“Pfeile mit Widerhaken”: On the Aphorisms in Goethe’s Wahlverwandtschaften and Wanderjahre

Germanic Languages and Literature

Screening for childhood adversity: the what and when of identifying individuals at risk for lifespan health disparities.

Existing research on childhood adversity and health risk across the lifespan lacks specificity regarding which types of exposures to assess and when. The purpose of this study was to contribute to an empirically-supported framework to guide practitioners interested in identifying youth who may be at greatest risk for a lifelong trajectory of health disparities. We also sought to identify the point in childhood at which screening for adversity exposure would capture the largest group of at risk individuals for triage to prevention and intervention services. Participants (n = 4036) collected as part of the Midlife in the United States study reported their medical status and history including physical (cardiovascular disease, hypertension, obesity, diabetes, cancer) and mental health (depression, substance use problems, sleep problems). Participants indicated whether they were exposed to 7 adversities at any point in childhood and their age of exposure to 19 additional lifetime adversities before the age of 18. Parent drug abuse, dropping out or failing out of school, being fired from a job, and sexual assault during childhood exhibited the largest effect sizes on health in adulthood, which were comparable to the effects of childhood maltreatment. Childhood adversity screening in early adolescence may identify the largest proportion of youth at risk for negative health trajectories. The results of this descriptive analysis provide an empirical framework to guide screening for childhood adversity in pediatric populations. We discuss the implications of these observations in the context of prevention science and practice

Welfare Reform in Maryland: Flexibility in Action

This site visit took federal participants on a tour around Maryland, providing a three-way comparison of suburban, urban, and rural service delivery in a diverse state. The site visit focused on the Family Investment Program, a statewide effort to reduce the state\u27s welfare caseload through temporary cash assistance (TCA) and other needed supports to help customers become self-sufficient. In particular, site visitors examined rural perspectives on reform, substance abuse assessment and treatment innovations, and fatherhood and family support initiatives. The group heard from state officials, researchers, advocates, and a variety of direct service providers about the successes and challenges of the Family Investment Program and the effects of program implementation on low-income families. Site visitors had several opportunities to meet and interact with TCA customers to gain a clearer perspective of the issues faced each day

Duo Trompiano!

Judy Cole and Doug Lindsey met in the Fall of 2012 and have since performed dozens of concerts all over Georgia and the Southeast. From their very first collaboration, Duo Trompiano! have been committed to making great music accessible to audiences of all ages that spans genres from jazz standards to modern trumpet repertoire.https://digitalcommons.kennesaw.edu/musicprograms/1959/thumbnail.jp

Health-Related Quality of Life in the Gender, Race, And Clinical Experience Trial

Background. We report health-related QoL (HRQoL) from GRACE (Gender, Race, And Clinical Experience) study by sex and race over 48 weeks. Methods. 429 treatment-experienced adults (HIV-1 RNA ≥ 1000 copies/mL) received darunavir/ritonavir 600/100 mg twice daily plus an appropriate background regimen. QoL was measured by the Functional Assessment of HIV Infection (FAHI) questionnaire. Results. 67% women and 77% men, including 67.4% black, 76.0% Hispanic, and 73.8% white patients, completed the trial. Baseline total FAHI scores were similar between sexes and races. Total FAHI of the entire population improved by Week 4 (P < .05); near-maximum changes obtained by Week 12 were maintained through Week 48. Women and black patients demonstrated larger improvements in total FAHI versus men, and Hispanic and white patients, respectively. Conclusion. HRQoL improved in all sex and racial/ethnic groups. Sex-based and race-based differences in improvements in FAHI subscales may provide insight into subtle differences of HIV-1 and treatment on HRQoL in different populations

Theory of change for the delivery of talking therapies by lay workers to survivors of humanitarian crises in low-income and middle-income countries: protocol of a systematic review.

INTRODUCTION: There is a severe shortage of specialist mental healthcare providers in low-income and middle-income countries (LMICs) affected by humanitarian crises. In these settings, talking therapies may be delivered by non-specialists, including lay workers with no tertiary education or formal certification in mental health. This systematic review will synthesise the literature on the implementation and effectiveness of talking therapies delivered by lay workers in LMICs affected by humanitarian crises, in order to develop a Theory of Change (ToC). METHODS AND ANALYSIS: Qualitative, quantitative and mixed-methods studies assessing the implementation or effectiveness of lay-delivered talking therapies for common mental disorders provided to adult survivors of humanitarian crises in LMICs will be eligible for inclusion. Studies set in high-income countries will be excluded. No restrictions will be applied to language or year of publication. Unpublished studies will be excluded. Seven electronic databases will be searched: MEDLINE, Embase, PsycINFO, PsycEXTRA, Global Health, Cochrane Library and ClinicalTrials.gov. Contents pages of three peer-reviewed journals will be hand-searched. Sources of grey literature will include resource directories of two online mental health networks (MHPSS.net and MHInnovation.net) and expert consultation. Forward and backward citation searches of included studies will be performed. Two reviewers will independently screen studies for inclusion, extract data and assess study quality. A narrative synthesis will be conducted, following established guidelines. A ToC map will be amended iteratively to take into account the review results and guide the synthesis. ETHICS AND DISSEMINATION: Findings will be presented in a manuscript for publication in a peer-reviewed journal and disseminated through a coordinated communications strategy targeting knowledge generators, enablers and users. PROSPERO REGISTRATION NUMBER: CRD42017058287

Religious Art: two cases of Iconography

For a conspectus of religious art in Australia one need only look into Sister Rosemary Crumlin's Images of Religion in Australian Art which must be for a considerable time to come the definitive text. For news about religious art in Australia one looks about, for confirmation or denial of the rumours that the Blake Prize for religious art - founded in 1951 - is to become extinct.Asked for a short note on religious art in Australia we decided not to attempt a summary of the current scene but to take two cases. There are cases from different thought systems, art systems, and iconographic systems: and their mutual relationship will be, necessarily problematic

Improving Interpretation of the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function Scale for Specific Tasks in Community-Dwelling Older Adults

Background and purpose: New generic patient-reported outcomes like the Patient-Reported Outcomes Measurement Information System (PROMIS) are available to physical therapists to assess physical function. However, the interpretation of the PROMIS Physical Function (PF) T-score is abstract because it references the United States average and not specific tasks. The purposes of this study were to (1) determine convergent validity of the PROMIS PF scale with physical performance tests; (2) compare predicted performance test values to normative data; and (3) identify sets of PROMIS PF items similar to performance tests that also scale in increasing difficulty and align with normative data. Methods: Community-dwelling older adults (n = 45; age = 77.1 ± 4.6 years) were recruited for this cross-sectional analysis of PROMIS PF and physical performance tests. The modified Physical Performance Test (mPPT), a multicomponent test of mostly timed items, was completed during the same session as the PROMIS PF scale. Regression analysis examined the relationship of mPPT total and component scores (walking velocity, stair ascent, and 5 times sit to stand) with the PROMIS PF scale T-scores. Normative data were compared with regression-predicted mPPT timed performance across PROMIS PF T-scores. The PROMIS PF items most similar to walking, stair ascent, or sit to stand were identified and then PROMIS PF model parameter-calibrated T-scores for these items were compared alongside normative data. Results and discussion: There were statistically significant correlations (r = 0.32-0.64) between PROMIS PF T-score and mPPT total and component scores. Regression-predicted times for walking, stair ascent, and sit-to-stand tasks (based on T-scores) aligned with published normative values for older adults. Selected PF items for stair ascent and walking scaled well to discriminate increasing difficulty; however, sit-to-stand items discriminated only lower levels of functioning. Conclusions: The PROMIS PF T-scores showed convergent validity with physical performance and aligned with published normative data. While the findings are not predictive of individual performance, they improve clinical interpretation by estimating a range of expected performance for walking, stair ascent, and sit to stand. These findings support application of T-scores in physical therapy testing, goal setting, and wellness plans of care for community-dwelling older adults

Reducing pain and disability for patients with chronic neck pain : results of a double-blind randomised controlled trial comparing strength to endurance training

Neck pain is a common musculo-skeletal problem in the industrialised world with fifty to ninety percent of people experiencing one or more episodes of neck pain during their lifetime. The majority recover quickly from these episodes, but five percent of all cases persist for more than three months. The recurrence rate is high at sixty-percent. The cost to the individual in terms of reduced earning capacity and personal and family distress is very high. The cost to society in terms of lost productivity and compensation payouts is reported to be substantial. Thus, there are very compelling· reasons for finding the most effective therapies for neck pain. Most whiplash injuries to the neck recover spontaneously within three months, but chronic symptoms develop in some 25% of individuals, where pain persists more than three months after the initial injury. If associated restricted mobility persists for more than a few weeks, joint immobility becomes progressively more complete. Disuse atrophy, with attendant lowered fatigue resistance, also occurs. The link between muscular weakness and chronic low-back pain is well established. Research also suggests a correlation between weak cervical musculature and chronic neck pain. Further, as neck muscle strength is shown to be a controlling factor in the stability of the cervical spine it seems logical to seek safe and effective ways of strengthening it. However, many clinicians feel that strength-training the cervical spine, where the emphasis is on exercising slowly with heavy weights, is unsafe and may even aggravate patients' symptoms . Other clinicians maintain that muscular endurance-training, where the emphasis is on exercising fast with light weights, may be more suitable in the initial stages of training, the theory being that it facilitates maximal blood perfusion thereby maximising healing. Hence, muscular endurance-training is prescribed more often because clinicians believe it is less likely to harm patients, but will still increase their muscular strength. It is also important to establish whether ·physiological changes in muscle size and structure resulting from different training methods impact differently on people's pain and disability. Therefore, the research questions of this thesis are, for patients with chronic neck pain, when compared with muscular endurance-training, (1) does strength training result in a greater increase in muscle strength? (2) Does strength-training result in a greater reduction in pain and disability? The underlying rationale of strength training the cervical muscles, therefore, is that by strengthening the weakened muscles of the neck the symptoms of pain and disability that accompany chronic neck pain will be significantly reduced