Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Not a Problem to Be Fixed: Successful First-Generation Graduates and Implications for College Counselors

This article describes a qualitative study with seven first-generation college graduates who went on to complete graduate school and are now working in colleges and universities as counselors and counselor educators. The findings highlight the resources that these participants possessed that contributed to their college success stories. Relational-cultural theory is proposed as a fitting developmental model for college counselors working with this student demographic. Este artículo describe un estudio cualitativo con siete graduados universitarios de primera generación que completaron programas de posgrado y actualmente trabajan como consejeros y educadores de consejeros en universidades y otros centros de estudios superiores. Los resultados resaltan los recursos que poseían los participantes y que contribuyeron a sus historias de éxito en la educación superior. Se propone la teoría relacional-cultural como un modelo de desarrollo apropiado para consejeros de educación superior que trabajan con este grupo demográfico de estudiantes.     

What we talk about when we talk about pediatric suffering

Theoretical Medicine and Bioethics - In this paper I aim to show why pediatric suffering must be understood as a judgment or evaluation, rather than a mental state. To accomplish this task, first I...     

Editorial

Addressing the issues of intersubjectivity and hermenutics and their relevance for psychoanalysis, the author presents a model for interpreting inspired by the existential hermeneutics of Martin Heidegger. This analysis is then applied to the clinical reality of the psychoanalytical situation. The author discusses the matrix of transference, the analytical dialogue as a form of reflection, the functions of hope and faith, and lastly, truth as faithfulness in the hermeneutic context.     

An integrative conceptual framework of disability. New directions for research

Advances in research on disability and rehabilitation are essential to creating equal opportunity, economic self-sufficiency, and full participation for persons with disabilities. Historically, such initiatives have focused on separate and specific areas, including neuroscience, molecular biology and genetics, gerontology, engineering and physical sciences, and social and behavioral sciences. Research on persons with disabilities should examine the broader context and trends of society that affect the total environment of persons with disabilities. This article examines the various disability paradigms across time, assessing the relative contribution of the socioecological perspective in guiding research designed to improve the lives of persons with disabilities. The authors recommend new research directions that include a focus on life span issues, biomedicine, biotechnology, the efficacy and effectiveness of current interventions, an emphasis on consumer-driven investigations within a socioecological perspective of disability, and the implications for research and practice.     

A practice-based exploration of therapeutic change in a charitable,community-based person-centred counselling service using routine outcome measures of anxiety and depression. I: Statistical and clinically significant change

Background

Establishing the value of differing treatments for depression and anxiety is crucial in a climate of delimited spending and increased demand. Drawing from a well-founded, diverse evidence base is salient to constructive evaluation and any subsequent recommendations being fit for purpose.

Design

This study employed a practice-based quantitative design to explore therapeutic gains in adult counselling clients attending person-centred therapy (n = 301), delivered in a charitable, community-based UK service.

Measures

Outcome measures PHQ-9 and GAD-7 were used from three time points: initial assessment (IA), first ongoing session and last or 6th ongoing appointment (whichever occurred first; T1, T2 and T3).

Analysis

Repeated measures ANOVA, CSI, RI and RCSI calculations were used to consider significant change in clients.

Findings

Reductions in PHQ-9 and GAD-7 outcome measures were observed over time (between T2 & T3 and T1 & T3) and were all statistically significant (p = <0.001). By T3: CSI was achieved by 48.1% of clients on PHQ-9 and 50.8% of clients on GAD-7, RI was achieved by 47.8% of clients on PHQ-9 and 60.5% of clients on GAD-7, and RCSI was achieved by 32.6% of clients on PHQ-9 and 41.2% of clients on GAD-7.

Conclusions

The treatment observed resulted in effective outcomes equivalent to other therapies reviewed in the literature for clients' symptoms of anxiety and depression as measured by GAD-7 and PHQ-9.     

Analyzing Individual Status and Change with Hierarchical Linear Models:Illustration with Depression in College Students

ABSTRACT A recently developed class of multilevel or hierarchical linear models (HLM) provides an intuitive and efficient way to estimate individual growth or change curves. The approach also models the between-subjects variation of the individual change curves with treatment factors and individual attributes. Unlike other repeated measures analysis methods common in the behavioral sciences, HLM allows the fit of data with unequal numbers of repeated observations for each subject, variable timing of observations, and missing data, features which are often characteristic of data from field studies. The application of HLM for the analysis of repeated psychological measures is discussed and illustrated here with depression data for college students. Strengths and limitations of the approach are discussed.