Functional impairment in South African children and adolescents with obsessive-compulsive disorder

Includes bibliographical references (leaves 109-115).This research aimed to increase current understanding of functional impairment in children and adolescents with Obsessive-Compulsive Disorder (OCD). Twenty-six South African children and adolescents with OCD participated in the study. The Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (KSADS-PL), the Mini International Neuropsychiatric Interview For Children and Adolescents Version 5 (MINIKID5.0), the Children's Global Assessment Scale (CGAS), the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) and the Child Obsessive-Compulsive Impact Scale-Revised (COIS-R) were used to assess the children's and adolescent's past and current psychopathology, OCD symptom severity and OCD-related functional impairment. Findings suggest that most of the children (88.46%) in this study had one or more comorbid disorders. Parents and children agreed on very few of the rating items common the COIS-R-P and COIS-R-C. Parents, however, consistently reported higher rates of significant problems than did their children. Correlations between the various instruments revealed that parents are more accurate than their children in rating their child's global impairment and OCD-specific impairment. Therefore, collateral information from parents is vital for the clinician to accurately assess and fully understand the child's OCD-related functional impairment. Moreover, the number of comorbid disorders, and whether the child had ADHD or not, did not impact on the COIS-R total scores, suggesting that the COIS-R is a useful measure to assess OCD-specific impairment. Parents and children both reported that the most significant domain of impairment is the school domain. Moreover, parents reported that the most significant functional problem is "concentrating on his/her work" and children reported that the most significant functional problem is "getting good grades." Findings from studies such as this help clinicians to have a better understanding of childhood OCD-related functional impairment, which helps them to accurately diagnose and treat children with OCD

Personal Transparency in Perspective: The Impact of Social Networking Sites on the Recruitment Process

The “transparency trend” is hot for the summer of 2011. At least that is what they said in the fashion capitals of Milan, Paris, and London. In the new summer collections, sheer seethrough dresses reveal the beauties of the human body and leave little to the imagination. Architects too are attracted by the intriguing properties of transparent materials to create a new perception of space and boundaries, which challenges some traditional understandings of private living and daily work life. Whereas in the past, it was a Puritan statement to live without curtains at the windows, to show you had nothing to hide, today, the transparent way of life is often used to enable the owner to display their wealth and luxury. Institutions have increasingly followed this transparency trend in fashion and architecture by using glass for their buildings. Transparency is not only a fashion trend, but also a political challenge. Fashion and politics meet in the huge glass buildings of the European Union in Brussels and Strasbourg, which reflect the Union’s strategy to improve its democratic legitimacy; one of the main aims of the Lisbon Treaty (2009). In terms of adaption to this see-through trend, institutions are not only voluntarily moving towards greater transparency, they are being ambushed by those who believe that information is a public good, which should not be guarded by a few. By revealing “suppressed and censored injustices” (WikiLeaks, n.d.), WikiLeaks practices what some call “guerrilla transparency” (The Economist, 2010). When people think of transparency, the recent commotion caused by WikiLeaks’ publication of thousands of documents on nationally and internationally sensitive issues is at the forefront of their minds. This event has triggered a worldwide debate on the balance between state security and citizens’ right to know

Conclusion

 If you search for ´transparency´ on an internet search engine, it will provide more than 87 million hits to choose from. By clicking through the results, a diverse variety of types of transparency can be found, ranging from governmental or state transparency to transparency in the financial sector to transparency in sports. While some hits provide state or corporate policies on transparency, others refer to organizations that push for increased openness of organizations. Transparency is a concept that can be applied to a broad variety of different situations and domains in our social, political and economic world, often making it difficult to grasp clearly defined conditions. Since transparency seemingly illustrates a concept with unparalleled possibilities of application, it was referred to as a ´buzzword´ throughout this volume. The contributions of this volume sought, however, to give more substance to the ‘buzzword’. In which fields of social life do matters of transparency come up? What specific role does it play? Do we understand it in an instrumental or consequential way? Who or what is at the focal point of transparency – individuals, public persons, institutions or professions? The answers to these questions, which seek to define the characteristics and criteria of transparency, and the expectations attached to the concept will differ from case to case. What is needed, therefore, is further refinement of what is actually meant when speaking about transparency. Such refinement is inevitably context-based. This is exactly what this volume aimed to do: it analyzes the concept of transparency within specific cases and attempts to show what implications it can have for individuals, politics, social media, international development aid and the pharmaceutical industry. In this regard, the approaches of our authors followed the rationale that transparency is not to be understood as a value in itself, but as instrumental in achieving specific objectives

Transparency – more than a buzzword?

The concept of transparency can be applied to nearly every domain of human activity. In each of these diverse domains transparency is thought to provide the public with information in order to make reasoned judgements: be it information about who to vote for, who to employ, which medications to take, or which Non Governmental Organization to support. If people are sufficiently informed, the argument goes, they are able to hold political officials accountable, find more competent staff, and even punish mismanagement and corruption. As Bessire (2005) puts it, “transparency is strongly related to information – and information is power” (p. 429). This line of reasoning ignores the fact that the availability of information is not the only aspect of accountability. If the public does not know what is happening behind closed doors, it naturally has no incentive – and indeed no chance – to hold somebody accountable necessary. As well as having access to relevant information, people must have measures at their disposal to punish responsible actors

Thinking fast, thinking badly

We test for the construct validity of the cognitive reflection test (CRT) by eliciting response times. We find that incorrect answers to the CRT are quicker than correct answers. At the individual level, we classify subjects into impulsive and reflective, depending on whether they choose the incorrect intuitive answer or the correct answer the majority of the time. We show that impulsive subjects complete the test quicker than reflective subjects

Masivukeni: Development of a Multimedia Based Antiretroviral Therapy Adherence Intervention for Counselors and Patients in South Africa

Effective medical treatment for HIV/AIDS requires patients’ optimal adherence to antiretroviral therapy (ART). In resource-constrained settings, lack of adequate standardized counseling for patients on ART remains a significant barrier to adherence. Masivukeni (“Let’s Wake Up” in Xhosa) is an innovative multimedia-based intervention designed to help people living with HIV in resource-limited settings achieve and maintain high levels of ART adherence. Adapted from a couples-based intervention tested in the United States (US), Masivukeni was developed through community-based participatory research with US and South African partners and informed by Ewart’s Social Action Theory. Innovative computer-based multimedia strategies were used to translate a labor- and training-intensive intervention into one that could be readily and widely used by lay counselors with relatively little training with low-literacy patients. In this paper, we describe the foundations of this new intervention, the process of its development, and the evidence of its high acceptability and feasibility

Stability Walls in Heterotic Theories

We study the sub-structure of the heterotic Kahler moduli space due to the presence of non-Abelian internal gauge fields from the perspective of the four-dimensional effective theory. Internal gauge fields can be supersymmetric in some regions of the Kahler moduli space but break supersymmetry in others. In the context of the four-dimensional theory, we investigate what happens when the Kahler moduli are changed from the supersymmetric to the non-supersymmetric region. Our results provide a low-energy description of supersymmetry breaking by internal gauge fields as well as a physical picture for the mathematical notion of bundle stability. Specifically, we find that at the transition between the two regions an additional anomalous U(1) symmetry appears under which some of the states in the low-energy theory acquire charges. We compute the associated D-term contribution to the four-dimensional potential which contains a Kahler-moduli dependent Fayet-Iliopoulos term and contributions from the charged states. We show that this D-term correctly reproduces the expected physics. Several mathematical conclusions concerning vector bundle stability are drawn from our arguments. We also discuss possible physical applications of our results to heterotic model building and moduli stabilization.Comment: 37 pages, 4 figure

Monogenic diseases that can be cured by liver transplantation

While the prevalence of most diseases caused by single-gene mutations is low and defines them as rare conditions, all together, monogenic diseases account for approximately 10 in every 1000 births according to the World Health Organisation. Orthotopic liver transplantation (LT) could offer a therapeutic option in monogenic diseases in two ways: by substituting for an injured liver or by supplying a tissue that can replace a mutant protein. In this respect, LT may be regarded as the correction of a disease at the level of the dysfunctional protein. Monogenic diseases that involve the liver represent a heterogeneous group of disorders. In conditions associated with predominant liver parenchymal damage (i.e., genetic cholestatic disorders, Wilson's disease, hereditary hemochromatosis, tyrosinemia, α1 antitrypsin deficiency), hepatic complications are the major source of morbidity and LT not only replaces a dysfunctional liver but also corrects the genetic defect and effectively cures the disease. A second group includes liver-based genetic disorders characterised by an architecturally near-normal liver (urea cycle disorders, Crigler-Najjar syndrome, familial amyloid polyneuropathy, primary hyperoxaluria type 1, atypical haemolytic uremic syndrome-1). In these defects, extrahepatic complications are the main source of morbidity and mortality while liver function is relatively preserved. Combined transplantation of other organs may be required, and other surgical techniques, such as domino and auxiliary liver transplantation, have been attempted. In a third group of monogenic diseases, the underlying genetic defect is expressed at a systemic level and liver involvement is just one of the clinical manifestations. In these conditions, LT might only be partially curative since the abnormal phenotype is maintained by extrahepatic synthesis of the toxic metabolites (i.e., methylmalonic acidemia, propionic acidemia). This review focuses on principles of diagnosis, management and LT results in both paediatric and adult populations of selected liver-based monogenic diseases, which represent examples of different transplantation strategies, driven by the understanding of the expression of the underlying genetic defect. © 2013 European Association for the Study of the Liver

Penumbral Rescue by normobaric O = O administration in patients with ischemic stroke and target mismatch proFile (PROOF): Study protocol of a phase IIb trial.

Oxygen is essential for cellular energy metabolism. Neurons are particularly vulnerable to hypoxia. Increasing oxygen supply shortly after stroke onset could preserve the ischemic penumbra until revascularization occurs. PROOF investigates the use of normobaric oxygen (NBO) therapy within 6 h of symptom onset/notice for brain-protective bridging until endovascular revascularization of acute intracranial anterior-circulation occlusion. Randomized (1:1), standard treatment-controlled, open-label, blinded endpoint, multicenter adaptive phase IIb trial. Primary outcome is ischemic core growth (mL) from baseline to 24 h (intention-to-treat analysis). Secondary efficacy outcomes include change in NIHSS from baseline to 24 h, mRS at 90 days, cognitive and emotional function, and quality of life. Safety outcomes include mortality, intracranial hemorrhage, and respiratory failure. Exploratory analyses of imaging and blood biomarkers will be conducted. Using an adaptive design with interim analysis at 80 patients per arm, up to 456 participants (228 per arm) would be needed for 80% power (one-sided alpha 0.05) to detect a mean reduction of ischemic core growth by 6.68 mL, assuming 21.4 mL standard deviation. By enrolling endovascular thrombectomy candidates in an early time window, the trial replicates insights from preclinical studies in which NBO showed beneficial effects, namely early initiation of near 100% inspired oxygen during short temporary ischemia. Primary outcome assessment at 24 h on follow-up imaging reduces variability due to withdrawal of care and early clinical confounders such as delayed extubation and aspiration pneumonia. ClinicalTrials.gov: NCT03500939; EudraCT: 2017-001355-31