Handbook of life design : from practice to theory and from theory to practice

Our lives and careers are becoming ever more unpredictable. The "life-design paradigm" described in detail in this ground-breaking handbook helps counselors and others meet people's increasing need to develop and manage their own lives and careers. Life-design interventions, suited to a wide variety of cultural settings, help individuals become actors in their own lives and careers by activating, stimulating, and developing their personal resources. This handbook first addresses life-design theory, then shows how to apply life designing to different age groups and with more at-risk people, and looks at how to train life-design counselors

Exposure to contaminated water: perceptions and practices in a neighborhood in the city of Manaus, Brazil

Objective. To investigate the modes of water supply and the perception concerning the problems caused by this water among residents of a neighborhood without public supply of water, settled in an area previously used as a garbage dump in the city of Manaus, Brazil. Methods. One hundred and sixty-two semi-structured household interviews were conducted. In addition, a focal group with teachers from a local public school and a meeting with residents were held. The instruments employed focused on the perception and modes of water use and on the process of exposure to chemical contaminants through water. Results. Untreated well water was used by most families. This water was considered to be ""good"" by 64.8% of the individuals interviewed. Most residents (88.3%) declared knowledge about the garbage dump. Of these, 77.6% stated that the garbage dump caused health and environmental problems. However, qualitative analysis of the responses revealed that the residents were not aware of contamination by chemical elements or of the consequences of such contamination. The activities carried out with teachers revealed that they were partially aware of the problem, but did not design interventions to address the issue. In a meeting with neighborhood residents, the presence of social activism concerning the problem was identified, but it did not extend beyond the neighborhood or reach governmental spheres. Conclusions. The study identified a situation of critical exposure that tends to be maintained as a result of misperceptions and lack of social mobilization. The dissemination of research results to teachers and residents was useful to empower subjects.

Mothers' beliefs concerning severity and need for intervention in child maltreatment

Dissertação de mestrado integrado em Psicologia Clínica e da Saúde

Does falls efficacy predict gait performance in high-functioning older people?

Introduction: Falls efficacy, defined as confidence in performing activities without falling, is a measure of fear of falling associated with gait impairment, falls and functional decline in frail older people. This relationship has not been well studied in high-functioning older people. Objective: To evaluate the relationship between falls efficacy and gait performance in a cohort of high-functioning older people. Methods: Subjects (N = 864) were a subsample of communitydwelling older people aged 65 to 70 years, enrolled in the "Lc65+" cohort, who completed gait assessment at baseline. Data were collected on demographics, functional, cognitive, affective, and health status. Falls efficacy was assessed using the Falls Efficacy Scale- International (FES-I) that measures confidence in performing 16 activities of daily life (ADL) without falling (score from 16 to 64, higher score indicates lower confidence). Gait parameters were measured over a 20 m walk at preferred gait speed using Physilog, an ambulatory gait monitoring system. Results: Participants (mean age 68.0 ± 1.4 years, 55.0% women) had excellent physical (92.2% independent in basic ADL, mean gait speed 1.13 ± 0.16 m/sec) and cognitive (98.0% with MMSE 024) performance. Nevertheless, 22.1% reported depressive symptoms and 16.1% one or more fall in the previous year. Mean FES-I score was 18.8 ± 4.1. Falls efficacy was associated with gait speed (Spearman rho -0.23, P <.001) and gait variability (Spearman rho 0.10, P = .006), measured by the coefficient of variation of stride velocity. These associations remained in multivariate analysis for both gait speed (adj [beta] coeff: -0.008, 95%CI -0.005 to -0.010, P <.001) and gait variability (adj [beta] coeff 0.024, 95%CI 0.003 to 0.045, P = .023) independent of gender, falls, functional, affective, cognitive, and frailty (Fried's criteria) status. On average, compared to subjects with poor confidence in performing one ADL without falling, those with full confidence had a 0.02 m/sec (2%) faster gait speed and a 2% decrease in gait variability. Conclusion: Even in high-functioning older people, poor falls efficacy is associated with reduced gait speed and stability, independent of health, functional, and frailty status. The direction of this relationship needs to be investigated prospectively to determine causality and design interventions to improve gait performance, reduce fall risk, and prevent functional decline.

Surveillance Network Overview, 2007-2008

Seasonal influenza surveillance is conducted October through March every year. The overall goal of surveillance is to be able to characterize the impact of seasonal influenza to create and design interventions that might reduce the burden of disease.

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Our lives and careers are becoming ever more unpredictable. The "life-design paradigm" described in detail in this ground-breaking handbook helps counselors and others meet people's increasing need to develop and manage their own lives and careers. Life-design interventions, suited to a wide variety of cultural settings, help individuals become actors in their own lives and careers by activating, stimulating, and developing their personal resources. This handbook first addresses life-design theory, then shows how to apply life designing to different age groups and with more at-risk people, and looks at how to train life-design counselors.

Molecular detection of enteropathogenic Escherichia coli in asymptomatic captive psittacines

Psittaciformes are one of the most endangered groups of birds, and several Brazilian species are classified between vulnerable and critically endangered. It is thus necessary to identify agents that cause infections in captive wild animals and to assess the risks posed thereof and to design interventions to minimize the possibility of disease outbreaks, leading to the conservation of endangered species. The purpose of this study was to identify enteropathogenic Escherichia coli (EPEC) cloacal isolates from asymptomatic psittacines in captivity and evaluate the distribution of the EPEC pathotype. Cloacal swabs were obtained from 46 asymptomatic birds, and resulting isolates were tested by polymerase chain reaction (PCR) for the presence of the attaching and effacing gene (eae) and bundle-forming pilus structural gene (bfpA) of EPEC. Samples from several species were tested, and three samples were found to be positive for the eae and bfpA genes and characterized as typical EPEC. This is the first report of this pathotype in asymptomatic psittacines. Although certain E. coli strains are more pathogenic than others, various factors should be considered when determining the potential of E. coli isolates to cause disease in captive psittacines. Birds that are positive for the EPEC (typical) strain could be zoonotic sources of infection, and may have acquired these strains through contact with humans or domestic animals. These findings may also be valuable for the long-term management of endangered species ex situ as one EPEC sample was isolated from a Red-tailed Amazon (Amazona brasiliensis).

School Bullies’ Quest for Power: Implications for Group Dynamics and Intervention

Bullying is characterized by an inequality of power between perpetrator and target. Findings that bullies can be highly popular have helped redefine the old conception of the maladjusted school bully into a powerful individual exerting influence on his peers from the top of the peer status hierarchy. Study I is a conceptual paper that explores the conditions under which a skillful, socially powerful bully can use the peer group as a means of aggression and suggests that low cohesion and low quality of friendships make groups easier to manipulate. School bullies’ high popularity should be a major obstacle for antibullying efforts, as bullies are unlikely to cease negative actions that are rewarding, and their powerful position could discourage bystanders from interfering. Using data from the Finnish program KiVa, Study II supported the hypothesis that antibullying interventions are less effective with popular bullies in comparison to their unpopular counterparts. In order to design interventions that can address the positive link between popularity and aggression, it is necessary to determine in which contexts bullies achieve higher status. Using an American sample, Study III examined the effects of five classroom features on the social status that peers accord to aggressive children, including classroom status hierarchy, academic level and grade level, controlling for classroom mean levels of aggression and ethnic distribution. Aggressive children were more popular and better liked in fifth grade relative to fourth grade and in classrooms of higher status hierarchy. Surprisingly, the natural emergence of status hierarchies in children’s peer groups has long been assumed to minimize aggression. Whether status hierarchies hinder or promote bullying is a controversial question in the peer relations’ literature. Study IV aimed at clarifying this debate by testing the effects of the degree of classroom status hierarchy on bullying. Higher hierarchy was concrrently associated with bullying and predictive of higher bullying six months later. As bullies’ quest for power is increasingly acknowledged, some researchers suggest teaching bullies to attain the elevated status they yearn for through prosocial acts. Study V cautions against such solutions by reviewing evidence that prosocial behaviors enacted with the intention of controlling others can be as harmful as aggression.

Association entre consommation de drogues illicites et symptomatologie dépressive à l’adolescence : une étude longitudinale auprès de jeunes Québécois fréquentant l’école secondaire en milieu défavorisé

L’usage de drogues illicites et la symptomatologie dépressive sont associés, mais la nature de cette association demeure mal comprise. Une clarification des mécanismes en jeu est nécessaire afin de pouvoir intervenir sur la cooccurrence des deux phénomènes, dont les conséquences individuelles et sociales sont lourdes. Ces efforts de clarification débutent à l’adolescence, moment où sont typiquement initiés la consommation de substances et les problèmes affectifs. L’objectif de cette thèse est de contribuer à clarifier la nature des associations entre l’usage de certaines des drogues illicites les plus fréquemment consommées et les symptômes dépressifs chez les adolescents. Les données utilisées proviennent d’une cohorte de l’échantillon longitudinal de la Stratégie d’Intervention Agir Autrement (SIAA) comprenant plus de 3000 jeunes fréquentant des écoles en milieu défavorisé du Québec, qui ont été suivis pendant leur secondaire (2003-2007). Le premier article empirique de la thèse porte sur la relation entre l’usage de cannabis et la symptomatologie dépressive. Cette étude a examiné l’existence d’associations prospectives bidirectionnelles entre les deux phénomènes du début (13-14 ans) à la fin du secondaire (16-17 ans). Les analyses ont considéré des liens directs, mais également des liens indirects via deux facteurs reflétant des appartenances sociales normatives et non normatives : l’attachement à l’école et l’affiliation à des pairs déviants et consommateurs de drogues. Les résultats indiquent que les symptômes dépressifs et l’usage de cannabis peuvent représenter des facteurs de risque mutuels et suggèrent qu’un mécanisme indirect impliquant une érosion des attaches normatives pourrait jouer un rôle dans des cascades développementales reliant les deux manifestations. Le deuxième article empirique visait à déterminer si l’usage de deux drogues de synthèse, le MDMA (ecstasy) et les méth/amphétamines (speed), à 15-16 ans était associé au développement de symptômes dépressifs élevés un an plus tard, en prenant en considération des facteurs confondants potentiels. Tel qu’attendu, les résultats montrent une prédiction de la symptomatologie dépressive par l’usage de MDMA et de méth/amphetamines, particulièrement lorsque cet usage est concomitant. Ces résultats représentent une des premières évidences d’un risque posé par l’usage de drogues de synthèse par rapport au développement de symptômes affectifs chez les jeunes.

La résilience conjugale du couple parental confronté à la greffe de son enfant dans un contexte d’oncologie pédiatrique

Essai présenté en vue de l’obtention du grade de Doctorat en psychologie, option psychologie clinique (D. Psy)

Freiräume auf Zeit

Zwischennutzungen sind ein Alltagsphänomen, das seit Ende der 1990er Jahre im wissenschaftlichen Kontext und der kommunalen Praxis der Stadt- und Freiraumentwicklung auffallend an Aufmerksamkeit gewinnt. Die vorliegende Arbeit widmet sich dem Phänomen aus der Perspektive der Freiraumentwicklung als kommunaler Aufgabe. Im Zentrum des Interesses steht die Frage, welche aktuelle Bedeutung Zwischennutzungen, verstanden als die vorübergehende Freiraumnutzung brachliegender Baugrundstücke, für freiraumbezogene öffentliche Aufgaben und Handlungsansätze haben bzw. welche Potentiale sie dafür bieten. Vor dem Hintergrund heterogener gesellschaftlicher und räumlicher Gegebenheiten, der Erkenntnis um eine begrenzte hoheitliche Steuerbarkeit der weiteren stadträumlichen Entwicklung und angesichts knapper Haushaltsmittel ist die kommunale Freiraumentwicklung gefordert, sich bezüglich ihrer Kernaufgaben aber auch bezüglich ihrer Rolle bei der Erfüllung dieser Aufgaben neu zu positionieren. Vermehrt werden Forderungen nach einem Abgehen von „allgemeingültigen“ Versorgungsstandards und traditionellen „Produktionsprozessen“ laut. Flexiblere Freiraumangebote sollen Gestaltungsspielräume für eigeninitiatives Handeln und wechselhafte oder neuartige Nutzungen eröffnen. Mit dem Setzen von Prioritäten, einer verstärkten Kundenorientierung und aktivierenden bzw. kooperativen Handlungsansätzen soll der schlechten Haushaltslage begegnet werden. Zwischennutzungen deuten aufgrund ihrer funktionalen, räumlichen und zeitlichen Flexibilität Möglichkeiten an, auf diese Anforderungen einzugehen. Der Blick in die Verwaltungspraxis einzelner Städte zeigt, dass Zwischennutzungen in der kommunalen Freiraumentwicklung in verschiedenen Zusammenhängen gezielt aufgegriffen werden und dabei diverse Bezüge zu diesen aktuellen Anforderungen herstellen lassen. Der Stellenwert, der ihnen beigemessen wird, reicht dabei vom Ausnahmefall bis zum bewährten Ansatz. Mit den Maßnahmen werden häufig akute bzw. kurzfristige Ziele verfolgt, etwa die vorübergehende Schaffung zusätzlicher Spiel- und Aufenthaltsmöglichkeiten oder die Aufwertung brachliegender Flächen durch extensive Gestaltungsmaßnahmen. Die Projekte sind häufig charakterisiert durch intensive Kooperationen mit anderen öffentlichen und mit nicht-öffentlichen Akteuren. Die Einbindung von Zwischennutzungen in das alltägliche Verwaltungshandeln ist allerdings auch mit diversen Schwierigkeiten verbunden, wie erste Institutionalisierungsansätze in manchen Städten zeigen. Die Verknüpfung unterschiedlicher Zeithorizonte im Planungsgeschehen, die Verbindung des temporären Phänomens Zwischennutzung mit dem traditionellerweise auf Dauerhaftigkeit ausgerichteten Aufgabenverständnis der kommunalen Freiraumentwicklung verlangt nach einer Modifizierung bisheriger Positionen und Herangehensweisen. Ein solcher Anpassungsprozess im Verwaltungshandeln lässt sich nur langfristig und schrittweise bewältigen und ist als Teil der – angesichts aktueller Entwicklungen notwendigen – Weiterentwicklung freiraumbezogener Aufgaben und Handlungsansätze zu verstehen. Zwischennutzungen können neben ihren kurzfristig umsetzbaren Funktionen einen Beitrag dazu leisten.

The comfort, energy and health implications of London’s urban heat island

The urban heat island (UHI) is a well-known effect of urbanisation and is particularly important in world megacities. Overheating in such cities is expected to be exacerbated in the future as a result of further urban growth and climate change. Demonstrating and quantifying the impact of individual design interventions on the UHI is currently difficult using available software tools. The tools developed in the LUCID (‘The Development of a Local Urban Climate Model and its Application to the Intelligent Design of Cities’) research project will enable the related impacts to be better understood, quantified and addressed. This article summarises the relevant literature and reports on the ongoing work of the project.

Molecular detection of enteropathogenic Escherichia coli in asymptomatic captive psittacines

Psittaciformes are one of the most endangered groups of birds, and several Brazilian species are classified between vulnerable and critically endangered. It is thus necessary to identify agents that cause infections in captive wild animals and to assess the risks posed thereof and to design interventions to minimize the possibility of disease outbreaks, leading to the conservation of endangered species. The purpose of this study was to identify enteropathogenic Escherichia coli (EPEC) cloacal isolates from asymptomatic psittacines in captivity and evaluate the distribution of the EPEC pathotype. Cloacal swabs were obtained from 46 asymptomatic birds, and resulting isolates were tested by polymerase chain reaction (PCR) for the presence of the attaching and effacing gene (eae) and bundle-forming pilus structural gene (bfpA) of EPEC. Samples from several species were tested, and three samples were found to be positive for the eae and bfpA genes and characterized as typical EPEC. This is the first report of this pathotype in asymptomatic psittacines. Although certain E. coli strains are more pathogenic than others, various factors should be considered when determining the potential of E. coli isolates to cause disease in captive psittacines. Birds that are positive for the EPEC (typical) strain could be zoonotic sources of infection, and may have acquired these strains through contact with humans or domestic animals. These findings may also be valuable for the long-term management of endangered species ex situ as one EPEC sample was isolated from a Red-tailed Amazon (Amazona brasiliensis).

An exploratory study of screening practices and barriers for postpartum depression in Texas

Purpose. To evaluate the prevalence of Postpartum Depression (PPD) screening among practicing obstetrician-gynecologists in Texas, and to identify factors and barriers associated with routine depression screening practices.^ Subjects. One hundred and eighty-nine fellows and junior fellows of the Texas Association of Obstetricians & Gynecologists (District XI).^ Methods. A survey questionnaire was developed and sent to 2,028 obstetriciangynecologists, asking about their current screening practices related to PPD. The survey questions were related to the physician's demographics, the patient population, screening practices, barriers to screening, and perceptions about resources in the community. Responses were analyzed to determine associations between these factors and the physician's screening practices. ^ Results. The respondents (n=189) constituted 9.3% of the surveyed population, thus the findings cannot be considered representative of all practicing Ob-Gyns in Texas. However, the following trends were observed. Of the respondents, 85.4% reported routinely screening for PPD, while 14.6% did not. However, of those that screened, only 20.2% used the Edinburgh Postnatal Depression Scale and 7.6% screened with the Postpartum Depression Screening Scale, both validated screening tools. The majority (77.2%) reported using an informal patient interview to screen. For those who did not routinely screen, inadequate training and inadequate resources to screen for PPD were the top two barriers. Physician's age was associated with routine screening practice, as older physicians were less likely to screen routinely. Primary insurance coverage of the patient population was also associated with screening practice; physicians with Medicaid and uninsured patients were less likely to screen routinely. Lastly, physicians that believed that adequate resources existed in their communities for the treatment of PPD were more likely to screen than those that did not.^ Conclusions. The present study is the first attempt at assessing Postpartum Depression screening practices and barriers in Texas. Although the response rate was low, the findings related to informal screening methods and inadequate training indicated that education and training with regards to PPD screening and validated screening tools among Ob-Gyns stand to be improved. Connecting physicians to psychiatric resources may also improve screening rates. This first look at screening practices in Texas serves as a platform for future research in order to gain definitive insight into the diagnosis and treatment of PPD, and ultimately design interventions to improve detection rates and treatment.^

Cuidados paliativos : um olhar sobre a dignidade no fim da vida : caso clínico

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014