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The primary purpose of this review is to compare the implementation of Balint groups (mandatory versus voluntary participation) in medical training, particularly for medical students and psychiatry trainees, and the accreditation pathways for Balint leaders across the United Kingdom (UK), the United States (USA), Ireland, Canada, and Germany. The review aims to highlight the rationales and implications of each model. A comparative literature review was conducted to evaluate existing approaches in the specified countries, drawing on national guidelines, society requirements, and relevant studies. The methods focused on identifying specific requirements set by governing bodies such as the Royal College of Psychiatrists (UK), the American Balint Society (ABS), the College of Psychiatrists of Ireland, and the German Medical Association. Data were handled by summarizing the variations in implementation and accreditation. Implementation varies significantly; the UK, Ireland, Canada, and Germany typically mandate some form of reflective group work for psychiatry trainees, linking it to progression or certification. Ireland and Germany have explicit session requirements, while the USA largely maintains a voluntary model. Accreditation pathways share core philosophies but differ in specific hour requirements, with European pathways being more rigorous than the portfolio-based models in the USA and Canada. The global trend recognizes a clinician‘s emotional awareness as crucial for effective patient care, pushing toward mandatory exposure to reflective group work in psychiatry training. To ensure consistency across diverse national Balint societies, the International Balint Federation could develop global minimum standards for participation and co-leadership to eliminate ambiguity.
Ankyrin-B syndrome, which has been linked to variants in ANK2 and classified as long QT syndrome type 4, is characterised by heterogeneous arrhythmic manifestations, including sinus node dysfunction and conduction abnormalities. Clinically significant atrioventricular block requiring permanent pacing in paediatric patients has rarely been described. We report a 10-year-old boy who presented with recurrent syncope and seizure-like episodes. Electrocardiography demonstrated QT prolongation, and continuous monitoring revealed persistent high-degree atrioventricular block. Genetic testing identified a heterozygous ANK2 variant of uncertain significance (NM_001148.4:c.5626G>A, p. Glu1876Lys), which was also detected in his mother and brother, while his father tested negative. Family evaluation revealed variable phenotypic expression, and a sister who died suddenly at 12 years of age had no available genotype but had autopsy findings of structural cardiac abnormalities. This case highlights clinically significant conduction disease in a child found to harbor an ANK2 VUS and long-QT phenotype and underscores the importance of detailed family phenotyping, rhythm surveillance, and individualised management.
Caregivers of children with CHD frequently experience psychological distress related to the chronic and unpredictable demands of their child’s diagnosis. Peer support can mitigate distress and promote resilience, but few studies have explored factors affecting its implementation or the experiences of those who provide or facilitate peer support. This study aimed to identify barriers, facilitators, and recommendations for optimising peer support from the unique perspectives of leaders of patient/family organisations within the CHD community.
Methods:
Using online crowdsourcing methods, qualitative data on the implementation of peer support was collected from 16 leaders representing five patient/family organisations. Crowdsourced data were coded and analysed using thematic analysis, with themes categorised as barriers, facilitators, and recommendations.
Results:
Four overarching themes were constructed: 1) Training and Expertise, highlighting the value of lived experience alongside the need for structured training in mental health and bereavement; 2) Peer Mentor Wellbeing, including burnout, secondary traumatic stress, and the importance of clear role boundaries and expectations; 3) Partnerships and Collaboration, emphasising relationships with clinical care centres; and (4) Support for all Families and Family Members, including fathers, siblings, and bereaved families.
Discussion:
The results provide insight into the implementation of peer support, with recommendations for next steps including hospital-community partnerships to improve access and intentional programme design to protect peer mentor wellbeing. Further understanding of caregiver and peer mentor needs is critical for elucidating ways to develop and implement optimal models of peer support.
Tocharian A ṣtākkrukke* occurs in the Maitreyasamiti-Nāṭaka, an extensive drama on the future Buddha Maitreya written in Tocharian A. Based on the Old Uyghur translation of the text, a preliminary translation of “slanderer” has been proposed, but nothing else is known about the history of the word. In this article, I argue that it was borrowed from an earlier form of Old Khotanese ṣṭakulcā-, a derivative of Old Khotanese ṣṭakulā- “abuse”. In its turn, Old Khotanese ṣṭakulā- “abuse” may have been borrowed from an unattested Gāndhārī source. By examining Old Uyghur, Old Khotanese, Late Khotanese and Buddhist Sanskrit sources, I uncover the complex web of relationships that surrounds Tocharian A ṣtākkrukke* and its spread across the Tarim Basin.
We study the asymptotic behavior of a critical decomposable 3-type Galton–Watson process with immigration when its offspring mean matrix is triangular with diagonal entries all 1. It is proved that, under second-order or fourth-order moment assumptions on the offspring and immigration distributions, a sequence of appropriately scaled random step processes formed from such a Galton–Watson process converges weakly. The limit process can be described with the use of independent squared Bessel processes $({\mathcal X}_{t,1})_{t\geq0}$, $({\mathcal X}_{t,2})_{t\geq0}$, and $({\mathcal X}_{t,3})_{t\geq0}$, the linear combinations of the integral processes of $({\mathcal X}_{t,1})_{t\geq0}$ and $({\mathcal X}_{t,2})_{t\geq0}$, and possibly the 2-fold iterated integral process of $({\mathcal X}_{t,1})_{t\geq0}$. The presence of the 2-fold iterated integral process in the limit distribution is a new phenomenon in the description of asymptotic behavior of critical multitype Galton–Watson processes with immigration. Our results complete and extend some results of Foster and Ney (1978 Z. Wahrscheinlichkeitstheor. Verwandte Geb.46, 13–43) for some strongly critical decomposable 3-type Galton–Watson processes with immigration.
In Sources of Christian Ethics, Servais Pinckaers submits that, contrary to the presumed disjunction between Scholastic theology and mystical spirituality, a harmony historically existed between the two. In support of Pinckaers’ claim, this study proposes that such a harmony may be found between the theological writings of Thomas Aquinas and Catherine of Siena. One key place of convergence is their respective treatments of charity. Christ’s charity figures prominently in the accounts of both Thomas and Catherine, who each describe its pedagogic and exemplary efficacy in relation to the charity of the baptized. When treating the effects of the Redemption, Thomas emphasizes the exemplary efficacy of Christ’s charity to elicit our charity. Similarly for Catherine, Christ’s charity – displayed emblematically by his Blood – enkindles a reciprocal charity in the soul who contemplates it. Furthermore, Thomas and Catherine conceive of charity as the foundation of the moral life, describing it as the ‘form’ of the virtues and the essence of spiritual perfection. Examining these accounts, drawn primarily from the Summa and Dialogue, yields insight into charity’s fundamental place in the theology of Aquinas and Catherine, as well as the complementary insights each offers regarding Christ’s charity and ours.
Drawing on participatory research with grassroots organisers, activists, and legal practitioners, this article offers a pioneering account of how anticarceral feminists in Ecuador understand, negotiate, and resist international human rights (IHRs) amid severe prison violence and endemic violence against women (VAW). Key findings include the participants’ widespread scepticism towards IHRs as a tool for emancipation, which is influenced by the distinctive impact of penal violence on their survival strategies and reproductive labor. Notably, the penal apparatus criminalises women’s precarious livelihoods and extracts care work from those supporting incarcerated relatives and friends. Building on these findings, the article presents an anticolonial feminist critique of IHRs, demonstrating how rights-based frameworks can reinforce a penal system that causes gendered and racialised harm through human rights penality. The article then theorises “penal violence against women,” referring to a systemic harm inflicted on many women who encounter the penal system, even if they are not incarcerated or involved in a penal process. In response, participants prioritise community support, cooperative projects, and the redistribution of labor and resources over rights-based penal remedies. The article recommends considering penal violence in rights-based responses to violence against women (VAW) and calls for a fundamental rethinking of human rights commitments to penality.
Hermann Cohen’s “neo-Kantian” critique of capitalism is primarily ethical. It is anchored in the principle that social relations must include people as ends in themselves, never merely as means. But Cohen draws on law to exemplify such inclusion: artificial legal persons such as cooperatives incorporate members as free and equal. I criticise Cohen for downplaying the constraints involved and, further, for only gesturing toward the role of law in capitalism. Kantian principles, if not Kant’s own views, can help address these flaws. I suggest that the form of capitalism rests on money, employment, and another sort of legal person, the business corporation.
This article focuses on benefits of understanding magic and animism in archaeological study of migration. We argue that new religious movements offer causes for migration and that ethnic understandings of animistic power shape preferences in construction materials, artifacts, and closure practices. In our North American Southwest case study of the Cottonwood Spring Pueblo Community (LA 175), we contend this fourteenth-century site formed through coalescence of migrants from the northern reaches of Jornada Mogollon Culture with others from its eastern and southern boundaries. Under pressure from new religious movements, northern migrants moved south to preserve their social relations with human and nonhuman (spirit) beings populating their material world (people, artifacts, and architecture). They knew the Cottonwood area, having exchanged pottery in the region during the previous two centuries. Their animistic understanding of architecture and artifacts persisted in their new homes. This led persistence of patterns in artifacts, wall construction, and closure practices.
Dual diagnosis (DD) refers to the coexistence in the same individual of a substance use disorder and other mental disorder. The increase in substance use among women over the past two decades, along with related health issues and mortality rates, has underscored the importance of integrating a gender-based approach in addiction research and treatment. This transition has led to an increased focus on substance use among women and individuals of other gender identities. This narrative review aims to examine the evidence on gender differences in DD to enhance knowledge that supports the development of innovative, evidence-based policies and practices. These efforts seek to improve access to and the adequate treatment of drug use disorders and comorbid conditions among women and LGBTQIA+ individuals. Additionally, advancements in the literature on epidemiology, clinical characteristics, environmental factors, treatment needs, and final recommendations are discussed. This manuscript supports a progression from gender integration towards gender transformation – a paradigm shift extending beyond the simple incorporation of gender perspectives into existing systems towards a deeper transformation that challenges and changes current gender norms and structures, aiming for a more equitable system.
This study examines how three Nanyang pioneer artists, Chen Chong Swee, Chen Wen Hsi, and Cheong Soo Pieng, negotiated cultural identity through the practice of their modern ink painting. This paper argues that the artistic practice of these three artists could be read as embodying a sustained dialogue between inherited Chinese ink traditions and the modernist expressions of Southeast Asia. Drawing on Stuart Hall’s interpretation of diaspora and identity, together with Homi Bhabha’s concepts of hybridity and the “Third Space,” the paper integrates a formal visual analysis with historical interpretation in examining selected works by these artists. This paper argues that these artists have redefined modern ink painting as a medium of cultural translation and transformation of the Chinese diaspora in Southeast Asia.
The melting of ice shelves into the ocean plays a major role, and is a key source of uncertainty, in sea level rise projections. Under-ice shelves, meltwater moves upslope, setting up a stratified shear flow with the warmer, but critically saltier, ocean beneath, regulating the transfer of heat between ice and the ambient ocean. Such features are incredibly difficult to access in situ, and so most research has focussed on the use of numerical modelling, laboratory experiments and analytical models to understand these processes, each with their own trade-offs. Here, novel numerical simulations of the Navier–Stokes equations approximate this flow for a tilted domain forced with fixed densities at the upper and lower boundaries to induce such a buoyant boundary shear current. These simulations and accompanying linear stability analysis (LSA) reveal that the shear flows under-ice shelves form a unique mixed-mode shear instability. This instability consists of paired Kelvin Helmholtz and Holmboe instabilities, highly effective at mixing the water column, and due to the restoring effect of the boundary forcing, results in a cyclical instability. The flow criticality is found to be well predicted by LSA, and dependent on diagnostic flow Reynolds and bulk Richardson numbers, whilst the local gradient Richardson number is not a useful indicator of instability in this problem. Based on these results, it is unclear how well this unusual route to turbulent mixing is represented in current models, highlighting the need for further investigation into turbulent heat transfer and ice-shelf melting.
We prove that several natural graph classes have tree-decompositions with minimum width such that each bag has bounded treewidth. For example, every planar graph has a tree-decomposition with minimum width such that each bag has treewidth at most 3. This treewidth bound is best possible. More generally, every graph of Euler genus $g$ has a tree-decomposition with minimum width such that each bag has treewidth in $O(g)$. This treewidth bound is best possible. Most generally, every $K_p$-minor-free graph has a tree-decomposition with minimum width such that each bag has treewidth at most some polynomial function $f(p)$. In such results, the assumption of an excluded minor is justified, since we show that analogous results do not hold for the class of 1-planar graphs, which is one of the simplest non-minor-closed monotone classes. In fact, we show that 1-planar graphs do not have tree-decompositions with width within an additive constant of optimal and with bags of bounded treewidth. On the other hand, we show that 1-planar $n$-vertex graphs have tree-decompositions with width $O(\sqrt {n})$ (which is the asymptotically tight bound) and with bounded treewidth bags. Moreover, this result holds in the more general setting of bounded layered treewidth, where the union of a bounded number of bags has bounded treewidth.