Psychiatric placement of children: an exploratory study of twenty cases where the Worcester Youth Guidance Center recommended placement

Thesis (M.S.)--Boston Universit

An Account of ‘Life after Guantánamo’: a rehabilitation project for former Guantánamo detainees across continents

This paper describes a project established in 2009 by the human rights charity, Reprieve, to coordinate rehabilitation for men who have been released from long-term detention at the US military base of Guantánamo Bay.  The majority of the men referred to the project were deemed unable to return to their home country because of the risk they faced of torture or other persecution and were therefore resettled in a third country. This paper also refers to Tunisian former Guantánamo detainees with whom Reprieve worked, who had initially been resettled in a third country but then following the Jasmine Revolution and the fall of the Ben Ali regime, were able to return to their home country.  Reprieve then provided assistance to them and their families under the Life after Guantánamo in Tunisia project.  This paper briefly outlines the abuse and nature of psychological control at Guantánamo and, based on the first-hand experiences of the Project Coordinator and Caseworker, offers non-clinical observations of the apparent consequences of this control on the former detainees who were referred to the project. The Life after Guantánamo project facilitated social, medical, psychological, legal and financial assistance in partnership with local service providers and through liaison with host governments and intergovernmental organisations, such as the International Organisation for Migration (IOM), United Nations High Commissioner for Refugees (UNHCR) and the International Committee of the Red Cross (ICRC).  The paper recounts the type of assistance provided, highlights some of the challenges faced and, based on learnings made over the project’s eight year duration, makes recommendations, for future work with former Guantánamo detainees and others who have been detained and subject to torture and inhuman and degrading treatment in the ‘War on Terror’

Effect of intramuscular methadone on pharmacokinetic data and thermal and mechanical nociceptive thresholds in the cat

Objectives The aim of the study was to assess simultaneous pharmacokinetics and thermal and mechanical antinociception after intramuscular methadone (0.6 mg/kg) in 10 cats. Methods Thermal and mechanical threshold (TT and MT, respectively) testing and blood collection were conducted at baseline and up to 24 h after administration. Methadone plasma concentrations were determined by liquid chromatography–tandem mass spectrometry and pharmacokinetic parameters were estimated by a non-compartmental method. TT and MT were analysed using ANOVA ( P &lt;0.05). Time of maximum plasma concentration (Tmax), time of onset of antinociception and time of reaching cut-out threshold (TT 55°C; MT 30 Newtons [N]) were determined. Results TT and MT increased above baseline from 20–240 mins and 5–40 mins, respectively, after intramuscular (IM) administration ( P &lt;0.005). Mean maximum delta T (measured as TT minus baseline threshold) was 7.9°C (95% confidence interval [CI] 4.3–11.6) at 60 mins and mean maximum delta F (measured as MT minus baseline threshold) was 4.2 (95% CI 1.6–6.7) N at 45 mins. IM methadone concentration–time data decreased curvilinearly, and gave a clearance estimate of mean 9.1 ml/kg/min (range 5.2–15.7) with median Tmax at 20 mins (range 5–360 mins). Conclusions and relevance IM data followed classical disposition and elimination in all cats. Plasma concentrations after IM administration were associated with an antinociceptive effect, including negative hysteresis. These data can be used for devising dosing schedules for methadone in clinical feline practice. </jats:sec

Protocol for a randomised controlled feasibility study examining the efficacy of brief cognitive therapy for the Treatment of Anxiety Disorders in Adolescents (TAD-A)

Background: Anxiety disorders affect a quarter of the population during their lifetime, and typically emerge in childhood or adolescence . Anxiety disorders disrupt young people’s social, emotional and academic development and in the absence of treatment, often follow a chronic course. Although effective treatments, such as Cognitive Behaviour Therapy (CBT), exist, only a small proportion of adolescents with anxiety disorders who need treatment receive them. Barriers to treatment provision include the fact that CBT typically requires 14–16 sessions by a highly qualified therapist and services are stretched – resulting in lengthy waiting lists and limited access to treatment. This highlights the importance of developing new ways of providing effective treatments for adolescent anxiety disorders. This study aims to assess the feasibility of a future, large-scale trial. This will give a clear indication of the likely success of running a randomised controlled trial to compare a new, brief cognitive therapy treatment to an existing CBT group therapy for adolescents with anxiety disorders. Methods/design: The study will examine whether a definitive trial can be conducted on the basis of a feasibility RCT using a number of well-defined criteria. The feasibility RCT is a single-centre, randomised control trial. Forty-eight Young people (age 11–17.5 years) attending a university research clinic, who meet the diagnostic criteria for a DSM-5 anxiety disorder, will be randomly allocated to receive either (1) Adolescent Cognitive Therapy for Anxiety (ACTA), which involves six 60–90-min sessions and a booster session or (2) group CBT, which involves eight 2-h sessions and a booster session. As part of the feasibility indicators, patient outcomes, expectations and experiences, as well as heal th economic factors, will be assessed before, at the end of treatment and at a 3-month follow-up. Discussion: The successful delivery of a future, definitive trial has the potential to bring direct benefits to young people and their families, adolescent mental health service providers, as well as benefits to adult mental health services and society more broadly by disrupting the negative trajectory commonly associated with adolescent anxiety disorder

Symphonic Winds

Center for the Performing Arts February 16, 2018 Friday Evening 8:00p.m

Detomidine and butorphanol for standing sedation in a range of zoo-kept ungulate species

General anesthesia poses risks for larger zoo species, like cardiorespiratory depression, myopathy, and hyperthermia. In ruminants, ruminal bloat and regurgitation of rumen contents with potential aspiration pneumonia are added risks. Thus, the use of sedation to perform minor procedures is justified in zoo animals. A combination of detomidine and butorphanol has been routinely used in domestic animals. This drug combination, administered by remote intramuscular injection, can also be applied for standing sedation in a range of zoo animals, allowing a number of minor procedures. The combination was successfully administered in five species of nondomesticated equids (Przewalski horse [Equus ferus przewalskii; n = 1], onager [Equus hemionus onager; n = 4], kiang [Equus kiang; n = 3], Grevy's zebra [Equus grevyi; n = 4], and Somali wild ass [Equus africanus somaliensis; n = 7]), with a mean dose range of 0.10-0.17 mg/kg detomidine and 0.07-0.13 mg/kg butorphanol; the white (Ceratotherium simum simum; n = 12) and greater one-horned rhinoceros (Rhinoceros unicornis; n = 4), with a mean dose of 0.015 mg/kg of both detomidine and butorphanol; and Asiatic elephant bulls (Elephas maximus; n = 2), with a mean dose of 0.018 mg/kg of both detomidine and butorphanol. In addition, the combination was successfully used for standing sedation in six species of artiodactylids: giraffe (Giraffa camelopardalis reticulata; n = 3), western bongo (Tragelaphus eurycerus eurycerus; n = 2), wisent (Bison bonasus; n = 5), yak (Bos grunniens; n = 1), water buffalo (Bubalus bubalis; n = 4) and Bactrian camel (Camelus bactrianus; n = 5). The mean dose range for artiodactylid species except bongo was 0.04-0.06 mg/kg detomidine and 0.03-0.06 mg/kg butorphanol. The dose in bongo, 0.15-0.20 mg/kg detomidine and 0.13-0.15 mg/kg butorphanol, was considerably higher. Times to first effect, approach, and recovery after antidote were short. The use of detomidine and butorphanol has been demonstrated to be a reliable, safe alternative to general anesthesia for a number of large ungulate species

Mentors as instructional coaches for new teachers: lessons learnt from the early career framework in England

Purpose: The paper provides analysis of the use of instructional coaching (IC) as a prevalent trend supporting new teachers in the English system and aims to inform ongoing policy development and implementation. The qualitative study examines mentors' conceptualisations and enactment of the role of instructional coach and the readiness of mentors to assume mentors' key stakeholder roles in the professional education of early career teachers (ECTs). Design/methodology/approach: Semi-structured interviews with 37 mentors explored mentors' understandings and experiences of becoming instructional coaches as part of a pilot support initiative to support ECTs in England. Two rounds of interviews were conducted to generate data related to the first six months of mentoring on the programmes. Thematic analysis identified seven semantic themes which describe manifest content found within the data and identify mentors' perceptions of their role and practice as instructional coaches. Three latent themes were developed from mentors' accounts which indicate challenges in becoming an instructional coach in this context. Findings: Concern to apply IC “correctly” according to the programme models was a strong feature amongst both novice and experienced mentors. A key finding is the lack of explicit knowledge of professional learning pedagogies amongst mentors and insecure understanding of how new teachers learn. Assuming the role of instructional coach presented both benefits of having a “model” to follow and disadvantages in fostering limited and over-prescribed concepts and practices related to the learning of new teachers. Research limitations/implications: The study investigated mentors during the first six months of a pilot programme and the paper reports on analysis of one type of data. The research results may lack generalisability, and a longitudinal study is necessary to further explore the validity of the findings. Practical implications: Sustained, high-quality professional learning for mentors is crucial to mentors' role as instructional coaches to enable mentors to develop deep, critical understanding of how IC might support new teachers and how to exercise professional judgement in working with “models”. Judicious use of time and resource is needed to enable mentors to fulfil the potential of national mentoring programmes. Originality/value: The study is timely in its examination of mentors that assume the role of instructional coach as one response to national policy development that makes support for ECTs mandatory. Such strategies have wide international relevance where the retention of new teachers is a policy priority

Data Collection for the Fourth Multicentre Confidential Enquiry into Perioperative Equine Fatalities (CEPEF4) Study:New Technology and Preliminary Results

It is almost 20 years since the largest observational, multicentre study evaluating the risks of mortality associated with general anaesthesia in horses. We proposed an internet-based method to collect data (cleaned and analysed with R) in a multicentre, cohort, observational, analytical, longitudinal and prospective study to evaluate peri-operative equine mortality. The objective was to report the usefulness of the method, illustrated with the preliminary data, including outcomes for horses seven days after undergoing general anaesthesia and certain procedures using standing sedation. Within six months, data from 6701 procedures under general anaesthesia and 1955 standing sedations from 69 centres were collected. The results showed (i) the utility of the method; also, that (ii) the overall mortality rate for general anaesthesia within the seven-day outcome period was 1.0%. In horses undergoing procedures other than exploratory laparotomy for colic (“noncolics”), the rate was lower, 0.6%, and in “colics” it was higher, at 3.4%. For standing sedations, the overall mortality rate was 0.2%. Finally, (iii) we present some descriptive data that demonstrate new developments since the previous CEPEF2. In conclusion, horses clearly still die unexpectedly when undergoing procedures under general anaesthesia or standing sedation. Our method is suitable for case collection for future studies