From cultural to existential diversity : the impossibility of psychotherapy integration within a traditional framework

The authors build upon Castonguay and Goldfried's analysis regarding issues and directions central to advancing psychotherapy integration. They elaborate on two issues addressed only minimally in Castonguay and Goldfried's article. The first involves moving beyond traditional psychotherapy territory to include cultural, self-in-relationship, and interdisciplinary domains. The second concerns using more holistic and synergistic processes to coconstruct integrative theories and approaches. Finally, the authors offer some insights into what they believe should be the goals of the integrative movement and into additional issues they think should be addressed to attain these goals. Psychotherapy has become so complex and changing that we need a new view--one that recognizes the impossibility of any final or superior integrative theory and the need for constant change and evolution in theory and practice.(undefined

Turbulence and Fossil Turbulence in Oceans and Lakes

Turbulence is defined as an eddy-like state of fluid motion where the inertial-vortex forces of the eddies are larger than any of the other forces that tend to damp the eddies out. Energy cascades of irrotational flows from large scales to small are non-turbulent, even if they supply energy to turbulence. Turbulent flows are rotational and cascade from small scales to large, with feedback. Viscous forces limit the smallest turbulent eddy size to the Kolmogorov scale. In stratified fluids, buoyancy forces limit large vertical overturns to the Ozmidov scale and convert the largest turbulent eddies into a unique class of saturated, non-propagating, internal waves, termed fossil-vorticity-turbulence. These waves have the same energy but different properties and spectral forms than the original turbulence patch. The Gibson (1980, 1986) theory of fossil turbulence applies universal similarity theories of turbulence and turbulent mixing to the vertical evolution of an isolated patch of turbulence in a stratified fluid as its growth is constrained and fossilized by buoyancy forces. These theories apply to the dynamics of atmospheric, astrophysical and cosmological turbulence.Comment: 31 pages, 11 figures, 2 tables, see http://www-acs.ucsd.edu/~ir118 Accepted for publication by the Chinese Journal of Oceanology and Limnolog

Skeletal muscle gene expression in response to resistance exercise: sex specific regulation

<p>Abstract</p> <p>Background</p> <p>The molecular mechanisms underlying the sex differences in human muscle morphology and function remain to be elucidated. The sex differences in the skeletal muscle transcriptome in both the resting state and following anabolic stimuli, such as resistance exercise (RE), might provide insight to the contributors of sexual dimorphism of muscle phenotypes. We used microarrays to profile the transcriptome of the biceps brachii of young men and women who underwent an acute unilateral RE session following 12 weeks of progressive training. Bilateral muscle biopsies were obtained either at an early (4 h post-exercise) or late recovery (24 h post-exercise) time point. Muscle transcription profiles were compared in the resting state between men (n = 6) and women (n = 8), and in response to acute RE in trained exercised vs. untrained non-exercised control muscle for each sex and time point separately (4 h post-exercise, n = 3 males, n = 4 females; 24 h post-exercise, n = 3 males, n = 4 females). A logistic regression-based method (LRpath), following Bayesian moderated t-statistic (IMBT), was used to test gene functional groups and biological pathways enriched with differentially expressed genes.</p> <p>Results</p> <p>This investigation identified extensive sex differences present in the muscle transcriptome at baseline and following acute RE. In the resting state, female muscle had a greater transcript abundance of genes involved in fatty acid oxidation and gene transcription/translation processes. After strenuous RE at the same relative intensity, the time course of the transcriptional modulation was sex-dependent. Males experienced prolonged changes while females exhibited a rapid restoration. Most of the biological processes involved in the RE-induced transcriptional regulation were observed in both males and females, but sex specificity was suggested for several signaling pathways including activation of notch signaling and TGF-beta signaling in females. Sex differences in skeletal muscle transcriptional regulation might implicate a mechanism behind disproportional muscle growth in males as compared with female counterparts after RE training at the same relative intensity.</p> <p>Conclusions</p> <p>Sex differences exist in skeletal muscle gene transcription both at rest and following acute RE, suggesting that sex is a significant modifier of the transcriptional regulation in skeletal muscle. The findings from the present study provide insight into the molecular mechanisms for sex differences in muscle phenotypes and for muscle transcriptional regulation associated with training adaptations to resistance exercise.</p

Health risk behaviours among adolescents in the English-speaking Caribbean: a review

<p>Abstract</p> <p>Background</p> <p>The aim of this paper was to review and summarize research on prevalence of health risk behaviours, their outcomes as well as risk and protective factors among adolescents in the English-speaking Caribbean.</p> <p>Methods</p> <p>Searching of online databases and the World Wide Web as well as hand searching of the <it>West Indian Medical Journal </it>were conducted. Papers on research done on adolescents aged 10 – 19 years old and published during the period 1980 – 2005 were included.</p> <p>Results</p> <p>Ninety-five relevant papers were located. Five papers were published in the 1980s, 47 in the 1990s, and from 2000–2005, 43 papers. Health risk behaviours and outcomes were divided into seven themes. Prevalence data obtained for these, included lifetime prevalence of <b>substance use</b>: cigarettes-24% and marijuana-17%; <b>high risk sexual behaviour</b>: initiation of sexual activity ≤ 10 years old-19% and those having more than six partners-19%; <b>teenage pregnancy</b>: teens account for 15–20% of all pregnancies and one-fifth of these teens were in their second pregnancy; <b>Sexually-Transmitted Infections (STIs)</b>: population prevalence of gonorrhoea and/or chlamydia in 18–21 year-olds was 26%; <b>mental health</b>: severe depression in the adolescent age group was 9%, and attempted suicide-12%; <b>violence and juvenile delinquency</b>: carrying a weapon to school in the last 30 days-10% and almost always wanting to kill or injure someone-5%; <b>eating disorders and obesity</b>: overweight-11%, and obesity-7%. Many of the risk behaviours in adolescents were shown to be related to the adolescent's family of origin, home environment and parent-child relationships. Also, the protective effects of family and school connectedness as well as increased religiosity noted in studies from the United States were also applicable in the Caribbean.</p> <p>Conclusion</p> <p>There is a substantial body of literature on Caribbean adolescents documenting prevalence and correlates of health risk behaviours. Future research should emphasize the designing and testing of interventions to alleviate this burden.</p

Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Cultural Expertise: If the Counsellor is to Become a Teacher, Toward What Should That Teaching Be Directed?

The psychoeducational movement is presented as an important new challenge to the professional helper. Many, perhaps even most, helpers now find themselves engaged in the teaching of communication skills, decision-making, or any of a wide array of workshops. What is to be the relationship of these new duties to individual counselling? More important, toward what direction should these activities focus? This article presents the concept of "cultural expertise" as a goal construct for both counselling and psychoeducation.On présente le mouvement psychoéducationnel comme un nouveau défi aux conseillers et aux psychologues. L'enseignement de l'art de communiquer et deprendre des décisions, la participation à plusieurs ateliers, voilà de nouvelles responsabilités qui leur sont maintenant confiées. Quel rapport y a-t-il entre ces nouvelles fonctions et la consultation individuelle? De plus, dans quelle direction ces activités devraient-elles s'orienter? Cet article présente le concept d' "expertise culturel" comme une idée à réaliser tant pour la consultation que pour la psychoeducation

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