, current residency status, and traumatic event exposure, with P values less than 0.001 for all variables.
CONCLUSIONS: Major depressive disorder was highly prevalent among Sudanese children and adolescents included in the present study. Additionally, suicidal ideation, which requires immediate intervention, was reported to be very high. The findings will help the government to provide proper mental health interventions for affected people.

UNASSIGNED: Little work has been done investigating the prevalence and impact of comorbidities on cholera outcomes within conflict settings. We describe the clinical outcomes of patients treated for cholera in Latakia, Syria, during the 2022-2023 cholera outbreak.
UNASSIGNED: We performed a single-centre retrospective observational cohort study of patients admitted to the hospital with suspected cholera between 15th December 2022 and 15th February 2023 at National Hospital, Latakia, Syria. Multivariable negative binomial regression analysis was used to investigate the variables\' relationship to hospital length of stay.
UNASSIGNED: The study involved 89 patients admitted to the hospital; none were vaccinated against cholera. Cholera rapid diagnostic test was positive in 91 % of patients. Half of the patients (51 %) were male; a third (35 %) had hypertension, and a fifth (19 %) had diabetes. One patient passed away during admission. Patients who were male, had diabetes and were hypertensive tended to have longer hospital stays in univariable analysis. When these factors were added to a multivariable negative binomial model (consisting of age, gender, hypertension and diabetes), male sex (IRR: 4.1, 95 % CI: 1.28-6.2, p = 0.001), the presence of hypertension (IRR: 2.1,95 % CI: 1.14 to 4.1, p = 0.004) and diabetes (IRR: 2, 95 % CI: 1.2 to 2.7, p = 0.001) were independent predictors of longer hospital stays.
UNASSIGNED: In conflict settings, hypertension and diabetes are common in patients admitted to hospital with cholera and are associated with longer hospital stays. Mortality from cholera, however, was low. Our findings highlight the importance of comorbidity control in mitigating excess morbidity during infectious disease outbreaks within conflict areas.

BACKGROUND: Colombia has high numbers of internally displaced people, forced to migrate due to the conflict. 1 in 3 displaced women undergo pregnancy during adolescence, compared to around 1 in 5 in the non-displaced population, alongside health and resource inequalities between these groups. There is limited qualitative information available from the perspectives of displaced women experiencing adolescent pregnancy. This research explores how structural violence may feature in their experiences.
METHODS: Qualitative methods were used. Participants were recruited with purposive sampling, using key informants and snowball sampling technique. 14 semi-structured interviews were conducted in Ciudad Bolívar, Bogotá, involving 11 displaced women who began childbearing age 15-19 in the past 10 years, and 4 participants\' mothers. Data was analysed using the theoretical framework of structural violence, and emergent themes categorised using thematic analysis.
RESULTS: Pregnancy was considered advantageous in many ways, but this was contradicted by resulting disadvantages that ensued. Structural violence was embedded in life stories, manifesting in poverty and difficulties accessing reliable income, poor access to healthcare and education following pregnancy. Institutional and interpersonal discrimination confounded these challenges.
CONCLUSIONS: Pregnancy during adolescence was a contradictory experience, representing both a safety net and a trap due to a complex interplay of structural and cultural violence in everyday survival. Policymakers must consider the importance of the context surrounding adolescent pregnancy and address systematic disadvantages affecting women in these positions.
The violent conflict in Colombia has left many people forced to leave their homes and become ‘internally displaced’. Internally displaced women are more likely to become pregnant during their adolescence than non-displaced women. This work tries to understand more about the everyday lives of displaced women who experience adolescent pregnancy, through interviews. The interviews were analysed and results interpreted using the theory of ‘structural violence’. Structural violence describes how social structures such as racism, sexism, war and poverty determine life choices, leading to suffering and inequality. The work found that pregnancy and motherhood in adolescence for displaced women was positive in many ways by bringing purpose, status and companionship. However, these women also experienced many challenges after pregnancy, such as exclusion from education and secure employment and difficulty accessing healthcare. This demonstrated that structural violence features in multiple interconnected forms in the daily lives of displaced adolescent mothers. The work urges policymakers to appreciate the complexity of context surrounding adolescent pregnancy and motherhood, and to address the structural disadvantages facing women in these situations.

The process of athlete selection and deselection in sport involves not only athletes but also coaches, managers, performance directors, talent pathway coordinators and the wider organisation. Athlete selection and deselection can be viewed as the opposite sides of the same coin in that the process may be the same for all athletes but the outcome is very different. The outcome of this process can evoke extremely powerful emotions ranging from elevation to devastation. While selection and deselection are part of competitive sport regardless of type, level, gender or age, research is scarce. Employing the Delphi method, a total of 20 participants comprised the expert panel (coaches, athletes and other key personnel in high performance) from various sports, and ages ranged from 21 to 59 years old. Following three rounds, 60 items reached the pre-determined consensus level of 75%. The 60 items were then further content analysed and grouped with respect to the three key stakeholders: athlete (14), coach (21) and organisation (25). Within each of these categories, subcategories emerged: personal, interpersonal, procedural, educational, supportive, communicative and reviewing behaviours and actions that athletes, coaches and organisations can take to ease the navigation, apply consistency and establish a common ground during this challenging situation.

The planned missions to the Moon and Mars will present more significant health challenges to astronauts compared to low earth orbit missions. During deep space missions, astronauts will be constantly exposed to Space radiation (SR). Multiple rodent studies suggest that < 25 cGy of SR impairs performance in executive functions, which play a key role in advanced cognitive processes, but also regulate response inhibition and impulse control. There is the possibility that SR exposure may exacerbate aberrant behaviors evoked by psychological stress related to exposure to isolated and confined (ICE) hostile environment or independently induce additional aberrant behaviors. This study has determined that female Wistar rats exposed to 10 cGy of 250 MeV/n He had an increased risk taking propensity (RTP)\\compared to shams. The increased RTP of the He-exposed rats was associated with significantly increased reaction times during the trials, suggesting a SR-induced loss of processing speed. The response times of the He-exposed rats were even further reduced in trials that immediately followed a loss, raising the possibility that conflict and interference avoidance may be impaired after SR exposure. Whether these findings occur following other types of SR exposure, and/or in male rats remains to be determined.

People regularly encounter various types of conflict. Here, we ask if, and, if so, how, different types of conflict, from lab-based Stroop conflicts to everyday-life self-control or moral conflicts, are related to one other. We present a framework that assumes that action-goal representations are hierarchically organized, ranging from concrete actions to abstract goals. The framework\'s key assumption is that conflicts involving more abstract goals (e.g., self-control/moral conflict) are embedded in a more complex action space; thus, to resolve such conflicts, people need to consider more associated goals and actions. We discuss how differences in complexity impact conflict resolution mechanisms and the costs/benefits of resolving conflicts. Altogether, we offer a new way to conceptualize and analyze conflict regulation across different domains.

The author reflects on how his relationship with Jeremy Safran during graduate school continues to inform his thinking around pedagogy and clinical training. Safran\'s emphasis on independent inquiry is highlighted, especially regarding the importance of seeking out perspectives and evidence that come into conflict with one\'s primary orientation. The author argues that Safran\'s pedagogical stance could be described as inhabiting a state of \"pre-judgment,\" which is essential in both clinical and pedagogical contexts in the psychoanalytic field.

OBJECTIVE: Leadership development assessments are a critical component of student pharmacists\' understanding and development of effective team strategies.
METHODS: The 5 Voices tool, developed by GiANT Worldwide, was incorporated into the leadership curriculum across 2 colleges of pharmacies for second-year Doctor of Pharmacy (PharmD) students. One public land-grant institution administers the assessment in the fall semester during a 2-h class session as part of a leadership elective leadership course and a private liberal arts institution distributes the 5 Voices assessment to all students during a 1-h spring semester required course.
RESULTS: Responses from 456 PharmD students were included in the analysis, with 159 (34.9%) and 297 (65.1%) coming from the University of Minnesota and Drake University, respectively. Overall, 49.1% of PharmD students had nurturer as their foundational (first) voice. No differences were found in the distribution of first voices between institutions. The PharmD data are higher than the nurturer population-level average (43%).
CONCLUSIONS: Introducing students to the 5 Voices assessment provides an opportunity for them to gain a better understanding of what they can contribute to a team. In addition, because nurturer is a dominant voice, this understanding can help provide appreciation for other voices necessary for team development.

UNASSIGNED: The experience of war in recent time is very common around the world, and the impact is profound on the mental health of the victims, especially among the young population. The most implicated mental health problem is post-traumatic stress disorder, which comes after an exposure to trauma as a severe and long-term result of the traumatic event. Studies in developed countries revealed this finding, but there is insufficient information in developing countries, where much of war and conflict exist and young population live including Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of post-traumatic stress disorder among high school students who experienced war.
UNASSIGNED: We assessed the prevalence and factors associated with post-traumatic stress disorder among high school students who experienced war.
UNASSIGNED: A multi-centered school base cross-sectional study was conducted from May 23 to June 08, 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression was used to identify the independent factors associated with post-traumatic stress disorder.
UNASSIGNED: A total of 338 of the 410 students participated in this study (94.5% response rate). The prevalence of post-traumatic stress disorder was 39.2%. In the multivariable analysis, poor social support (AOR = 3.40, 95% CI: 1.45, 7.95), depression (AOR = 3.24, 95% CI: 1.69,6.21), high level of perceived stress (AOR = 2.98, 95% CI: 1.61, 5.50), being in war fighting situation (AOR = 2.85, 95% CI: 1.40, 5.78), and witnessing the murder of family members or friends (AOR = 3.05, 95% CI: 1.47, 6.32) were factors significantly associated with post-traumatic stress disorder at a p-value <0.05.
UNASSIGNED: In this study, around two in five of high school students had post-traumatic stress disorder. Independent factors of PTSD were depression, high stress levels, poor social support, witnessing the murder of family members/friends, and being in war fighting situation. We recommend that the Ministry of Education and the Ministry of Health collaborate to integrate mental health services into schools. This focuses on the early detection of students at risk of PTSD, such as those with depression, high perceived stress levels, and exposure to murder or war, and provides necessary social support to prevent PTSD.

Fred Pine is a major contributor to contemporary Freudian analytic work. He expanded the breadth of clinical psychoanalysis by showing how the analyst could integrate ever expanding perspectives in analysis, and he expanded its depth through greater insight into how development affects psychic structure and, thereby, the context within which unconscious conflict and compromise is experienced and processed. Both of these-his expansion of potential variables implicated in the process of dynamic conflict and his developmental focus on structural deficit-have led to a way of Freudian thinking that is highly assimilative and integrative. Pine\'s focus on integrating disparate points of view-not different theories, but clinical observations that are featured in different overall theories-illuminates clinical possibility and nuance. Pine\'s work leads to questions about the relation of psychoanalytic theory to analytic practice and the definition of contemporary Freudian psychoanalysis itself.