The Co-regulatory Effects of Emotionally Focused Therapy

Mental health literature emphasizes the necessity of expanding emotional regulation to improve symptomology of a variety of mental health disorders. Coregulatory experiences have been shown to expand individual emotional regulation and are more likely in relationships with secure attachment. Emotionally Focused Therapy (EFT) is focused on developing secure attachment between partners. This study examined the coregulatory effects of EFT with a single couple over the course of couples’ counseling. The participating couple received eight couples’ counseling sessions from a clinician who is a certified EFT trainer, supervisor, and therapist while having their heart rate, electrodermal activity, and skin temperature taken during the sessions. Surrogate synchrony analysis (SUSY) was used to assess physiological synchrony between the couple over their sessions. Heart rate variability was also calculated. The degree of relationship between the heart rate variabilities of the couple was measured using linear regression. While the results of the study did not show significant increases in physiological synchrony between the couple, the results emphasize the presents of in and out of synchrony pendulation occurring between the couple as well as the presence of lagged synchrony as the couple responds according to the partner’s experience. Implications for future research are also included

A Phenomenological Study of Teachers and Mental Health Paraprofessionals Implementing the Jesse Lewis Choose Love Program

This study examined the lived experience of teachers and mental health paraprofessionals implementing the Jesse Lewis Choose Love curriculum in an alternative school setting. Social emotional learning curriculum implementation within the unique structure of alternative schools is important to investigate in order to better understand the unique needs of those providing services to students in this setting. This study utilized open-ended written prompts and two focus groups with teachers and mental health paraprofessionals for 10 weeks of implementation of this social emotional learning program. Participants reported changes in students and themselves and an increase in group cohesion. Five identified themes included change in students, change in staff, group cohesion, awareness of student needs, and existing stability; all of which have implications for future social emotional learning curricula. Suggestions for best practices for SEL implementation are included

Annular Lichen Planus with Central Clearing

Annular lichen planus is an uncommon clinical variant of lichen planus. Characteristics include an annular configuration associated with a narrow rim of erythema and inflammation and a depressed center. There is a tendency toward central clearing. We present an illustrative case of annular lichen planus in an 82-year-old woma

Impact of Extended Recess: A Grounded Theory Study

Existing literature has established the benefits of recess and physical activity for children. In response, more schools in the United States (U.S.) are implementing, or even requiring, extended recess time for students. With these policy changes, it is important to understand the impact upon students, faculty, and staff. The following study used the shared experience of three elementary schools in the southern U.S. who recently implemented extended recess. Semi-structured focus groups with administrators, teachers, paraprofessionals, and students from three elementary schools were included in this pilot study. A Grounded theory approach was utilized, and findings confirmed the known benefits of recess but also enhanced understanding of the process, which included the challenges involved as well as the importance of stakeholder feedback. Recommendations are included for the professional school counselor which are applicable in both, the U.S. and internationally

Biomarkers of Systemic Inflammation in Ugandan Infants and Children Hospitalized With Respiratory Syncytial Virus Infection

Background: Optimizing outcomes in respiratory syncytial virus (RSV) pneumonia requires accurate diagnosis and determination of severity that, in resource-limited settings, is often based on clinical assessment alone. We describe host inflammatory biomarkers and clinical outcomes among children hospitalized with RSV lower respiratory tract infection (LRTI) in Uganda and controls with rhinovirus and pneumococcal pneumonia. Methods: 58 children hospitalized with LRTI were included. We compared 37 patients with RSV, 10 control patients with rhinovirus and 11 control patients with suspected pneumococcal pneumonia. Results: Patients in the RSV group had significantly lower levels of C-reactive protein (CRP) and chitinase-3-like protein 1 (CHI3L1) than the pneumococcal pneumonia group (P < 0.05 for both). Among children with RSV, higher admission levels of CRP predicted prolonged time to resolution of tachypnea, tachycardia and fever. Higher levels of CHI3L1 were associated with higher composite clinical severity scores and predicted prolonged time to resolution of tachypnea and tachycardia, time to wean oxygen and time to sit. Higher levels of lipocalin-2 (LCN2) predicted prolonged time to resolution of tachypnea, tachycardia and time to feed. Higher admission levels of all 3 biomarkers were predictive of a higher total volume of oxygen administered during hospitalization (P < 0.05 for all comparisons). Of note, CHI3L1 and LCN2 appeared to predict clinical outcomes more accurately than CRP, the inflammatory biomarker most widely used in clinical practice. Conclusions: Our findings suggest that CHI3L1 and LCN2 may be clinically informative biomarkers in childhood RSV LRTI in low-resource settings

TB STIGMA – MEASUREMENT GUIDANCE

TB is the most deadly infectious disease in the world, and stigma continues to play a significant role in worsening the epidemic. Stigma and discrimination not only stop people from seeking care but also make it more difficult for those on treatment to continue, both of which make the disease more difficult to treat in the long-term and mean those infected are more likely to transmit the disease to those around them. TB Stigma – Measurement Guidance is a manual to help generate enough information about stigma issues to design and monitor and evaluate efforts to reduce TB stigma. It can help in planning TB stigma baseline measurements and monitoring trends to capture the outcomes of TB stigma reduction efforts. This manual is designed for health workers, professional or management staff, people who advocate for those with TB, and all who need to understand and respond to TB stigma

The Stellar Halos of Massive Elliptical Galaxies

We use the Mitchell Spectrograph (formerly VIRUS-P) on the McDonald Observatory 2.7m Harlan J. Smith Telescope to search for the chemical signatures of massive elliptical galaxy assembly. The Mitchell Spectrograph is an integral-field spectrograph with a uniquely wide field of view (107x107 sq arcsec), allowing us to achieve remarkably high signal-to-noise ratios of ~20-70 per pixel in radial bins of 2-2.5 times the effective radii of the eight galaxies in our sample. Focusing on a sample of massive elliptical galaxies with stellar velocity dispersions sigma* > 150 km/s, we study the radial dependence in the equivalent widths (EWs) of key metal absorption lines. By twice the effective radius, the Mgb EWs have dropped by ~50%, and only a weak correlation between sigma* and Mgb EW remains. The Mgb EWs at large radii are comparable to those seen in the centers of elliptical galaxies that are approximately an order of magnitude less massive. We find that the well-known metallicity gradients often observed within an effective radius continue smoothly to 2.5R_e, while the abundance ratio gradients remain flat. Much like the halo of the Milky Way, the stellar halos of our galaxies have low metallicities and high alpha-abundance ratios, as expected for very old stars formed in small stellar systems. Our observations support a picture in which the outer parts of massive elliptical galaxies are built by the accretion of much smaller systems whose star formation history was truncated at early times.Comment: To appear in ApJ, 15 pages, 9 figure

What is different about living alone with cancer in older age? A qualitative study of experiences and preferences for care

Background: Increasing numbers of older patients with advanced cancer live alone but there is little research on how well health services meet their needs. The aim of this study was to compare the experiences and future preferences for care between two groups of older people with cancer in their last year of life; those who live alone, and those who live with co-resident carers. Methods: In-depth qualitative interviews were conducted with 32 people aged between 70 and 95 years who were living with cancer. They were recruited from general practices and hospice day care, when the responsible health professional answered no to the question, of whether they would be surprised if the patient died within twelve months. Twenty participants lived alone. Interviews were recorded and transcribed and the data analysed using a Framework approach, focussing on the differences and commonalities between the two groups. Results: Many experiences were common to all participants, but had broader consequences for people who lived alone. Five themes are presented from the data: a perception that it is a disadvantage to live alone as a patient, the importance of relational continuity with health professionals, informal appraisal of care, place of care and future plans. People who lived alone perceived emotional and practical barriers to accessing care, and many shared an anxiety that they would have to move into a care home. Participants were concerned with remaining life, and all who lived alone had made plans for death but not for dying. Uncertainty of timescales and a desire to wait until they knew that death was imminent were some of the reasons given for not planning for future care needs. Conclusions: Older people who live alone with cancer have emotional and practical concerns that are overlooked by their professional carers. Discussion and planning for the future, along with continuity in primary care may hold the key to enhancing end-of-life care for this group of patients

Effectiveness of Motivational Interviewing in improving lipid level in patients with dyslipidemia assisted by general practitioners: Dislip-EM study protocol

<p>Abstract</p> <p>Background</p> <p>The non-pharmacological approach to cholesterol control in patients with hyperlipidemia is based on the promotion of a healthy diet and physical activity. Thus, to help patients change their habits, it is essential to identify the most effective approach. Many efforts have been devoted to explain changes in or adherence to specific health behaviors. Such efforts have resulted in the development of theories that have been applied in prevention campaigns, and that include brief advice and counseling services. Within this context, Motivational Interviewing has proven to be effective in changing health behaviors in specific cases. However, more robust evidence is needed on the effectiveness of Motivational Interviewing in treating chronic pathologies -such as dyslipidemia- in patients assisted by general practitioners. This article describes a protocol to assess the effectiveness of MI as compared with general practice (brief advice), with the aim of improving lipid level control in patients with dyslipidemia assisted by a general practitioner.</p> <p>Methods/Design</p> <p>An open, two-arm parallel, multicentre, cluster, controlled, randomized, clinical trial will be performed. A total of 48-50 general practitioners from 35 public primary care centers in Spain will be randomized and will recruit 436 patients with dyslipidemia. They will perform an intervention based either on Motivational Interviewing or on the usual brief advice. After an initial assessment, follow-ups will be performed at 2, 4, 8 and 12 months. Primary outcomes are lipid levels (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides) and cardiovascular risk. The study will assess the degree of dietary and physical activity improvement, weight loss in overweight patients, and adherence to treatment guidelines.</p> <p>Discussion</p> <p>Motivational interview skills constitute the primary strategies GPs use to treat their patients. Having economical, simple, effective and applicable techniques is essential for primary care professionals to help their patients change their lifestyle and improve their health. This study will provide scientific evidence on the effectiveness of Motivational interviewing, and will be performed under strict control over the data collected, ensuring the maintenance of therapeutic integrity.</p> <p>Trials Registration</p> <p>ClinicalTrials.gov (<a href="http://www.clinicaltrials.gov/ct2/show/NCT01282190">NCT01282190</a>).</p