Complete recovery from anxiety disorders following Cognitive Behavioural Therapy in children and adolescents: a meta analysis

Cognitive Behavior Therapy (CBT) is a well-established treatment for childhood anxiety disorders. Meta-analyses have concluded that approximately 60% of children recover following treatment, however these include studies using a broad range of diagnostic indices to assess outcomes including whether children are free of the one anxiety disorder that causes most interference (i.e. the primary anxiety disorder) or whether children are free of all anxiety disorders. We conducted a meta-analysis to establish the efficacy of CBT in terms of absence of all anxiety disorders. Where available we compared this rate to outcomes based on absence of primary disorder. Of 56 published randomized controlled trials, 19 provided data on recovery from all anxiety disorders (n = 635 CBT, n = 450 control participants). There was significant heterogeneity across those studies with available data and full recovery rates varied from 47.6 to 66.4% among children without autistic spectrum conditions (ASC) and 12.2 to 36.7% for children with ASC following treatment, compared to up to 20.6% and 21.3% recovery in waitlist and active treatment comparisons. The lack of consistency in diagnostic outcomes highlights the urgent need for consensus on reporting in future RCTs of childhood anxiety disorders for the meaningful synthesis of data going forwards

Letter Report: Rio Blanco Sampling of Proximate Producing Natural Gas Wells

Two wells proximate to the Rio Blanco gas stimulation test were sampled and the gas analyzed. The samples from two wells showed no tritium above the detection limit concentrations of 10 and 12.4 (TU), respectively. The analytical results from the gas production wells show no impact from the Rio Blanco nuclear tes

Addressing English Learner Teacher Shortage: Conceptualizing Collaborative Efforts Between K–12 Schools and Higher Education

With the rapid increase of English Learners (ELs) in K–12 schools, school districts are struggling to find ways to meet the needs for EL teachers. One approach to address the shortage is to build teacher capacity by collaborating with higher education institutions where English as a Second Language (ESL) teacher preparation programs are offered. However, such collaborations are expensive to local schools due to the credit hours that those programs require. In this paper, comparing the contexts in the State of Michigan and the State of New York, we describe a partnership experience between a university in Michigan and its neighboring K–12 partner school districts. In 2016, the collaboration secured a five-year, 2.53 million, grant to support districts’ efforts to address such teacher shortage. Using Richardson’s (1994) crystallization method, we identified the unique features of three evolving stages of the school district’s capacity-building process. We conceptualized these stages into a two-layered model, based on the partners’ discourse patterns, role played, ownership, and information flow. We argue that the model can be used by other K–12 higher-education collaborations, particularly in the States like New York and Michigan. Specific recommendations are offered to maximize such collaborative efforts

Loneliness, social relationships, and mental health in adolescents during the COVID-19 pandemic

Loneliness is a common experience in adolescence and is related to a range of mental health problems. Such feelings may have been increased by social distancing measures introduced during the COVID-19 pandemic. We aimed to investigate the effect of loneliness, social contact, and parent relationships on adolescent mental health during lockdown in the UK. Young people aged 11–16 years (n = 894) completed measures of loneliness, social contact, parent-adolescent relationships, and mental health difficulties during the first 11 weeks of lockdown and one-month later (n = 443). We examined cross-sectional associations and longitudinal relationships between loneliness, social contact, and parent relationships and subsequent mental health. Adolescents who reported higher loneliness had significantly higher symptoms of mental health difficulties during lockdown. We found that adolescents who had closer relationships with their parents reported significantly less severe symptoms of mental health difficulties and lower levels of loneliness. We also found that adolescents who spent more time texting others reported higher symptoms of mental health difficulties. Our hypothesis that loneliness would predict poorer mental health one month later was not supported. Time spent texting others at baseline was significantly associated with higher hyperactivity at follow-up, and closeness to parents was significantly associated with lower psychological distress at follow-up. We conclude that while loneliness was associated with greater mental health difficulties at baseline, it did not predict increased mental health difficulties one month later. Moreover, existing mental health problems significantly predicted later increase, thereby highlighting the importance of continuing support for vulnerable people

Sex and Haplotype Associations with Adverse Effects of Calcineurin Inhibitors Post-Renal Transplant

BACKGROUND: P-glycoprotein (P-gp), an ABC transport protein contributes to the interpatient pharmacokinetic and pharmacodynamic variability of calcineurin inhibitors(CNI), tacrolimus(TAC) and cyclosporine (CYA). ABCB1 encodes P-gp and the single nucleotide polymorphisms (SNP) 1236C\u3eT, 2677G\u3eT/A, 3435C\u3eT may alter protein expression or function. Our objective was to examine the association of ABCB1 haplotypes, sex and race with chronic CNI adverse effects (AE) in renal transplant recipients (RTR). METHODS: A meta-analysis of 3 prospective observational studies was completed in 149 stable RTR [GFR= 51 ±17 ml/min/1.73m2] using identical inclusion and exclusion criteria in 62 African Americans (AA) and 81 Caucasians (C) treated with CYA (troughs: 50- 150 ng/ml) and mycophenolate mofetil or TAC (troughs: 5-10 ng/ml) and mycophenolate sodium. Each RTR had AE assessed using standardized objective scales by study physicians. A Cumulative AE ratio was determined using 14 AE. Separate gastrointestinal (GI), central nervous system (CNS), and aesthetic AE ratios were also assessed. DNA from peripheral blood mononuclear cells was collected to characterize ABCB1 SNPs completed on 11/15/12. Haplotype computation and association with AE was completed by THESIAS program on 12/3/12. RESULTS: All genotypes were in Hardy-Weinberg equilibria. AA had a greater frequency of the C-G-C haplotype (SNPs: 1236-2677-3435) compared to C (71.6% vs. 44.2%; p\u3c0.001). A gender difference was noted for Cumulative (p\u3c0.001); GI (p=0.046); aesthetic (p=0.0002) and CNS (p=0.051) AE ratios with greater AE ratios in females. The Aesthetic AE ratio was associated with haplotype T-T-C (p=0.008). Haplotype C-T-T was associated with increased GI AE ratio (p=0.02) though the effect was not significant when sex was included as a covariate (p=0.13). Race had no associations with AE. CONCLUSION: RTR receiving CNI based immunosuppression within the therapeutic range exhibited interpatient variability in AE with associations to sex and ABCB1 haplotypes.https://dune.une.edu/pharmsci_facpost/1001/thumbnail.jp

Allelic segregation and independent assortment in <i>T. brucei</i> crosses: proof that the genetic system is Mendelian and involves meiosis

The genetic system on Trypanosoma brucei has been analysed by generating large numbers of independent progeny clones from two crosses, one between two cloned isolates of Trypanosoma brucei brucei and one between cloned isolates of T. b. brucei and Trypanosoma brucei gambiense, Type 2. Micro and minisatellite markers (located on each of the 11 megabase housekeeping chromosomes) were identified, that are heterozygous in one or more of the parental strains and the segregation of alleles at each locus was then determined in each of the progeny clones. The results unequivocally show that alleles segregate in the predicted ratios and that alleles at loci on different chromosomes segregate independently. These data provide statistically robust proof that the genetic system is Mendelian and that meiosis occurs. Segregation distortion is observed with the minisatellite locus located on chromosome I of T. b. gambiense Type 2 and neighboring markers, but analysis of markers further along this chromosome did not show distortion leading to the conclusion that this is due to selection acting on one part of this chromosome. The results obtained are discussed in relation to previously proposed models of mating and support the occurrence of meiosis to form haploid gametes that then fuse to form the diploid progeny in a single round of mating

Clinician perspectives on what constitutes good practice in community services for people with complex emotional needs: A qualitative thematic meta-synthesis

INTRODUCTION: The need to improve the quality of community mental health services for people with Complex Emotional Needs (CEN) (who may have a diagnosis of 'personality disorder') is recognised internationally and has become a renewed policy priority in England. Such improvement requires positive engagement from clinicians across the service system, and their perspectives on achieving good practice need to be understood. AIM: To synthesise qualitative evidence on clinician perspectives on what constitutes good practice, and what helps or prevents it being achieved, in community mental health services for people with CEN. METHODS: Six bibliographic databases were searched for studies published since 2003 and supplementary citation tracking was conducted. Studies that used any recognised qualitative method and reported clinician experiences and perspectives on community-based mental health services for adults with CEN were eligible for this review, including generic and specialist settings. Meta-synthesis was used to generate and synthesise over-arching themes across included studies. RESULTS: Twenty-nine papers were eligible for inclusion, most with samples given a 'personality disorder' diagnosis. Six over-arching themes were identified: 1. The use and misuse of diagnosis; 2. The patient journey into services: nowhere to go; 3. Therapeutic relationships: connection and distance; 4. The nature of treatment: not doing too much or too little; 5. Managing safety issues and crises: being measured and proactive; 6. Clinician and wider service needs: whose needs are they anyway? The overall quality of the evidence was moderate. DISCUSSION: Through summarising the literature on clinician perspectives on good practice for people with CEN, over-arching priorities were identified on which there appears to be substantial consensus. In their focus on needs such as for a long-term perspective on treatment journeys, high quality and consistent therapeutic relationships, and a balanced approach to safety, clinician priorities are mainly congruent with those found in studies on service user views. They also identify clinician needs that should be met for good care to be provided, including for supervision, joint working and organisational support

Senda recorrida en los procesos de Planificación y Autoevaluación Institucional de la Universidad Comunitaria Intercultural

At the University of the Autonomous Regions of the Nicaraguan Caribbean Coast, the reconstruction of the path of the institutional planning and evaluation process allowed the critical compilation of the experiences and demonstrate the development and growth of the institution. For this recreation of experiences, the guide “Paths to recreate and walk the experience with an intercultural gender perspective” was used, which led to experiencing the three stages of strategic planning and the two institutional self-evaluation processes that were developed. In this sense, the importance of having a variety of points of view, documentary analysis, as well as the fulfillment of a methodological route that was carried out at five different times and with particular purposes was recognized. It should be noted that the systematization process included the university community of the four URACCAN campuses and extensions, as well as the headquarter office, where the informants narrated their experiences of the 3 planning processes and the institutional evaluation processes. It was demonstrated that, at this stage, the planning and evaluation teams learned to walk hand in hand to ensure those processes. A greater institutional ordering and articulation of the areas was achieved, as a result of this, it was created the University Management System, fundamental aspects that had to do with the intercultural community university model were strengthened, the university model and its outward projection were consolidated, allowing so the achievement of local, national and international recognitionEn la Universidad de las Regiones Autónomas de la Costa Caribe Nicaragüense, la reconstrucción de la senda del proceso de planificación y evaluación institucional permitió la recopilación crítica de las experiencias que se vivieron y que evidencian el desarrollo y crecimiento de la institución. Para esta recreación de experiencias se utilizó la guía “Sendas para recrear y caminar la experiencia con perspectiva intercultural de género.”, que conllevó a vivenciar las tres etapas de la planificación estratégica y los dos procesos de autoevaluación institucional que se desarrollaron. En este sentido, se reconoció la importancia de contar con una variedad de puntos de vista, análisis documental, así como el cumplimiento de una ruta metodológica que se realizó en cinco momentos diferentes y con propósitos particulares. Cabe señalar que el proceso de sistematización incluyó a la comunidad universitaria de los cuatro recintos de URACCAN y extensiones, así como la oficina de enlace, en donde los informantes narraron sus experiencias tanto de los 3 procesos de la planificación como de los procesos de evaluación institucional. Evidenciando que, en esta etapa, los equipos de planificación y evaluación aprendieron a caminar de la mano para asegurar los procesos, se logró un mayor ordenamiento institucional y articulación de las áreas, creándose así un Sistema de Gestión Universitaria, se fortalecieron aspectos fundamentales que tenían que ver con el modelo de universidad comunitaria intercultural, se consolidó el modelo de universidad y su proyección hacia afuera, lográndose el reconocimiento local, nacional e internacional

Salivary cortisol in longitudinal associations between affective symptoms and midlife cognitive function: A British birth cohort study

Affective disorders are associated with accelerated cognitive ageing. However, current understanding of biological mechanisms which underlie these observed associations is limited. The aim of this study was to test: 1) Whether cortisol acts as a pathway in the association between depressive or anxiety symptoms across adulthood and midlife cognitive function; 2) Whether cortisol is associated with later depressive or anxiety symptoms, and cognitive function. Data were used from the National Child Development Study, a sample of infants born in mainland UK during one week of 1958. A measure of the accumulation of affective symptoms was derived from data collected from age 23 to 42 using the Malaise Inventory Scale. Salivary cortisol measures were available at age 44–45. Cognitive function (memory, fluency, information processing) and affective symptoms were assessed at the age of 50. Path models were run to test whether salivary cortisol explained the longitudinal association between depressive or anxiety disorder symptoms and cognitive function. Direct effects of affective symptoms are shown across early to middle adulthood on cognitive function in midlife (memory and information processing errors). However, there were no effects of affective symptoms on cognitive function through cortisol measures. Additionally, cortisol measures were not significantly associated with subsequent affective symptoms or cognitive function at the age of 50. These results do not provide clear evidence to suggest that cortisol plays a role in the association between affective symptoms and cognitive function over this period of time. These findings contribute to our understanding of how the association between affective symptoms and cognitive function operates over time

Electronic structure of the strongly hybridized ferromagnet CeFe2

We report on results from high-energy spectroscopic measurements on CeFe2, a system of particular interest due to its anomalous ferromagnetism with an unusually low Curie temperature and small magnetization compared to the other rare earth-iron Laves phase compounds. Our experimental results indicate very strong hybridization of the Ce 4f states with the delocalized band states, mainly the Fe 3d states. In the interpretation and analysis of our measured spectra, we have made use of two different theoretical approaches: The first one is based on the Anderson impurity model, with surface contributions explicitly taken into account. The second method consists of band-structure calculations for bulk CeFe2. The analysis based on the Anderson impurity model gives calculated spectra in good agreement with the whole range of measured spectra, and reveals that the Ce 4f -- Fe 3d hybridization is considerably reduced at the surface, resulting in even stronger hybridization in the bulk than previously thought. The band-structure calculations are ab initio full-potential linear muffin-tin orbital calculations within the local-spin-density approximation of the density functional. The Ce 4f electrons were treated as itinerant band electrons. Interestingly, the Ce 4f partial density of states obtained from the band-structure calculations also agree well with the experimental spectra concerning both the 4f peak position and the 4f bandwidth, if the surface effects are properly taken into account. In addition, results, notably the partial spin magnetic moments, from the band-structure calculations are discussed in some detail and compared to experimental findings and earlier calculations.Comment: 10 pages, 8 figures, to appear in Phys. Rev. B in December 200