Pervasive refusal syndrome as part of the refusal–withdrawal–regression spectrum: critical review of the literature illustrated by a case report

Pervasive refusal syndrome (PRS) is a rare child psychiatric disorder characterized by pervasive refusal, active/angry resistance to help and social withdrawal leading to an endangered state. Little has been written about PRS. A literature search yielded only 15 relevant articles, all published between 1991 and 2006. This article presents a critical review of the published literature, illustrated by a case report of an 11-year-old girl. PRS most often affects girls (75%). The mean age of the known population is 10.5 years. A premorbid high-achieving, perfectionist, conscientious personality seems to play an important role in the aetiology of PRS, as can a psychiatric history of parents or child and environmental stressors. PRS shows a symptom overlap with many other psychiatric disorders. However, none of the current DSM diagnoses can account for the full range of symptoms seen in PRS, and the active/angry resistance can be considered as the main distinguishing feature. Treatment should be multidisciplinary and characterized by patience, gentle encouragement and tender loving care. Hospitalization, ideally in a child and adolescent psychiatric unit, is almost always required. Although the recovery process is painfully slow (average duration of therapy 12.8 months), most children recover fully (complete recovery in 67% of known cases). In our opinion, it is important to increase knowledge of PRS, not only because of its disabling, potential life-threatening character, but also because there is hope for recovery through suitable treatment. We therefore propose an incorporation of PRS into the DSM and ICD classifications. However, an adaptation of the current diagnostic criteria is needed. We also consider PRS closely related to regression, which is why we introduce a new concept: “the refusal–withdrawal–regression spectrum”

Learning from a fool: searching for the 'unmanaged' context for radical learning

Drawing on the existing theorizing of organizational learning from a radical perspective, this article attempts to problematize such notion of learning and position it within the existing organizational contexts informed by divergent types of rationality. The study scrutinizes these frameworks with a view to reflect on the potentiality for radical learning to occur within them. In this vein, the conceptual analysis of non-technical and non-marginal notions, namely, ‘spirituality’, ‘luck’ and ‘wisdom’, in different modes of rationality is conducted. This article demonstrates that since the conceptual inclusiveness is entailed by the specificity of sensemaking mechanisms, which these modes employ, the analysed notions can be approached as their litmus paper. The functionalist rationality types are found to be incommensurate with exigencies of the radical context for learning. In pursue of the conducive area for radical learning, the notions of unmanaged organization and the technology of foolishness provide the theoretical frame for the study, and their joint sensemaking context is discussed using examples. This unmanaged space driven by inclusive foolishness is recognized as one that enables the liminal sensemaking processes conducive for radical learning to occur

The association between delusional-like experiences, and tobacco, alcohol or cannabis use: a nationwide population-based survey

<p>Abstract</p> <p>Background</p> <p>Previous population-based studies have found that delusional-like experiences (DLE) are prevalent in the community, and are associated with a wide range of mental health disorders including substance use. The aim of the study was to explore the association between DLE and three commonly used substances - tobacco, alcohol and cannabis.</p> <p>Methods</p> <p>Subjects were drawn from the Australian National Survey of Mental Health and Wellbeing 2007. The Composite International Diagnostic Interview was used to identify DLE, common psychiatric disorders, and substance use. We examined the relationship between the variables of interest using logistic regression, adjusting for potential confounding factors.</p> <p>Results</p> <p>Of 8 773 participants, 8.4% (n = 776) subjects endorsed one or more DLE. With respect to tobacco use, compared to nonusers, DLE were more common in those who (a) had daily use, (b) commenced usage aged 15 years or less, and (c) those who smoked heavily (23 or more cigarettes per day). Participants with cannabis use disorders were more likely to endorse DLE; this association was most prominent in those with an onset of 16 years or younger. In contrast, the pattern of association between DLE versus alcohol use or dependence was less consistent, however those with early onset alcohol use disorders were more likely to endorse DLE probe items.</p> <p>Conclusions</p> <p>While cannabis use disorders have been previously linked with DLE, our findings linking alcohol and tobacco use and DLE suggest that the influence of these substances on psychosis-related outcomes warrants closer scrutiny in longitudinal prospective studies.</p

Developmental Exposure to a Toxic Spill Compromises Long-Term Reproductive Performance in a Wild, Long-Lived Bird: The White Stork (Ciconia ciconia)

Background/Objective: Exposure to environmental contaminants may result in reduced reproductive success and long- lasting population declines in vertebrates. Emerging data from laboratory studies on model species suggest that certain life- stages, such as development, should be of special concern. However, detailed investigations of long-term consequences of developmental exposure to environmental chemicals on breeding performance are currently lacking in wild populations of long-lived vertebrates. Here, we studied how the developmental exposure to a mine spill (Aznalco´ llar, SW Spain, April 1998) may affect fitness under natural conditions in a long-lived bird, the White Stork (Ciconia ciconia). Methodology: The reproductive performance of individually-banded storks that were or not developmentally exposed to the spill (i.e. hatched before or after the spill) was compared when these individuals were simultaneously breeding during the seven years after the spill occurred (1999–2005). Principal Findings: Female storks developmentally exposed to the spill experienced a premature breeding senescence compared with their non-developmentally exposed counterparts, doing so after departing from an unusually higher productivity in their early reproductive life (non-developmentally exposed females: 0.560.33SE fledglings/year at 3-yr old vs. 1.3860.31SE at 6–7 yr old; developmentally exposed females: 1.560.30SE fledglings/year at 3-yr old vs. 0.8660.25SE at 6– 7 yr old). Conclusions/Significance: Following life-history theory, we propose that costly sub-lethal effects reported in stork nestlings after low-level exposure to the spill-derived contaminants might play an important role in shaping this pattern of reproduction, with a clear potential impact on population dynamics. Overall, our study provides evidence that environmental disasters can have long-term, multigenerational consequences on wildlife, particularly when affecting developing individuals, and warns about the risk of widespread low-level contamination in realistic scenarios.Peer reviewe

Association of insularity and body condition to cloacal bacteria prevalence in a small shorebird

Do islands harbour less diverse disease communities than mainland? The island biogeography theory predicts more diverse communities on mainland than on islands due to more niches, more diverse habitats and availability of greater range of hosts. We compared bacteria prevalences ofCampylobacter,ChlamydiaandSalmonellain cloacal samples of a small shorebird, the Kentish plover (Charadrius alexandrinus) between two island populations of Macaronesia and two mainland locations in the Iberian Peninsula. Bacteria were found in all populations but, contrary to the expectations, prevalences did not differ between islands and mainland. Females had higher prevalences than males forSalmonellaand when three bacteria genera were pooled together. Bacteria infection was unrelated to bird's body condition but females from mainland were heavier than males and birds from mainland were heavier than those from islands. Abiotic variables consistent throughout breeding sites, like high salinity that is known to inhibit bacteria growth, could explain the lack of differences in the bacteria prevalence between areas. We argue about the possible drivers and implications of sex differences in bacteria prevalence in Kentish plovers

Time-shifting laundry practices in a smart grid perspective: a cross-cultural analysis of Pakistani and Danish middle-class households

Future smart infrastructure development, in both developing and developed countries, is hinged on demand management and response strategies with consumers actively involved in time-shifting electricity consumption for improved efficiency. This paper presents a qualitative, interview-based, comparative study of how homeowners adapt their practices to the changing systems of electricity provision in two countries, Pakistan and Denmark. It reveals that household practices like laundering are flexible, highly contextualised and embedded in the wider socio-material and cultural context. In Denmark, time-shifting of laundering in households with photovoltaics is done voluntarily and closely interwoven with the temporal rhythms of the common dual-income household, as well as the natural cycles of the sun and weather, and is in most cases based on some degree of automation. In Pakistan, blackout schedules dictate time-shifting of most practices. Large family sizes and nuanced clothing make laundering more complex, socially-bound and time-consuming; however, joint family systems, provision of house-staff and outsourcing make it more time-flexible and less dependent on automation and electricity-use. Using theories on temporalities of practices in a cross-cultural analysis highlights the significance of local socio-material and cultural context in the performance, bundling and synchronisation of practices. While practice theories prove useful in cross-cultural comparison of temporalities of household practices and demand, further theory development is needed to conceptualise practices as shared or socially differentiated entities in varying cultural contexts. This has implications for demand management policies proposed in smart-grid transitions as well as in the possible cross-cultural transfer of smart technology and demand response strategies.The Pakistan case-study is part of a PhD research at the University of Cambridge, funded by Vicky Noon Cambridge Scholarship under the Cambridge Commonwealth, European & International Trust. The Danish case-study is part of the ERA-Net Smart Grid Plus funded project Markets, Actors & Technologies – A comparative study of smart grid solutions (MATCH). The international cooperation was made possible through the UserTEC project funded by Innovation Fund Denmark

Norwegian self-taught : with phonetic pronunciation /

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