Psychosocial Issues in Families Affected by Maple Syrup Urine Disease

The primary aim of this study was to ascertain the psychosocial issues faced by families affected by maple syrup urine disease (MSUD). The psychosocial adjustment and quality of life of children with MSUD were also described. Participants included 55 families and their children (ages 5 to 18 years) and teachers. Measures included a MSUD Family Survey, the Behavior Assessment System for Children (BASC) and the Pediatric Quality of Life Inventory (PedsQL). Parents reported via the MSUD Family Survey that the greatest sources of stress were financial and emotional. Many parents reported difficulty interacting with the medical staff and with schools. On the BASC, half of the children fell within the average range in psychosocial adjustment, although there were elevations in scales measuring attention, hyperactivity, and learning problems. On the PedsQL, the mean quality of life scores were closer to children with cancer than to a healthy sample. Despite the emotional and financial burden, parents reported that MSUD has also had a positive influence on their lives, leading to a world-view that is more compassionate and caring.     

Young Adults with MSUD and Their Transition to Adulthood: Psychosocial Issues

Maple Syrup Urine Disease (MSUD) is an autosomal recessive condition with an incidence of 1 in 185,000 births worldwide. Regardless of the type of MSUD, treatment includes immediate and lifelong dietary restriction of isoleucine, leucine and valine. There is little known about the psychosocial impact of MSUD on the developmental milestones of emerging adulthood. We used a qualitative case study approach to explore the human experiences of MSUD on young adults (n?=?8) and parents (n?=?8). All participants were administered a semi-structured, qualitative interview as well as quantitative measures. Six core themes emerged: 1) lifelong strain of dietary management; 2) social isolation from peers and impact on dating; 3) impact of MSUD on academics and employment; 4) medical experiences and transition to adult care; 5) impact on family functioning; and 6) positive effects and growth. The results of this investigation highlight and expand awareness of the psychological and social needs of young adults with MSUD. This study calls for a collaborative, multidisciplinary effort in the treatment of these patients and their families.     

Community-Based Research in India: A Case Example of International and Transdisciplinary Collaboration

While there has been a trend toward greater disciplinary collaboration over the last several decades, the emergence of the HIV pandemic has required that disciplines work more closely and creatively to generate the multiple and innovative approaches necessary to meet the demands for effective prevention and treatment. This paper describes the nature of collaborative relationships among U.S. and Indian anthropologists, psychologists, demographers, epidemiologists, physicians and representatives of other fields and sectors in conducting a large scale, multi-year HIV/STD prevention project directed toward married men in urban poor communities in Mumbai (Bombay), India. The project has challenged members of the participating disciplines to develop a transdisciplinary conceptual model, to test the model with community-based formative research and to utilize the results in the development and implementation of a multi-level (community, provider and patient) intervention. The paper describes the interaction among disciplines and international sectors in the conceptualization, methodology and community-based action components of the project. In addition, it examines both the inhibiting and facilitating factors that are a part of the collaborative process. The paper concludes with implications for future transdisciplinary partnerships.     

Foster Children Caught in Loyalty Conflicts: Implications for Mental Health Treatment Providers

Fifty-two foster parents participated in a two-hour training on the topic of children caught in loyalty conflicts. Prior to and following the training attendees completed measures including one in which they rated their foster children's exposure to 15 different family situations which research indicates are likely to induce feelings of loyalty conflict in children. Analyses of these data indicate that each of the situations was endorsed by between one fourth and one half of the sample. Three-fourths of the foster parents endorsed at least one of the situations, with the average number 5.5. Implications for clinicians working with this population are discussed.     

The Effect of Pedagogy on Students' Perceptions of the Importance of Ethics and Social Responsibility in Business Firms

Human moral rights place justified limits on what people are free to do to one another. Animals also have moral rights, and arguments to support the use of animals in scientific research based on the benefits allegedly derived from animal model research are thus invalid. Animals do not belong in laboratories because placing them there, in the hope of benefits for others, violates their rights.     

Righteous Rhetoric: Sex,Speech and the Politics of Concerned Women for America

Abstract

This article considers the Catholic Church's rejection of female sexed bodies as capable of symbolizing Christ in the Eucharist of God's agency in the world. The theories of René Girard provide a useful resource for analyzing the fear of female sexuality within Catholicism. They reveal that an obsessive focus upon sex has been the means through which the male tendency towards sacrificial violence, forbidden within Christianity, has continued to exert a powerful influence. A recognition of this substitutory process would not only enable a revisioning of the roles women and men might play within the Church, but also enable the Church to more effectively oppose the ‘culture of death’ which endangers us all.     

Adolescent-specific patterns of behavior and neural activity during social reinforcement learning

Humans are sophisticated social beings. Social cues from others are exceptionally salient, particularly during adolescence. Understanding how adolescents interpret and learn from variable social signals can provide insight into the observed shift in social sensitivity during this period. The present study tested 120 participants between the ages of 8 and 25 years on a social reinforcement learning task where the probability of receiving positive social feedback was parametrically manipulated. Seventy-eight of these participants completed the task during fMRI scanning. Modeling trial-by-trial learning, children and adults showed higher positive learning rates than did adolescents, suggesting that adolescents demonstrated less differentiation in their reaction times for peers who provided more positive feedback. Forming expectations about receiving positive social reinforcement correlated with neural activity within the medial prefrontal cortex and ventral striatum across age. Adolescents, unlike children and adults, showed greater insular activity during positive prediction error learning and increased activity in the supplementary motor cortex and the putamen when receiving positive social feedback regardless of the expected outcome, suggesting that peer approval may motivate adolescents toward action. While different amounts of positive social reinforcement enhanced learning in children and adults, all positive social reinforcement equally motivated adolescents. Together, these findings indicate that sensitivity to peer approval during adolescence goes beyond simple reinforcement theory accounts and suggest possible explanations for how peers may motivate adolescent behavior.     

How We See Ourselves: A Resident’s Reflection on the Class Play

The “class play” is an annual tradition in residency training programs and medical schools that celebrates the end of the academic year. It is also a locally generated narrative that reveals important components of an institution’s values, culture, and group dynamics. Exploring the class play is a reflexive exercise that allows one to reflect on his or her professional development and place in the department in a structural, historical, and experience-near driven way. In this way, the creation of and examining of the class play may be seen as an opportunity to understand and expand upon medicine’s Hidden Curriculum.     

Psychological Intervention in a Case of Bulimia Nervosa: A Case Report

This paper presents a case report detailing the use of an enhanced form of enhanced cognitive behavior therapy (CBT) and other techniques that were employed when faced with impediments in adhering to manualized CBT-E. Ms. S, 22 years old unmarried female pursuing MBBS final year, belonging to upper middle socioeconomic status and urban domicile was provided with 28 weekly sessions of psychotherapy to simultaneously address the patient’s symptoms and try to effect change across multiple domains. A single case design was adopted. Therapy was conducted over 9 months. A total of 28 sessions were taken, with the frequency of two sessions/week initially, and then moving onto one session/week. Pre and Post assessments using Binge Eating Scale, BDI-II, height and weight measurements and frequency of binging episodes using visual analogue scale were done. On measures of pre and post assessment there was 87 % improvement in Binging Episodes, 82 % improvement on Binge Eating Scale and client had 3 kg weight gain with reduction in depression as assessed on BDI-II. The gains were maintained at 1 month follow up. The use and deviations from CBT E, therapy process, role of family and challenges to intervention will be discussed in this case report.     

Associations Between Mixed-Gender Friendships,Gender Reference Group Identity and Substance Use in College Students

We investigated the associations between same-gender friendship, gender reference group identity, and substance use in college students (54 % male, M age?=?19.23, SD?=?1.23) from the northeastern United States using an online survey. Male students reported greater weekly marijuana, but not alcohol use than female students. Regression analyses revealed that having a greater proportion of same-gender friendships was associated with greater weekly alcohol use for male students and lesser weekly alcohol and marijuana use for female students. Gender reference group identity was negatively associated with weekly marijuana use for male and female students. For female students, gender reference group identity mediated the association between proportion of same-gender friendships and weekly marijuana use. Our study highlights the importance of considering the social context (e.g., the gender of friends) and individual variables relating to gender (e.g. gender reference group identity) in substance use research. Our findings fit within social constructionist models of social development that suggest participation in gendered contexts (e.g., same-gender or other-gender-peer contexts) over time cue gender-typed behaviors such as using marijuana.