Child health and the income gradient : evidence from Australia

The positive relationship between household income and child health is well documented in the child health literature but the precise mechanisms via which income generates better health and whether the income gradient is increasing in child age are not well understood. This paper presents new Australian evidence on the child health–income gradient. We use data from the Longitudinal Study of Australian Children (LSAC), which involved two waves of data collection for children born between March 2003 and February 2004 (B-Cohort: 0–3 years), and between March 1999 and February 2000 (K-Cohort: 4–7 years). This data set allows us to test the robustness of some of the findings of the influential studies of Case et al. [Case, A., Lubotsky, D., Paxson, C., 2002. Economic status and health in childhood: the origins of the gradient. The American Economic Review 92 (5) 1308–1344] and Currie and Stabile [Currie, J., Stabile, M., 2003. Socioeconomic status and child health: why is the relationship stronger for older children. The American Economic Review 93 (5) 1813–1823], and a recent study by Currie et al. [Currie, A., Shields, M.A., Price, S.W., 2007. The child health/family income gradient: evidence from England. Journal of Health Economics 26 (2) 213–232]. The richness of the LSAC data set also allows us to conduct further exploration of the determinants of child health. Our results reveal an increasing income gradient by child age using similar covariates to Case et al. [Case, A., Lubotsky, D., Paxson, C., 2002. Economic status and health in childhood: the origins of the gradient. The American Economic Review 92 (5) 1308–1344]. However, the income gradient disappears if we include a rich set of controls. Our results indicate that parental health and, in particular, the mother's health plays a significant role, reducing the income coefficient to zero; suggesting an underlying mechanism that can explain the observed relationship between child health and family income. Overall, our results for Australian children are similar to those produced by Propper et al. [Propper, C., Rigg, J., Burgess, S., 2007. Child health: evidence on the roles of family income and maternal mental health from a UK birth cohort. Health Economics 16 (11) 1245–1269] on their British child cohort.

Career counseling : joint contributions of contextual action theory and the systems theory framework

The influence of constructivism and the ongoing drive for convergence, both of career theories and between theory and practice, have been key drivers in the career development literature for two decades (Patton, International Handbook of Career Guidance, 2008). Both contextual action theory and systems theory are derived from the root metaphor of contextualism, which has been proffered as a worldview to assist scientists and practitioners in organizing day-to-day experiential data. This chapter identifies the theoretical contributions of the Systems Theory Framework (STF) (Patton and McMahon, Career development and systems theory: A new development, 1999, Career psychology in South Africa, 2006) and Contextual Action Theory (Young and Valach, The future of career, 2000, Journal of Vocational Behavior 64:499–514, 2004; Young et al., Career choice and development, 1996, Career choice and development, 2002), each of which has advanced thinking in theory integration and in the integration between theory and practice in the career development and counseling field. Young et al. (Career development in childhood and adolescence, 2007) noted the connections between the Patton and McMahon systems theory approach and the contextual action theory approach and these connections will be highlighted in terms of the application of these theoretical developments to practice in career counseling, with a particular focus on the commonalities between the two approaches and what counselors can learn from each of them. In particular, this chapter will discuss common conceptual understandings and practice dimensions.

The culture wars of climate change

Of late, there has been a growth in cultural expression about climate change – with the rise of climate fiction (‘cli-fi’); art and photography responding to changes in nature; musical anthems about climate change; plays and dramas about climate change; and environmental documentaries, and climate cinema. Drawing comparisons to past controversies over cultural funding, this paper considers the cultural wars over climate change. This article considers a number of cultural fields. Margaret Atwood made an important creative and critical contribution to the debate over climate change. The work examines Ian McEwan's novel, Solar, a tragi-comedy about authorship, invention, intellectual property, and climate science. After writing a history of Merchants of Doubt, Naomi Oreskes and Erik Conway have experimented with fiction – as well as history. This article focuses upon artistic works about climate change. It analyses James Balog’s work with the Extreme Ice Survey, which involved photography of glaciers under retreat in a warming world. The work was turned into a documentary called Chasing Ice. It also considers the artistic project of 350.org 'to transform the human rights and environmental issues connected to climate change into powerful art that gets people to stop, think and act.' The paper examines musical storytelling in respect of climate change. The paper explores dramatic works about climate change including Steve Waters' The Contingency Plan, Stephen Emmott's Ten Billion, and Andrew Bovell's When the Rain Stops Falling and Hannie Rayson’s Extinction. The paper also examines the role of documentary film-making. It also considers the cinematographic film, Beasts of the Southern Wild. Such a survey will enable a consideration of the larger question of whether creative art about climate change matters; and whether it is deserving of public funding.

Blurred Lines may be the biggest music copyright case of 2015

The year is still young, but this week a judgement was handed down in what may well be the biggest music case of 2015. Marvin Gaye’s children have won a copyright law suit against Robin Thicke (no stranger to controversy) and Pharrell Williams for the song Blurred Lines. The 2013 hit was found to have infringed Gaye’s musical copyright in Got To Give It Up. A jury in the US awarded damages of nearly US$7.4 million – nearly half of the song’s US$16.6 million takings to date.

Does failed chronic wet cough response to antibiotics predict bronchiectasis?

Aim: To determine whether a child with chronic wet cough and poor response to at least 4 weeks of oral antibiotics is more likely to have bronchiectasis. Methods: All chest multi-detector computerised tomography (MDCT) scans at a single paediatric tertiary hospital from April 2010 to August 2012 were reviewed retrospectively so as to identify those ordered by respiratory physicians for assessment of children with a chronic wet cough. Information regarding age, sex, ethnicity, indication for imaging and the response to at least 4 weeks of antibiotics before having the scan were recorded from their charts. The data were analysed using simple and multiple logistic regression. Results: Of the 144 (87 males) eligible children, 106 (65 males, 30 Indigenous) aged 10–199 months had MDCT scan evidence of bronchiectasis. Antibiotic data were available for 129 children. Among the 105 children with persistent cough despite at least 4 weeks of antibiotics, 88 (83.8%) had bronchiectasis, while of the 24 children whose cough resolved after antibiotics, only six (25.0%) received this diagnosis (adjusted OR 20.9; 95% CI 5.36 to 81.8). Being Indigenous was also independently associated with radiographic evidence of bronchiectasis (adjusted OR 5.86; 95% CI 1.20 to 28.5). Conclusions: Further investigations including a MDCT scan should be considered in a child with a chronic wet cough that persists following 4 weeks of oral antibiotics. However, while reducing the likelihood of underlying bronchiectasis, responding well to a single prolonged course of antibiotics does not exclude this diagnosis completely.

Current treatment of Helicobacter pylori infection and peptic ulcer disease

Since the initial report by Warren and Marshall in 1984, Helicobacter pylori has assumed an increasingly important role in the pathogenesis of peptic ulcer disease and gastric carcinoma in all ages. A recent National Institutes of Health Consensus Development conference acknowledges the relationship between H. pylori infection and peptic ulcer disease and recommends that the medical community treat H. pylori infection in all patients with Helicobacter pylori and peptic ulcer. Although the same organism, the response to Helicobacter pylori infection in childhood differs somewhat from that seen in adults. The paediatric patient mounts a different inflammatory response, has different macroscopic appearances and has a markedly diminished peptic ulcer disease frequency compared with their adult counterparts. The appearances of antral nodularity appear to be characteristic of Helicobacter pylori infections. The appearances, however, are unrelated to symptoms and the underlying cause for this nodularity remains obscure. Younger children with peptic ulcer diseases are more likely to be Helicobacter pylori negative. This may suggest an increased susceptibility to gastric acid or possibly a very transient Helicobacter pylori infection rather than the well described lifelong infection without treatment. It is well known that the epidemiology of Helicobacter pylori would suggest that the incidence of infection increases with age. There is also geographical variations with the incidence being higher in countries of a third world background. These epidemiological observations fly in the face of all other infections where the major period of acquisition is in childhood. There has been recent evidence to suggest that in fact the incidence in childhood is decreasing in developed countries which could support the observation that there is a decreasing positive serology with successive decades in some countries. It is felt that the most likely mode of transmission of Helicobacter pylori is faecal to oral or oral to oral route. These are similar modes of transmission to Hepatitis A infections. It is obvious that most infections in childhood remain asymptomatic. It is also clear that there is no relationship between chronic recurrent abdominal pain of childhood syndrome and the presence of Helicobacter pylori infections. It remains to be seen as to who should be treated, what with and when. All of these issues will be discussed in the paper.

Neonatal screening for cystic fibrosis

Two groups of patients with cystic fibrosis were compared. The screened group, detected with an improved neonatal screening assay for immunoreactive trypsin, developed fewer chest infections requiring treatment and gained more weight than the unscreened group. Early diagnosis by screening seems to affect early morbidity.

Affective sensing + wearable imaging: Vision impairment and implications for spatial enquiry

Recent interest in affect and the body have mobilized a contemporary review of aesthetics and phenomenology within architecture to unpack how environments affect spatial experience. Emerging spatial studies within the neuro-sciences, and their implications for architectural research as raised by architectural theorists Juhani Pallasmaa (2014) and Harry Mallgrave (2013) has been well supported by a raft of scientists and institutions including the prestigious Salk Institute. Although there has been some headway in spatial studies of the vision impaired (Cattaneo et al, 2011) to understand the role of their non-visual systems in assisting navigation and location, little is discussed in terms of their other abilities in sensing particular qualities of space which impinge upon emotion. This paper reviews a collection of studies exploring face vision and echo-location, amongst others, which provide insight into what might be termed affective perception of the vision impaired, and how further interplay between this research and the architectural field can contribute new knowledge regarding space and affect. By engaging with themes from the Aesthetics, Phenomenology and indeed Neuro-science fields, the paper provides background of current and potential cross disciplinary research, and highlights the role wearable technologies can play in enhancing knowledge of affective spatial experience.

Finnish Homicides and Mental Disorders: An investigation of offense and offender characteristics

Although the majority of people with mental illness are not violent, scientific studies over the last decades show that certain psychiatric disorders increase the risk of violent behavior, including homicide. This thesis examined crime scene behaviors and offender background characteristics among mentally ill Finnish homicide offenders. Previously, homicide crime scene behaviors have been investigated in relation to offender demographic characteristics, whereas this study compares the behaviors of offenders with various mental illnesses. The study design was a retrospective chart review of the forensic psychiatric statements of Finnish homicide offenders. The work consists of four substudies. The aims of the study were as follows: To describe differences in the childhood and family backgrounds as well as in the adolescent and adult adjustment of Finnish homicide offenders belonging to different diagnostic categories (schizophrenia, personality disorder, alcoholism, drug addiction or no diagnosis). Further, the study examined associations between the crime scene behaviors and mental status of these offenders. Also, the distinguishing characteristics between two groups of offenders with schizophrenia were examined: early starters, who present antisocial behavior before the onset of schizophrenia, and late starters, who first offend after the onset of mental disorder. Finally, it was investigated how the use of excessive violence is associated with clinical and circumstantial variables as well as offender background characteristics among homicide offenders with schizophrenia. The main findings of the study can be summarized as follows. First, offenders with personality disorder or drug addiction had experienced multiple difficulties in their early environments: both family and individual problems were typical. Offenders with schizophrenia were relatively well-adjusted in childhood compared to the other groups. However, in adolescence and adulthood, social isolation, withdrawal and other difficulties attributable to these offenders illness became evident. In several aspects, offenders with alcohol dependency resembled offenders with no diagnosis in that these offenders had less problematic backgrounds compared to other groups. Second, the results showed that crime scene behaviors, victim gender and the victim-offender relationship differ between the groups. In particular, offenders with a diagnosis of schizophrenia or drug addiction have some unique features in their crime scene behaviors and choice of victims. Offenders with schizophrenia were more likely to kill a blood relative, to use a sharp weapon and to injure the victim s face. Drug addiction was associated with stealing from the victim and trying to cover up the body. Third, the results suggest that the offense characteristics of early- and late-start offenders with schizophrenia differ only modestly. However, several significant differences between the groups were found in characteristics of offenders: early starters had experienced a multitude of problems in their childhood surroundings and also later in life. Fourth, violent acts where the offender did not commit the offense alone or had previous homicidal history were predictive of excessive violence among offenders with schizophrenia. Positive psychotic symptoms did not predict the use of excessive violence. Nearly one third of the cases in the sample involved multiple and severe violence, including features such as sadism, mutilation, sexual components or extreme stabbing. In sum, mentally disordered homicide offenders are heterogeneous in their offense characteristics as well as their background characteristics. Empirically based information on how the offender s mental state is associated with specific crime scene behaviors can be utilized within the police force in developing methods of prioritizing suspects in unsolved homicide cases. Also, these results emphasise the importance of early interventions for problem families and children at risk of antisocial behavior. They may also contribute to the development of effective treatment for violent offenders.

Luova mieli : lähikuvassa muusikoiden luomisprosessit

This work studied the creative process of musicians. The subject was chosen partly due to the attention given to creativity in social discussion. The approach was material-based, because during the work it became clear that the theoretical models describing the creative process in general did not provide adequate tools for the examination of musical creation. In this study, the creative process was defined as a process, which generated a work found by the musician novel to him or her. There were two principal research questions: 1) How does the creative process of musicians progress? 2) What makes a process creative? The main emphasis was on the first question, because the study aimed at modeling the creative process of musicians. The material for this study was collected by interviewing five professional musicians, each qualified by an expert of music to be creative. The interviews were thematically linked with each musician’s recently implemented creative process. The work generated in the process was used as a stimulant in the interview. The main themes of the interview dealt with the musician’s concrete action, cognitive functioning and affective experience during the process. Secondary themes included his or her goals as well as the factors that enhanced or inhibited the process. A material-based analysis was made of the interviews. The conceptualization and modelling of the creative process was founded on a phenomenological-hermeneutic interpretation. In addition to the primary interviews, also supplementary interviews were made in order to ensure that the description of the musician was understood correctly. Further supplementary interviews were made when the material was analyzed and results were deduced. This aimed at increasing the reliability of interpretations and conclusions. The study resulted in a four-level model representing the progress of a creative process. The levels were defined by means of the conception of state. The levels used in defining the process were 1) the state determining the potential of the process, 2) the state delimiting the process, 3) the state orienting the process, and 4) the state determined by the process. The progress of the process was described as changes taking place in the state. It was discovered that the factors having an effect on the creativity of the process were the dynamism of the process, the musician’s work in relation to his or her inner standard and the impulses that caused variation in the musician’s thinking. The interview method used in this study proved to be a very suitable tool in an examination of a creative process. Thus it may well be applicable in other research contexts associated with creative processes. The outcome of this study, the model of the progress of a creative process, should also provide a feasible basis for the examination of different kinds of creative processes. It enables a comprehensive examination of a creative process, simultaneously justifying the dynamic nature of the process.

Käsityön sukupuolirajat ja rajojen rikkojat

Gender-specific division of crafts is significant in Finnish culture. The aim of craft education in comprehensive schools has been to unify education for both girls and boys during the thirty years of modern comprehensive education, but in reality crafts has diverged into two different subjects for girls and boys. Craft education has taught different things: girls have been taught things that are feminine and included in private life, while the boys’ education has been mostly directed at public and working life. At the same time girls and boys have been educated and socialized towards a certain womanhood and manhood. Craft as a hobby is also very gender divided but there are some clues that tell of the changing positions on the border areas. The starting point of this study has been the assumption that gender structures within crafts can be transformed. But it is important to know the background that creates and maintains these constructions and the expedients for dismantling the structures. The main purpose of this study is to find out how the gender-specific crafts are changing and how they are still maintained. My study analyses why men and woman have chosen untypical hobbies and through that I shall discuss how gendered structures can be dismantled. In the autumn of 2008 I interviewed borderline breakers within crafts: men who had an interest in textile crafts and women who had an interest in technical work. Informants of this study were 20-31 years old and they studied behavioural sciences. The data was collected in 12 theme interviews and document analysis was used to study the results. The dismantling of the gender divide in crafts is slow, but new borders are drawn all the time. The informants have started textile and technical handicrafts soon after comprehensive school or during their studies at university. A main motivation for the new hobby has been the possibility to study for a teacher’s degree with technology or textile studies as a main or a secondary subject. Gender-specific division of crafts is constructed early in childhood as different skills are taught to girls and boys. School teaches gender specific skills and the different skills of girls and boys have not been taken into account. Instead, it has been assumed through comprehensive school that both girls and boys share certain basic skills, and attention has not been paid to the differences between genders. At university the same assumption has still thrived. Skill levels between men and women are substantial and that may have hindered a move by women to technical studies and by men to textile studies. Hence an assumption of naturally gendered crafts has been developed.

Affective Sensing: Vision Impairment and Implications for Spatial Enquiry

Recent interest in affect and the body have mobilised a contemporary review of aesthetics and phenomenology within architecture to unpack how environments affect spatial experience. Emerging spatial studies within the neurosciences, and their implications for architectural research as raised by architectural theorists has been well supported by a raft of scientists and institutions. Although there has been some headway in spatial studies of the vision impaired (Cattaneo et al., 2011) to understand the role of their non-visual systems in assisting navigation and location, little is discussed in terms of their other abilities in sensing particular qualities of space which impinge upon emotion and wellbeing. This research explores, through published studies and constructed spatial interviews, the affective perception of the vision impaired and how further interplay between this research and the architectural field can contribute new knowledge regarding space and affect. The research aims to provide background of current and potential cross disciplinary research and highlight the role wearable technologies can play in enhancing knowledge of affective spatial experience.

Pappi ja Raamattu : Suomen evankelis-luterilaisen kirkon pappien suhde Raamattuun

The Pastor and the Bible: Finnish Evangelical Lutheran Pastors Relationship with the Bible Since 1970s there has been extensive discussion in Finland about questions relating to the interpretation of the Bible. The themes of this discussion have focused on the trustworthiness and authority of the Bible, and the discussion has attracted participation not only from representatives of the Evangelical Lutheran Church of Finland but also from representatives of the academic community. The discussion has resulted in extensive publication on the relation of postmodern theology to the Bible. Despite this debate and the texts that have been produced, there is little empirical data on how Evangelical Lutheran pastors with theological education view the Bible. In the present study, 22 pastors of the Evangelical Lutheran Church of Finland were interviewed about how they defined their relationship with the Bible. The interview material was analyzed by means of data-based content analysis. The analysis showed, first, that the pastors viewed the Bible as a mirror of the spiritual growth that they had experienced in the past. Second, the Bible was viewed as a source in the interpretation of matters of faith. The third theme concerned the pastors key experiences in their relationship with the authority of the Bible. The time periods that were significant in defining pastors spiritual growth and past perspective on the Bible included childhood, youth, the period of theological education, and the time spent as a pastor. In childhood, the Bible was part of the spiritual atmosphere of the home, and parents and grandparents made a crucial contribution to the child s emerging view of the Bible. In childhood, the Bible was essentially the Old Testament and its exciting stories. In youth, reading the Bible became more personal, and the teachings of Jesus began to take on a more central role. In youth, most of the interviewees had strong experiences of faith and began to view the Bible as an absolute and divine source of dogma. The period of theological studies meant a change in their relationship with the Bible and particularly, revelation of the human aspects of the Bible. These changes were associated with a deepening of belief in the Bible and also a painful crisis in questions related to the trustworthiness of the Bible. For many of the interviewees, their relationship with the Bible changed also when they started their work as pastors. When faced with a call to work as a pastor, the interviewees created a synthesis of the secure faith that they had experienced in their childhood and the more critical views with which they had become acquainted during their theological education. Pastorhood meant the beginning of public teaching of the Bible. The interviewees felt that, in this new role, they discovered again - but now in a deeper sense - the trustworthiness in the bible that they had experienced during their childhood. Based on the interviewees experiences during the periods mentioned above, five different interpretations were formed regarding how the interviewed pastors viewed their past relationship with the Bible. These interpretations were detachment from literal interpretation of the Bible (1), changes in their relationship with the Bible arising from experiences of faith (2), a slow process during which their relationship with the Bible became more human (3), overcoming hardships (4), and no change in their relationship with the Bible (5). In interpretations 1-3, the past was described as a linear development and journey towards a more coherent relationship with the Bible. Interpretations 4-5, in turn, reflected a desire to detach oneself from the perspectives of linear development and change and, instead, emphasize the immutable and process-like nature of one s relationship with the Bible. Concerning the Bible as a source in matters of faith, a conspicuous aspect of the interviews was that all pastors wanted to disconnect themselves from a fundamentalistic view of the Bible, regarding this as an intellectually dishonest relationship with the Bible. On the other hand, none of the interviewees supported a totally relativist view of the Bible. Instead, all interviewees regarded the Bible as a vital source for both them and the Evangelical Lutheran Church. Between the two poles of extremely fundamental and extremely relativistic views, four different categories of viewing the Bible emerged from the interviews: absolute truth (a), a book about the message of salvation (b), a book about holiness and generous love (c), and a source of inspiration (d). The views in categories (a) and (b) emphasized the divine nature of the Bible. According to the pastors who expressed these views, the Bible contains a clear and trustworthy message of God. The views in categories (c) and (d), in turn, emphasized the human aspects of the Bible. The pastors who expressed these views regarded the Bible as a collection of books that was born in a specific historical and cultural context and includes material characteristic to this time. Due to the time-bound nature of the Bible, each generation has to update its view of the Bible. The views in categories (c) and (d) arose from human reality. Comparisons of the views in the different categories indicated that despite their obvious differences, they also shared some common features. The views in categories (a) and (d) shared the common feature of absoluteness, which was seen in category (a) as an emphasis on dogmatism and in category (d) as an emphasis on rationalism. The views in categories (b) and (c), in turn, shared the common feature of a flexible and dynamic relationship with the Bible. The key experiences that appeared to characterize pastors relationship with the authority of the Bible were a joy that arises from self-evidence, awakening to confusion, fear of openness, falling back upon paradoxes, and new confidence. These experiences reveal the circular nature of the process that was common to all interviewees interpretation of their relationship with the Bible. That is, the interviewees experiences of their relationship with the Bible seem to go through a circular process that is activated again and again in new life events. It is like a journey from self-evidence towards critical questions and again back to new confidence. The interview material showed, hence, that relationship with the Bible are characterized by a process that involves experiences of trust, questioning and new trust. The present study brings out the multifaceted reality of pastors relationship with the Bible. The study breaks down contradictions between conservative and liberal views of the Bible by showing how representatives of these opposing poles share commonalities in their attitudes. The study points to a close association between an individual s life history and his or her relationship with the Bible, and lays the groundwork for future studies to investigate the relation between personality and view of the Bible.

Socialist Realism instead of Formalism : the Formation and Development of the Soviet Music Control System 1932-1950

Whereas it has been widely assumed in the public that the Soviet music policy system had a “top-down” structure of control and command that directly affected musical creativity, in fact my research shows that the relations between the different levels of the music policy system were vague, and the viewpoints of its representatives differed from each other. Because the representatives of the party and government organs controlling operas could not define which kind of music represented Socialist Realism, the system as it developed during the 1930s and 1940s did not function effectively enough in order to create such a centralised control of Soviet music, still less could Soviet operas fulfil the highly ambiguous aesthetics of Socialist Realism. I show that musical discussions developed as bureaucratic ritualistic arenas, where it became more important to reveal the heretical composers, making scapegoats of them, and requiring them to perform self-criticism, than to give directions on how to reach the artistic goals of Socialist Realism. When one opera was found to be unacceptable, this lead to a strengthening of control by the party leadership, which lead to more operas, one after the other, to be revealed as failures. I have studied the control of the composition, staging and reception of the opera case-studies, which remain obscure in the West despite a growing scholarly interest in them, and have created a detailed picture of the foundation and development of the Soviet music control system in 1932-1950. My detailed discussion of such case-studies as Ivan Dzerzhinskii’s The Quiet Don, Dmitrii Shostakovich’s Lady Macbeth of Mtsensk District, Vano Muradeli’s The Great Friendship, Sergei Prokofiev’s Story of a Real Man, Tikhon Khrennikov’s Frol Skobeev and Evgenii Zhukovskii’s From All One’s Heart backs with documentary precision the historically revisionist model of the development of Soviet music. In February 1948, composers belonging to the elite of the Union of Soviet Composers, e.g. Dmitri Shostakovich and Sergei Prokofiev, were accused in a Central Committee Resolution of formalism, as been under the influence of western modernism. Accusations of formalism were connected to the criticism of the conciderable financial, material and social privileges these composers enjoyed in the leadership of the Union. With my new archival findings I give a more detailed picture of the financial background for the 1948 campaign. The independent position of the music funding organization of the Union of Soviet Composers (Muzfond) to decide on its finances was an exceptional phenomenon in the Soviet Union and contradicted the strivings to strengthen the control of Soviet music. The financial audits of the Union of Soviet Composers did not, however, change the elite status of some of its composers, except for maybe a short duration in some cases. At the same time the independence of the significal financial authorities of Soviet theatres was restricted. The cuts in the governmental funding allocated to Soviet theatres contradicted the intensified ideological demands for Soviet operas.

Juvenile neuronal ceroid lipofuscinosis; psychiatric symptoms, GAD-autoantibodies, and response to medication

Juvenile neuronal ceroid lipofuscinosis (JNCL) is one of the most common neurodegenerative diseases in childhood. Its clinical onset, with visual failure as the first sign, is between the ages of 4 to 8 years. During the disease progress, epilepsy, motor symptoms, cognitive decline, and psychiatric symptoms become apparent. It leads to premature death between ages 15 and 30. Treatment consists of symptomatic drug administration and various forms of rehabilitation, but to date, no curative treatment exists. To gain a more comprehensive picture of psychiatric problems, symptoms were evaluated by the Child Behavior Checklist, the Teacher Report Form, and the Children s Depression Inventory. The JNCL patients had a great number of severe psychiatric symptoms, with wide inter-individual variability. The most common symptoms were social, thought, attention, and sleep problems, somatic complaints, and aggressive behaviour. Patients with psychotropic treatment had more problems than did those without psychotropic treatment, and female patients had more problems than did males. Between 10 and 20% of the patients reported depressive symptoms. In a 5-year follow-up, [123I]β-CIT SPECT and MRI revealed a tendency of decreasing serotonin transporter (SERT) availability and progressive brain atrophy. The correlation between changes in midbrain SERT and total brain volume was positive; no correlation appeared between SERT or brain atrophy and depressive symptoms. Thus, it seems likely that the low SERT availability is associated with progressive brain atrophy; it may also predispose towards depression, however. An open survey of psychotropic drugs and their efficacy was performed on JNCL patients in Finland. The most commonly used psychotropic drugs were the antidepressant citalopram and the antipsychotic risperidone. Their efficacy was good or satisfactory in the majority of cases and they seemed well tolerated. Quetiapine had a marked effect on one patient with a history of severe psychotic symptoms. Glutamate decarboxylase 65 autoantibodies (GAD65ab), found in JNCL patients, indicate that an immunomediated reaction against GAD or GABAergic neurons may play a part in the underlying pathogenetic mechanism. GAD65ab s also appeared in the serum of all eight JNCL patients included and intermittent corticosteroid therapy was initiated in all cases. After one year, the GAD65ab s had disappeared in the two oldest patients, who experienced an improvement in motor symptoms and alertness associated with their prednisolone therapy. Two younger patients experienced a significant IQ increase, but no change in GADab s. A randomized study with longer follow-up time is needed, however, to clarify the effect of prednisolone on disease progression.