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This article provides an overview of selected ongoing international efforts that have been inspired by Edward Zigler's vision to improve programs and policies for young children and families in the United States. The efforts presented are in close alignment with three strategies articulated by Edward Zigler: (a) conduct research that will inform policy advocacy; (b) design, implement, and revise quality early childhood development (ECD) programs; and (c) invest in building the next generation of scholars and advocates in child development. The intergenerational legacy left by Edward Zigler has had an impact on young children not only in the United States, but also across the globe. More needs to be done. We need to work together with a full commitment to ensure the optimal development of each child.
Compulsory admission procedures of patients with mental disorders vary between countries in Europe. The Ethics Committee of the European Psychiatric Association (EPA) launched a survey on involuntary admission procedures of patients with mental disorders in 40 countries to gather information from all National Psychiatric Associations that are members of the EPA to develop recommendations for improving involuntary admission processes and promote voluntary care.
The survey focused on legislation of involuntary admissions and key actors involved in the admission procedure as well as most common reasons for involuntary admissions.
We analyzed the survey categorical data in themes, which highlight that both medical and legal actors are involved in involuntary admission procedures.
We conclude that legal reasons for compulsory admission should be reworded in order to remove stigmatization of the patient, that raising awareness about involuntary admission procedures and patient rights with both patients and family advocacy groups is paramount, that communication about procedures should be widely available in lay-language for the general population, and that training sessions and guidance should be available for legal and medical practitioners. Finally, people working in the field need to be constantly aware about the ethical challenges surrounding compulsory admissions.
Do your students struggle to see the point in learning a language other than English? Do you teach in an English-dominant setting? If so, this book is a 'must-read'. It offers international perspectives on CLIL, a revolutionary teaching approach where students study subjects, for example physics or history, in a language which is not their own. Informed by research carried out by the authors, it addresses the issues of developing CLIL in Anglophone contexts and shows how to implement this method of language learning successfully in the reality of the classroom. Through three key themes, sustainability, pedagogy and social justice, each author explores CLIL as a means of addressing the high levels of cultural diversity and socio-economic disparity in Anglophone-dominant settings. Authored by experts in the field, it offers a set of flexible teaching tools, which serve to combine language and content, ultimately enhancing the learning experience of students.
Physical activity (PA) is recognized to be an efficient therapy for depression but few patients are practicing it.
This study investigates whether motivational interviewing stimulates hospitalized depressed patients to participate to PA therapeutic programs.
70 depressed patients, hospitalized in a psychiatric unit were followed regarding their participation to indoor bike training sessions. The first 39 ones (controls = C) were informed that this training possibility was at their disposal without further comment. The 31 next ones (the participants = P) received one session per week of motivational interviewing. Frequency, time, and intensity of the indoor bike training were compared between groups. Demographical variables, BDI and STAI were recorded. There were no significant differences between groups regarding these variables. Participation frequency was recorded as the total number of sessions of physical training by each patient divided by the number of his hospitalization days.
The frequency of participation to AP for the P group is 0.45 participations per day [SD=0.14] versus 0.16 for the C group[SD=0.14](p<0.0001). The mean energy spent at each participation is equivalent in both groups, 41.9 Kcal [SD=21.8] for the P group versus 44.2 Kcal [SD=32.7] for the C group.
Motivational interviewing is able to raise significantly the frequency of participation to physical activity programs in depressed inpatients.
Individuals with obsessive-compulsive disorder (OCD) and separation anxiety disorder (SAD) tend to present higher morbidity than do those with OCD alone. However, the relationship between OCD and SAD has yet to be fully explored.
This was a cross-sectional study using multiple logistic regression to identify differences between OCD patients with SAD (OCD + SAD, n = 260) and without SAD (OCD, n = 695), in terms of clinical and socio-demographic variables. Data were extracted from those collected between 2005 and 2009 via the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders project.
SAD was currently present in only 42 (4.4%) of the patients, although 260 (27.2%) had a lifetime diagnosis of the disorder. In comparison with the OCD group patients, patients with SAD + OCD showed higher chance to present sensory phenomena, to undergo psychotherapy, and to have more psychiatric comorbidities, mainly bulimia.
In patients with primary OCD, comorbid SAD might be related to greater personal dysfunction and a poorer response to treatment, since sensory phenomena may be a confounding aspect on diagnosis and therapeutics. Patients with OCD + SAD might be more prone to developing specific psychiatric comorbidities, especially bulimia. Our results suggest that SAD symptom assessment should be included in the management and prognostic evaluation of OCD, although the psychobiological role that such symptoms play in OCD merits further investigation.
Alexithymia is characterized by difficulties identifying and communicating feelings, and problems differentiating between feelings and bodily sensations; its concrete cognitive style focused on the external environment is typical of psychosomatic patients. Patients with eating disorders (EDs) have high levels of alexithymia, particularly difficulties identifying and describing their feelings.
The aims of our study are (1) to assess the alexythimia, emotional empathy, facial emotion identification skills and social inference abilities in a sample of ED patients; (2) to compare these variables between ED patients and healthy controls (HC); and (3) to correlate levels of alexithymia with the severity of the ED as measured by the Eating Disorder Inventory-3 (EDI-3) EDRC score in the ED group.
ED (N=42) and HC (N=42) were tested with the Toronto Alexithymia Scale (TAS-20), Eating Disorder Inventory (EDI-3), Facial Emotion Identification Test (FEIT), The Awareness of Social Inference Test (TASIT) and Interpersonal Reactivity Index (IRI).
Data collection is being completed and the results’ analysis is ongoing. We expect the ED sample to show greater alexythimia and a poorer performance at FEIT and TASIT than HCs. We expect to find a linear correlation between the TAS-20 and EDRC score.
A better understanding of the role of alexithymia in ED etiology and maintenance might allow the development of targeted treatment approaches to help patients improve their skills in identifying and expressing emotions.
The nurse practice model at the family health strategy is characterized by direct involvement in the patient's health-disease recovery process, deconstruction of social stigma involving mental health disorders, and the restoration of patient autonomy their social ties. This descriptive study follows a qualitative approach to document and analyse practices performed by mental health nurses at the family health strategy (FHS) in Rio das Ostras, Brazil. The study identifies practices implemented by Mental Health Nurses at FHS and the nurses’ own reflection and analysis on these mental health practices. Data was collected through semi-structured interviews. All interviewed nurses had worked in the primary mental health care for at least one year at the FHS units in Rio das Ostras. Data was analysed, grouped, and coded according to two categories: 1) The nurses’ professional practices in mental health at the FHS, and 2) The nurses’ view on mental health practices at the FHS. Results show that the main activities in mental health at FHS involve working with the matricial team, continuing education, reception, home visits, referrals, therapeutic workshops and community therapy. Nurse perspectives on professional practices involve prevention, establishment of bonds with patient, and nurses’ training to deliver care to patients who are suffering. The bond with and care for the patient, family and community, is one of the FHS differentiators. In that vein, the study looks at the link between health care delivery, territory and population attended. The health care based on territoriality, allows increased patient and family confidence.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Duchenne muscular dystrophy is associated with progressive cardiorespiratory failure, including left ventricular dysfunction.
Methods and Results:
Males with probable or definite diagnosis of Duchenne muscular dystrophy, diagnosed between 1 January, 1982 and 31 December, 2011, were identified from the Muscular Dystrophy Surveillance Tracking and Research Network database. Two non-mutually exclusive groups were created: patients with ≥2 echocardiograms and non-invasive positive pressure ventilation-compliant patients with ≥1 recorded ejection fraction. Quantitative left ventricular dysfunction was defined as an ejection fraction <55%. Qualitative dysfunction was defined as mild, moderate, or severe. Progression of quantitative left ventricular dysfunction was modelled as a continuous time-varying outcome. Change in qualitative left ventricle function was assessed by the percentage of patients within each category at each age. Forty-one percent (n = 403) had ≥2 ejection fractions containing 998 qualitative assessments with a mean age at first echo of 10.8 ± 4.6 years, with an average first ejection fraction of 63.1 ± 12.6%. Mean age at first echo with an ejection fraction <55 was 15.2 ± 3.9 years. Thirty-five percent (140/403) were non-invasive positive pressure ventilation-compliant and had ejection fraction information. The estimated rate of decline in ejection fraction from first ejection fraction was 1.6% per year and initiation of non-invasive positive pressure ventilation did not change this rate.
In our cohort, we observed that left ventricle function in patients with Duchenne muscular dystrophy declined over time, independent of non-invasive positive pressure ventilation use. Future studies are needed to examine the impact of respiratory support on cardiac function.
The Rio Grande Cone is a major fanlike depositional feature in the continental slope of the Pelotas Basin, Southern Brazil. Two representative sediment cores collected in the Cone area were retrieved using a piston core device. In this work, the organic matter (OM) in the sediments was characterized for a continental vs. marine origin using chemical proxies to help constrain the origin of gas in hydrates. The main contribution of OM was from marine organic carbon based on the stable carbon isotope (δ13C-org) and total organic carbon/total nitrogen ratio (TOC:TN) analyses. In addition, the 14C data showed important information about the origin of the OM and we suggest some factors that could modify the original organic matter and therefore mask the “real” 14C ages: (1) biological activity that could modify the carbon isotopic composition of bulk terrestrial organic matter values, (2) the existence of younger sediments from mass wasting deposits unconformably overlying older sediments, and (3) the deep-sediment-sourced methane contribution due to the input of “old” (>50 ka) organic compounds from migrating fluids.