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Gestalt therapy (GT) and systemic pedagogy (SP) are useful tools to approach emotional difficulties and mental health problems among children and adolescents. The main objective of this study was to explore the perceptions on GT and SP techniques in paediatric mental health-related consultations in a primary healthcare (PHC) centre in Catalonia in 2018–2019, among families, healthcare, and education professionals.
Methods:
Qualitative study, combining semi-structured interviews with families (N = 42) and professionals (N = 15), conducted after a series paediatric PHC consultations including GT and SP techniques. Interviews lasted between 15 and 90 min and were conducted at the PHC centre where GT/SP consultations took place, and at professionals’ workplaces. Socio-demographics, reasons for consultation, and quantitative ratings on the perceived effectiveness of GT/SP consultations were also collected to combine these data with the qualitative interviews. Qualitative data were analyzed descriptively using thematic analysis. Quantitative data were analyzed by calculating frequencies (percentages) for categorical variables, and means, medians, and ranges for continuous variables.
Results:
Narratives from families and healthcare professionals indicate that GT/SP consultations might have been effective in improving children and adolescents’ symptomatology and emotional health. Improved well-being within the family context was another main finding, based on families’ perceptions and experiences. Besides, GT/SP were considered acceptable for approaching emotional and mental health in PHC services, although barriers for implementation were identified.
Conclusions:
This study presents data on the potential usefulness of GT/SP to design and implement services that promote emotional and mental health among children and adolescents in PHC. Also, for the development of health policies and future research in this area.
Copper(II) triethylenetetramine [Cu(trien)]2+ is an agent suitable for the 1-step determination of the cation exchange capacity (CEC) of many geomaterials using a procedure much less laborious than other, commonly used methods. It is also suitable for the determination of the composition of original exchangeable cations. In contrast to other common ions used for CEC analysis, the Cu(II) complex with triethylenetetramine, [Cu(trien)]2+, is specific for expandable clay minerals. The robustness of [Cu(trien)]2+ analysis was verified using reference clays, ion-exchanged reference clays, sediments, and soils. The [Cu(trien)]2+-based CEC of expandable clay minerals is not influenced significantly by ferrihydrite, goethite, manganite, birnessite, calcite, and gypsum. Birnessite, calcite, and gypsum admixtures affect the composition of the evolved cations. [Cu(trien)]2+ does not recover the entire CEC of soils (but rather that of the clay minerals only) which contain components other than clays which contribute to the CEC, e.g. soil organic matter. In a series of loess with buried paleosols and recent soils the [Cu(trien)]2+-based CEC ranged from 30 to 110% of total CEC obtained by traditional BaCl2 methods. The relative ratio of Ca to Mg, the prevailing exchangeable cations in soils and sediments in exogenic environments, are similar after [Cu(trien)]2+ and conventional BaCl2 treatments. The Ca/Mg ratio in the exchangeable fraction was used successfully for chemostratigraphic correlation of paleolacustrine sediments from a large lake in the Upper Carboniferous basins of eastern equatorial Pangaea and a series of recent flood plain sediments of the meandering Morava River in the Czech Republic. The Ca/Mg ratio obtained by [Cu(trien)]2+ analysis is proposed as a novel tool for the chemostratigraphic correlation of sediment series containing expandable clay minerals.
Dating organic inclusions in mortars such as charcoals is a useful alternative or complementary method to dating mortars themselves, helping to estimate the building age. To assess the limitations of this dating approach, organic inclusions were searched for in surface mortar layers of six early to late medieval buildings in the Czech Republic with relatively well-known age. Altogether, 123 samples were found. About 80% were successfully radiocarbon (14C) dated. However, only 66% originated from wood relatively young when used in lime burning. To judge which samples are relevant to the actual building date, sufficient statistics is crucial. We recommend dating at least 5–10 samples, i.e., collecting 6–12 samples, for a site with uncomplicated building history, or per building phase. Otherwise, unrealistically old or young dates might be obtained. With the recommended statistics, inclusion-based dating provides building ages with uncertainty of 50–100 years.
Rýzmburk Castle is one of the largest and most important medieval castles in Bohemia, documented since 1250 AD. Its North tower is assumed to be built in 1260–1300 AD. To test this assumption, the surface layers of mortar were inspected for the presence of charcoals suitable for radiocarbon dating, and 10 charcoals were found. The charcoals probably originated from wood used for lime burning. The results of radiocarbon dating using accelerator mass spectrometry agree with the historical estimation. Single post-1287 sample indicates that the building date might be refined to 1287–1300 AD.
Animal mass mortality events (MMEs) will increase with weather and climate extremes. MMEs can add significant stress to ecosystems through extraordinary nutrient pulses or contribute to potential disease transmission risks. Given their efficient removal of carrion biomass from landscapes, we argue here for the potential of scavenger guilds to be a key nature-based solution to mitigating MME effects. However, we caution that scavenger guilds alone will not be a silver bullet. It is critical for further research to identify how the composition of scavenger guilds and the magnitude of MMEs will determine when scavengers will buffer the impacts of such events on ecosystems and when intervention might be required. Some MMEs are too large for scavengers to remove efficiently, and there is a risk of MMEs subsidizing pest species, altering nutrient cycling or leading to disease spread. Prioritizing native scavenger taxa in conservation management policies may help to boost ecosystem resilience through preserving their key ecological services. This should be part of a multi-pronged approach to MME mitigation that combines scavenger conservation with practices such as carcass dispersal or removal when exceeding a threshold quantity. Policymakers are urged to identify such thresholds and to recognize both the insects and the vertebrate scavengers that could act as allies for mitigating the emerging problem of climate-driven MMEs.
Breast-feeding rates are unsatisfactory in Lebanon. Social media groups could play an important role in promoting breast-feeding in normal conditions and post crisis. The aim of this study is to identify breast-feeding challenges, facilitators and assets and to describe how community assets via social media could build community resilience to pandemic’s and disaster’s effects.
Design:
A two-phase qualitative content analysis was performed on posts and comments collected from a Facebook breast-feeding support group. Data were categorised into themes, categories and subcategories.
Setting:
Posts and comments retrieved from a Facebook breast-feeding support group in Lebanon during the month of August 2020.
Participants:
Group members: mothers who breastfed, breast-feeding mothers and group admins that are lactation consultants.
Results:
In phase one, breast-feeding ‘Challenges’ identified were lack of support from peers and family, lack of supportive policies, lack of knowledge and maternal stress related to political instability, COVID-19 and economic crisis. ‘Assets and facilitators’ included community support and donations. In phase two, analysis revealed how assets were being used on social media platform to build community resilience post crisis, through access to social support in challenging times, community engagement, material resources and transformative potential.
Conclusion:
Challenges faced during breast-feeding were diminished due to the support and assets received on a Facebook breast-feeding support group, and social media has been shown to be an important community asset implicated in empowering women to breastfeed and to build community resilience in moments of crisis.
Researchers have long discussed whether Scandinavian rock art reflects narratives. Their interpretations have frequently been based on inspections of rock art panels combined with knowledge from ethnographic and historical sources. Here, the authors adopt a more focused narratological approach that takes the concept of (visual) narrativity into consideration and draws on studies by literary analysts, cognitive psychologists, and semioticians. Images of spear use in the provinces of Bohuslän and Östergötland in Sweden, given their diversity and indexical qualities, are well-suited to such a study. They reveal different kinds of indexical relationships, i.e. how the spears direct attention to possible targets, arguably corresponding to action scripts well-known to Bronze Age communities. Many spear images may be regarded as mini-narratives and mnemonic devices intended to represent schematized action sequences. The authors suggest that concepts such as iconicity, indexical relationships, scripts, and mini-narratives could be fruitfully employed in research on Scandinavian rock art and beyond.
This paper discusses rock art in southern Scandinavia as a multisensory format, where both sight and touch would have contributed to the comprehension of the images. From a structural semiotic point of view, we suggest that rock art can be construed as an organised set of features, such as visual and tactile elements, organised into heterogeneous unities with dynamic relations between elements that can change over time with respect to how they are experienced. We argue that in order to understand the rock art medium, it is crucial to take into consideration the multisensory interaction between the perceiver and the qualities of the rock art surface. The reason for including tactile elements in our interpretation of the conception of rock art is the way it was created: by hands interacting with tools and rock surfaces, as well as the spontaneous human tendency to explore the physical world through touch. One can identify key features in the images that would arguably facilitate tactile recognition, as well as be better explained from a multisensorial perspective. This includes the position of the images on horizontal outcrops, the moderate size of the images, the application of an orthographic perspective, the use of ‘tactile markers’ (ie crucial features having a strategic function for understanding images by touch), and the occurrence of incomplete images. A multisensorial perspective on rock art furthermore has semiotic implications. Incomplete images, for example, can be understood as indexical stand-ins for the whole imagined picture, ie as iconic indices. A multisensorial approach to Scandinavian rock art thus allows for new explanations for certain design choices, as well as a new understanding of how the images could relay meaning to a perceiver.
To assess the extent of the treatment gap for mental disorders in the Czech Republic, determine factors associated with the utilization of mental health services and explore what influences willingness to seek mental health care.
Methods:
Data from the CZEch Mental health Study, a nationally representative study of community-dwelling adults in the Czech Republic were used. The Mini International Neuropsychiatric Interview assessed the presence of mental disorders. 659 participants with current affective, anxiety, alcohol use and substance use disorders were studied.
Results:
The treatment gap for mental disorders ranged from 61% for affective to 93% for alcohol use disorders. Mental health service use was associated with greater disability (OR 1.04; 95% CI 1.02–1.05; p < 0.001), female gender (OR 3.31; 95% CI 1.97–5.57; p < 0.001), urban residence (OR 1.84; 95% CI 1.12–3.04; p < 0.05) and a higher number of somatic diseases (OR 1.32; 95% CI 1.03–1.67; p < 0.05). Self-identification as having a mental illness was associated with greater willingness to seek a psychiatrist and a psychologist.
Conclusions:
The treatment gap for mental disorders is alarmingly high in the Czech Republic. Interventions to decrease it should target in particular rural areas, men and people with low self-identification as having a mental illness.
In Europe, Scandinavia holds the largest concentration of rock art (i.e. petroglyphs), created c. 5000–first century bc, many of them showing figurative and seemingly narrative representations. In this paper, we will discuss possible narratological approaches applied to these images. We might reasonably distinguish between three levels of pictorial narrativity: representations of (i) single events, understood as the transition from one state of affairs to another, usually involving (groups of) agents interacting; (ii) stories, e.g. particular sequences of related events that are situated in the past and retold for e.g. ideological or religious purposes; and (iii) by implication, master-narratives deeply embedded in a culture, which provide and consolidate cosmological explanations and social structures. Some concrete examples of petroglyphs will be presented and analysed from narratological and iconographical perspectives. We will as a point of departure focus on (i), i.e. single events, though we shall also further consider the possibility of narrative interpretations according to (ii) and (iii).
A large variation in cognitive performance exists between European regions. However, it is unclear how older Europeans differ in the rate of cognitive decline.
Methods:
We analysed data from 22 181 individuals (54% women; median age 71) who participated in the Survey on Health, Ageing and Retirement in Europe. Cognition was measured using tests on verbal fluency, immediate and delayed recall. We used linear regression and linear mixed effects regression to examine regional differences in the level of cognitive performance and the rate of cognitive decline.
Results:
Scandinavians had the highest baseline cognitive scores (mean standardized overall cognitive score 0.3), followed by Western Europeans (mean 0.2), Central and Eastern Europeans (mean 0.1) and individuals from Mediterranean countries (mean -0.4). These differences persisted even after adjustment for sociodemographic and clinical characteristics. The annual cognitive decline in Scandinavia (0.59%) was approximately two times greater than in Western Europe (0.28%), Central and Eastern Europe (0.25%) and Mediterranean countries (0.23%).
Discussion:
There are substantial differences in cognitive performance as well as rates of cognitive decline among the elderly throughout European regions. This might be explained by differing levels of cognitive reserve.
Abnormalities in reward circuit function are considered a core feature of addiction. Yet, it is still largely unknown whether these abnormalities stem from chronic drug use, a genetic predisposition, or both.
Methods
In the present study, we investigated this issue using a large sample of adolescent children by applying structural equation modeling to examine the effects of several dopaminergic polymorphisms of the D1 and D2 receptor type on the reward function of the ventral striatum (VS) and orbital frontal cortex (OFC), and whether this relationship predicted the propensity to engage in early alcohol misuse behaviors at 14 years of age and again at 16 years of age.
Results
The results demonstrated a regional specificity with which the functional polymorphism rs686 of the D1 dopamine receptor (DRD1) gene and Taq1A of the ANKK1 gene influenced medial and lateral OFC activation during reward anticipation, respectively. Importantly, our path model revealed a significant indirect relationship between the rs686 of the DRD1 gene and early onset of alcohol misuse through a medial OFC × VS interaction.
Conclusions
These findings highlight the role of D1 and D2 in adjusting reward-related activations within the mesocorticolimbic circuitry, as well as in the susceptibility to early onset of alcohol misuse.
Cardiomyopathy is a common manifestation in neonates and infants with mitochondrial disorders. In this study, we report two cases manifesting with fatal mitochondrial hypertrophic cardiomyopathy, which include the third known patient with thymidine kinase 2 deficiency and the ninth patient with alanyl-tRNA synthetase 2 deficiency. The girl with thymidine kinase 2 deficiency had hypertrophic cardiomyopathy together with regression of gross motor development at the age of 13 months. Neurological symptoms and cardiac involvement progressed into severe myopathy, psychomotor arrest, and cardiorespiratory failure at the age of 22 months. The imaging methods and autoptic studies proved that she suffered from unique findings of leucoencephalopathy, severe, mainly cerebellar neuronal degeneration, and hepatic steatosis. The girl with alanyl-tRNA synthetase 2 deficiency presented with cardiac failure and underlying hypertrophic cardiomyopathy within 12 hours of life and subsequently died at 9 weeks of age. Muscle biopsy analyses demonstrated respiratory chain complex I and IV deficiencies, and histological evaluation revealed massive mitochondrial accumulation and cytochrome c oxidase-negative fibres in both cases. Exome sequencing in the first case revealed compound heterozygozity for one novel c.209T>C and one previously published c.416C>T mutation in the TK2 gene, whereas in the second case homozygozity for the previously described mutation c.1774C>T in the AARS2 gene was determined. The thymidine kinase 2 mutations resulted in severe mitochondrial DNA depletion (to 12% of controls) in the muscle. We present, for the first time, severe leucoencephalopathy and hepatic steatosis in a patient with thymidine kinase 2 deficiency and the finding of a ragged red fibre-like image in the muscle biopsy in a patient with alanyl-tRNA synthetase 2 deficiency.
We present comparative studies of optical properties of GaN nanowires (NWs) obtained by two different self-formation techniques: Plasma-Assisted Molecular Beam Epitaxy (PAMBE) growth; and plasma etching of GaN layers deposited by Metal-Organic Vapor Phase Epitaxy (MOVPE). The effects of the coalescence process on grown NW and plasma-induced defects in etched NWs have been studied by photoluminescence (PL) and Raman scattering. In MBE grown NWs, the coalescence-associated defects are extended toward the NW top for intermediate Ga flux. Using High Resolution Electron Microscopy of reactive plasma etching (RIE) NWs, it was found that NWs obtained with an optimal combination of inductive (ICP) and capacitive (RF) plasma are free of extended structural defects. The PL efficiency is strongly increased in plasma etched NWs. However, plasma-induced point defects have to be taken into account for explaining the changes of the PL spectra. Less plasma-induced degradation is observed for high ICP/RF power ratios.
The digestive system of sea spiders (Pycnogonida) presents peculiarities that have not been discussed in the context of their ecology or feeding behaviour. We investigated the digestive system of two Mediterranean species, a carnivorous species Ammothella longipes and a detritivorous Endeis spinosa, with special focus on its correlation with behavioural feeding habits. The midgut and hindgut sections did not present significant differences between the two species, but major differences were observed in the foregut, reflecting concordance to their diet and their feeding behaviour. Jaws, setose lips, the structure of the pharyngeal filter and musculature of the proboscis are the main differential elements when comparing feeding habits of A. longipes and E. spinosa. These elements are responsible for the reduction of the food pulp down to subcellular size. The digestion process observed in the species studied agrees with that observed in other pycnogonid lineages, but differs from most marine arthropods mainly because of the absence of midgut gland cells and the presence of a unique multifunctional type of midgut epithelial cell. Epithelial digestive cells are present in a small ‘resting’ form during starvation periods. During digestion, secretion granules possibly containing zymogen move to their apical border to be secreted to the midgut lumen, secondary lysosomes are formed and intracellular digestion occurs within them. Residual bodies are formed within the epithelial cell and released to the midgut lumen to be transported towards the hindgut. The characteristics of the digestive process of the pycnogonids studied seem to reflect a plesiomorphic state in arthropods.
Internet-delivered self-help programmes with added therapist guidance have shown efficacy in social anxiety disorder, but unguided self-help has been insufficiently studied.
Aims
To evaluate the efficacy of guided and unguided self-help for social anxiety disorder.
Method
Participants followed a cognitive–behavioural self-help programme in the form of either pure bibliotherapy or an internet-based treatment with therapist guidance and online group discussions. A subsequent trial was conducted to evaluate treatment specificity. Participants (n = 235) were randomised to one of three conditions in the first trial, or one of four conditions in the second.
Results
Pure bibliotherapy and the internet-based treatment were better than waiting list on measures of social anxiety, general anxiety, depression and quality of life. The internet-based therapy had the highest effect sizes, but directly comparable effects were noted for bibliotherapy augmented with online group discussions. Gains were well maintained a year later.
Conclusions
Unguided self-help through bibliotherapy can produce enduring improvement for individuals with social anxiety disorder.
In human alcoholics, the cell density is decreased in the prefrontal cortex (PFC) and other brain areas. This may be due to persistent activation of cell death pathways. To address this hypothesis, we examined the status of cell death machinery in the dorsolateral PFC in alcoholics. Protein and mRNA expression levels of several key pro- and anti-apoptotic genes were compared in post-mortem samples of 14 male human alcoholics and 14 male controls. The findings do not support the hypothesis. On the contrary, they show that several components of intrinsic apoptotic pathway are decreased in alcoholics. No differences were evident in the motor cortex, which is less damaged in alcoholics and was analysed for comparison. Thus, cell death mechanisms may be dysregulated by inhibition of intrinsic apoptotic pathway in the PFC in human alcoholics. This inhibition may reflect molecular adaptations that counteract alcohol neurotoxicity in cells that survive after many years of alcohol exposure and withdrawal.
This study contains the current list of the austral pycnogonids together with details of their depth range and distribution. To date 264 species have been recorded, accounting for 19.6% of the 1344 species recorded worldwide. One hundred and eight species are endemic to Antarctic waters, 62 to the sub-Antarctic, 63 are common in both regions, and 55 are circumpolar. The richest genus is Nymphon, with 67 species and the richest area is the Scotia Sea. Comparing species lists between the years 2000 and 2007 shows that increased expeditions with more sampling has increased the circumpolarity of species and decreased zonal endemicity. The benthic insular refuge hypothesis is proposed as an explanation for the southern distribution of the present pycnogonid fauna, with an origin in the Scotia Arc.