Early Detection and Treatment of Psychosis: The Bern Child and Adolescent Psychiatric Perspective

Commonly conceptualized as neurodevelopmental disorders of yet poorly understood aetiology, schizophrenia and other nonorganic psychoses remain one of the most debilitating illnesses with often poor outcome despite all progress in treatment of the manifest disorder. Drawing on the frequent poor outcome of psychosis and its association with the frequently extended periods of untreated first-episode psychosis (FEP) including its prodrome, an early detection and treatment of both the FEP and the preceding at-risk mental state (ARMS) have been increasingly studied. Thereby both approaches are confronted with different problems, for example, treatment engagement in FEP and predictive accuracy in ARMS. They share, however, the problems related to the lack of understanding of developmental, that is, age-related, peculiarities and of the presentation and natural course of their cardinal symptoms in the community. Most research on early detection and intervention in FEP and ARMS is still related to clinical psychiatric samples, and little is known about symptom presentation and burden and help-seeking in the general population related to these experiences. Furthermore, in particular in the early detection of an ARMS, studies often address adolescents and young adults alike without consideration of developmental characteristics, thereby applying risk criteria that have been developed predominately in adults. Combining our earlier experiences described in this paper in child and adolescent, and general psychiatry as well as in both lines of research, that is, on early psychosis and its treatment and on the early detection of psychosis, in particular in its very early states by subjective disturbances in terms of basic symptoms, age-related developmental and epidemiological aspects have therefore been made the focus of our current studies in Bern, thus making our line of research unique

Humans and Scavengers: The Evolution of Interactions and Ecosystem Services

Since the origin of early Homo species during the Late Pliocene, interactions of humans with scavenging birds and mammals have changed in form through shifting ecological scenarios. How humans procured meat during the Quaternary Period changed from confrontational scavenging to hunting; shepherding of wild animals; and, eventually, intensive husbandry of domesticated animals. As humans evolved from carcass consumers to carcass providers, the overall relationship between humans and scavengers shifted from competition to facilitation. These changing interactions have translated into shifting provisioning (by signaling carcass location), regulating (e.g., by removing animal debris and controlling infectious diseases), and cultural ecosystem services (e.g., by favoring human language and social cooperation skills or, more recently, by enhancing ecotourism) provided by scavenging vertebrates. The continued survival of vultures and large mammalian scavengers alongside humans is now severely in jeopardy, threatening the loss of the numerous ecosystem services from which contemporary and future humans could benefit.

Doing House and Family in der Sattelzeit

Vorstellung des Programms des Sinergiaprojekts

Climate change impacts on tree species, forest properties, and ecosystem services

– Swiss forests experience strong impacts under the CH2011 scenarios, partly even for the low greenhouse gas scenario RCP3PD. Negative impacts prevail in low-elevation forests, whereas mostly positive impacts are expected in high-elevation forests. – Major changes in the distribution of the two most important tree species, Norway spruce and European beech, are expected. Growth conditions for spruce improve in a broad range of scenarios at presently cool high-elevation sites with plentiful precipitation, but in the case of strong warming (A1B and A2) spruce and beech are at risk in large parts of the Swiss Plateau. – High elevation forests that are temperature-limited will show little change in species composition but an increase in biomass. In contrast, forests at low elevations in warm-dry inner-Alpine valleys are sensitive to even moderate warming and may no longer sustain current biomass and species. – Timber production potential, carbon storage, and protection from avalanches and rockfall react differently to climate change, with an overall tendency to deteriorate at low elevations, and improve at high elevations. – Climate change will affect forests also indirectly, e.g., by increasing the risk of infestation by spruce bark beetles, which will profit from an extended flight period and will produce more generations per year.

People, protected areas and ecosystem services: a qualitative and quantitative analysis of local people's perception and preferences in Côte d'Ivoire

The long-term integrity of protected areas (PAs), and hence the maintenance of related ecosystem services (ES), are dependent on the support of local people. In the present study, local people's perceptions of ecosystem services from PAs and factors that govern local preferences for PAs are assessed. Fourteen study villages were randomly selected from three different protected forest areas and one control site along the southern coast of Côte d'Ivoire. Data was collected through a mixed-method approach, including qualitative semi-structured interviews and a household survey based on hypothetical choice scenarios. Local people's perceptions of ecosystem service provision was decrypted through qualitative content analysis, while the relation between people's preferences and potential factors that affect preferences were analyzed through multinomial models. This study shows that rural villagers do perceive a number of different ecosystem services as benefits from PAs in Côte d'Ivoire. The results based on quantitative data also suggest that local preferences for PAs and related ecosystem services are driven by PAs' management rules, age, and people's dependence on natural resources.

Lichtheimia Infection in a Lymphoma Patient: Case Report and a Brief Review of the Available Diagnostic Tools

We describe the case of a patient with a T-lymphoblastic lymphoma whose disseminated mucormycosis was diagnosed with delay, and we address the diagnostic and therapeutic decision-making process and review the diagnostic workup of patients with potential IFD. The diagnosis was delayed despite a suggestive radiological presentation of the patient's pulmonary lesion. The uncommon risk profile (T-lymphoblastic lymphoma, short neutropenic phases) wrongly led to a low level of suspicion. The diagnosis was also hampered by the lack of indirect markers for infections caused by Mucorales, the low sensitivity of both fungal culture and panfungal PCR, and the limited availability of species-specific PCR. A high level of suspicion of IFD is needed, and aggressive diagnostic procedures should be promptly initiated even in apparently low-risk patients with uncommon presentations. The extent of the analytical workup should be decided on a case-by-case base. Diagnostic tests such as the galactomannan and β-D-glucan test and/or PCR on biological material followed by sequencing should be chosen according to their availability and after evaluation of their specificity and sensitivity. In high-risk patients, preemptive therapy with a broad-spectrum mould-active antifungal agent should be started before definitive diagnostic findings become available.

Socioemotional Wealth, Ambidexterity, and Family Firm Performance: An Empirical Study

While family business literature agrees that family firms are driven by both non-economic and financial motives, it is unclear how the prioritization of socioemotional wealth (SEW) over financial considerations affects family firms' financial performance. Based on a sample of 343 family firm owners from German-speaking Europe, this study reveals a significant and positive relationship between the firm owners' SEW considerations and their family businesses' financial performance. This relationship, in turn, is found to be mediated by organizational ambidexterity. A fine-grained analysis of the different SEW dimensions indicates that this pattern may be driven by two elements of socioemotional wealth only (family members' identification with the firm and emotional attachment). Our findings demonstrate that business families do not necessarily face a trade-off when prioritizing the preservation of their SEW over stabilizing or improving the financial performance of their business. The study enriches several streams of literature and opens up numerous avenues for future research.