A universally delivered CBT based intervention in a Scottish secondary school: a pilot feasibility study

Objectives: To evaluate the feasibility of a universally delivered CBT-based programme for pupils within a Scottish secondary school setting. Design: A pre-post, within and between groups design was utilised. Setting: Religious Moral Citizenship and Education (RMCE) classes in a Scottish secondary school. Participants: Four (n = 103) classes of third year secondary school pupils were arbitrarily allocated to two conditions: RMCE-as usual (RMCE-AU) controls, and LLTTF intervention. Intervention: Living Life to the Full (LLTTF) is a series of Cognitive Behavioural Therapy (CBT)-based booklets and accompanying 8 classes to improve coping skills. An adolescent version of LLTTF was recently developed. This was delivered over nine weeks by school teachers trained in the approach. Outcome measures: The Strengths and Difficulties Questionnaire, Rosenberg Self-Esteem scale, General Self-Efficacy Scale, and Locus of Control scale were administered at baseline and 9 week follow-up. To determine acceptability and utility of the materials course feedback was gathered weekly from the intervention group and a focus group (n=5) was conducted at 3 month follow up. Results: Outcome measures showed no significant improvement in overall wellbeing of those in the intervention group compared with that of the control group. Weekly feedback suggested that the majority of pupils found the materials useful and relevant. Focus group feedback suggested that pupils found the intervention useful, had utilised strategies in everyday life and would welcome recurring provision of such interventions within the school setting. Conclusions: Universally delivered CBT intervention is acceptable and feasible within the secondary school environment. However, objective measurement using standardised tools does not adequately corroborate qualitative feedback from pupils. Issues relating to measurement, study design and implementation of future interventions are discussed.

Être médecin diplômé à l’étranger au Québec : des parcours contrastés d’intégration professionnelle

En 2015, il y aurait au Québec plus de 5 000 médecins diplômés à l’étranger, dont près de 2 500 travaillent comme médecins et possiblement autant qui ont emprunté d’autres voies professionnelles, momentanément ou durablement. Les migrants très qualifiés sont réputés faire face à de multiples barrières sur le marché du travail, particulièrement ceux membres de professions réglementées. Le cas des médecins est exemplaire compte tenu de sa complexité et de la multiplicité des acteurs impliqués au cours du processus de reconnaissance professionnelle. Ayant comme principal objectif de documenter les trajectoires d’intégration professionnelle de diplômés internationaux en médecine (DIM) et leurs expériences sur le marché du travail québécois, cette thèse s’attache à comprendre ce qui pourrait distinguer les trajectoires d’intégration en emploi pour un même groupe professionnel. En observant notamment les stratégies d’intégration et les ressources mobilisées, nous cherchons à mieux saisir les parcours des DIM qui se requalifient et qui exercent au Québec et ceux qui se réorientent vers d’autres secteurs d’activités. La démarche méthodologique est qualitative (terrain 2009 à 2012), le cœur des analyses étant basé sur 31 récits de vie professionnelle de DIM ayant migré au Québec principalement dans les années 2000. Les données secondaires incluent 22 entretiens non dirigés auprès d’acteurs clés de milieux institutionnels, communautaires ou associatifs ainsi qu’auprès de DIM très récemment immigrés ou ayant le projet d’immigrer. S’y ajoute l’observation ethnographique ponctuelle, telle que des activités associatives. La forme retenue pour cette thèse en est une par articles. Le fil directeur est l’exploration de l’interface entre les politiques, les pratiques et les individus au cœur des trajectoires d’intégration professionnelle. Les trois articles (chapitres 4 à 6) visent des focales complémentaires avec le même objectif : l’exploration de la complexité des trajectoires d’intégration professionnelle et la dialectique entre les niveaux micro, méso et macrosociaux. Ces derniers renvoient respectivement à la puissance d’agir des individus et leurs contraintes d’action, les relations sociales, les institutions et les pratiques organisationnelles et plus largement les structures sociopolitiques. Les résultats de cette thèse mettent en lumière des aspects complémentaires de l’intégration professionnelle et en interaction dynamique : 1) dimension macrosociale et politique; 2) dimensions institutionnelles et relations sociales; 3) identité professionnelle. Suite à l’introduction, la problématique (chap. 1) et la méthodologie (chap.2), le chapitre 3 expose les types des trajectoires d’intégration des DIM, leur hétérogénéité, et met en relief leurs récits de vie professionnelle. Le chapitre 4 soulève le paradoxe entre les politiques d’attraction de l’immigration déployés par les gouvernements canadien et québécois et les mécanismes de régulation opérant sur le marché du travail. Le chapitre 5 explore les stratégies et ressources mobilisées par les DIM et met en lumière l’effet positif des ressources symboliques. Les ressources institutionnelles de soutien, quoique élémentaires dans le processus de reconnaissance professionnelle, ne sont subjectivement pas considérées comme un élément central. Ce sont plutôt les ressources informelles qui jouent ce rôle d’appui significatif, en particulier les pairs DIM. Le chapitre 6 adopte une perspective microsociale et explore le caractère dynamique et relationnel de l’identité professionnelle, mais surtout, la puissance des conditions d’appartenance qui obligent à une flexibilité professionnelle et parfois au retrait de la profession ou du pays. Le chapitre 7 discute au plan théorique de l’intérêt d’une combinaison d’échelles analytiques et d’une ouverture disciplinaire afin de souligner les tensions et angles morts en ce qui concerne les mobilités de professionnels de la santé et leur intégration professionnelle. Cette thèse explore l’interrelation complexe entre les ressources économiques, sociales et symboliques, dans un contexte de fragmentation des ressources institutionnelles et de corporatisme.

The Influence of Pre-Migration Factors and Post-Migration Climate of the Receiving Community on the Psychological Distress of Latino Immigrants

Over forty million foreign-born residents currently live in the United States. Latinos make up the largest population of immigrants living in the U.S. Previous research suggests that Latino immigrants often experience pre-migration stressors, such as traumatic experiences, political upheaval, and unplanned migration. These stressors may have a negative impact on immigrants’ post-migration mental health. Research also suggests that the post-migration climate of the receiving community may inform the connection between pre-migration experiences and post-migration mental health. The current study examined the relationship between Latino immigrants’ reasons for migration, migration planning, and pre-migration experience of political and/or interpersonal violence, and post-migration symptoms of psychological distress. In addition to examining the effect of these pre-migration factors, the current study also examined the community “climate” experienced by Latino immigrants post-migration by assessing the influence of three post-migration factors: 1) community support and engagement, 2) discrimination, and 3) employment. The study was a secondary analysis of data collected for the National Latino and Asian American Study, which focused on the mental health and service utilization of Latinos and Asian Americans. Participants included 1,629 Latino immigrants from across the United States. Results indicated that pre-migration experience of political and/or interpersonal trauma, post-migration experience of discrimination, and female sex were positively associated with psychological distress. Post-migration employment was negatively associated with psychological distress. In addition, discrimination modified the association between unplanned migration and psychological distress; the relationship between unplanned migration and psychological distress decreased for participants who reported more discrimination. Furthermore, employment modified the association between political and/or interpersonal trauma and psychological distress; the connection between trauma and psychological distress increased among those who reported having less employment. Recommendations for further research were presented. Policy and clinical practice implications were discussed, particularly given the current climate of high anti-immigrant sentiment and hostility in the U.S.

INCORPORATING STIMULATING QUICK-WRITE PROMPTS WITHIN A SECONDARY SCIENCE CLASSROOM: A CASE STUDY IN LESOTHO

The use of intriguing open-ended quick-write prompts within the Basotho science classroom could potentially provide a way for secondary teachers in Lesotho to have a time-efficient alternative to stimulate student thinking and increase critical thinking or application of scientific principles. Writing can be used as a powerful means to improve the achievement of students across many subject areas, including the sciences (Moore, 1993; Rivard, 1994; Rillero, Zambo, Cleland, and Ryan, 1996; Greenstein, 2013). This study focuses on the use of a non-traditional nor extensively studied writing method that could potentially support learning in science. A quasi-experimental research design, with a control and experimental group, was applied. The study was conducted at two schools, with one experimental classroom in one school and a second control group classroom in the second school for a period of 4 weeks. 51 Form B (US Grade 9 equivalent) students participated as the experimental group and 43 Form B students as the control group. In an effort to assess learning achievement, a 1 hour (35 mark) pre-test evaluation was made by and given to students by Basotho teachers at the beginning of this study to have an idea of student’s previous knowledge. Topics covered were Static Electricity, Current Electricity, Electromagnetic Waves, and Chemistry of Water. After the experimental trial period, an almost completely identical post-test evaluation was given to students in the same fashion to observe and compare gains in achievement. Test data was analyzed using an inferential statistics procedure that compared means and gains in knowledge made by the experimental and control groups. Difference between the gains of mean pre-test and post-test scores were statistically significant within each group, but were not statistically significant when the control and experimental groups were compared. Therefore, there was no clear practical effect. Qualitative data from teachers’ journals and students’ written feedback provides insight on the assessments, incorporation of the teaching method, and the development of participating students. Both mid and post-study student feedback shows that students had an overall positive and beneficial experience participating in this activity. Assessments and teacher journals showed areas of strength and weaknesses in student learning and on differences in teaching styles. They also helped support some feedback claims made by students. Areas of further research and improvement of the incorporation of this teaching method in the Basotho secondary science classroom are explored.

The Japanese History Textbook Controversy Amid Post-War Sino-Japanese Relations

The relations between China and Japan are strained and continue to foster negative emotions partly because of China’s grievances about Japan’s actions during World War II and the allegedly false historiographical accounts found in Japanese history textbooks. This study will utilize historical analysis of the events leading up to the Nanjing Massacre in December of 1937, examine the Japanese Ministry of Education’s (MEXT) critical and contentious role in the selection of textbooks, used for primary and secondary schools, and will also juxtapose the controversial 2001 Atarashii rekishi kyōkasho with current Japanese history textbooks. The study will also include a syntactical analysis of key terms through my own original translations of multiple Japanese history textbooks, which are currently used in the Japanese school curriculum, to reveal that the textbook publishers, MEXT, and regulation councils are involved in adjusting the content causing the information to reveal various degrees of whitewashing.

The effect of mobile technology as an active student response system on the acquisition of U.S. history content of secondary students with specific learning disabilities

Students with specific learning disabilities (SLD) typically learn less history content than their peers without disabilities and show fewer learning gains. Even when they are provided with the same instructional strategies, many students with SLD struggle to grasp complex historical concepts and content area vocabulary. Many strategies involving technology have been used in the past to enhance learning for students with SLD in history classrooms. However, very few studies have explored the effectiveness of emerging mobile technology in K-12 history classrooms. ^ This study investigated the effects of mobile devices (iPads) as an active student response (ASR) system on the acquisition of U.S. history content of middle school students with SLD. An alternating treatments single subject design was used to compare the effects of two interventions. There were two conditions and a series of pretest probesin this study. The conditions were: (a) direct instruction and studying from handwritten notes using the interactive notebook strategy and (b) direct instruction and studying using the Quizlet App on the iPad. There were three dependent variables in this study: (a) percent correct on tests, (b) rate of correct responses per minute, and (c) rate of errors per minute. ^ A comparative analysis suggested that both interventions (studying from interactive notes and studying using Quizlet on the iPad) had varying degrees of effectiveness in increasing the learning gains of students with SLD. In most cases, both interventions were equally effective. During both interventions, all of the participants increased their percentage correct and increased their rate of correct responses. Most of the participants decreased their rate of errors. ^ The results of this study suggest that teachers of students with SLD should consider a post lesson review in the form of mobile devices as an ASR system or studying from handwritten notes paired with existing evidence-based practices to facilitate students’ knowledge in U.S. history. Future research should focus on the use of other interactive applications on various mobile operating platforms, on other social studies subjects, and should explore various testing formats such as oral question-answer and multiple choice. ^

The impact of personal background and school contextual factors on academic competence and mental health functioning across the primary-secondary school transition

Students negotiate the transition to secondary school in different ways. While some thrive on the opportunity, others are challenged. A prospective longitudinal design was used to determine the contribution of personal background and school contextual factors on academic competence (AC) and mental health functioning (MHF) of 266 students, 6-months before and after the transition to secondary school. Data from 197 typically developing students and 69 students with a disability were analysed using hierarchical linear regression modelling. Both in primary and secondary school, students with a disability and from socially disadvantaged backgrounds gained poorer scores for AC and MHF than their typically developing and more affluent counterparts. Students who attended independent and mid-range sized primary schools had the highest concurrent AC. Those from independent primary schools had the lowest MHF. The primary school organisational model significantly influenced post-transition AC scores; with students from Kindergarten--Year 7 schools reporting the lowest scores, while those from the Kindergarten--Year 12 structure without middle school having the highest scores. Attending a school which used the Kindergarten--Year 12 with middle school structure was associated with a reduction in AC scores across the transition. Personal background factors accounted for the majority of the variability in post-transition AC and MHF. The contribution of school contextual factors was relatively minor. There is a potential opportunity for schools to provide support to disadvantaged students before the transition to secondary school, as they continue to be at a disadvantage after the transition.

State-narco networks and the ‘War on Drugs’ in post-transition Bolivia, with special reference to 1989-1993

This thesis examines the development of state-narco networks in post-transition Bolivia. Mainstream discourses of drugs tend to undertheorise such relationships, holding illicit economies, weak states and violence as synergistic phenomena. Such assumptions fail to capture the nuanced relations that emerge between the state and the drug trade in different contexts, their underlying logics and diverse effects. As an understudied case, Bolivia offers novel insights into these dynamics. Bolivian military authoritarian governments (1964-1982), for example, integrated drug rents into clientelistic systems of governance, helping to establish factional coalitions and reinforce regime authority. Following democratic transition in 1982 and the escalation of US counterdrug efforts, these stable modes of exchange between the state and the coca-cocaine economy fragmented. Bolivia, though, continued to experience lower levels of drug-related violence than its Andean neighbours, and sustained democratisation despite being a major drug producer. Focusing on the introduction of the Andean Initiative (1989-1993), I explore state-narco interactions during this period of flux: from authoritarianism to (formal) democracy, and from Cold War to Drug War. As such, the thesis transcends the conventional analyses of the drugs literature and orthodox readings of Latin American narco-violence, providing insights into the relationship between illicit economies and democratic transition, the regional role of the US, and the (unintended) consequences of drug policy interventions. I utilise a mixed methods approach to offer discrete perspectives on the object of study. Drawing on documentary and secondary sources, I argue that state-narco networks were interwoven with Bolivia’s post-transition political settlement. Uneven democratisation ensured pockets of informalism, as clientelistic and authoritarian practices continued. This included police and military autonomy, and tolerance of drug corruption within both institutions. Non-enforcement of democratic norms of accountability and transparency was linked to the maintenance of fragile political equilibrium. Interviews with key US and Bolivian elite actors also revealed differing interpretations of state-narco interactions. These exposed competing agendas, and were folded into alternative paradigms and narratives of the ‘war on drugs’. The extension of US Drug War goals and the targeting of ‘corrupt’ local power structures, clashed with local ambivalence towards the drug trade, opposition to destabilising, ‘Colombianised’ policies and the claimed ‘democratising mission’ of the Bolivian government. In contrasting these US and Bolivian accounts, the thesis shows how real and perceived state-narco webs were understood and navigated by different actors in distinct ways. ‘Drug corruption’ held significance beyond simple economic transaction or institutional failure. Contestation around state-narco interactions was enmeshed in US-Bolivian relations of power and control.

Índice acumulativo de riesgo (nice) como prueba diagnóstica con base en tomografía corneal por elevación en la prevención de ectasia corneal post-lasik

Antecedentes La ectasia corneal post-lasik (ECPL) es una complicación infrecuente, pero devastadora en la cirugía lasik (queratomileusis asistida con éxcimer láser) para el tratamiento de la miopía con o sin astigmatismo. Con base en la tomografía corneal por elevación por imágenes de Scheimpflug (Sistema Pentacam HR, Oculus Wetzlar, Alemania), se propone un novedoso índice acumulativo de riesgo para ser utilizado como prueba diagnóstica de tamizaje y así prevenir esta complicación. Metodología Se realizó un estudio observacional analítico, de corte transversal tipo pruebas diagnósticas, con el fin de evaluar las características operativas del índice NICE teniendo como estándar de referencia el módulo de Belin-Ambrosio (Pentacam HR) utilizando un modelo de regresión logística binaria, tablas de contingencia y estimando el área bajo la curva ROC. Resultados Se evaluaron 361 ojos de los cuales el 59,3% provenían de pacientes de sexo femenino, la edad media global fue de 30 años (RIC 11,0). El modelo logístico binario aplicado se construyó con base en cuatro variables independientes cuantitativas (K2, PAQUI, EP e I-S) y una cualitativa (SEXO), y se determinó su relación con la variable dependiente, NICE (puntaje final). Las variables predictoras fueron estadísticamente significativas clasificando adecuadamente el 92,9% de los ojos evaluados según presencia o ausencia de riesgo. El coeficiente de Nagelkerke fue de 74,4%. Conclusiones El índice acumulativo de riesgo NICE es una herramienta diagnóstica novedosa en la evaluación de candidatos a cirugía refractiva lasik para prevenir la ectasia secundaria.

Competencies Required in Education Research and Teaching Systematization according to Students from the Preschool, Primary and Secondary Education Programs of the University of Costa Rica

The purpose of this paper is to present the results of two online forums carried out with the participation of 42 students of the Licenciaturas  in Preschool Education, Primary Education and Secondary Education of the University of Costa Rica. The main purpose of the forums was to determine the insights of the participant students about the competencies they have achieved in the field of education research, and which have been the essential tools for them to systematize their own teaching practices. The discussion forums were part of the course FD5091 Métodos de Investigación Educativa [Education Research Methods] of the School of Teacher Education, delivered from March-April 2010.  Of the sample, 60 percent were students of the Preschool teaching program, 35 percent were from the Primary Education teaching program and 5 percent were from the Secondary Education teaching program in the fields of Science, Mathematics and Social Studies. According to the insights and beliefs showed by the participants –both, the future teachers and the profession practitioners–, there are no opportunities for research or systematization of their own teaching mediation, in the current work situation.(1) Translator’s Note: In Costa Rica, the “Licenciatura” is a one-year post-Bachelor study program, usually including thesis. “Primary Education” refers to students from the 1st to 6th grades, and “Secondary Education” refers to students from the 7th to 11th grades.

Synthesis and characterization of prussian blue analogue materials for post-Li ion batteries

Energy issues have always been a subject of concern to people. During the past 30 years, rechargeable Li-ion batteries (LIBs) have been widely used in portable electronic devices and power tools because of their high energy density and efficiency among practical secondary batteries. While the unevenly distribution of Lithium sources and the increasing cost of lithium-raw material can not satisfy the requirement for further cost reduction, especially for the grid-scale energy storage. Post-lithium ion batteries as promising replacement for LIBs have attracted wide attention, owing to their high abundant resources and adequate insertion potential. Similar with Li-ion batteries, finding a suitable electrode material is the key for the research and application of the post-Li ion batteries. In our project, we focus our study on Prussian blue analogues (PBAs), with formula AxM[M’(CN)6]1-y□y•zH2O (0≤x≤2, 0

La diplomazia culturale come via di politica estera italiana tra guerra fredda e periodo post bipolare

Il soft power di uno Stato è l’immagine che questo dà di sé agli altri, ed è naturalmente riempito di suoi ideali e valori, della sua lingua e delle sue conoscenze. La cultura, nella sua più ampia declinazione, in tal senso si rivela uno strumento diplomatico rilevante nella politica estera dello Stato. Questa può affermarne la presenza, preservarne l’identità, sviluppare forme di solidarietà, favorire obiettivi politici attraverso l’influenza del pubblico internazionale. La diplomazia culturale italiana negli anni di guerra fredda si è rappresentata come “strada operativa” particolare nel più ampio ventaglio di scelte di politica estera del nostro paese, a volte precorrendo le mire e gli obiettivi della diplomazia cosiddetta “tradizionale”. La cultura ha offerto all’Italia una prospettiva aggiuntiva nei termini del dialogo internazionale, ponendosi come canale privilegiato di relazioni difficilmente concertabili altrimenti nel corso della seconda metà del Novecento, segnata dal conflitto bipolare. Nella sua tensione verso la pace e la stabilità, con il suo costante richiamo ai diritti ed ai valori della democrazia, la diplomazia culturale italiana ha potuto inoltre vantare un contributo non secondario nella transizione dalle dinamiche internazionali segnate dalla guerra fredda alla determinazione delle relazioni internazionali propriamente post-bipolari.

Hemorrhagic Shock Secondary To Button Battery Ingestion.

Button battery ingestion is a frequent pediatric complaint. The serious complications resulting from accidental ingestion have increased significantly over the last two decades due to easy access to gadgets and electronic toys. Over recent years, the increasing use of lithium batteries of diameter 20 mm has brought new challenges, because these are more detrimental to the mucosa, compared with other types, with high morbidity and mortality. The clinical complaints, which are often nonspecific, may lead to delayed diagnosis, thereby increasing the risk of severe complications. A five-year-old boy who had been complaining of abdominal pain for ten days, was brought to the emergency service with a clinical condition of hematemesis that started two hours earlier. On admission, he presented pallor, tachycardia and hypotension. A plain abdominal x-ray produced an image suggestive of a button battery. Digestive endoscopy showed a deep ulcerated lesion in the esophagus without active bleeding. After this procedure, the patient presented profuse hematemesis and severe hypotension, followed by cardiorespiratory arrest, which was reversed. He then underwent emergency exploratory laparotomy and presented a new episode of cardiorespiratory arrest, which he did not survive. The battery was removed through rectal exploration. This case describes a fatal evolution of button battery ingestion with late diagnosis and severe associated injury of the digestive mucosa. A high level of clinical suspicion is essential for preventing this evolution. Preventive strategies are required, as well as health education, with warnings to parents, caregivers and healthcare professionals.

An Efficient Protocol For The Generation Of Monocyte Derived Dendritic Cells Using Serum-free Media For Clinical Applications In Post Remission Aml Patients.

Protocols for the generation of dendritic cells (DCs) using serum as a supplementation of culture media leads to reactions due to animal proteins and disease transmissions. Several types of serum-free media (SFM), based on good manufacture practices (GMP), have recently been used and seem to be a viable option. The aim of this study was to evaluate the results of the differentiation, maturation, and function of DCs from Acute Myeloid Leukemia patients (AML), generated in SFM and medium supplemented with autologous serum (AS). DCs were analyzed by phenotype characteristics, viability, and functionality. The results showed the possibility of generating viable DCs in all the conditions tested. In patients, the X-VIVO 15 medium was more efficient than the other media tested in the generation of DCs producing IL-12p70 (p=0.05). Moreover, the presence of AS led to a significant increase of IL-10 by DCs as compared with CellGro (p=0.05) and X-Vivo15 (p=0.05) media, both in patients and donors. We concluded that SFM was efficient in the production of DCs for immunotherapy in AML patients. However, the use of AS appears to interfere with the functional capacity of the generated DCs.

Temporomandibular Dysfunction Post-craniotomy: Evaluation Between Pre- And Post-operative Status.

To identify risk factors associated with post-operative temporomandibular joint dysfunction after craniotomy. The study sample included 24 patients, mean age of 37.3 ± 10 years; eligible for surgery for refractory epilepsy, evaluated according to RDC/TMD before and after surgery. The primary predictor was the time after the surgery. The primary outcome variable was maximal mouth opening. Other outcome variables were: disc displacement, bruxism, TMJ sound, TMJ pain, and pain associated to mandibular movements. Data analyses were performed using bivariate and multiple regression methods. The maximal mouth opening was significantly reduced after surgery in all patients (p = 0.03). In the multiple regression model, time of evaluation and pre-operative bruxism were significantly (p < .05) associated with an increased risk for TMD post-surgery. A significant correlation between surgery follow-up time and maximal opening mouth was found. Pre-operative bruxism was associated with increased risk for temporomandibular joint dysfunction after craniotomy.