The young brain is particularly vulnerable to injury due to inherent physiological and developmental factors, and even mild forms of traumatic brain injury (mTBI) can sometimes result in cognitive and behavioural difficulties. Despite the high prevalence of paediatric mTBI, little is known of its impact on children's social functioning. Parent–child relationships represent the centre of young children's social environments and are therefore ideal contexts for studying the potential effects of mTBI on children's social functioning. The aim of this study was to assess the quality of parent–child interactions after mTBI using observational assessment methods and parental report. The sample included 130 children (18–60 months at recruitment) divided into three groups: children with uncomplicated mTBI (n =47), children with orthopaedic injury (OI, n =27), and non‐injured children (NI, n =56). The quality of parent–child interactions was assessed 6 months post‐injury using the Mutually Responsive Orientation (MRO) scale, an observational measure which focuses on the dyadic nature of parent–child exchanges, and the Parental Stress Index questionnaire (Parent‐Child Dysfunctional Interaction (PCDI) domain). Significant differences with medium effect sizes were found between the mTBI group and the NI group on the MRO, but not between the OI group and the other two groups. PCDI scores did not differ across groups, suggesting that observational measures may be more sensitive to changes in parent–child interactions after TBI. The current findings have implications for children's post‐injury social development and highlight the importance of monitoring social outcomes even after minor head injuries. 相似文献
The study raises the question of whether guide dogs and pet dogs are expected to differ in response to cues of referential
communication given by their owners; especially since guide dogs grow up among sighted humans, and while living with their
blind owners, they still have interactions with several sighted people. Guide dogs and pet dogs were required to respond to
point, point and gaze, gaze and control cues of referential communication given by their owners. Results indicate that the
two groups of dogs do not differ from each other, revealing that the visual status of the owner is not a factor in the use
of cues of referential communication. Both groups of dogs have higher frequencies of performance and faster latencies for
the point and the point and gaze cues as compared to gaze cue only. However, responses to control cues are below chance performance
for the guide dogs, whereas the pet dogs perform at chance. The below chance performance of the guide dogs may be explained
by a tendency among them to go and stand by the owner. The study indicates that both groups of dogs respond similarly in normal
daily dyadic interaction with their owners and the lower comprehension of the human gaze may be a less salient cue among dogs
in comparison to the pointing gesture. 相似文献
In this ethnographic study, data were collected four months, one year, and three years following a terror attack on civilians in a small Israeli community. The data included protocols of meetings of the intervention team, informal and formal interviews, and follow-up telephone interviews with local leaders and psychosocial professionals who worked with individuals, families, and groups in the community. Content analysis of field notes and interviews led to the elaboration of the theoretical construct “complex collective trauma.” The analysis of the community voices and psychosocial interventions indicated the importance of action-oriented, meaning-making community projects and memorials, screening and government-funded short-term trauma therapy, mapping interlocking circles of vulnerability, and an integrated clinical-community model coordinated long-term (one year) by an outside professional. 相似文献
Objective: The recommended dose of cyproterone acetate (CPA), an anti-androgen that is commonly used in the hormonal treatment of transgender women, is 50–100 mg daily. Our objective was to determine whether CPA at 25 mg daily would suppress total testosterone as effectively as 50 mg daily in transgender women.
Methods: We conducted a retrospective cohort analysis of transgender women attending an endocrinology clinic between April 1, 2009, and June 30, 2015. We used a generalized linear mixed model to compare total testosterone between patients on CPA 25 mg versus CPA 50 mg or higher. In a subgroup of patients for which the CPA dose was decreased from 50 mg to 25 mg, we compared total testosterone levels before and after the decrease.
Results: We divided the sixty-eight patients included in the study into 4 groups: group 1, CPA 25 mg (N =31); group 2, CPA 50 mg or higher (N = 19); group 3, CPA dose lowered from 50 mg to 25 mg (N = 15); group 4, CPA dose increased from 25 mg to 50 mg (N = 3). The mean total testosterone on treatment was 0.9 nmol/L (95% CI 0.7 to 1.1) in group 1 and 1.2 nmol/L (95% CI 0.9–1.5) in group 2 and were not significantly different (p = 0.087). In group 3, there was no significant difference between total testosterone levels before and after decreasing the dose of CPA from 50 mg to 25 mg, p = 0.86. Group 4 was excluded from analysis.
Conclusions: We found that 25 mg of CPA daily was effective at suppressing testosterone levels to within normal female range when used in combination with recommended estrogen therapy in transgender women. Clinicians should consider using a lower dose of CPA in order to minimize potential adverse effects. 相似文献
It has been claimed that, in response to certain kinds of evidence (“incomplete” or “non‐specific” evidence), agents ought to adopt imprecise credences: doxastic states that are represented by sets of credence functions rather than single ones. In this paper I argue that, given some plausible constraints on accuracy measures, accuracy‐centered epistemologists must reject the requirement to adopt imprecise credences. I then show that even the claim that imprecise credences are permitted is problematic for accuracy‐centered epistemology. It follows that if imprecise credal states are permitted or required in the cases that their defenders appeal to, then the requirements of rationality can outstrip what would be warranted by an interest in accuracy. 相似文献
To date, few studies have examined the social and psychological effects of sexting behaviors. The current study examined how delinquency, social, and psychological factors were associated with sexting behavior in a sample of rural, high school students (n = 548). The results demonstrated that property delinquency, bully-victimization, alcohol, marijuana use, and bullying increased odds of sending and receiving nude photos. Gender specific models indicated that females who had participated in sexting behavior were more likely to report using alcohol and being a victim of bullying, while males were more likely to report using marijuana and being a perpetrator of bullying. Implications are discussed. 相似文献
ABSTRACTIn this essay, Miriam Greenspan reviews her life’s work as an early pioneer of Feminist Therapy, the influence of her birth in a displaced person’s camp to parents who were Holocaust survivors, and her development as a feminist, social activist, and psychotherapist. She discusses her most influential works, including A New Approach to Women & Therapy (1983Greenspan, M. (1983). A new approach to women & therapy. New York: McGraw Hill.[Google Scholar], 1993Greenspan, M. (1993). A new approach to women & therapy (10th anniversary ed.). New York: McGraw Hill.[Google Scholar]) and Healing Through the Dark Emotions: The Wisdom of Grief, Fear, and Despair (2003Greenspan, M. (2003). Healing through the dark emotions: The wisdom of grief, fear, and despair. Boston: Shambhala.[Google Scholar]). She concludes with a look back at her own spiritual evolution, her assessment of the ultimate contribution of Feminist Therapy to society, the need for a wide model of therapy that incorporates the political and spiritual dimensions of experience, and the challenges that psychology and psychotherapy face in an age of global threat. 相似文献
Toxic stressors (e.g., parental violence, depression, low income) place children at risk for insecure attachment. Parental reflective function—parents’ capacity to understand their own and their child's mental states and thus regulate their own feelings and behavior toward their child—may buffer the negative effects of toxic stress on attachment. Our objective was to test the effectiveness of the Attachment and Child Health (ATTACH) intervention, focusing on improving reflective function and children's attachment security, for at-risk mothers and children <36 months of age. Three pilot studies were conducted with women and children from an inner city agency serving vulnerable, low-income families and a family violence shelter. Randomized control trial (n = 20, n = 10 at enrollment) and quasi-experimental (n = 10 at enrollment) methods tested the effect of the ATTACH intervention on the primary outcome of reflective function scores, from transcribed Parent Development Interviews. Our secondary outcome was children's attachment patterns from Ainsworth's Strange Situation Procedure. Despite some attrition, mixed methods analysis of covariance and t tests revealed significant differences in maternal, child, and overall reflective function, with moderate effect sizes. While more children whose mothers received the ATTACH program were securely attached posttreatment, as compared with controls, significant differences were not observed, which may be due to missing observations (n = 5 cases). Understanding the effectiveness of programs like the ATTACH intervention contributes to improved programs and services to promote healthy development of children affected by toxic stress. 相似文献
In his multi-faceted attack on Rawls’s account of justice, G.A. Cohen has argued that the notion of basic structure is necessarily
insensitive to the importance of informal social norms to social justice. The paper argues that the most plausible account
of the basic structure is not blind to informal social norms in any meaningful sense. Whereas informal, non-legally coercive
institutions are not part of the basic structure as such, their careful consideration is necessary for the assessment of whether the basic structure
itself is indeed just. This claim is based on an account of what it means for normative principle to apply to institutions,
which I expound in detail throughout the paper. Principles apply to institutions, I argue, not in that they restrain their
conduct, but in that they indicate which social conditions they should bring about.
Children of parents suffering from a serious disease (e.g. cancer, multiple sclerosis, Aids) are at increased risk for mental health problems. Empirically based interventions for these children are missing. At the University Medical Centre Hamburg-Eppendorf, a preventive short-term counselling service has been existing since July 2000. Results from a 6-month evaluation (n=50) are presented. The evaluation encompasses a retrospective interrogation in a multiperspective und multidimensional approach. Most families experienced the intervention as helpful and supportive in coping with the multiple stressors of the situation. Out of a previously defined list of 12 intervention goals, enhancing anticipatory grief in children, their active coping behaviour as well as parents’ sense of their own parenting competence were identified as the most important foci of the counselling interventions, as reported by parents, children and therapists. 相似文献