Preserving Corn

Corn is not only a favorite vegetable, but it is also the source of corn starch, cornmeal, corn oil, corn syrup, bourbon, and laundry starch

The Feasibility and Acceptability of a Behavioural Activation Intervention for Young People with Depression in Child and Adolescent Mental Health Services

Depression in young people is common, resulting in morbidity and mortality. Behavioural Activation (BA) is a cost-effective and efficacious treatment for reducing depressive symptoms in adults. There is little published research relating to BA as a treatment option for young people with depression. Thus, the aim was to explore the feasibility of conducting a trial of BA for depression in Child and Adolescent Mental Health Services (CAMHS). Stage I The initial stage of the study comprised a focused ethnography, conducted over a six-month period. The purpose was to explore the CAMHS study site, with a view to pre-empting (and addressing) any difficulties that may be encountered during a planned trial. Participant observation (158 hours), staff interviews (n= 6) and document collection (n= 17) were used to gather data. Data were coded using thematic analysis and the resulting themes were verified by a second coder. Insights into the individual, practical and organisational boundaries of the service guided implementation of Stage II. Stage II The second stage involved a randomised controlled feasibility trial with an embedded qualitative component. Participants were identified via a case note review or self/clinician referral from three CAMHS over seventeen months. Young people (aged 12 to 17 years) displaying symptoms of depression were offered a structured diagnostic interview to confirm depression status. Additional measures of mood, functioning and self-esteem were recorded. Twenty-two patients were randomised to BA or usual CAMHS care. Existing CAMHS staff were trained to deliver the 8-week manualised BA intervention. Following treatment, participants in the BA arm, their parents and clinicians were offered semi-structured interviews to explore their experiences of receiving or administering BA. Verbatim interview transcripts were coded using thematic analysis. At three months post-baseline, the diagnostic interview and outcome measures were repeated. At six months post-baseline, a telephone interview repeated selected outcomes. Participant recruitment was successful but the trial suggests that the process used could be streamlined. Participants were 82% female, with a mean age of 15.7 (SD, 1.2) years. Qualitative feedback from patients and their caregivers supported the acceptability of BA treatment. Families also identified barriers to participating in the intervention. Most staff found the intervention acceptable, but some raised concerns about the manualised treatment delivery. Retention at three months was 68%, with higher loss to follow-up in the BA (4/11; 36%) vs. usual care (3/11; 27%). Although not powered to demonstrate statistical differences, preliminary quantitative data suggest BA treatment may result in improved outcomes compared to usual care, such as remission from depression. Fewer BA participants met depression criteria at three-month follow-up (3/7; 42.9%) than in usual care (7/8; 87.5%). However, the assessor was not blinded to treatment allocation, fidelity was not assessed and the number of sessions was not controlled for, which increases uncertainty relating to the results. This research contributes valuable information about how a BA trial could be implemented in an adolescent mental health setting, and provides indications about the potential of the approach to treat depression in this context. However, outstanding questions relating to the feasibility of the intervention remain

Reflections 1977

The 1977 issue of Reflections is sponsored by Sigma Tau Delta (the Gamma Lamba chapter) and the Department of English at Gardner-Webb College. Wayn Blakenship, Becky Bost, Suzette Thompson, David Putnam, Barbara Wray, and Charlotte Hughes served as editors of the issue. Artistic renderings from the issue are sampled from Scenes from the 19th Century Stage in Advertising Woodcuts collected by Stanley Applebaum (1976).https://digitalcommons.gardner-webb.edu/reflections/1003/thumbnail.jp

Behavioural activation for overweight and obese adolescents with low mood delivered in a community setting : feasibility study

Background Mood and weight problems are common in young people, yet few treatments address both conditions concurrently. Behavioural activation (BA) has shown promise as a treatment for adults with comorbid obesity and depression. This study aimed to examine the feasibility and acceptability of a manualised BA treatment targeting weight and mood problems in young people. Methods Young people with low mood and weight difficulties were identified via a school-based screening process. Following a diagnostic interview, young people with clinically significant mood problems and concurrent overweight/obesity were invited to participate. A total of 8–12 sessions of BA were delivered by a graduate therapist to eight adolescents (four male) aged 12–15 years. Weight, mood and functioning were assessed before, during and after treatment, and a semistructured qualitative interview was conducted, along with selected outcome measures at 4 months’ follow-up. Results Low attrition and positive qualitative feedback suggested the intervention was acceptable. Trends towards a reduction in reported depression symptoms and improved functioning scores were observed at follow-up, with more mixed results for change in body mass index. Of those attending the 4-month follow-up, 57% (4/7) no longer met the screening threshold for major depressive disorder. However, low screening and baseline recruitment rates would pose challenges to executing a larger trial. Conclusions BA delivered by a graduate therapist in a British community setting is an acceptable, feasible treatment for comorbid mood and weight problems in adolescence, and its effectiveness should be evaluated in an adequately powered randomised controlled trial

The normalisation of \u27excessive\u27 workforce drug testing?

In \u27The normalization of \u27sensible\u27 recreational drug use\u27 Parker, Williams and Aldridge (2002) present data on illegal drug use by adolescents and young adults in the UK. They argue that it is both widespread and largely socially benign - ie, normal. We contrast this \u27normalisation\u27 thesis with evidence of an increase in the introduction of drug policies - and drug testing - in British organisations. Such policies construct employee drug use as excessive enough to necessitate heightened management vigilance over workers, in order to preserve corporate interests. These contrasting representations of drug use inspire our discussion. We deploy the normal/ excessive couplet to unpick drug taking, to examine organisational drug policies and to comment upon emerging and potential resistance to these policies. Our contribution is to suggest that each of these activities can be understood as simultaneously normal and excessive, in an area where orthodox and critical analyses alike tend to be far more dualistic. <br /

Metabolic Abnormalities of Chronic High-Dose Glucocorticoids Are Not Mediated by Hypothalamic AgRP in Male Mice.

Glucocorticoids are potent and widely used medicines but often cause metabolic side effects. A murine model of corticosterone treatment resulted in increased hypothalamic expression of the melanocortin antagonist AgRP in parallel with obesity and hyperglycemia. We investigated how these adverse effects develop over time, with particular emphasis on hypothalamic involvement. Wild-type and Agrp-/- male mice were treated with corticosterone for 3 weeks. Phenotypic, biochemical, protein, and mRNA analyses were undertaken on central and peripheral tissues, including white and brown adipose tissue, liver, and muscle, to determine the metabolic consequences. Corticosterone treatment induced hyperphagia within 1 day in wild-type mice, which persisted for 3 weeks. Despite this early increase in food intake, the body weight only started to increase after 10 days. Hyperinsulinemia occurred at day 1. Also, although after 2 days, alterations were present in the genes often associated with insulin resistance in several peripheral tissues, hyperglycemia only developed at 3 weeks. Throughout, sustained elevation in hypothalamic Agrp expression was present. Mice with Agrp deleted [using clustered regularly interspaced short palindromic repeats (CRISPR)-Cas9, Agrp-/-] were partially protected against corticosterone-induced hyperphagia. However, Agrp-/- mice still had corticosterone-induced increases in body weight and adiposity similar to those of the Agrp+/+ mice. Loss of Agrp did not diminish corticosterone-induced hyperinsulinemia or correct changes in hepatic gluconeogenic genes. Chronic glucocorticoid treatment in mice mimics many of the metabolic side effects seen in patients and leads to a robust increase in Agrp. However, AgRP does not appear to be responsible for most of the glucocorticoid-induced adverse metabolic effects.MR

Being a child with intellectual disabilities in hospital: The need for an individualised approach to care

BACKGROUND: There is limited qualitative research focussed specifically on what it is like for children and young people with intellectual disabilities coming into hospital, with much of the evidence-base being about those with Autism Spectrum Condition or adults with intellectual disabilities. AIM: To share rich detail of the emotional and physical impact on children and young people with intellectual disabilities of attending hospital, from their own and their parent's perspective. METHODS: Talking Mats interviews, sticker survey and photography with children and young people with intellectual disabilities, and in-depth interviews, hospital diaries and photography with their parents. RESULTS AND CONCLUSIONS: The multiple and compounding layers of complexity surrounding hospital care of children and young people with intellectual disabilities resulted in challenges associated with loss of familiarity and routine, undergoing procedures, managing sensory overload, managing pain and having a lack of safety awareness. An individualised approach to their care is needed