Refugees, trauma and adversity-activated development

The nature of the refugee phenomenon is examined and the position of mental health professionals is located in relation to it. The various uses of the word 'trauma' are explored and its application to the refugee context is examined. It is proposed that refugees' response to adversity is not limited to being traumatized but includes resilience and Adversity-Activated Development (AAD). Particular emphasis is given to the distinction between resilience and AAD. The usefulness of the 'Trauma Grid' in the therapeutic process with refugees is also discussed. The Trauma Grid avoids global impressions and enables a more comprehensive and systematic way of identifying the individual refugee's functioning in the context of different levels, i.e. individual, family, community and society/culture. Finally, I discuss implications for therapeutic work with refugees

Prioritization of high-cost new drugs for HCV: making sustainability ethical

Hepatitis C virus (HCV) infection is a major health problem worldwide. Chronic HCV infection may in the long run cause cirrhosis, hepatic decompensation and hepatocellular carcinoma, with an ultimate disease burden of at least 350,000 deaths per year worldwide. The new generation of highly effective direct acting antivirals (DAA) to treat HCV infection brings major promises to infected patients in terms of exceedingly high rates of sustained virological response (SVR) but also of tolerability, allowing even the sickest patients to be treated. Even in the face of the excellent safety and efficacy and wide theoretical applicability of these regimens, their introduction is currently facing cost and access issues denying their use to many patients in need. Health systems in all countries are facing a huge problem of distributive justice, since while they should guarantee individual rights, among which the right to health in its broader sense, therefore not limited to healing, but extended to quality of life, they must also grant equal access to the healthcare resources and keep the distribution system sustainable. In the face of a disease with a relatively unpredictable course, where many but not of all chronically infected will eventually die of liver disease, selective allocation of this costly resource is debatable. In most countries the favorite solution has been a stratification of patients for prioritization of treatment, which means allowing Interferon-free DAA treatment only in patients with advanced fibrosis or cirrhosis, while keeping on hold persons with lesser stages of liver disease. In this report, we will perform an ethical assessment addressing the issues linked to access to new therapies, prioritization and eligibility criteria, analyzing the meaning of the term “distributive justice” and the different approaches that can guide us (individualistic libertarianism, social utilitarianism and egalitarianism) on this specific matter. Even if over time the price of new DAA will be reduced through competition and eventual patent expiration, the phenomenon of high drug costs will go on in the next decades and we need adequate tools to face the problems of distributive justice that come with it

Variability of the auroral footprint of io detected by Juno‐JIRAM and modeling of the Io plasma torus

One of the auroral features of Jupiter is the emission associated with the orbital motion of its moon Io. The relative velocity between Io and the surrounding plasma trigger perturbations that travels as Alfvén waves along the magnetic field lines toward the Jovian ionosphere. These waves can accelerate electrons into the atmosphere and ultimately produce an auroral emission, called the Io footprint. The speed of the Alfvén waves—and hence the position of the footprint—depends on the magnetic field and on the plasma distribution along the field line passing through Io, whose SO2-rich atmosphere is the source of a dense plasma torus around Jupiter. Since 2016, the Jovian InfraRed Auroral Mapper (JIRAM) onboard Juno has been observing the Io footprint with a spatial resolution of ∼few tens of km/pixel. JIRAM detected evidences of variability in the Io footprint position that are not dependent on the System III longitude of Io. The position of the Io footprint in the JIRAM images is compared with the position predicted by a model of the Io Plasma Torus and of the magnetic field. This is the first attempt to retrieve quantitative information on the variability of the torus by looking at the Io footprint. The results are consistent with previous observations of the density and temperature of the Io Plasma Torus. However, we found that the plasma density and temperature exhibit considerable non-System III variability that can be due either to local time asymmetry of the torus or to its temporal variability

Eyetracking measures of social attention in young children: How gaze patterns translate to real‐life social behaviors

The aim of this study was to evaluate to what degree eyetracking paradigms of social attention, in combination with synchronous measurements of affective arousal, were associated with real‐life social behavior of children aged 3–7 years. Several eyetracking paradigms were used, involving social interactions, single/multiple faces, and emotional faces. Arousal was measured using electrocardiography. Real‐life social behavior was measured using structured behavior observations, parent questionnaires, and developmental interviews. Time spent looking at social stimuli was significantly associated with real‐life social behaviors, and independent of age, IQ, or gender. Paradigms involving social interactions and looking time to the eyes showed the most consistent relations with social behaviors. Stronger affective arousal responses were associated with shorter looking times toward eyes, which in turn were associated with less social awareness in real life. Eyetracking and arousal measures allow for sensitive and objective assessment of social abilities that have great relevance for real‐life social behaviors, with the potential to use in a broad and diverse population. These measures may help gain insight into the underpinnings of social behavior and may serve as a valuable marker or outcome measure in understanding, monitoring, and stimulating social‐emotional development early in life.Development Psychopathology in context: clinical setting

Does a 6-point scale approach to post-treatment 18F-FDG PET-CT allow to improve response assessment in head and neck squamous cell carcinoma? A multicenter study

Abstract Purpose Response assessment to definitive non-surgical treatment for head and neck squamous cell carcinoma (HNSCC) is centered on the role of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET-CT) 12 weeks after treatment. The 5-point Hopkins score is the only qualitative system available for standardized reporting, albeit limited by suboptimal positive predictive value (PPV). The aim of our study was to explore the feasibility and assess the diagnostic accuracy of an experimental 6-point scale ("Cuneo score"). Methods We performed a retrospective, multicenter study on HNSCC patients who received a curatively-intended, radiation-based treatment. A centralized, independent qualitative evaluation of post-treatment FDG-PET/CT scans was undertaken by 3 experienced nuclear medicine physicians who were blinded to patients' information, clinical data, and all other imaging examinations. Response to treatment was evaluated according to Hopkins, Cuneo, and Deauville criteria. The primary endpoint of the study was to evaluate the PPV of Cuneo score in assessing locoregional control (LRC). We also correlated semi-quantitative metabolic factors as included in PERCIST and EORTC criteria with disease outcome. Results Out of a total sample of 350 patients from 11 centers, 119 subjects (oropharynx, 57.1%; HPV negative, 73.1%) had baseline and post-treatment FDG-PET/CT scans fully compliant with EANM 1.0 guidelines and were therefore included in our analysis. At a median follow-up of 42 months (range 5-98), the median locoregional control was 35 months (95% CI, 32-43), with a 74.5% 3-year rate. Cuneo score had the highest diagnostic accuracy (76.5%), with a positive predictive value for primary tumor (Tref), nodal disease (Nref), and composite TNref of 42.9%, 100%, and 50%, respectively. A Cuneo score of 5-6 (indicative of residual disease) was associated with poor overall survival at multivariate analysis (HR 6.0; 95% CI, 1.88-19.18; p = 0.002). In addition, nodal progressive disease according to PERCIST criteria was associated with worse LRC (OR for LR failure, 5.65; 95% CI, 1.26-25.46; p = 0.024) and overall survival (OR for death, 4.81; 1.07-21.53; p = 0.04). Conclusions In the frame of a strictly blinded methodology for response assessment, the feasibility of Cuneo score was preliminarily validated. Prospective investigations are warranted to further evaluate its reproducibility and diagnostic accuracy

Morphology of the Auroral Tail of Io, Europa, and Ganymede From JIRAM L-Band Imager

Jupiter hosts intense auroral activity associated with charged particles precipitating into the planet's atmosphere. The Galilean moons orbiting within the magnetosphere are swept by the magnetic field: the resulting perturbation travels along field lines as Alfven waves, which are able to accelerate electrons toward the planet, producing satellite-induced auroral emissions. These emissions due to the moons, known as footprints, can be detected in various wavelengths (UV, visible, IR) outside the main auroral emission as multiple bright spots followed by footprint tails. Since 2016 the Juno spacecraft orbiting Jupiter has surveyed the polar regions more than 30 times at close distances. Onboard the spacecraft, the Jovian InfraRed Auroral Mapper (JIRAM) is an imager and spectrometer with an L-band imaging filter suited to observe auroral features at unprecedented spatial resolution. JIRAM revealed a rich substructure in the footprint tails of Io, Europa, and Ganymede, which appear as a trail of quasi-regularly spaced bright sub-dots whose intensity fades away along the emission trail as the spatial separation from the footprint increases. The fine structure of the Europa and Ganymede footprint tails is reported in this work for the first time. We will also show that the typical distance between subsequent sub-dots is the same for all three moons at JIRAM resolution in both hemispheres. In addition, the sub-dots observed by JIRAM are static in a frame corotating with Jupiter. A feedback mechanism between the ionosphere and the magnetosphere is suggested as a potential candidate to explain the morphology of the footprint tails

“Excellence R Us”: university research and the fetishisation of excellence

The rhetoric of “excellence” is pervasive across the academy. It is used to refer to research outputs as well as researchers, theory and education, individuals and organisations, from art history to zoology. But does “excellence” actually mean anything? Does this pervasive narrative of “excellence” do any good? Drawing on a range of sources we interrogate “excellence” as a concept and find that it has no intrinsic meaning in academia. Rather it functions as a linguistic interchange mechanism. To investigate whether this linguistic function is useful we examine how the rhetoric of excellence combines with narratives of scarcity and competition to show that the hypercompetition that arises from the performance of “excellence” is completely at odds with the qualities of good research. We trace the roots of issues in reproducibility, fraud, and homophily to this rhetoric. But we also show that this rhetoric is an internal, and not primarily an external, imposition. We conclude by proposing an alternative rhetoric based on soundness and capacity-building. In the final analysis, it turns out that that “excellence” is not excellent. Used in its current unqualified form it is a pernicious and dangerous rhetoric that undermines the very foundations of good research and scholarship

Efectividad de una intervención motivacional breve para procesos de cambio en jóvenes colombianos consumidores de marihuana

Estudio de casoEste trabajo establece la efectividad de una intervención motivacional breve para procesos de cambio frente al consumo de marihuana en jóvenes colombianos. El programa de prevención selectiva fue implementado mediante la estrategia de taller y los parámetros del modelo transteórico. La intervención motivacional breve afectó los procesos de cambio asociados al consumo de marihuana, siendo efectiva para la muestra seleccionada.1. ANTECEDENTES TEÓRICOS Y EMPÍRICOS 2. JUSTIFICACIÓN Y PLANTEAMIENTO DEL PROBLEMA 3. OBJETIVOS 4. VARIABLES 5. HIPÓTESIS 6. MÉTODO 7. RESULTADOS 8. DISCUSIÓN REFERENCIAS APÉNDICESMaestríaMagister en Psicologí

Maltreated children use more grammatical negations

Many studies reveal a strong impact of childhood maltreatment on language development, mainly resulting in shorter utterances, less rich vocabulary, or a delay in grammatical complexity. However, different theories suggest the possibility for resilience – a positive adaptation to an otherwise adverse environment – in children who experienced childhood maltreatment. Here, we investigated different measures for language development in spontaneous speech, examining whether childhood maltreatment leads to a language deficit only or whether it can also result in differences in language use due to a possible adaptation to a toxic environment. We compared spontaneous speech during therapeutic peer-play sessions of 32 maltreated and 32 non-maltreated children from the same preschool and equivalent in gender, age (2 to 5 years), home neighborhood, ethnicity, and family income. Maltreatment status was reported by formal child protection reports, and corroborated by independent social service reports. We investigated general language sophistication (i.e., vocabulary, talkativeness, mean length of utterance), as well as grammatical development (i.e., use of plurals, tense, grammatical negations). We found that maltreated and non-maltreated children showed similar sophistication across all linguistic measures, except for the use of grammatical negations. Maltreated children used twice as many grammatical negations as non-maltreated children. The use of this highly complex grammatical structure shows an advanced linguistic skill, which shows that childhood maltreatment does not necessarily lead to a language deficit. The result might indicate the development of a negativity bias in the structure of spontaneous language due to an adaptation to their experiences