22 resultados para Withholding and withdrawing life prolonging treatment
em CentAUR: Central Archive University of Reading - UK
Resumo:
This article revisits the Neolithic transition in Mediterranean Iberia taking into account an aspect usually neglected in the archaeological discourse: the rock art styles that emerged in this context. These distinct styles have been generally attributed to different populations, according to a historicist point of view that equates stylistic variability and ethnic identity. However, the recent recognition that they were developed by the same social group requires the formulation of an alternative explanation. My proposal is based on the exploration of the social context of production and consumption of the rock art, through the analysis of the patterns of location of the sites within the landscape and the definition of their archaeological context.
Resumo:
Interpretation biases towards threat play a prominent role in cognitive theories of anxiety, and have been identified amongst highly anxious adults and children. Little is known, however, about the development of these cognitive biases although family processes have been implicated. The current study investigated the nature of threat interpretation of anxious children and their mothers through (i) comparison of a clinic and non-clinic population, (ii) analysis of individual differences; and (ill) pre- and post-treatment comparisons. Participants were 27 children with a primary anxiety disorder and 33 children from a non-clinic population and their mothers. Children and mothers completed self-report measures of anxiety and indicated their most likely interpretation of ambiguous scenarios. Clinic and non-clinical groups differed significantly on measures of threat interpretation. Furthermore, mothers' and children's threat interpretation correlated significantly. Following treatment for child anxiety, both children and their mothers reported a reduction in threat interpretation. (c) 2005 Elsevier Ltd. All rights reserved.
Longitudinal investigation of the role of temperament and stressful life events in childhood anxiety
Resumo:
The current study investigated the longitudinal relationships between BI, life events, and anxiety in a sample of 102 behaviourally inhibited (BI) and 100 uninhibited (BUI) children aged 3 to 4 years. Children’s parents completed questionnaires on BI, stressful life events, and anxiety symptoms, and were administered a diagnostic interview three times in a 5-year period. In line with our hypotheses, negative life events, and negative behaviour- dependent life events (i.e. life events that are related to the children’s own behaviours) in particular, and the impact of negative life events, were predictive of increases in subsequent anxiety symptoms, the likelihood of having an anxiety disorder, and increased number of anxiety diagnoses over the five year follow-up period. Experiencing more positive, behaviour-independent life events decreased the risk of being diagnosed with an anxiety disorder. Furthermore, differences were found in life events between BI and BUI children. That is, BI children experienced fewer positive and specifically positive behaviour-dependent life events, and the impact of these positive life events was also lower in BI children than in BUI children. However, BI did not interact with life events in the prediction of anxiety problems as hypothesized. Therefore, this study seems to indicate that BI and life events act as additive risk factors in the development of anxiety problems.
Resumo:
Background: Reports of the clinical characteristics of children and adolescents with anxiety disorders are typically based on community populations or from clinical samples with exclusion criterion applied. Little is known about the clinical characteristics of children and adolescents routinely referred for treatment for anxiety disorders. Furthermore, children and adolescents are typically treated as one homogeneous group although they may differ in ways that are clinically meaningful. Methods: A consecutive series of children (n = 100, aged 6-12 years) and adolescents (n = 100, aged 13-18 years), referred to a routine clinical service, were assessed for anxiety and comorbid disorders, school refusal and parental symptoms of psychopathology. Results: Children were significantly more likely to be diagnosed with separation anxiety disorder than adolescents. Adolescents with a primary anxiety disorder had significantly higher self and clinician rated anxiety symptoms and had more frequent primary diagnoses of social anxiety disorder, diagnoses and symptoms of mood disorders, and irregular school attendance. Limitations: Childhood and adolescence were considered categorically as distinct, developmental periods; in reality changes would be unlikely to occur in such a discrete manner. Conclusions: The finding that children and adolescents with anxiety disorders have distinct clinical characteristics has clear implications for treatment. Simply adapting treatments designed for children to make the materials more ‘adolescent-friendly’ is unlikely to sufficiently meet the needs of adolescents.
Resumo:
Habitat modification for agriculture is one of the greatest current threats to global biodiversity. Studies show large-scale population declines and short-term demographic impacts, but knowledge of the long-term effects of agriculture on individuals remains poor. This thesis examines the short- and long-term impact of agriculture on a reintroduced population of the Mauritius kestrel Falco punctatus, a tropical forest-dwelling raptor endemic to the island of Mauritius, that also utilises agricultural habitats. This population is a particularly appropriate model system, because complete life history data exists for individuals over a 22-year period, alongside detailed habitat and climate data. Agriculture has a short-term detrimental effect on Mauritius kestrel breeding success by exacerbating the seasonal decline in fledgling production. This is partly driven by the habitat-specific composition of the prey community that kestrels exploit to feed their chicks. The fledglings from agricultural territories tend to recruit in agricultural territories. This is largely due to poor natal dispersal and fine-scale spatial autocorrelation in the habitat matrix. Breeders do not respond to agriculture in the breeding territory by dispersing, unless the pair bond is broken. Therefore, individuals originating in agricultural territories tend to recruit, and remain in, agricultural territories throughout their lives. In addition to this, females from agricultural natal territories have shorter lifespans, schedule their peak reproductive output earlier in life, and exhibit more rapid senescence than non-agricultural females. The combination of this long-term effect and the adult experience of agriculture imposed by life history and environmental constraints, leads to a lower mean lifetime reproductive rate compared to females originating in non-agricultural habitats. These results demonstrate that agriculture experienced in early life has a lifelong effect on individuals. The effects can persist in time and space, with potentially delayed effects on population dynamics. These findings are important for understanding species’ responses to agricultural expansion.
Resumo:
Background We have previously shown that the selective serotonergic re-uptake inhibitor, citalopram, reduces the neural response to reward and aversion in healthy volunteers. We suggest that this inhibitory effect might underlie the emotional blunting reported by patients on these medications. Bupropion is a dopaminergic and noradrenergic re-uptake inhibitor and has been suggested to have more therapeutic effects on reward-related deficits. However, how bupropion affects the neural responses to reward and aversion is unclear. Methods 17 healthy volunteers (9 female, 8 male) received 7 days of bupropion (150 mg/day) and 7 days of placebo treatment, in a double-blind crossover design. Our functional Magnetic Resonance Imaging task consisted of 3 phases; an anticipatory phase (pleasant or unpleasant cue), an effort phase (button presses to achieve a pleasant taste or to avoid an unpleasant taste) and a consummatory phase (pleasant or unpleasant tastes). Volunteers also rated wanting, pleasantness and intensity of the tastes. Results Relative to placebo, bupropion increased activity during the anticipation phase in the ventral medial prefrontal cortex (vmPFC) and caudate. During the effort phase, bupropion increased activity in the vmPFC, striatum, dorsal anterior cingulate cortex and primary motor cortex. Bupropion also increased medial orbitofrontal cortex, amygdala and ventral striatum activity during the consummatory phase. Conclusions Our results are the first to show that bupropion can increase neural responses during the anticipation, effort and consummation of rewarding and aversive stimuli. This supports the notion that bupropion might be beneficial for depressed patients with reward-related deficits and blunted affect.