Peran Orang Tua Dalam Pemberian Imunisasi Campak Pada Anak Sekolah Di Sekolah Dasar Luar Biasa Kota Jambi Tahun 2015

Pemberian imunisasi campak pada anak sekolah dasar di Kota Jambi belum mencapai target. Padapelaksanaan BIAS (Bulan Imunisasi Anak Sekolah) capaian imunisasi campak anak sekolah diSekolah Dasar Luar Biasa (SDLB) Kota Jambi hanya 87,5% tahun 2014. Penelitian terdahulumenunjukkan bahwa peran aktif orang tua menentukan tingkat kesehatan anak berkebutuhan khusus.Tujuan penelitian ini untuk mengetahui gambaran peran orang tua meliputi pengetahuan dan sikaporang tua terhadap pemberian imunisasi pada anak sekolah dasar di SDLB Kota Jambi Tahun 2015.Penelitian ini merupakan penelitian deskriptif dengan analisis univariat. Pengumpulan datamenggunakan kuisioner dan wawancara. Teknik sampel yang digunakan adalah total samplingsehingga seluruh populasi menjadi responden penelitian yaitu 49 responden.Hasil penelitian menunjukkan bahwa 63% responden yang memiliki pengetahuan kurang baik dan37% responden memiliki pengetahuan yang baik tentang imunisasi campak pada anak sekolah.Sementara itu 47% responden memiliki sikap negatif dan 53% responden memiliki sikap positifterhadap pemberian imunisasi campak pada anak sekolah.Pengetahuan yang kurang baik memberi dampak pada kurangnya peran orang tua dalam pemberianimunisasi pada anak sekolah di SDLB Kota Jambi. Diperlukan peran guru maupun petugaskesehatan untuk memberikan informasi pada orang tua tentang pentingnya imunisasi campak padaanak sekolah dasar di SDLB Kota Jambi

Innovative Higher Education Approaches for Power System Courses

Higher education plays a crucial role in modern society and in emerging energy systems, due to the rising complexity of the phenomena and the interplay among various layers (physical, cyber, social and economic). To cope with this context, universities need to develop new visions and tools for education and training. Real-time simulation (RTS) is emerging as a novel and effective approach to analyzing power system aspects, and this characteristic can be effectively used in power system courses. Hence, after the presentation of the basics about the RTS, the paper will show the advantages of employing RTS for teaching activities. Finally, two examples of didactic activities involving RTS at Politecnico di Torino will be presented. In fact, RTS is part of both multi-disciplinary projects (where students with different backgrounds can face the issues affecting the protection and control of power systems) and the course “Electrical systems and safety”, where RTS is used to study the behavior of voltage transformers in saturation

Dynamics between insight and medication adherence in first-episode psychosis: Study of 3-year trajectories.

While specialized early intervention programs represent the gold standard in terms of optimal management of first-episode psychosis (FEP), poor medication adherence remains a predominant unmet need in the treatment of psychosis. In this regard, an interaction between insight and adherence in FEP patients has been hypothesized but has been challenged by multiple pitfalls. Latent profile analysis and trajectory modeling techniques were used to evaluate insight and adherence of 331 FEP patients engaged at the beginning, middle, and end of a 3-year specialized early psychosis program. A Bayesian model comparison approach was used to compare scores of clinical, functional, and socioeconomic outcomes at the end point of the study. Nearly one-third of the patients maintain a high level of insight and adherence during the entire program. At the end of the 3-year follow-up, more than three-quarters of patients are considered adherent to their medication. Patients with low levels of insight and adherence at the beginning of the program improve first in terms of adherence and then of insight. Furthermore, patients with high levels of insight and adherence are most likely to reach functional recovery and to experience an increase in environmental quality of life. Latent FEP subpopulations can be identified based on insight and adherence. Medication adherence was the first variable to improve, but a gain in insight possibly plays a role in the reinforcement of adherence

Moderating role of cannabis use between insight and depression in early psychosis.

A high level of insight in first episode psychosis (FEP) is positively correlated to important prognostic factors such as medication adherence and functional outcome but is associated with increased depression level and suicidal behavior. This is the first study questioning the potential moderating role of cannabis use in the relationship between insight and depression one year after a FEP. In this prospective observational study, we enrolled 214 FEP patients who had provided informed consent and been referred to a specialized early psychosis program and followed for 36 months. A series of multivariate regression models were used. Baseline insight, medication adherence and cannabis use (level of use on a continuum) were entered as independent variables, while the PANSS (positive and negative), the MADRS and the SOFAS scores after one year were alternately selected as the dependent variable. We found a three-way interaction term between cannabis use, insight and medication adherence on depression level one year after the entry into the program. A high level of insight was significantly associated with higher MADRS scores in patients with high cannabis use, while depression decreased in high-insight patients with low cannabis use. Cannabis use continuation during the year following a first episode psychosis may play a significant role in the development or the maintenance of post-psychotic depression in patients who present with high level of insight and adherence to medication, stressing the need for specific therapeutic strategies in this subgroup of patients

Six months functional response to early psychosis intervention program best predicts outcome after three years.

Not all patients respond well to early interventions for their psychosis. The present study's goal was to evaluate whether patients' responses in the first six months of treatment in a specialised three-year programme could predict final outcomes. 206 early psychosis patients were assessed at baseline, using a large set of sociodemographic and clinical variables, and then monitored for 36 months. Among those variables, changes in their Global Assessment of Functioning (GAF) scores during the first six months were used to predict outcomes after three years. Changes in GAF scores during the first six months were the only variables that predicted every symptom of functional outcome. GAF scores were also always the first or second most important predictor for every outcome. This finding held for both high- and low-functioning patients at baseline. Predicting poor long-term outcomes after only six months should help clinicians to improve treatments

Mentalization-based treatment in clinical high risk for psychosis: A rationale and clinical illustration

Developmental clinical research in recent years has highlighted the value treating psychotic disorders at the earliest stage to reduce long-term morbidity. It is now suggested that treatment during the clinical high risk states (CHR), preceding by 1 to 4 years the onset of psychotic disorders, may delay or prevent the onset of psychosis, and contribute to a more positive prognosis. In this article, we wish to provide a rationale and clinical illustration of mentalization-based treatment (MBT) as an indicated preventive treatment for CHR. We will first review the notion of high-risk for psychosis, providing a trans-theoretical developmental framework for conceptualizing the clinical progression from sub-clinical towards clinical psychotic states. Second, we address the commonalities and differences between the constructs of mentalization and metacognition, and discuss their relevance in preventive psychotherapeutic treatment for CHR. Thirdly, we provide a clinical illustration of MBT to emerging psychosis. Finally, we conclude by discussing the specific contributions of MBT approach in youths at CHR, and the necessary research for evaluating its relevance in the context of risk for developing psychosis

Symptom dimensions stability over time in recent onset psychosis: A prospective study.

The factorial structure of schizophrenia symptoms has been much debated but little is known on its degree of unicity, specificity as well as its dynamic over time. Symptom differentiation is a phenomenon according to which patients' symptoms could differentiate from one another during illness to form more independent, distinct dimensions. On the contrary, symptom dedifferentiation is an increase in the correlations between those symptoms over time. The goal of this study was to investigate symptom differentiation or dedifferentiation over time in recent onset psychosis using the Positive and Negative Syndrome Scale. A confirmatory factor analysis model based on the consensus five-factor model of the Positive and Negative Syndrome Scale for schizophrenia was estimated on seven different time points over a three-year period. A general factor capturing common variance between every symptom was also included. Explained common variance was computed for the general factor and each specific factor. Three hundred and sixty-two recent onset psychosis patients were assessed. Results showed no evidence for either symptom differentiation or dedifferentiation over time. Specific symptoms accounted for >70 % of the variance suggesting a high degree of specificity of the symptomatology. Overall, this study adds support for a highly multidimensional approach to clinical symptom assessment with an explicit focus on depression. The premise behind the staging approach being inherently one-dimensional, implications for further research is discussed

The differential impact of duration of untreated psychosis on functioning and quality of life: a threshold analysis

AIM: Reduction of duration of untreated psychosis (DUP) remains a key goal of early intervention programs. While a significant body of literature suggests that a short DUP has a positive impact on outcome, little is known regarding the threshold above which various dimensions of outcome are impaired. In this study, we explore the DUP threshold that best discriminates subgroups with poorer outcome regarding global functioning and quality of life after 3 years of treatment. METHOD: A total of 432 patients were followed-up prospectively over 3 years. Several hypothetical cut-off points for DUP were tested in order to maximize differences in effect size for quality of life and general functioning. RESULTS: While a DUP cut-off of 86 weeks defined two subpopulations with a difference of greatest effect size in quality of life after 3 years, it is already at a cut-off of 3 weeks of DUP that two subpopulations with a difference in global functioning of the greatest effect size was reached. CONCLUSION: DUP seems to have a differential impact on the various components of outcome, and in particular on quality of life and global functioning. Our data suggest that aiming at very short DUP is justified, but that DUP over 3 weeks are still compatible with good quality of life after 3 years of treatment

Attachment, Neurobiology, and Mentalizing along the Psychosis Continuum.

In this review article, we outline the evidence linking attachment adversity to psychosis, from the premorbid stages of the disorder to its clinical forms. To better understand the neurobiological mechanisms through which insecure attachment may contribute to psychosis, we identify at least five neurobiological pathways linking attachment to risk for developing psychosis. Besides its well documented influence on the hypothalamic-pituary-adrenal (HPA) axis, insecure attachment may also contribute to neurodevelopmental risk through the dopaminergic and oxytonergic systems, as well as bear influence on neuroinflammation and oxidative stress responses. We further consider the neuroscientific and behavioral studies that underpin mentalization as a suite of processes potentially moderating the risk to transition to psychotic disorders. In particular, mentalization may help the individual compensate for endophenotypical impairments in the integration of sensory and metacognitive information. We propose a model where embodied mentalization would lie at the core of a protective, resilience response mitigating the adverse and potentially pathological influence of the neurodevelopmental cascade of risk for psychosis

Age at the time of onset of psychosis: A marker of specific needs rather than a determinant of outcome?

While there is suggestion that early onset of psychosis is a determinant of outcome; knowledge regarding correlates of later onset age is more limited. This study explores the characteristics of patients developing psychosis after age 26, towards the end of the usual age range of early intervention programs, in order to identify potential specific needs of such patients. Two hundred and fifty-six early psychosis patients aged 18-35 were followed-up prospectively over 36 months. Patients with onset after 26 ("later onset", LO) were compared to the rest of the sample. LO patients (32% of the sample) had shorter DUP, were less likely to be male, had better premorbid functioning and were more likely to have been exposed to trauma. They had greater insight at presentation and less negative symptoms overall. The trajectories for positive and depressive symptoms were similar in both groups. Evolution of functional level was similar in both groups, but while LO patients recovered faster, they were significantly less likely to return to premorbid functional level. Later psychosis onset correlates with better premorbid functioning and higher rate of trauma exposure; the latter should therefore be a treatment focus in such patients. LO patients were less likely to return to premorbid functional level, which suggests that current treatment strategies may not be efficient to help patients maintain employment. The possibility of distinct illness mechanisms according to onset age and the more central role for trauma in patients with onset after age 26 needs to be further explored