Enhancing cognitive behavioral therapy for childhood anxiety disorders: a parent manual

Anxiety disorders are among the most common psychiatric disorders affecting children and adolescents. In the past several decades, great advances have been made in the treatment of these disorders. While many psychopharmacological and psychotherapeutic treatments exist, Cognitive Behavioral Therapy (CBT) is currently the treatment approach with the most empirical support. Based on a large evidence-base, several CBT manuals have been developed for the treatment of anxiety disorders in children. While research on incorporating parents into these treatments is mixed, parent involvement is widely recommended in these treatments as well as in unmanualized CBT treatment. Although some self-help books and manual-specific guides for parents exist, there is no current manual that provides parents with information and guidance to facilitate their involvement in both manualized and unmanualized CBT for child anxiety disorders. The current project involved the development of a manual for parents whose children (ages 8-13 years) are involved in CBT treatment for Separation Anxiety Disorder, Generalized Anxiety Disorder, Specific Phobia, and Social Phobia. The resulting manual was informed by a review of the literature on child anxiety, CBT treatments for anxiety, and the roles parents may play in CBT. The manual consists of introductory psychoeducation on anxiety and CBT followed by six chapters on the major components of CBT for anxiety. In addition to descriptions of these components, each chapter includes instructions on how parents can be involved to facilitate their child’s treatment. Following a discussion of strengths, limitations, and potential modifications to the current manual, plans for evaluating the efficacy of the manual as well as disseminating it to parents are described

Stabilizing Low-Wage Work: Legal Remedies for Unpredictable Work Hours & Income Stability

Low-wage, hourly-paid service workers are increasingly subject to employers\u27 just-in-time scheduling practices. In a just-in-time model, employers give workers little advance notice of their schedules, call workers in to work during non-scheduled times to meet unexpected customer demand, and send workers home early when business is slow. The federal Fair Labor Standards Act, the main guarantor of workers\u27 wage and hour rights, provides no remedy for the unpredictable work hours and income instability caused by employers\u27 last minute call-in and send-home practices. This Article examines two alternative sources of legal protection that have received little attention in the literature on low-wage work: provisions in unionized workers\u27 collective bargaining agreements that guarantee a minimum number of hours of pay when workers are called in to or sent home from work unexpectedly, and state laws that contain similar guaranteed-pay provisions. The Article concludes by assessing these tools\u27 effectiveness in stabilizing low-wage work

Christkind vs. Santa Claus

In den letzten Jahren schien die Debatte rund um „Christkind vs. Santa Claus“ und den amerikanischen Einfluss auf das österreichische Weihnachtsfest immer lauter zu werden. Durch eine quantitative Inhaltsanalyse acht verschiedener österreichischer Zeitschriften und einer hermeneutischen Interpretation, zeigt diese Diplomarbeit auf, inwieweit die amerikanische Kultur tatsächlich die Darstellung von Weihnachten in österreichischen Zeitschriften beeinflusst hat und ob österreichische Kulturmerkmale dadurch bereits verdrängt wurden. Diverse Globalisierungsprozesse und die äußerst wichtige Rolle der Vereinigten Staaten im globalen Kulturwandel, dienten als Ausgangspunkt für diese Studie und werden ausführlich erklärt und miteinander in Bezug gebracht. Vor allem die Angst vor einer Homogenisierung der Kulturen, durch den großen Einfluss von amerikanischen Medien- und Kulturprodukten, wird näher beleuchtet. Durch die Betrachtung des historischen Einflusses der USA auf Österreich seit dem Ende des Zweiten Weltkriegs und die Bedeutung des Weihnachtsfestes im 21.Jahrhundert, soll der österreichische Kontext verstanden werden. Diverse Aussagen, die das Verschwinden österreichischer Kultursymbole durch amerikanische von Beginn an anzweifelten, wurden bestätigt. Dennoch sind amerikanische Einflüsse sehr wohl bemerkbar, vor allem in Zeitschriften mit einer größeren männlichen als weiblichen Leserschaft und in Werbeanzeigen. Santa Claus wird öfter bildlich dargestellt, während das Christkind öfter wörtlich erwähnt wird. Insgesamt zeigen die Ergebnisse, dass Merkmale beider Kulturen nebeneinander bestehen und neue Bedeutungen schaffen, wie zum Beispiel die des ChristkindsOver the last number of years there have been public objections against the adoption and inclusion of American Christmas symbols and practices in Austria. Through a quantitative content analysis of eight different Austrian magazines and a hermeneutic interpretation, this thesis will address to what extent American culture has influenced the representation of Christmas in Austrian magazines and whether Austrian characteristics are currently being replaced. Various globalization processes and the crucial role of the United States in global cultural changes served as a starting point for this study and will be explained and related to each other in this paper. Particular attention is paid to the fear of the homogenization of different cultures because of the high impact of American media and culture products. Furthermore, the historical influence of America on Austria since the end of World War II and the meaning of Christmas in the 21st century will be discussed to better understand the Austrian context. The results of this study show that numerous claims about American symbols not displacing Austrian symbols were confirmed. However, American influences are evident and can be spotted particularly well in magazines with a greater male than female audience as well as in advertisements. The visual image of Santa Claus appears more often than that of Christkind, but the term Christkind is mentioned more often than the term Santa Claus/Weihnachtsmann. Overall, the outcome of this study demonstrates that both American and Austrian symbols co-exist and generate new hybridities, such as a new meaning of Christkind

The Mitogen-Induced Increase in T Cell Size Involves PKC and NFAT Activation of Rel/NF-κB-Dependent c-myc Expression

AbstractCell growth during the G1 stage of the cell cycle is partly controlled by inducing c-myc expression, which in B cells is regulated by the NF-κB1 and c-Rel transcription factors. Here, we show that c-myc-dependent growth during T cell activation requires c-Rel and RelA and that blocking this growth by inhibiting protein kinase C theta (PKCθ) coincides with a failure to upregulate c-myc due to impaired RelA nuclear import and inhibition of NFAT-dependent c-rel transcription. These results demonstrate that different Rel/NF-κB dimers regulate the mitogenic growth of mature T and B cells, with a signaling pathway incorporating PKCθ and NFAT controlling c-Rel/RelA-induced c-myc expression in activated T cells

Projeto “Meio Ambiente e Cidadania” – como ferramenta de transformação e apoio ao programa de gestão ambiental no município de Jaguari/RS

A Educação Ambiental é considerada, neste trabalho, uma ferramenta de transformação social, sendo desenvolvida através de uma educação dialógica, participativa e emancipatória, proporcionando o desenvolvimento de educadores ambientais críticos aptos a decidir e atuar nas escolas frente a realidade socioambiental vivenciada na atualidade. O projeto “Meio Ambiente e Cidadania” foi realizado a partir do Convênio de Cooperação Técnica e Consultoria Ambiental entre a Fundação MO´Ã - Estudos e Pesquisas para a Proteção e o Desenvolvimento Ambiental e o Município de Jaguari - RS. Este Projeto teve como objetivo geral auxiliar na formação de educadores ambientais para a construção da Agenda Ambiental nas Escolas Municipais. Os objetivos específicos foram: Estimular o debate acerca dos problemas e potencialidades existentes no Município; Contribuir na formação e qualificação de educadores ambientais com a finalidade de potencializar os esforços do núcleo formador e Promover por meio de uma formação teóricometodológica qualificada, a reflexão e proposição pelos professores de práticas educativas ambientais para o enfrentamento das questões sócio-ambientais vividas pela comunidade escolar. A metodologia buscou a dialogicidade, onde os temas, as propostas, as atividades serão com base na metodologia da Pesquisa Ação, tendo como referências teóricas Michel Thiollent, onde o grupo desempenha um papel ativo na própria realidade dos fatos observados e nas mudanças que se pretende alcançar, promovendo a melhoria da qualidade de vida da população local. Ralizou-se encontros, proporcionando espaços de diálogo, a partir de reflexões coletivas, explanações teórico-metodológicas, estudos de caso, discussão de textos e práticas educativas ambientais que permitiram unir a qualificação teórica com a experiência prática do grupo de professores participantes. Estes momentos presenciais, somados ao trabalho que os educadores desenvolvem nas suas respectivas escolas permitirão ao município contar com um grupo de educadores ambientais aptos a propor e desenvolverem práticas ambientais transformadoras e multidisciplinares, a partir das diferentes realidades escolares

High early mortality following percutaneous nephrostomy in metastatic cancer:a national analysis of outcomes

Objectives: To assess the outcomes of percutaneous nephrostomy in England for renal decompression, in the context of metastatic cancer.Methods: Retrospective observational study of all patients undergoing nephrostomy with a diagnosis of metastatic cancer from 2010 to 2019 in England, identified and followed up within Hospital Episode Statistics.The primary outcome measure was mortality (14-day and 30-day postprocedure). Secondary outcomes included subsequent chemotherapy or surgery and direct complications of nephrostomy.Results: 10 932 patients were identified: 58.0% were male, 51.0% were &gt;70 years old and 57.7% had no relevant comorbidities (according to Charlson’s criteria, other than cancer).1 in 15 patients died within 14 days of nephrostomy and 1 in 6 died within 30 days. Factors associated with higher 30-day mortality were the presence of comorbidities (Charlson score 1–4 (OR 1.27, 95% CI 1.08 to 1.50, p=0.003), score 5+ (OR 1.29, 95% CI 1.14 to 1.45), p &lt; 0.001)); inpatient nephrostomy (OR 3.76, 95% CI 2.75 to 5.14, p &lt; 0.001) and admitted under the care of specialities of internal medicine (OR 2.10, 95% CI 1.84 to 2.40, p &lt; 0.001), oncology (OR 1.80, 95% CI 1.51 to 2.15, p &lt; 0.001), gynaecology/gynaeoncology (OR 1.66, 95% CI 1.21 to 2.28, p=0.002) or general surgery (OR 1.62, 95% CI 1.32 to 1.98, p &lt; 0.001)), compared with urology.25.4% received subsequent chemotherapy. Receiving chemotherapy was associated with younger patients (eg, age 18–29 (OR 4.04, 95% CI 2.66 to 6.12, p &lt; 0.001) and age 30–39 (OR 3.07, 95% CI 2.37 to 3.97, p &lt; 0.001)) and under the care of oncology (OR 1.60, 95% CI 1.40 to 1.83, p &lt; 0.001) or gynaecology/gynaeoncology (OR 1.64, 95%CI 1.28 to 2.10, p &lt; 0.001) compared with urology.43.8% had subsequent abdominopelvic surgery. Not receiving surgery was associated with inpatient nephrostomy (OR 0.82, 95%CI 0.72 to 0.95,p=0.007): non-genitourinary cancers (eg, gynaecology/gynaeoncology cancer (OR 0.86, 95% CI 0.74 to 0.99, p=0.037)); and under the care of a non-surgical specialty (medicine (OR 0.69, 95% CI 0.63 to 0.77, p &lt; 0.001), oncology (OR 0.58, 95% CI 0.51 to 0.66, p &lt; 0.001)).24.5% of patients had at least one direct complication of nephrostomy: 12.5% required early exchange of nephrostomy, 8.1% had bleeding and 6.7% had pyelonephritis.Conclusions: The decision to undertake nephrostomy in patients with poor prognosis cancer is complex and should be undertaken in a multidisciplinary team setting. Complication rates are high and minimal survival benefit is derived in many patients, especially in the context of emergency inpatient care.</div

Environmental Profile of a Community\u27s Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

Background The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. Method/Principal Findings The Environmental Profile of Community Health (EPOCH) instrument comprises two parts: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents\u27 perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient - ICC&gt;0.75) for 24 of 38 items and fair to good (ICC 0.4–0.75) for 14 of 38 items. Conclusion This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings

Impact of Borderline Resectability in Pancreatic Head Cancer on Patient Survival: Biology Matters According to the New International Consensus Criteria

Background: International consensus criteria (ICC) have redefined borderline resectability for pancreatic ductal adenocarcinoma (PDAC) according to three dimensions: anatomical (BR-A), biological (BR-B), and conditional (BR-C). The present definition acknowledges that resectability is not just about the anatomic relationship between the tumour and vessels but that biological and conditional dimensions also are important. Methods: Patients’ tumours were retrospectively defined b

Environmental Profile of a Community's Health (EPOCH): An Instrument to Measure Environmental Determinants of Cardiovascular Health in Five Countries

BACKGROUND: The environment in which people live is known to be important in influencing diet, physical activity, smoking, psychosocial and other risk factors for cardiovascular (CV) disease. However no instrument exists that evaluates communities for these multiple environmental factors and is suitable for use across different communities, regions and countries. This report describes the design and reliability of an instrument to measure environmental determinants of CV risk factors. METHOD/PRINCIPAL FINDINGS: THE ENVIRONMENTAL PROFILE OF COMMUNITY HEALTH (EPOCH) INSTRUMENT COMPRISES TWO PARTS: (I) an assessment of the physical environment, and (II) an interviewer-administered questionnaire to collect residents' perceptions of their community. We examined the inter-rater reliability amongst 3 observers from each region of the direct observation component of the instrument (EPOCH I) in 93 rural and urban communities in 5 countries (Canada, Colombia, Brazil, China and India). Data collection using the EPOCH instrument was feasible in all communities. Reliability of the instrument was excellent (Intraclass Correlation Coefficient--ICC>0.75) for 24 of 38 items and fair to good (ICC 0.4-0.75) for 14 of 38 items. CONCLUSION: This report shows data collection with the EPOCH instrument is feasible and direct observation of community measures reliable. The EPOCH instrument will enable further research on environmental determinants of health for population studies from a broad range of settings