Psychotherapeutic Techniques and Play Therapy with Children Who Experienced Trauma: A Review of The Literature

This research examined the use of Play Therapy with children who have experienced emotional, physical or psychological trauma. Past research supports other therapeutic modalities as being effective with children after a traumatic experience, though the validity of play therapy lacks comprehensive quantitative and qualitative support. Based on the concept that play is the natural language of children, this form of treatment is developmentally appropriate, specifically with children under the age of twelve. For the purposes of this research, trauma was categorized in to Type 1 (single occurrences) and Type 2 (recurring trauma). A review of the literature found that although there has been an increase in the use of play therapy, there are disparities in the suggested styles; directive versus child-centered. Though play therapy is becoming increasingly more validated, the field lacks longitudinal studies and research outside of the United States

Developing Cross-Cultural Empathy through Mindfulness

INTRODUCTION: The murder of George Floyd sparked international movements to address racial inequality. These movements have prompted critical conversations about medical racism, bias, and social determinants of health. These events have caused us to turn inwardly and question what we know, the limits of our understanding, and the role of medical training in developing the skills and perspectives needed to address racial inequality in health care systems. The purpose of this session is to share the design and preliminary outcomes of a curricular intervention that aims to train pediatrics residents to use mindful reflective practice to develop cross-cultural empathy and engage with anti-racist ideas. STUDY OBJECTIVE: To develop and implement a curriculum that teaches mindful reflective practice as a tool for developing cross-cultural empathy and advancing diversity, equity, inclusion, and justice in healthcare. METHODS: Pediatrics and combined medicine-pediatrics residents participated in four 90-minute small group sessions: (1) cultivating critical awareness of racism in medicine, (2) unpacking bias, microaggressions, and coded language, (3) exploring personal identity and intersectionality, and (4) committing to action and curriculum reflections/feedback. Each session was co-led by 3 facilitators (LB, JL, FW) and structured to provide opportunities for learners to engage, explore, explain, and elaborate on the content presented. Each session began with a guided mindfulness activity and concluded with individual written reflection. Participants completed the Maslach Burnout Inventory, Mindful Attention Awareness Scale, Empathy Quotient, and Stanford Professional Fulfillment assessments prior to session 1, following session 4, and 3 months after completion of the curriculum. Participants also completed the Social Justice and Empathy Assessment following session 4, and 3 months post-curriculum. Quantitative data was analyzed for pre-post changes using t-tests. Curriculum acceptability, facilitator effectiveness, and perceived benefit of each portion of session content was reviewed. Participants engaged in a brief audio-recorded focus group at the end of session 4. The transcribed focus groups and participants’ written reflections following each session were qualitatively analyzed to identify common themes. RESULTS: Preliminary results from first two cohorts (N=9) indicate that all residents found the course to be sufficiently challenging and that it helped them to pursue growth. The majority of participants expressed increased understanding of curriculum domains; mindfulness (77.8%), medical racism (88.9%), bias/coded language/microaggressions (100%), and identity/oppression/intersectionality (88.9%) and rated the overall course as excellent (88.9%). All residents endorsed agreement for facilitator’s content expertise and excellence in teaching skills. Qualitative analysis of focus groups is ongoing at this time. Preliminary review suggests that participants enjoyed the curriculum, found it to be unique in their residency experience, and desire more opportunities to discuss DEIJ issues in small groups. We expect full quantitative an qualitative analysis of all 6 cohorts in this pilot study will be completed and available for presentation at IU Education Day

Association of socioeconomic status, truncal fat and sICAM-1 with carotid intima-media thickness in adolescents: The HELENA study

Objective: To measure the carotid intima-media-thickness (cIMT) and to assess its determinant factors in healthy adolescents Methods: 319 adolescents aged 12.5-17.5 years (135 boys, 184 girls) were enrolled in this cross-sectional studycIMT and carotid diameter were measured by high-resolution B-mode ultrasoundAnthropometric parameters, blood pressure, physical activity (PA), aerobic fitness and dietary intakes were assessedSocioeconomic status was determined with the family affluence scale (FAS 4)Serum biological markers (lipids, glucose, high-sensitivity C-reactive protein, soluble adhesion molecules) were measured in a subsample of 96 adolescents Results: Multiple regression analysis showed that cIMT was positively associated with truncal fat (p = 0.021) and negatively with FAS 4 (p = 0.002) independently of age and blood pressureThere were no significant associations between cIMT and PA, fitness and dietary intakesIn the subsample soluble intercellular adhesion molecule 1 was positively correlated with cIMT (p = 0.017), independently of truncal fat, age and blood pressure Conclusions: Low socioeconomic conditions and increased truncal fat are associated with greater carotid intima-media-thickness in adolescents. © 2013 Elsevier Ireland Ltd.Peer Reviewe

Social engagement and health in younger, older, and oldest-old adults in the Louisiana Healthy Aging Study

Social support has been shown to influence health outcomes in later life. In this study, we focus on social engagement as an umbrella construct that covers select social behaviors in a life span sample that included oldest-old adults, a segment of the adult population for whom very little data currently exist. We examined relationships among social engagement, positive health behaviors, and physical health to provide new evidence that addresses gaps in the extant literature concerning social engagement and healthy aging in very old adults. Participants were younger (21-59 years), older (60-89 years), and oldest-old (90-97 years) adults (N = 364) in the Louisiana Healthy Aging Study (LHAS). Linear regression analyses indicated that age, gender, and hours spent outside of the house were significantly associated with self-reported health. The number of clubs and hours outside of home were more important factors in the analyses of objective health status than positive health behaviors, after considering age group and education level. These data strongly suggest that social engagement remains an important determinant of physical health into very late adulthood. The discussion focuses on practical applications of these results including social support interventions to maintain or improve late-life health

Mouse model of imiquimod-induced psoriatic itch

Itch is a major indicator of psoriasis, but the underlying mechanisms behind this symptom are largely unknown. To investigate the neuronal mechanisms of psoriatic itch, we tested whether mice subjected to the imiquimod-induced psoriasis model exhibit itch-associated behaviors. Mice received daily topical applications of imiquimod to the rostral back skin for seven days. Imiquimod-treated mice exhibited a significant increase in spontaneous scratching behavior directed to the treated area as well as touch-evoked scratching (alloknesis). To characterize this model, we measured the mRNA expression levels of pruritogens and itch-relevant receptors/channels using real-time RT-PCR. The mRNA expression of MrgprA3, MrgprC11, and MrgprD decreased gradually over time in the dorsal root ganglion (DRG) cells. There was no significant change in the mRNA expression of TRPV1 or TRPA1 in DRG cells. TRPV4 mRNA expression was transiently increased in the DRG cells, while TRPM8 mRNA was significantly decreased. The mRNA expression levels of histidine decarboxylase and tryptophan hydroxylase 1, as well as the intensity of histamine and serotonin immunoreactivity, were transiently increased in the skin on day 2, returning to baseline by day 7. Histamine H1 receptor (H1R) antagonists, chlorpheniramine and olopatadine, significantly inhibited spontaneous scratching on day 2, but not day 7. Neither chlorpheniramine nor olopatadine affected alloknesis on day 2 or day 7. These results may reflect the limited antipruritic effects of H1R antagonists on human psoriasis. The imiquimod-induced psoriasis model appears to be useful for the investigation of itch and its sensitization in psoriasis

Heteroscedastic ANOVA: old p values, new views

Accuracy of p value, Approximate F test, Nonhomogeneous one-way fixed model,