IMPORTANCE: Cognitively distinct subgroups of schizophrenia have been defined based on premorbid and current IQ, but little is known about the neuroanatomical differences among these cognitive ...subgroups. OBJECTIVES: To confirm previous findings related to IQ-based subgroups of patients with schizophrenia in an independent sample and extend those findings to determine the extent to which brain volumetric differences correspond to the IQ-based subgroups. DESIGN, SETTING, AND PARTICIPANTS: A total of 183 participants were assessed at the outpatient settings of Neuroscience Research Australia and Lyell McEwin Hospital from September 22, 2009, to August 1, 2012. Patients were classified using cluster analysis on the basis of current and premorbid IQ differences. Regional magnetic resonance imaging (MRI) brain volumes were compared among the IQ-based subgroups using analysis of covariance with intracranial volume and age as covariates. MAIN OUTCOMES AND MEASURES: Wechsler Adult Intelligence Scale, third edition, scores; Wechsler Test of Adult Reading scores; Positive and Negative Syndrome Scale scores; and MRI brain volumes. RESULTS: Ninety-six outpatients (mean SD age, 35.7 8.4 years; age range, 18-51 years; 59 men) with schizophrenia or schizoaffective disorder and 87 healthy controls (mean SD age, 31.9 8.4 years; age range, 20-50 years; 46 men) were studied. Sixty-two patients and 67 healthy controls underwent structural MRI of the brain. Cluster analyses revealed 25 putatively preserved patients (26%), 33 moderately deteriorated patients (34%), 27 severely deteriorated patients (28%), and 11 compromised patients (12%). Negative symptom scores were significantly worse in the severely deteriorated group relative to the putatively preserved group (F2,82 = 13.8, P < .001, effect size ES = 1.40). Patient subgroups analyzed revealed significantly reduced inferior parietal volume relative to controls (F3,113 = 9.7, P < .001, ES = 0.85-1.24). The severely deteriorated group had significantly reduced total hippocampal (mean SEM, 8309.6 175.0 vs 9024.0 145.5; P = .01), lingual gyrus (mean SEM, 11 996.0 531.5 vs 13 838.1 441.9; P = .05), and superior temporal sulcus (mean SEM, 4697.8 192.0 vs 5446.0 159.6; P = .05) gray matter volumes relative to the putatively preserved group (ES = 0.91-1.10). CONCLUSIONS AND RELEVANCE: Using an independent sample, we obtained proportions in each IQ-based subgroup that were similar to our previous work. Inferior parietal volume reduction was characteristic of schizophrenia relative to controls, and the severely deteriorated IQ group had widespread volumetric reductions. Classifying cognitive heterogeneity in schizophrenia provides a platform to better characterize the neurobiological underpinnings of the illness and its treatment.
Musical performance is a skilled activity performed under intense pressure, thus is often a profound source of anxiety. In other contexts, anxiety and its concomitant symptoms of sympathetic nervous ...system arousal have been successfully ameliorated with HRV biofeedback (HRV BF), a technique involving slow breathing which augments autonomic and emotional regulatory capacity.
This randomised-controlled study explored the impact of a single 30-minute session of HRV BF on anxiety in response to a highly stressful music performance.
A total of 46 trained musicians participated in this study and were randomly allocated to a slow breathing with or without biofeedback or no-treatment control group. A 3 Group×2 Time mixed experimental design was employed to compare the effect of group before and after intervention on performance anxiety (STAI-S) and frequency domain measures of HRV.
Slow breathing groups (n=30) showed significantly greater improvements in high frequency (HF) and LF/HF ratio measures of HRV relative to control (n=15) during 5 minute recordings of performance anticipation following the intervention (effect size: η(2) =0.122 and η(2) =0.116, respectively). The addition of biofeedback to a slow breathing protocol did not produce differential results. While intervention groups did not exhibit an overall reduction in self-reported anxiety, participants with high baseline anxiety who received the intervention (n=15) displayed greater reductions in self-reported state anxiety relative to those in the control condition (n=7) (r=0.379).
These findings indicate that a single session of slow breathing, regardless of biofeedback, is sufficient for controlling physiological arousal in anticipation of psychosocial stress associated with music performance and that slow breathing is particularly helpful for musicians with high levels of anxiety. Future research is needed to further examine the effects of HRV BF as a low-cost, non-pharmacological treatment for music performance anxiety.
Becoming a history teacher Sandwell, Ruth; von Heyking, Amy
Becoming a history teacher,
2014., 20140917, 2014, 2014-09-17
eBook
Becoming a History Teacher is a collection of thoughtful essays by history teachers, historians, and teacher educators on how to prepare student teachers to think historically and to teach historical ...thinking.
Issue addressed: The COVID-19 pandemic and associated social distancing regulations have disproportionally impacted the health of older adults. Lifestyle interventions targeting physical activity, ...diet and fostering social connection may help to alleviate the potential negative health consequences. This study aimed to determine the feasibility and preliminary effectiveness of delivering an online group lifestyle intervention for older adults during the COVID-19 pandemic.
Methods: Adults aged 60+, living in Australia were recruited to a single-arm feasibility study of a 6-week program delivered via a private Facebook group between June-August 2020. Facilitators provided motivation and education on weekly topics including goal setting and reducing sedentary behaviour in the form of Facebook posts and group video calls. Primary outcomes included feasibility and acceptability and secondary outcomes included psychological distress, quality of life (AQoL-6D), functioning, loneliness and physical activity (PA) with assessments conducted at baseline, post-intervention and 4-week follow-up.
Results: N = 11 participants were recruited and n = 10 (91%) completed the post-assessment questionnaires. High acceptability was observed and exploratory analysis from pre-post intervention found evidence of an effect on secondary outcomes.
Conclusions: A mental health informed lifestyle program delivered online via Facebook appears feasible and well-accepted among older adults and may help to prevent some of the consequences of inactivity and social isolation associated with the pandemic.
So what?: Online lifestyle interventions appear safe and may provide a scalable, cost-effective strategy for protecting the physical and mental health of older adults during the COVID-19 pandemic.
Impairments in executive functioning associated with posttraumatic stress disorder (PTSD) may impact the capacity of refugees and asylum seekers.
To examine the association between executive ...functioning and PTSD with and without prominent future-focused threat (FFT) intrusions at rest and after threat priming.
66 Farsi and Dari-speaking asylum-seekers, refugees, and immigrants were recruited into 3 groups: High PTSD & FFT Symptoms; High PTS Symptoms; Low PTSD & FFT symptoms. The Category Fluency Test (animals; food; flora) in Farsi was administered at baseline and after two counter-balanced future- and past-focused threat narrative tasks. Results: Higher PTSD and FFT symptom scores was associated with reduced verbal fluency correct words (PTS p < 0.001; FFT p < 0.007), clustered words (PTS, p < 0.004; FFT p < 0.009) and clusters (PTS p < 0.017; FFT p < 0.009). The PTSD group retrieved fewer correct words (17.6, p < 0.009) using fewer clusters (p < 0.008) than the low-symptom group at baseline. It was only after exposure to the narrative task that the FFT group displayed comparable impairment.
A subset of displaced persons with future threat symptoms exhibit cognitive impairment when asked to recount narrative details. Future threat may limit capacity to engage in cognitively demanding activities, such as participating in Refugee Status Determination.
•The PTSD group had consistently low verbal fluency functioning across all time points but not additional deterioration following the provocation.•The high Future Focus Threat and PTSD group did not display impairment in verbal fluency at the baseline of assessment but did after exposure to a future or past trauma provocation.•Under chronic future threat the symptoms associated with that threat may substantially resemble PTSD.•Asylum seekers reported a link between future-focused intrusive symptoms and objective future threat.
Background: Clinical supervision in providing mental health and psychosocial support services (MHPSSs) is an ethical imperative and a key to ensuring quality of care in terms of service users’ skills ...enhancement, well-being, and satisfaction. However, humanitarian contexts in low-resource countries usually lack sufficient infrastructures to ensure staff have access to supervision. Against this backdrop, a pilot supervision program was introduced in Bangladesh and Syria to help MHPSS staff provide quality care. However, supervision provided by experts unfamiliar with these contexts decontextualizes the supervision process and hinders cultural relevance. The aim of this paper is to present a decolonial model of supervision called “WONDERFUL Supervision”. Methods: We provided fortnightly online supervision to a total of 32 MHPSS practitioners (seven in Bangladesh and twenty-five in Syria) working in humanitarian contexts in Bangladesh and Syria as well as their surrounding countries (such as Türkiye) between 2019 and 2021.The issues talked about were the skills needed for the practitioners to provide optimal levels of service, manage staff burnout, and present cases. Focus group discussions and reflective discussions included 19 participants, involving both practitioners and supervisors across sites. Results: Despite some notable effects, the supervision was obstructed due to being decontextualized, such as the supervisors not having adequate knowledge about the contexts and culture of beneficiaries, a perceived feeling of power imbalance, practitioners having limited access to resources (e.g., internet connection and technical support), and different time zones. This defect paves the way for a new mode of supervision, WONDERFUL, which takes into account contextual factors and other sociocultural aspects. Conclusions: WONDERFUL supervision has the potential to indigenize the concept of clinical supervision and thereby more sustainably and effectively ensure quality mental health care in resource-limited countries, especially in humanitarian contexts.
BackgroundThis research examined the mental health of a cohort of asylum-seeking children, adolescents and their primary caregiver affected by insecure residency while living in the community, ...compared to refugees and immigrants. MethodsThe project investigated the prevalence of psychosocial problems among Iranian and Afghani asylum seeker, refugee and immigrant children and adolescents, and their caregivers who arrived in Australia from 2010. In total, n=196 children and adolescents aged 5-18 years, and their primary caregiver were asked about family visa status, country of origin, level of education, parent symptoms of posttraumatic stress disorder (Harvard Trauma Questionnaire) and child wellbeing (Strengths and Difficulties Questionnaire). An additional n=362 Farsi and Dari speaking children, recruited through the Building a New Life in Australia (BNLA) study, a national comparison sample of families with permanent refugee visas, were included. FindingsAsylum seeker children and adolescents displayed significantly more psychosocial problems compared to those with full refugee protection and immigrant background within the current sample and when benchmarked against a national sample of Farsi-Dari speaking refugee children. Higher parental posttraumatic stress disorder symptoms was associated with poorer child and adolescent psychosocial functioning. This effect was more marked in families with insecure residency. InterpretationInsecure visa status is associated with higher rates of children's mental health problems and a stronger association with parental PTSD symptoms compared to children with secure residency. This raises important questions about Australia's restrictive immigration policies. FundingThis project was supported by an Australian Rotary Health Research Fund / Mental Health of Young Australians Research Grant and by the Australian Research Council (DP160104378).
Objective
Emergency service workers are at risk of experiencing poor mental health due to repeated exposure to potentially traumatic events. Promoting healthy lifestyle factors may help improve ...health outcomes and quality of life among this population. This study aimed to evaluate the efficacy of a 10-week physical activity (PA) and diet programme delivered via Facebook for sedentary emergency service workers and their support partners on levels of psychological distress.
Methods
We delivered a 10-week intervention via a private Facebook group facilitated by exercise physiologists, a dietitian and peer-facilitators. Weekly education modules and telehealth calls were delivered, and participants were provided with a PA tracking device (Fitbit accelerometer). A stepped-wedge design was applied to compare levels of psychological distress (K6) during baseline, to intervention by comparing slopes of change. Secondary pre–post outcomes included mental health symptoms, PA, quality of life, social support to exercise, sleep quality and suicidal ideation.
Results
In total, N=90 participants (n=47 emergency service workers and n=43 support partners) were recruited in 4 cohorts (aged 42.3±11.5 years, 51% male). Levels of psychological distress did not change significantly during the baseline (control) slope and reduced significantly during the first 6 weeks of intervention (intervention slope 1). The slopes were significantly different, b=−0.351, p = 0.003 (i.e. the trajectories of change) and improvements plateaued until follow up. Retention was high (92%) and improvements in mental health symptoms, minutes of PA, sedentary time and quality of life were significant.
Conclusions
Our intervention delivered via social media is feasible and associated with reduced levels of psychological distress among emergency service workers and support partners.
Trial registration
Australian New Zealand Clinical Trials Registry (ACTRN): 12619000877189.
Canada's Rural Majorityis an engaging and accessible history of the distinctive experience of Canada's rural population, including not only farmers, but also hunters, gardeners, fishers, miners, ...loggers, and cannery workers who lived and worked in rural Canada.
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