159,749 research outputs found

    Psychological, social and welfare interventions for psychological health and well-being of torture survivors

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    Background: Torture is widespread, with potentially broad and long-lasting impact across physical, psychological, social and other areas of life. Its complex and diverse effects interact with ethnicity, gender, and refugee experience. Health and welfare agencies offer varied rehabilitation services, from conventional mental health treatment to eclectic or needs-based interventions. This review is needed because relatively little outcome research has been done in this field, and no previous systematic review has been conducted. Resources are scarce, and the challenges of providing services can be considerable. Objectives: To assess beneficial and adverse effects of psychological, social and welfare interventions for torture survivors, and to comp are these effects with those reported by active and inactive controls. Search methods: Randomised controlled trials (RCTs) were identified through a search of PsycINFO, MEDLINE, EMBASE, Web of Science, the Cumulative Index to Nursing and Allied Health Literature (CINA HL), the Cochrane Central Register of Controlled Trials (CENTR AL) and the Cochrane Depression, Anxiety and Neurosis Specialise d Register (CCDANCTR), the Latin American and Caribbean Health Science Information Database (LILACS), the Open System for Information on Grey Literature in Europe (OpenSIGLE), the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) and Published International Literature On Traumatic Stress (PILOTS) all years to 11 April 2013; searches of Cochrane resources, international trial registries and the main biomedical databases were updated on 20 June 2014. We also searched the On line Library of Dignity (Danish Institute against Torture), reference lists of reviews and included studies and the most frequently cited journals, up to April 2013 but not repeated for 2014. Investigators were contacted to provide updates or details as necessary. Selection criteria: Full publications of RCTs or quasi-RCTs of psychological, social or welfare interventions for survivors of torture against any active or inactive comparison condition. Data collection and analysis: We included all major sources of grey literature in our search and used standard methodological procedures as expected by The Cochrane Collaboration for collecting data, evaluating risk of bias and using GRADE (Grades of Recommendation, Assessment, Development and Evaluation) methods to assess the quality of evidence. Main results: Nine RCTs were included in this review. All were of psychological interventions; none provided social or welfare interventions. The nine trials provided data for 507 adults; none involved children or adolescents. Eight of the nine studies described individual treatment, and one discussed group treatment. Six trials were conducted in Europe, and three in different African countries. Most people were refugees in their thirties and forties; most met the criteria for post-traumatic stress disorder (PTSD) at the outset. Four trials used narrative exposure therapy (NET), one cognitive-behavioural therapy (CBT ) and the other four used mixed methods for trauma symptoms, one of which included reconciliation methods. Five interventions were compared with active controls, such as psychoeducation; four used treatment as usual or waiting list/no treatment; we analysed all control conditions together. Duration of therapy varied from one hour to longer than 20 hours with a median of around 12 to 15 hours. All trials reported effects on distress and on PTSD, and two reported on quality of life. Five studies followed up participants for at least six months. No immediate benefits of psychological therapy were noted in comparison with controls in terms of our primary outcome of distress (usually depression), nor for PTSD symptoms, PTSD caseness, or quality of life. At six-month follow-up, three NET and one CBT study (86 participants) showed moderate effect sizes for intervention over control in reduction of distress (standardised me an difference (SMD) -0.63, 95% confidence interval (CI) -1.07 to -0.19) and of PTSD symptoms (SMD -0.52, 95% CI -0.97 to -0.07). However, the quality of evidence was very low, and risk of bias resulted from researcher/therapist allegiance to treatment methods, effects of uncertain asylum status of some people and real-time non-standardised translation of assessment measures. No measures of adverse events were described, nor of participation, social functioning, quantity of social or family relationships, proxy measures by third parties or satisfaction with treatment. Too few studies were identified for review authors to attempt sensitivity analyses. Authors’ conclusions: Very low-quality evidence suggests no differences between psychological therapies and controls in terms of immediate effects on post- traumatic symptoms, distress or quality of life; however, NET and CBT were found to confer moderate benefits in reducing dis tress and PTSD symptoms over the medium term (six months after treatment). Evidence was of very low quality, mainly because non- standardised assessment methods using interpreters were applied, and sample sizes were very small. Most eligible trials also revealed medium to high risk of bias. Further, attention to the cultural appropriateness of interventions or to their psychometric qualities was inadequate, and assessment measures used were unsuitable. As such, these findings should be interpreted with caution. No data were available on whether symptom reduction enabled improvements in quality of life, participation in community life, or in social and family relationships in the medium term. Details of adverse events and treatment satisfaction were not available immediately after treatment nor in the medium term. Future research should aim to address these gaps in the evidence and should include larger sample sizes when possible. Problems of torture survivors need to be defined far more broadly than by PTSD symptoms, and re cognition given to the contextual influences of being a torture survivor, including as an asylum seeker or refugee, on psychological and social health

    Fighting racism and discrimination in Brazil : legislation and institutional action

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    En los últimos años, el Estado brasileño ha puesto en práctica varias acciones con la finalidad de eliminar las desigualdades históricas entre “negros” y “blancos” y combatir la discriminación y el racismo. Se impulsaron cambios legislativos referentes a la materia, políticas de acción afirmativa e instituciones públicas para recibir denuncias por actos discriminatorios. Nos interesa promover una reflexión sobre estas medidas, a más de diez años de la implementación de acciones afirmativas. Destacamos que todavía es necesario proponer y desarrollar iniciativas que impacten en la génesis y reproducción del racismo y la discriminación, y no sólo en sus consecuencias

    Control of a water delivery canal with cooperative distributed MPC

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    This article addresses the problem of controlling pool levels in a water delivery canal using a novel cooperative distributed MPC control algorithm that incorporates stability constraints. According to a distributed control strategy, a local control agent is associated to all canal gates (actuators). In order to achieve cooperative action, each control agent computes the corresponding gate position (manipulated variable) by performing the minimization of a cost function that considers not only its local control objectives, but also the ones of their immediate neighbors. For this purpose, a MPC algorithm with stability constraints is used (SIORHC). At the beginning of each sampling interval, local control agents exchange information with their neighbors and adjust their decision in an iterative way. The resulting distributed MPC is denoted D-SIORHC and yields a stable closed-loop. Experimental results are provided to show the influence of the controller configuration parameters on the resulting performance

    A “Marshall Plan” for Rule of Law in Europe

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    Legal pluralism and creative destruction

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    Commencing with an ironic parallel with some concepts of economic sciences, the author calls for an active solidarity of all jurists to safeguard a plural Europe, affected by a severe crisis. Firmly based on the thoughts of the honouree Cunha Rodrigues, the crucial importance of a homogeneous and trustworthy European Judiciary is also emphasized, in order to strengthen advances already provided by European Union Law, especially through the creative and innovative case law from the Court of Justice of the European Union.A partir de uma irónica analogia com alguns conceitos das Ciências Económicas, o autor reclama por uma ativa solidariedade dos juristas na salvaguarda de uma Europa plural, imersa hoje numa grave crise. Ancorado no pensamento do homenageado Conselheiro Cunha Rodrigues, enfatiza-se igualmente a importância crucial de um judiciário europeu homogéneo e merecedor da confiança dos cidadãos de forma a consolidar os progressos já proporcionados, no passado recente, pelo direito da União Europeia, em particular por força da jurisprudência criativa e inovadora do Tribunal de Justiça da União Europeia

    The globalisation of the Judicial Power – context and challenges

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    Judicial Independence today is facing, particularly in Europe, new threats emerging from populist political regimens. After a structural analysis of the main constraints to the upholding of an independent judiciary, some indications are listed, in a very brief note, to better affirm, at the level of the judiciary, the values of Democracy and Rule of Law, assuming an “ethics of practical responsibility”

    Understanding the EU Urban Agenda from the margins of Europe: the case of Porto

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    This research focuses on the EU regional policy and presents a critical analysis of its influence on the urban regeneration process of the Portuguese city of Porto. A particular attention is drawn to the historic centre area which in 1996 was formally recognised by the UNESCO as a World Heritage Site. The old town's social, cultural and historic heritage has been dealing with a diverse range of challenges and consequently has been the stage of different urban interventions. Among the actions that have been implemented during the last 50 years to steer the area's development, two area-based interventions linked to the EU Cohesion Policy have notably contributed to the processes of urban change—1990 Urban Pilot Project and 2006 Programa de Reabilitação Urbana. In order to make sense of the intricate relationship between the urban dimension of the EU regional policy and the processes of urban regeneration we started by tracing the development of the EU urban agenda. As a second step we contextualised the historic Bairro da Sé do Porto area within national and local urban policies and development patterns. Finally, it was possible to put forward a series of considerations regarding the influence of EU initiatives in this southwestern European city. Hopefully, the insights resulting from this research will not only help to understand local effects of EU instruments and their specificities at the level of implementation, but allow future EU policy making to capitalise on its urban agenda in order to promote a better future

    Media and legacies of war: responses to global film violence in conflict zones

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    This article examines the phenomenon of informal video houses showing action films with scenes of violence to young people in Gorongosa, a district in the center of Mozambique. Recent socioeconomic interventions and development in the region have occurred in tandem with the growing popularity of violent action films among young people, which has been cause for concern among their parents and guardians. The ambivalent responses of Gorongosa residents toward this trend indicate the need to analyze the implications of film violence in the context of evolving local rituals of revelation and multiple legacies of the civil war (1976–1992) as well as emerging postwar challenges. The results significantly contrast with psychological studies of media violence that link consumption of film violence to serious negative effects on young viewers. In Gorongosa, film violence is implicated in expanding relations of domination and submission and violence and its containment, which enhance ongoing processes of self-assertion among young people in unpredictable ways, without, however, inciting violence in the communities. This study has significant implications for understanding the reception of mass media violence among young people in conflict zones

    Influência do treino do passo rápido voluntário nas estratégias de feedforward e feedback em Adultos mais Velhos

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    Introdução:O envelhecimento influencia negativamente o controlo postural, diminuindo a capacidade de recuperar o equilíbrio após uma perturbação externa e consequentemente aumento do risco de queda nos adultos mais velhos Objetivo(s):Verificar a influência do treino do passo rápido voluntário nas estratégias de feedforward e feedback em adultos mais velhos aquando o stepping anterior e posterior, bem como o timing e sequência de ativação muscular, ajustes posturais antecipatórios (APA) e compensatórios (APC1,APC2), comprimento, latência, velocidade média (VM) do passo e estratégias de passo lateral Métodos:19 participantes foram distribuídos aleatoriamente por dois grupos, o grupo experimental (n=9) e o grupo controlo (n=10), estudo randomizado controlado. Ambos foram submetidos a um protocolo de exercício físico durante 3 meses, 2 vezes/semana. Adicionalmente o grupo experimental (GE) realizou o treino do passo rápido voluntário bilateral nas várias direções. A resposta a um desequilíbrio postural em vários sentidos e consequente resposta de stepping anterior, posterior ou lateral foram avaliadas por meio de eletromiografia de superfície e por um sistema de imagem 3D Resultados: Na variação entre o momento inicial e final (M0-M1), durante o stepping anterior o GE, comparativamente ao GC, aumentou e diminuiu significativamente o timing do RF ipsilateral e GemM, respetivamente. Na variação do timing dos músculos BF ipsilateral e contralateral e TA contralateral, o GE diminuiu significativamente menos do que o GC. O GE aumentou significativamente o comprimento do stepping posterior do que o GC. Quanto à variação da latência observou-se que o GE aumentou significativamente do que o GC nos dois steppings. Na variação da VM, do stepping anterior, o GE diminuiu significativamente mais do que GC. O GE aumentou e diminuiu significativamente os APAS e os APC1 do que o GC no stepping posterior e anterior, respetivamente. Verificou-se que a estratégia mais frequente nos dois momentos e grupos foi a estratégia de stepping lateral direto Conclusão: A contínua prática do stepping rápido voluntário parece promover um melhor controlo postural sendo um importante exercício específico para prevenção de queda
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