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Publisher: Independence First Press (August 1, 2007)
Caregiver Therapy (Elf-help)
Tackling Pensioner Poverty: Encouraging Take-up of Entitlements: Report with Proceedings, Minutes of Evidence and an Appendix 12th (House of Commons Papers)
Dignifying Dementia: A Caregiver's Struggle
Also, grandparents usually died before their grandchildren reached adulthood. This meant the family structure looked like a pyramid with a large number of children and parents and very few grandparents. In the 2000s, however, the family model is more like a lopsided rectangle. More generations are alive at the same point in time than in past eras. Families have fewer children, but grandparents and great-grandparents are living longer Changing Care for the Elderly in the Netherlands: Experiences and Research Findings from Policy Experiments http://tellfredericksburg.com/freebooks/changing-care-for-the-elderly-in-the-netherlands-experiences-and-research-findings-from-policy. In general, "It is now easier to administer a pill prescribed by a board-certified physician, than to firmly instruct a child and impose consequences for bad behaviour." Stephen Camarata, a professor of hearing and speech sciences and psychiatry at Vanderbilt University in Nashville echoes that point: "Parents say, 'My child can't do this particular exercise, they're not paying attention,' therefore I have to identify them as having a clinical condition." A medical diagnosis might negate parental shortcomings or a child's misbehaviour. "It displaces that failure," he says Housing and Support for Older download here Housing and Support for Older People, A. Now we're going to turn our attention to the challenge of caring for loved ones as they age. Tens of millions of Americans are already doing this. As one of our guests, former New York Times reporter Jane Gross, tells us in her new book, "A Bittersweet Season," some 65.7 million Americans, or 28 percent of the population, are currently serving as unpaid family caregivers Communicating with Your download for free http://hanoyobou.com/books/communicating-with-your-elderly-loved-ones-practical-recommendations-for-interacting-at-home-or-at. For example, African American and Hispanic families are more likely than Caucasian families to have multiple generations residing in the same home or close to one another Caring for the Elderly tellfredericksburg.com. Find & Connect support services provide information, support and counselling to Forgotten Australians and Former Child Migrants. Intensive Family Support Services is a family support service which provides the most vulnerable families access to evidence-based, intensive parenting support in their homes and communities and assists the development of parenting skills that improve the safety, health, education and wellbeing of their children ref.: Choosing Medical Care in Old Age: What Kind, How Much, When to Stop Choosing Medical Care in Old Age: What.
Aromatherapy in Alzheimer's Care (One Minute Caregiver)
Before It's Too Late - Don't Leave Your Loved Ones Unprepared
To Care or Not to Care
Mom Got Old! The Perils of Long-Term Care
Pushing Twilight: My Personal Adventure in Geriatric Home Care
How To Fold Superman's Cape: A Woman's Guide To Elder Care
Homeless Customers, Hostels, Residential Care and Nursing Homes: Procedures and Good Practice Guide
Providing for Long-Term Care: Response to the Government's Proposals for Partnership Schemes
Multiple Sclerosis, an Enigma
The Boomer Burden: Dealing with Your Parents' Lifetime Accumulation of Stuff
The Gift of Caring: Saving Our Parents from the Perils of Modern Healthcare
Life After 50: Issues for Policy Research (Transitions after fifty)
Caregiver Guide 3 - How to Identify and Replace Lost Documents (Caregiver Guide Series - A Guide to Caregiver Paperwork Management Book 4)
The Seasons of Good-Bye: An Alzheimer's Caregiver Journal
Aging Families and Caregiving (Wiley Series in Clinical Geropsychology)
The Retiring Mind: How to Make the Psychological Transition to Retirement
Women and Therapy in the Last Third of Life: The Long View
Staying Sane and Caring For An Elderly Parent: A Life Journey of Love, Loss and Reversed Roles
Socioeconomic Status, Parenting, and Child Development (Monographs in Parenting Series)
A Most Reluctant Caregiver: A daughter learns valuable lessons as her difficult mother enters the sunset of her years
Take That Nursing Home and Shove It!: How to Secure an Independent Future for Yourself and Your Loved Ones.
A Light in the Dark: Dealing with Alzheimer's
Powered By Positive: A Caregiver's Journey From Conflict to Courage, How to Beat Adversity And Live Again
A Helping Hand: A hand book to help you take care of aging family and friends.
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OBJECTIVE: To conduct the first support vector machine (SVM)-based study comparing the diagnostic accuracy of T1-weighted magnetic resonance imaging (T1-MRI), F-fluorodeoxyglucose-positron emission tomography (FDG-PET) and regional cerebral blood flow single-photon emission computed tomography (rCBF-SPECT) in Alzheimer's disease (AD). METHOD: Brain T1-MRI, FDG-PET and rCBF-SPECT scans were acquired from a sample of mild AD patients (n=20) and healthy elderly controls (n=18). SVM-based diagnostic accuracy indices were calculated using whole-brain information and leave-one-out cross-validation. RESULTS: The accuracy obtained using PET and SPECT data were similar. PET accuracy was 68B71% and area under curve (AUC) 0.77B0.81; SPECT accuracy was 68B74% and AUC 0.75B0.79, and both had better performance than analysis with T1-MRI data (accuracy of 58%, AUC 0.67). The addition of PET or SPECT to MRI produced higher accuracy indices (68B74%; AUC: 0.74B0.82) than T1-MRI alone, but these were not clearly superior to the isolated neurofunctional modalities. CONCLUSION: In line with previous evidence, FDG-PET and rCBF-SPECT more accurately identified patients with AD than T1-MRI, and the addition of either PET or SPECT to T1-MRI data yielded increased accuracy. The comparable SPECT and PET performances, directly demonstrated for the first time in the present study, support the view that rCBF-SPECT still has a role to play in AD diagnosis.
Descriptors: Alzheimer's disease; support vector machine; MRI; FDG-PET; SPECT
OBJECTIVE: Parents of children with autism spectrum disorders (ASD) seem to perceive that their child's development is not following the normal pattern as early as the first year of life. However, ASD children may not receive a diagnosis until they are of preschool age, especially in low- and middle-income countries. The objective of this study was to evaluate the pathway between initial parental concerns about atypical child development and ASD diagnosis in Brazil. METHODS: Nineteen mothers whose children had been diagnosed with ASD participated and were interviewed. The ASD group consisted of two girls and 17 boys, with a mean age of 93.0 months (SD 48.4 months; range 39-197 months). RESULTS: Mothers had their first concerns regarding ASD when children were 23.6±11.6 months old, but formal diagnosis occurred at a mean ± SD age of 59.6±40.5 months, corresponding to a 3-year delay. Most mothers felt discouraged to address their concerns due to negative experiences with health professionals. CONCLUSION: In Brazil, mothers perceived the first signs of ASD in their children at an age similar to that reported in other countries, but the diagnosis of ASD seemed to be delayed. Consistent with the literature, mothers reported negative experiences with health professionals during the pathway to achieving ASD diagnosis.
Descriptors: Autism spectrum disorder; parental identification; delayed diagnosis; low-and middle-income countries
OBJECTIVE: To determine the prevalence of childhood emotional and behavioral problems and examine their associations with cesarean delivery. METHODS: Our sample consisted of 8,900 preschoolers from 35 kindergartens in four cities in East China. Parents completed the Strengths and Difficulties Questionnaire (SDQ) and provided other information. Children's emotional and behavioral problems were assessed using five subscales of the SDQ. Mode of delivery was classified as vaginal or cesarean section (CS); in sub-analyses, we divided CS into elective or emergency delivery. Logistic regression was used to examine associations. RESULTS: A total of 1,209 (13.6%) children had a total SDQ score within abnormal range; 25.5% had peer problems within abnormal range, 9.0% had abnormal emotional symptoms, 13.9% had abnormal conduct problems, 18.9% had abnormal hyperactivity problems, and 16.2% were rated abnormal in pro-social behavior. Overall, 67.3% of the children who participated were delivered by CS. In fully adjusted analysis, CS was significantly associated with abnormal total SDQ score (OR = 1.27; 95%CI 1.10-1.46; p < 0.05) and pro-social behavior (OR = 1.27; 95%CI 1.12-1.45; p < 0.0001). No significant association was found between CS and risk of having conduct problems (OR 1.13; 95%CI 0.98-1.29), peer problems (OR 1.11; 95%CI 0.99-1.24), hyperactivity (OR 1.02; 95%CI 0.91-1.15), or emotional problems (OR 1.06; 95%CI 0.90-1.24). CONCLUSION: In this sample, CS was associated with risk of behavioral problems, but not with emotional problems. Further research is needed to better understand these associations.
Descriptors: Problem behavior; cesarean section; delivery mode; pregnancy; preschool children
OBJECTIVE: To compare the presence of criteria listed in the DSM-5 and ICD-10 diagnostic manuals in a Brazilian sample of transgender persons seeking health services specifically for physical transition. METHODS: This multicenter cross-sectional study included a sample of 103 subjects who sought services for gender identity disorder in two main reference centers in Brazil. The method involved a structured interview encompassing the diagnostic criteria in the two manuals. RESULTS: The results revealed that despite theoretical disagreement about the criteria, the manuals overlap regarding diagnosis confirmation; the DSM-5 was more inclusive (97.1%) than the ICD-10 (93.2%) in this population. CONCLUSIONS: Although there is no consensus on diagnostic criteria on transgenderism in the diversity of social and cultural contexts, more comprehensive diagnostic criteria are evolving due to society's increasing inclusivity.
Descriptors: Diagnosis and classification; gender differences; minority issues and cross-cultural psychiatry; history of psychiatry; social and political issues
OBJECTIVE: Cardiovascular disease is the leading cause of death in patients with bipolar disorder. The aim of this study was to evaluate the factors associated with positive coronary calcium score (CCS) in individuals with bipolar disorder type 1. METHODS: Patients from the Bipolar Disorder Program at Hospital de Clínicas de Porto Alegre, Brazil, underwent computed tomography scanning for calcium score measurement. Clinical and sociodemographic variables were compared between patients according to their CCS status: negative (CCS = 0) or positive (CCS > 0). Poisson regression analysis was used to examine the association of CCS with number of psychiatric hospitalizations. RESULTS: Out of 41 patients evaluated, only 10 had a positive CCS. Individuals in the CCS-positive group were older (55.2±4.2 vs. 43.1±10.0 years; p = 0.001) and had more psychiatric hospitalizations (4.7±3.0 vs. 2.6±2.5;p = 0.04) when compared with CCS-negative subjects. The number of previous psychiatric hospitalizations correlated positively with CCS (p < 0.001). CONCLUSION: Age and number of psychiatric hospitalizations were significantly associated with higher CCS, which might be a potential method for diagnosis and stratification of cardiovascular disease in bipolar patients. There is a need for increased awareness of risk assessment in this population.
Descriptors: Bipolar disorder; cardiovascular diseases; diagnostic techniques; cardiovascular; coronary disease
OBJECTIVE: Many studies correlate characteristics of family functioning and the development of drug addiction. This study sought to evaluate and compare the family environment styles of two groups of psychoactive substance users: 1) alcohol-only users and 2) crack-cocaine users. METHODS: Three hundred and sixty-four users of alcohol, crack-cocaine, and other drugs, recruited from research centers in four Brazilian capitals participated in this study. Subjects were evaluated through the Family Environment Scale and the Addiction Severity Index, 6th version (ASI-6). ASI-6 t-scores were compared by analysis of variance (ANOVA) and post-hoc tests. A final model was obtained using a logistic regression analysis. All analyses were adjusted for partner, age, and psychiatric t-score. RESULTS: We found a significant difference between groups in the cohesion subscale (p = 0.044). The post-hoc test revealed a difference of 1.06 points (95%Ci 0.11-2.01) between groups 1 (6.45±0.28) and 2 (5.38±0.20). No significant between-group differences were observed in the other subscales. However, categorical analyses of variables regarding family dynamic showed that crack users more often reported that sometimes people in their family hit each other (30.4% vs. 13.2%, p = 0.007) and that people in their family frequently compared each other regarding work and/or school achievement (57.2% vs. 42.6%, p = 0.041). CONCLUSION: These results suggest that families of crack-cocaine users are less cohesive than families of alcohol users. This type of family environment may affect treatment outcome, and should thus be adequately approached.
Descriptors: Family; family relationships; cohesion; substance abuse; alcohol use; crack-cocaine use
OBJECTIVE: To analyze the prevalence of common mental disorders (CMD) assessed with the Self Reporting Questionnaire (SRQ-20), using the established cutoff point, and comparing it with the results of a joint correspondence factor analysis (CFA) and cluster analysis and of a latent class analysis (LCA). METHODS: A cross-sectional study was carried out in an urban sample of 1,095 women aged 19 to 55 years. Joint CFA-cluster analysis and LCA were used. RESULTS: We found a high prevalence of CMD, regardless of classification method (37.6% when using the cutoff point; 44.4% and 52% for LCA and joint CFA-cluster, respectively). The alternative analysis strategies describe the cases more efficiently when compared to the traditional cutoff method, especially regarding more severe symptoms. Both alternative strategies also provide a description of the SRQ-20 dimensions in their particularities, which may be useful for the planning and implementation of specific actions in a given population. CONCLUSION: The SRQ-20 cutoff point seems to underestimate the magnitude of CMD among women. The alternative methods of analysis presented herein highlight the different possibilities of using this important instrument of screening for mental health.
Descriptors: Screening; mental health; multivariate analysis; latent class analysis; correspondence analysis
OBJECTIVE: A large proportion of psychotherapy patients remain untreated, mostly because they drop out. This study compares the short- and long-term outcomes of patients who dropped out of psychotherapy to those of therapy completers. METHODS: The sample included 63 patients (23 dropouts and 40 completers) from a controlled clinical trial, which compared narrative therapy vs. cognitive-behavioral therapy for major depressive disorder. Patients were assessed at the eighth session, post-treatment, and at 31-month follow-up. RESULTS: Dropouts improved less than completers by the last session attended, but continued to improve significantly more than completers during the follow-up period. Some dropout patients improved with a small dose of therapy (17% achieved a clinically significant change before abandoning treatment), while others only achieved clinically significant change after a longer period (62% at 31-month follow-up). CONCLUSION: These results emphasize the importance of dealing effectively with patients at risk of dropping out of therapy.Patients who dropped out also reported improvement of depressive symptoms without therapy, but took much longer to improve than did patients who completed therapy. This might be attributable to natural remission of depression. Further research should use a larger patient database, ideally gathered by meta-analysis.
Descriptors: Patient dropout; psychotherapy; outcome assessment; unipolar depression
Depression is a psychiatric disorder and major contributor to the burden of disease worldwide. The strength of evidence of the benefits of exercise as a therapeutic intervention for patients with depression has expanded in the last 30 years. In fact, the available evidence indicates exercise can not only help manage depressive symptoms, but also effect significant improvements in other health outcomes. Clinical guidelines including such recommendations have been issued by different agencies, namely the UK National Institute for Health and Clinical Excellence (NICE), the American Psychiatric Association (APA), and the Royal Australian and New Zealand College of Psychiatrists (rAnZCP). With increasing recognition of the benefits of exercise and shortcomings of healthcare systems, other countries, such as Sweden and Canada, have included exercise in their national guidelines for treating depression. Unfortunately, progress in incorporating exercise guidelines into clinical practice has been slow, and Portugal and Brazil reflect this reality. In this update, we reemphasize the importance of bridging this gap and integrating exercise into clinical practice guidelines as an essential component of depression treatment.
Descriptors: Depression; treatment; exercise; guidelines
OBJECTIVE: To explore how a genetically-influenced characteristic (the level of response to alcohol [LR]), ethnicity, and sex relate to environmental and attitudinal characteristics (peer drinking [PEER], drinking to cope [COPE], and alcohol expectancies [EXPECT]) regarding future alcohol-related blackouts (ARBs). METHODS: Structural equation models (SEMs) were used to evaluate how baseline variables related to ARB patterns in 462 college students over 55 weeks. Data were extracted from a longitudinal study of heavy drinking and its consequences at a U.S. university. RESULTS: In the SEM analysis, female sex and Asian ethnicity directly predicted future ARBs (beta weights 0.10 and -0.11, respectively), while all other variables had indirect impacts on ARBs through alcohol quantities (beta weights ~0.23 for European American ethnicity and low LR, 0.21 for cannabis use and COPE, and 0.44 for PEER). Alcohol quantities then related to ARBs with beta = 0.44. The SEM explained 23% of the variance. CONCLUSION: These data may be useful in identifying college students who are more likely to experience future ARBs over a 1-year period. They enhance our understanding of whether the relationships of predictors to ARBs are direct or mediated through baseline drinking patterns, information that may be useful in prevention strategies for ARBs.
Descriptors: Alcohol; blackout; college students; peer drinking; drinking to cope; drinking behavior; alcohol drinking in college; binge drinking
OBJECTIVE: To provide a comprehensive picture of mental health problems (MHPs) in Brazilian medical students by documenting their prevalence and association with co-factors. METHODS: We systematically searched the MEDLINE/PubMed, SciELO, LILACS, and PsycINFO databases for cross-sectional studies on the prevalence of MHPs among medical students in Brazil published before September 29, 2016. We pooled prevalences using a random-effects meta-analysis, and summarized factors associated with MHP. RESULTS: We included 59 studies in the analysis. For meta-analyses, we identified the summary prevalence of different MHPs, including depression (25 studies, prevalence 30.6%), common mental disorders (13 studies, prevalence 31.5%), burnout (three studies, prevalence 13.1%), problematic alcohol use (three studies, prevalence 32.9%), stress (six studies, prevalence 49.9%), low sleep quality (four studies, prevalence 51.5%), excessive daytime sleepiness (four studies, prevalence 46.1%), and anxiety (six studies, prevalence 32.9%). Signs of lack of motivation, emotional support, and academic overload correlated with MHPs. CONCLUSION: Several MHPs are highly prevalent among future physicians in Brazil. Evidence-based interventions and psychosocial support are needed to promote mental health among Brazilian medical students.
Descriptors: Mental health; depression; medical students; mental disorders
OBJECTIVES: Little is known about the prevalence and correlates of deliberate self-harm (DSH) in children from low- and middle-income countries. We investigated the prevalence of DSH and its clinical and maternal psychopathological associations in Brazilian children (n=2,508, ages 6-14y) in a community-based study. METHODS: Participants of the High Risk Cohort Study for the Development of Childhood Psychiatric Disorders (HRC) and their mothers were assessed in structured interviews. Current (last month) and lifetime DSH were estimated, including analysis stratified by age groups. Logistic regressions were performed to investigate the role of the children's clinical diagnoses and maternal psychopathology on DSH prevalence estimates, adjusting for potential confounding factors. RESULTS: The prevalence of current DSH was 0.8% (children 0.6%, adolescents 1%) and lifetime DSH was 1.6% (1.8% and 1.5%, respectively). Current and lifetime DSH were more frequent in children with depression, attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD), even in multiple models accounting for demographic variables and co-occurring psychiatric disorders. Maternal anxiety disorder was strongly associated with current and lifetime DSH in offspring; whereas current DSH, specifically in young children, was associated with maternal mood disorder. CONCLUSION: Diagnoses of depression, ADHD and ODD were consistently associated with DSH, as was having a mother with anxiety disorder.
Descriptors: Deliberate self-harm; self-injurious behavior; suicide attempt; community survey; family health; psychopathology
OBJECTIVE: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. METHOD: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline) and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale - RANSS), depression (Calgary Depression Scale), disease severity (Clinical Global Impression - CGI), functionality (Global Assessment of Functioning - GAF), personal and social performance (Personal and Social Performance - RSR) and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia - MATRICS battery) were applied at baseline and at the end of the study. RESULTS: Those with some previous work experience (n=19) presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05) than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS). CONCLUSIONS: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.
Descriptors: Schizophrenia; work; symptom; support
OBJECTIVE: To assess the effectiveness of three mood disorder treatment algorithms in a sample of patients seeking care in the Brazilian public healthcare system. METHODS: A randomized pragmatic trial was conducted with an algorithm developed for treating episodes of major depressive disorder (MDD), bipolar depressive episodes and mixed episodes of bipolar disorder (BD). RESULTS: The sample consisted of 259 subjects diagnosed with BD or MDD (DSM-IV-TR). After the onset of symptoms, the first treatment occurred ~6 years and the use of mood stabilizers began ~12 years. All proposed algorithms were effective, with response rates around 80%. The majority of the subjects took 20 weeks to obtain a therapeutic response. CONCLUSIONS: The algorithms were effective with the medications available through the Brazilian Unified Health System. Because therapeutic response was achieved in most subjects by 20 weeks, a follow-up period longer than 12 weeks may be required to confirm adequate response to treatment. Remission of symptoms is still the main desired outcome. Subjects who achieved remission recovered more rapidly and remained more stable over time. CLINICAL TRIAL REGISTRATION: NCT02901249, NCT02870283, NCT02918097
Descriptors: Mood disorders; bipolar; mood disorders; unipolar; clinical drug studies; economic issues; epidemiology
OBJECTIVE: To perform a spatial analysis of suicide mortality and its correlation with socioeconomic indicators in Brazilian municipalities. METHODS: This is an ecological study with Brazilian municipalities as a unit of analysis. Data on deaths from suicide and contextual variables were analyzed. The spatial distribution, intensity and significance of the clusters were analyzed with the global Moran index, MoranMap and local indicators of spatial association (LISA), seeking to identify patterns through geostatistical analysis. RESULTS: A total of 50,664 deaths from suicide were registered in Brazil between 2010 and 2014. The average suicide mortality rate in Brazil was 5.23/100,000 population. The Brazilian municipalities presenting the highest rates were Taipas do Tocantins, state of Tocantins (79.68 deaths per 100,000 population), Itaporã, state of Mato Grosso do Sul (75.15 deaths per 100,000 population), Mampituba, state of Rio Grande do Sul (52.98 deaths per 100,000 population), Paranhos, state of Mato Grosso do Sul (52.41 deaths per 100,000 population), and Monjolos, state of Minas Gerais (52.08 deaths per 100,000 population). Although weak spatial autocorrelation was observed for suicide mortality (I = 0.2608), there was a formation of clusters in the South. In the bivariate spatial and classical analysis, no correlation was observed between suicide mortality and contextual variables. CONCLUSION: Suicide mortality in Brazil presents a weak spatial correlation and low or no spatial relationship with socioeconomic factors.
Descriptors: Suicide; epidemiology; social and political issues; community mental health; statistics
OBJECTIVE: The aim of this study was to estimate nationally representative prevalence rates of amphetamine-type stimulant (ATS) use and to identify consumption-associated factors, proposing a conditional model of direct and indirect consumption paths. METHOD: Using data from the Second Brazilian National Alcohol and Drugs Survey, this cross-sectional study analyzed a subsample of 3,828 participants between 15 and 64 years old, gathering information on the use of psychoactive substances in a probabilistic sample of the Brazilian household population. RESULTS: Rates of lifetime and last-year ATS use were, respectively, 4.1 and 1.6%. Economically privileged individuals and users of other substances were more at risk for using ATS. The results suggest that higher education decreases the chances of ATS consumption. The conditional model showed that higher income increased ATS use, higher education lowered the odds of such an increase, and cocaine use cancelled that associative effect. CONCLUSION: Brazil presents high rates of ATS use. Prevention and treatment strategies should focus on the protective effect of higher education levels and should target polydrug use. Knowledge of ATS-associated factors and user profiles is the starting point for developing effective treatments and tailored prevention strategies.
Descriptors: Amphetamine-type stimulants; moderation model; epidemiology; prevalence; Brazil
OBJECTIVE: Associations between parental/caregiver depression and adverse child outcomes are well established and have been described through one or more mechanisms: child psychopathology following exposure to a depressed caregiver, child psychopathology exacerbating a caregiver's depression, and caregiver and offspring depression sharing the same etiology. Data from low and middle-income countries is scarce. We examined correlations between common symptoms of mental disorders in caregivers and their offspring's psychopathology in a Brazilian sample. METHODS: In this cross-sectional study, adult caregivers were screened for depression during routine home visits by community health workers as part of the Brazilian Family Health Strategy. Caregivers with suspected depression were assessed using the Zung Self-Rating Depression Scale and the Self-Reporting Questionnaire (SRQ-20). Children's symptoms were evaluated using the Strengths and Difficulties Questionnaire (SDQ). RESULTS: The sample included 68 primary caregivers and 110 children aged 6 to 15 years. Higher caregiver scores on the SRQ-20 correlated significantly with psychiatric symptoms in offspring. CONCLUSION: These results substantiate our hypothesis that child psychopathology correlates with caregivers' psychiatric symptoms. This paper adds to the growing literature on community mental health assessment and can help guide future strategies for reducing the burden of common mental disorders in caregivers and children alike in low and middle-income countries.
Descriptors: Depressive disorder; primary health care; child; caregivers; Brazil
OBJECTIVE: There have been significant reductions in numbers of psychiatric beds and length of stay (LOS) worldwide, making LOS in psychiatric beds an interesting outcome. The objective of this study was to find factors measurable on admission that would predict LOS in the acute psychiatric setting. METHODS: This was a prospective, observational study. RESULTS: Overall, 385 subjects were included. The median LOS was 25 days. In the final model, six variables explained 14.6% of the variation in LOS: not having own income, psychiatric admissions in the preceding 2 years, high Clinical Global Impression and Brief Psychiatric Rating Scale scores, diagnosis of schizophrenia, and history of attempted suicide. All variables were associated with longer LOS, apart from history of attempted suicide. CONCLUSIONS: Identifying patients who will need to stay longer in psychiatric beds remains a challenge. Improving knowledge about determinants of LOS could lead to improvements in the quality of care in hospital psychiatry.
Descriptors: Outcome studies; inpatient psychiatry; chronic psychiatric illness; administration; other delivery issues
OBJECTIVE: The findings of telomere length (TL) studies in bipolar disorder (BD) are controversial. The aim of the present study was to detect TL, human telomerase reverse transcriptase (hTERT), and brain derived neurotrophic factor (BDNF) in severe mania and subsequent remission. METHODS: Twenty-one medication-free male patients and 20 age and gender matched controls were recruited. The patients were followed in the inpatient clinic, and comparisons were made between the same patients in their remission state and controls. Patients received lithium plus antipsychotics during the follow-up period. Quantitative real-time polymerase chain reaction was performed to verify leukocyte tL and whole blood hTERT gene expression levels. Serum BDNF levels were verified by enzyme-linked immunosorbent assay (ELISA). RESULTS: Compared to controls, manic patients presented shorter telomeres (p < 0.001) whose length increased with treatment (p = 0.001). Patients in the late stages showed shorter TL than those in the early stages and controls (p < 0.001). hTERT gene expression levels were up-regulated in mania and remission compared to controls (p = 0.03 and p = 0.01, respectively). BDNF changes did not reach statistically significant levels. CONCLUSIONS: TL and hTERT gene expression might reflect a novel aspect of BD pathophysiology and TL might represent a novel biomarker for BD staging.
Descriptors: Bipolar disorder; telomere; TERT protein; human
OBJECTIVE: Suicidal ideation is modulated by several risk and protective factors. The aim of this study was to evaluate differences between patients with a history of suicide attempt and those with no such history, with special attention to depression, interpersonal sensitivity, humiliation, and resilience.
METHODS: One hundred consecutively admitted patients with an index depressive episode were recruited. The Brief Symptom Inventory, Humiliation Inventory, and Resilience Scale for Adult were administered.
RESULTS: Scores for humiliation, interpersonal sensitivity, and depression were higher in subjects with history of suicide attempt, while higher scores for resilience were observed in the group with no such history. Different patterns of relationships among the variables of interest were found in the two groups. Resilience dimensions such as social resources and familial cohesion were strongly and negatively correlated with humiliation, interpersonal sensitivity, and depression in subjects with a past suicide attempt.
CONCLUSIONS: Resilience factors can modulate and reduce the impact of suicide risk. Assessing risk and protective factors could enhance the ability to intervene appropriately.
Descriptors: Suicide; humiliation; interpersonal sensitivity; depression; resilience
OBJECTIVE: To explore the indirect self-destructiveness syndrome in patients with schizophrenia.
METHODS: Two hundred individuals with paranoid schizophrenia (117 men and 83 women, mean age 37.15 years), all in remission, were examined using the Polish version of the Chronic Self-Destructiveness Scale. Two hundred well-matched healthy individuals served as a control group.
RESULTS: The intensity of indirect self-destructiveness was greater in the schizophrenia group than in controls. The intensity of each manifestation was as follows (in decreasing order): helplessness and passiveness in the face of difficulties (A5), personal and social neglects (A3), lack of planfulness (A4), poor health maintenance (A2), transgression and risk (A1).
CONCLUSION: Patients with schizophrenia displayed more behaviors that were indirectly self-destructive than healthy controls; they scored better than healthy controls only on caring for their own health. The patients showed the lowest intensity of behaviors connected with the active form of indirect selfdestructiveness, and the highest intensity of behaviors connected with the passive form. These findings may enable delivery of more effective forms of pharmacological and psychosocial help to patients with schizophrenia.
Descriptors: Schizophrenia; indirect self-destructiveness; health maintenance; neglects; planfulness; helplessness
The objective of this paper is to provide an update to psychiatrists regarding the new Brazilian Law for the Inclusion of People with Disabilities (BlI, Law 13,146 of 2015), and, specifically, to discuss potential implications of situations in which examination by a forensic psychiatrist points toward civil incompetence, while the above-mentioned law mandates full civil capacity for disabled persons. A study of Law 13,146/2015 was conducted, including a comparative analysis of legal and psychiatric approaches on the subject. This analysis revealed that the BLI has generated differences of opinion among legislators. However, the greatest difference seems to arise between the justice system and psychiatric expertise in relation to the difference of criteria adopted in the two approaches. The BLI is very recent; it should be revised in response to debates among psychiatrists and the criminal justice system, and especially as jurisprudence is formed over time.
Descriptors: Forensic psychiatry; legal interdiction; disability advocacy; discrimination
OBJECTIVE: Most studies on conduct disorder (CD) have focused on male adolescents, disregarding analysis of this psychopathology in women. The purpose of this study was to identify differences in empathy and theory of mind (ToM) in a group of adolescent women with CD and a control group.
METHOD: Thirty-six adolescent women were selected from an initial sample of 239 adolescents (CD group = 18, control group = 18). Empathy and ToM were evaluated through objective instruments. Mean comparisons and multivariate analysis were performed to ascertain differences between cases and controls and to propose a prediction model based on clinical status.
RESULTS: Significant differences in empathic abilities and ToM were found between the groups. The model that differentiated both groups was composed of eye-reading ability, perspective taking, and personal distress.
CONCLUSION: These findings are consistent with previous studies. Capacity to take the other's perspective and the recognition of emotions in the face are protective factors against CD in women.
Descriptors: Conduct disorder; empathy; theory of mind; women; callous unemotional traits
OBJECTIVE: To identify child behaviors and types of impairment that increase the likelihood of maternal recognition of emotional/behavioral problems (EBP) in children and adolescents.
METHODS: Maternal-reported data were obtained from two subsamples of 11-to-16-year-olds derived from cross-sectional studies conducted in two Brazilian municipalities: Itaboraí, state of Rio de Janeiro (n=480), and Embu, state of São Paulo (n=217). The Itaboraí study involved a representative sample of 6-to-16-year-olds (n=1,248; response rate = 86.0%) selected from the Family Health Program registry, which covered 85.5% of the municipal population. The Embu study was based on a probabilistic sample of clusters of eligible households (women aged 15-49 years, child < 18 years), with one mother-child pair selected randomly per household (n=813; response rate = 82.4%). The outcome variable was mother's opinion of whether her child had EBP. Potential correlates included types of child behaviors (hyperactivity/conduct/emotional problems as isolated or combined conditions) and impairment, assessed using the Strengths and Difficulties Questionnaire (SDQ); child's age and gender; maternal education and anxiety/depression (assessed using the Self-Reporting Questionnaire [SRQ]).
RESULTS: Multivariate regression models identified the following correlates of maternal perception of child EBP: comorbidity (co-occurring hyperactivity/conduct/emotional problems), emotional problems alone, and interference of problems with classroom learning and friendships.
CONCLUSION: Comorbidity of different problem types, emotional problems alone, and interference with classroom learning and friendships increase the likelihood of maternal recognition of EBP in children.
Descriptors: Adolescents; child psychiatry; epidemiology; families; community mental health
Depression is a complex condition, and its classical biological/psychosocial distinction is fading. Current guidelines are increasingly advocating psychotherapy as a treatment option. Psychodynamic psychotherapy models encompass a heterogeneous group of interventions derived from early psychoanalytic conceptualizations. Growing literature is raising awareness in the scientific community about the importance of these treatment options, as well as their favorable impact on post-treatment outcomes and relapse prevention. Considering the shifting paradigm regarding treatment of depressive disorder, the authors aim to provide a brief overview of the definition and theoretical basis of psychodynamic psychotherapy, as well as evaluate current evidence for its effectiveness.
Descriptors: Depressive disorder; mood disorders, unipolar; psychotherapy; psychoanalysis and psychodynamic therapies
OBJECTIVE: Current treatment of borderline personality disorder (BPD) consists of psychotherapy and pharmacological interventions. However, the use of repetitive transcranial magnetic stimulation (rTMS) could be beneficial to improve some BPD symptoms. The objective of this study was to evaluate clinical improvement in patients with BPD after application of rTMS over the right or left dorsolateral prefrontal cortex (DLPFC).
METHOD: Twenty-nine patients with BPD from the National Institute of Psychiatry, Mexico, were randomized in two groups to receive 15 sessions of rTMS applied over the right (1 Hz, n=15) or left (5 Hz, n=14) DLPFC. Improvement was measured by the Clinical Global Impression Scale for BPD (CGI-BPD), Borderline Evaluation of Severity Over Time (BEST), Beck Depression Inventory (BDI), Hamilton Anxiety Rating Scale (HAM-A), and Barratt Impulsiveness Scale (BIS).
RESULTS: Intragroup comparison showed significant (p < 0.05) reductions in every psychopathologic domain of the CGI-BPD and in the total scores of all scales in both groups.
CONCLUSIONS: Both protocols produced global improvement in severity and symptoms of BPD, particularly in impulsiveness, affective instability, and anger. Further studies are warranted to explore the therapeutic effect of rTMS in BPD.
Descriptors: Borderline personality disorder; neurophysiology; neurosciences; psychosocial factors
OBJECTIVE: To perform a construct validation of the List of Threatening Events Questionnaire (LTE-Q), as well as convergence validation by identifying its association with drug use in a sample of the Brazilian population.
METHODS: This is a secondary analysis of the Second Brazilian National Alcohol and Drugs Survey (II BNADS), which used a cross-cultural adaptation of the LTE-Q in a probabilistic sample of 4,607 participants aged 14 years and older. Latent class analysis was used to validate the latent trait adversity (which considered the number of events from the list of 12 item in the LTE experienced by the respondent in the previous year) and logistic regression was performed to find its association with binge drinking and cocaine use.
RESULTS: The confirmatory factor analysis returned a chi-square of 108.341, weighted root mean square residual (WRMR) of 1.240, confirmatory fit indices (CFI) of 0.970, Tucker-Lewis index (TLI) of 0.962, and root mean square error approximation (RMSEA) score of 1.000. LTE-Q convergence validation showed that the adversity latent trait increased the chances of binge drinking by 1.31 time and doubled the chances of previous year cocaine use (adjusted by sociodemographic variables).
CONCLUSION: The use of the LTE-Q in Brazil should be encouraged in different research fields, including large epidemiological surveys, as it is also appropriate when time and budget are limited. The LTE-Q can be a useful tool in the development of targeted and more efficient prevention strategies.
Descriptors: Brazil; validation; epidemiology; adverse life events assessment
OBJECTIVE: To increase understanding of the influence of photoperiod variation in patients with bipolar disorders.
METHODS: We followed a sample of Italian bipolar patients over a period of 24 months, focusing on inpatients. All patients admitted to the Psychiatric Inpatient Unit of San Luigi Gonzaga Hospital in Orbassano (Turin, Italy) between September 1, 2013 and August 31, 2015 were recruited. Sociodemographic and clinical data were collected.
RESULTS: Seven hundred and thirty patients were included. The admission rate for bipolar patients was significantly higher during May, June and July, when there was maximum sunlight exposure, although no seasonal pattern was found. Patients with (hypo)manic episodes were admitted more frequently during the spring and during longer photoperiods than those with major depressive episodes.
CONCLUSIONS: Photoperiod is a key element in bipolar disorder, not only as an environmental factor but also as an important clinical parameter that should be considered during treatment.
Descriptors: Bipolar disorder; seasonality; photoperiod; sunlight
OBJECTIVE: To evaluate the prevalence of alcohol abuse and/or dependence in a population-based sample of young adults and assess the prevalence of comorbid mood disorders, anxiety, and suicide risk in this population.
METHODS: This cross-sectional, population-based study enrolled 1,953 young adults aged 18-35 years. The CAGE questionnaire was used to screen for alcohol abuse and/or dependence, with CAGE scores ≥ 2 considered positive. Psychiatric disorders were investigated through the structured Mini International Neuropsychiatric Interview (MINI).
RESULTS: Alcohol abuse and/or dependence was identified in 187 (9.60%) individuals (5.10% among women and 15.20% among men). Alcohol abuse and/or dependence were more prevalent among men than women, as well as among those who used tobacco, illicit drugs or presented with anxiety disorder, mood disorder, and suicide risk.
CONCLUSION: These findings suggest that alcohol abuse and/or dependence are consistently associated with a higher prevalence of psychiatric comorbidities, could be considered important predictors of other psychiatric disorders, and deserve greater public heath attention, pointing to the need for alcohol abuse prevention programs.
Descriptors: Alcohol abuse and/or dependence; anxiety; mood disorder; depression; suicide risk
OBJECTIVE: Requests for elective cesarean delivery (ECD) have increased in Iran. While some sociodemographic and fear-related factors have been linked with this choice, psychological factors such as self-esteem, stress, and health beliefs are under-researched.
METHODS: A total of 342 primigravidae (mean age = 25 years) completed questionnaires covering psychological dimensions such as self-esteem, perceived stress, marital relationship quality, perceived social support, and relevant health-related beliefs.
RESULTS: Of the sample, 214 (62.6%) chose to undergo ECD rather than vaginal delivery (VD). This choice was associated with lower self-esteem, greater perceived stress, belief in higher susceptibility to problematic birth and barriers to an easy birth, along with lower perceived severity of ECD, fewer perceived benefits from VD, lower self-efficacy and a lower feeling of preparedness. No differences were found for marital relationship quality or perceived social support.
CONCLUSIONS: The pattern suggests that various psychological factors such as self-esteem, self-efficacy, and perceived stress underpin the decision by primigravidae to have an ECD.
Descriptors: Elective cesarean delivery; vaginal delivery; psychological predictors; Health Belief Model; fear; stress
OBJECTIVE: To identify symptom-based subgroups within a sample of patients with co-occurring disorders (CODs) and to analyze intersubgroup differences in mental health services utilization.
METHODS: Two hundred and fifteen patients with COD from an addiction clinic completed the Symptom Checklist 90-Revised. Subgroups were determined using latent class profile analysis. Services utilization data were collected from electronic records during a 3-year span.
RESULTS: The five-class model obtained the best fit (Bayesian information criteria [BIC] = 3,546.95; adjusted BIC = 3,363.14; bootstrapped likelihood ratio test p < 0.0001). Differences between classes were quantitative, and groups were labeled according to severity: mild (26%), mild-moderate (28.8%), moderate (18.6%), moderate-severe (17.2%), and severe (9.3%). A significant time by class interaction was obtained (chi-square [χ2[15]] = 30.05, p = 0.012); mild (χ2[1] = 243.90, p < 0.05), mild-moderate (χ2[1] = 198.03, p < 0.05), and moderate (χ2[1] = 526.77, p < 0.05) classes displayed significantly higher treatment utilization.
CONCLUSION: The classes with more symptom severity (moderate-severe and severe) displayed lower utilization of services across time when compared to participants belonging to less severe groups. However, as pairwise differences in treatment utilization between classes were not significant between every subgroup, future studies should determine whether subgroup membership predicts other treatment outcomes.
Descriptors: Co-occurring disorders; latent class profile; treatment utilization; psychiatric symptoms
OBJECTIVE: To investigate plasma concentrations of S100B (a calcium-binding protein derived primarily from the glia) and inflammatory cytokines in children with autism and the relationship between S100B and cytokine concentrations.
METHODS: Plasma levels of S100B, tumor necrosis factor alpha (TNF-α), interferon gamma, interleukin (IL)-1β, IL-4, IL-6, IL-10, and IL-17A were measured in 40 unmedicated children with autism and 35 normally developing healthy children. The severity of autism was assessed using the Childhood Autism Rating Scale (CARS).
RESULTS: Concentrations of both S100B and TNF-α were higher in children with autism before and after adjusting for a priori-selected confounders (age, sex, and body mass index). S100B concentrations were higher in children with severe autism compared to children with mild-moderate autism. However, this association remained as a trend after adjusting for confounders. S100B concentrations correlated positively with TNF-α concentrations.
CONCLUSION: Our findings showing an increase in peripheral concentrations of S100B and TNF-α provide limited support to the hypothesis about the roles of altered immune function and S100B in autism spectrum disorder (ASD). Studies of larger numbers of well-characterized individuals with ASD are needed to clarify the potential role of the immune system in the pathophysiology of this disorder.
Descriptors: Autism; inflammation; glia; tumor necrosis factor; cytokine; S100B
OBJECTIVE: The aim of our study was to examine the prevalence of and factors associated with antipsychotic polypharmacy (APP) among patients with serious mental illness in the current South African health care context.
METHODS: We collected data on patient, illness, and treatment characteristics of patients discharged on one or more antipsychotic agents from January to June 2014. We analyzed the associations of APP with demographic and clinical variables using hierarchical multivariable logistic regression, and examined prescription patterns.
RESULTS: The prevalence of APP in our study population of 577 patients was 28.4%. Demographic and clinical characteristics significantly associated with APP included age > 29, male sex, diagnosis of schizophrenia, comorbid intellectual disability, comorbid substance use, greater number of hospital admissions, and high-dose prescribing. First-generation antipsychotics and long-acting injectable preparations were prominent in APP combinations. Co-prescription of anticholinergic agents and sodium valproate demonstrated a significant association with APP.
CONCLUSION: APP appears common in our population, despite lack of evidence for the practice and possible risk of harm. Our findings suggest a complex interplay among patient, illness, and treatment factors relevant to APP in our setting that could be targeted for intervention.
Descriptors: Antipsychotic agents; polypharmacy; mental illness
OBJECTIVE: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role.
METHODS: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs.
RESULTS: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype*group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients.
CONCLUSION: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.
Descriptors: Cognition; dopamine; gene
OBJECTIVES: To compare levels of a marker of lipid peroxidation (thiobarbituric acid reactive substances, TBARS) and brain-derived neurotrophic factor (BDNF) in umbilical cord blood (UCB) between newborns exposed to crack/cocaine in utero (exposed newborns [EN], n=57) and non-exposed newborns (NEN, n=99), as well as in maternal peripheral blood at delivery.
METHODS: This was a cross-sectional study. Potential confounders, including perinatal parameters, psychopathology, and use of other substances, were assessed.
RESULTS: After adjusting for potential confounders, adjusted mean BDNF was significantly higher in EN (3.86 ng/mL, 95% confidence interval [95%CI] 2.29-5.43) than in NEN (0.85 ng/mL, 95%CI 0.47-1.23; p < 0.001; Cohen effect size: 1.12), and significantly lower in crack/cocaine mothers than in control mothers (4.03 ng/mL, 95%CI 2.87-5.18 vs. 6.67 ng/mL, 95%CI 5.60-7.74; p = 0.006). The adjusted mean TbArS level was significantly lower in EN (63.97 µM MDA, 95%CI 39.43-88.50) than NEN (177.04 µM MDA, 95%CI 140.93-213.14; p < 0.001; effect size = 0.84), with no difference between mother groups (p = 0.86).
CONCLUSIONS: The changes in TBARS levels observed in EN suggest that fetuses exposed to cocaine mobilize endogenous antioxidant routes since very early stages of development. The increase in BDNF levels in EN might indicate changes in fetal development, whereas the changes in BDNF levels in mothers provide evidence of the complex metabolic processes involved in drug use during pregnancy.
Descriptors: TBARS; BDNF; pregnancy; crack/cocaine; umbilical cord blood; newborn
Emil Kraepelin (1856-1926) is considered one of the founders of modern psychiatric nosology. However, his conceptualization of obsessive-compulsive phenomena is relatively understudied. In this article, we compare and contrast excerpts from the eighth edition (1909-1915) of Kraepelin's Textbook of Clinical Psychiatry focusing on what Kraepelin called ''obsessive neurosis'' and related ''original pathological conditions'' with the current DSM-5 criteria for obsessive-compulsive disorder (OCD). Consistently with DSM-5 OCD, Kraepelin described obsessive neurosis as characterized by obsessive ideas, compulsive acts, or both together. His detailed descriptions of these symptoms are broadly coherent with their characterization in DSM-5, which is also true for the differential diagnoses he provided. He also mentioned cases illustrating decreased insight into symptoms and association with tic disorders. In conclusion, Kraepelin's experience, which reflects decades of consistent clinical work, may help validate current ideas and explain how the current conceptualization has emerged and developed. Even though one can hardly say that the classification laid out in DSM-5 goes back to Kraepelin's views directly, it still is true that Kraepelin played an outstanding role in systematizing psychiatric diagnostic criteria in general, and provided a major contribution to the conceptual history of OCD.
Descriptors: History of psychiatry; obsessive-compulsive disorder; diagnosis and classification; neurosis; Tourette's disorder
OBJECTIVE: To assess the effectiveness of a cognitive-behavioral therapy-based intervention (Superwellness Program) on weight gain compared with a treatment-as-usual (TAU) approach in patients treated with antipsychotics, and to evaluate the relationship between body mass index (BMI) variation and clinical variables.
METHOD: Eighty-five patients treated with antipsychotics were allocated across two groups, experimental (n=59) and control (n=26). The Superwellness Program (experimental group) consisted of 32 twice-weekly 1-hour sessions, conducted by a psychologist and a nutritionist/nurse, concurrently with moderate food intake and moderate physical activity plans. Sociodemographic, clinical, and biological variables were collected at baseline, at the end of intervention (16 weeks), and after 6 months.
RESULTS: BMI change from baseline differed significantly between the experimental and control groups, with a larger decrease in the experimental group (F = 5.5, p = 0.021). Duration of illness moderated the effect of treatment on BMI (p = 0.026). No significant (p = 0.499) effect of intervention during the follow-up period was found. Interestingly, the intervention indirectly induced a significant (p = 0.024) reduction in metabolic risk by reducing BMI.
CONCLUSION: A cognitive-behavioral therapy-based intervention could be useful in reducing weight in a clinical population taking antipsychotics, with consequent benefit to physical and mental health.
Descriptors: Antipsychotic; cognitive-behavioral therapy; obesity; weight gain
OBJECTIVE: To assess both cognitive and affective empathy in patients with bipolar disorder (BD) during an acute manic or depressive episode.
METHODS: The study included 25 patients with BD (aged 35±14 years) during an acute manic episode, 25 bipolar patients (aged 41±14 years) during a depressive episode, and 25 healthy control subjects (aged 36±11 years). Cognitive and affective empathy were assessed using the Multifaceted Empathy Test.
RESULTS: In both manic and depressive patients, a significant deficit in cognitive empathy was demonstrated. However, indices of affective empathy were significantly higher in the manic group than in depressed and control subjects. In the depressed patients, indices did not differ from those of healthy controls. For affective empathy, a significant positive correlation was found with intensity of manic symptoms and a negative correlation was found with intensity of depressive symptoms. No such correlations were observed with cognitive empathy.
CONCLUSION: We found evidence of increased affective empathy (overempathizing) during a manic episode in bipolar patients. This phenomenon may be connected with disturbances in emotion inhibition related to anastrophic thinking and associated with increased activity of mirror neurons, all of which occur during a manic episode.
Descriptors: Mood disorders, bipolar; cognitive neuroscience; emotion; tests/interviews, psychometric; models/theories of psychiatry
OBJECTIVE: To determine the association between body image dissatisfaction (BID) and depressive symptoms in adolescents from a school in Lima, Peru.
METHODS: A cross-sectional study was performed through a census of 875 high-school students, aged 13 to 17 years, from a school in Lima. Participants completed a survey containing the Body Shape Questionnaire (BSQ) and the Patient Health Questionnaire-9 (PHQ-9). Data regarding demographics, alcohol and tobacco use, self-esteem, and family history of depression were also obtained. To identify associated factors, Poisson regression with robust variance was used. Prevalence ratios with 95% confidence intervals were calculated.
RESULTS: Of the 875 adolescents, 55.8% were male. The mean age was 14.1±1.5 years. Depressive symptoms were observed in 19.9% of participants. An association between BID and depressive symptoms was found. Alcohol and tobacco use were also associated with the outcome of interest.
CONCLUSIONS: Teens who had BID were 3.7 times more likely to report depressive symptoms. Additionally, those who used tobacco or alcohol were 1.5 and 1.4 times more likely to have depressive symptoms, respectively. Further studies targeting other populations and using longitudinal designs are recommended.
Descriptors: Adolescents; body image; depression
OBJECTIVE: To evaluate the association between dietary patterns and mental disorders among pregnant women in southern Brazil.
METHODS: Cross-sectional study with 712 pregnant women recruited from the Study of Food Intake and Eating Behaviors in Pregnancy (ECCAGe). Food intake assessment was performed using the Food Frequency Questionnaire. Dietary patterns were identified by cluster analysis. The Primary Care Evaluation of Mental Disorders (PRIME-MD) was used to evaluate participants' mental health. Poisson regression models with robust variance were fitted to estimate prevalence ratios (PR).
RESULTS: In the adjusted models, there was a high prevalence of major depressive disorder among women with low fruit intake (43%, PR 1.43, 95%CI 1.04-1.95) and high sweets and sugars intake (91%, PR 1.91, 95%CI 1.19-3.07). Women with a common-Brazilian dietary pattern had higher prevalence of major depressive disorder compared to those with a varied consumption pattern (PR 1.43, 95%C11.01-2.02). Low intake of beans was significantly associated with generalized anxiety disorder (PR 1.40, 95%CI 1.01-1.93).
CONCLUSIONS: Low consumption of fruits and beans and intake of the common-Brazilian dietary pattern during pregnancy were associated with higher prevalence of mental disorders. These results reinforce the importance of an adequate dietary intake to ensure better mental health in pregnancy.
Descriptors: Dietary patterns; food patterns; food intake; pregnancy; mental health
OBJECTIVE: To determine the frequency of weight control behaviors (WCBs) and their correlation with body mass index (BMI) and weight-based self-evaluation.
METHODS: Data were collected by the Brazilian Internet Study on Temperament and Psychopathology (BRAINSTEP) from 27,501 volunteers (30.4% men, mean age 28.9±8.7 years).
RESULTS: The most prevalent WCBs for men and women were exhaustive physical exercise and prolonged fasting, respectively. Frequent exhaustive physical exercise was the only behavior more often adopted by men. BMI was positively associated with WCBs, which were very frequent in obese subjects. About 15% of normal-weight women reported using diuretics and laxatives, and 12.2% reported vomiting as a WCB at least occasionally. Among subjects who regarded body weight highly in their self-evaluation, there was a strong positive association with all WCBs, at similar degrees, in both genders. Compared to those who never base their intrinsic personal value on body weight, those who frequently base intrinsic value on body weight were at 25-30 times higher risk of inducing vomiting.
CONCLUSION: The prevalence of participants adopting WCBs was high, especially in women and obese subjects. Weight-based self-evaluation was more strongly associated with WCBs than BMI.
Descriptors: Weight perception; body weight; weight loss; body mass index; self-concept
OBJECTIVE: Sedation/somnolence are major side effects of pharmacotherapies for depression, and negatively affect long-term treatment compliance in depressed patients. Use of mirtazapine (MIR), an atypical antidepressant approved for the treatment of moderate to severe depression with comorbid anxiety disorders, is associated with significant sedation/somnolence, especially in short-term therapy. Nonetheless, studies with human subjects suggest that MIR-induced sedation is transient, especially when high and repeated doses are used. The purpose of this study was to explore the effects of acute and chronic administration of different doses of MIR on sedation in the rat.
METHODS: Assessment of sedation was carried out behaviorally using the rotarod, spontaneous locomotor activity, and fixed-bar tests.
RESULTS: A 15-mg/kg dose of MIR induced sedative effects for up to 60 minutes, whereas 30 mg/kg or more produced sedation within minutes and only in the first few days of administration.
CONCLUSION: These results suggest that 30 mg/kg is a safe, well-tolerated dose of MIR which generates only temporary sedative effects.
Descriptors: Mirtazapine; sedation; depression; dosing schedules; pharmacotherapy; antidepressant
Multiple sclerosis (MS) is a chronic progressive inflammatory disease of the central nervous system. Psychiatric comorbidities are highly prevalent in patients with MS, and can have drastic impact on quality of life and interpersonal relationships. Despite this high prevalence, whether psychiatric manifestations may represent the first signs of MS is still debatable. This constitutes an important issue, since early diagnosis of ''psychiatric-onset MS'' would result in prompt management, which usually ameliorates long-term prognosis. Here, we discuss clinical and radiological hints that suggest a diagnosis of psychiatric-onset MS. Briefly, this entity should be considered in healthy patients presenting with late-onset psychiatric symptoms, with or without cognitive decline, and with negative family history of psychiatric diseases. A thorough neurological exam is crucial to detect any subtle neurological signs. Brain magnetic resonance imaging is recommended to rule out frontotemporal lesions that might explain the clinical picture. Poor response to standard psychiatric treatments provides additional evidence for the diagnosis of an organic disease (e.g., MS). Combining psychopharmaceuticals with intravenous corticosteroids would result in good outcomes, but patients should be monitored carefully for possible psychiatric exacerbation, a common side effect of steroids.
Descriptors: Psychiatric relapse; multiple sclerosis; mood; depression; mania; psychosis
OBJECTIVE: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence.
METHODS: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community.
RESULTS: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors.
CONCLUSIONS: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.
Descriptors: Non-suicidal self-injury; suicide ideation; adolescence; risk-behaviors; impulsivity
OBJECTIVE: Schizophrenia is a chronic mental illness characterized by positive and negative symptoms. Cognitive impairment continues to be a core and consistent deficit. Previous studies have shown that physical activity (PA) is positively associated with cognitive performance. Thus, it may play a supportive role in mitigating cognitive impairments among individuals with schizophrenia. The aim of this study was to analyze the relationship between moderate-to-vigorous physical activity (MVPA) and executive function among adults with schizophrenia.
METHODS: The weekly amount of MVPA (assessed using accelerometers) and executive function (as per Brief Neurocognitive Assessment for Schizophrenia) of 78 adults with schizophrenia (mean [SD] age 42.4 [11.4] years; illness duration 17.0 [11.0] years; 58.2% male) were assessed in this cross-sectional study. Pearson correlations were calculated, followed by a linear regression. Participants were first analyzed together and then dichotomized on the basis of illness duration.
RESULTS: There was no significant association between MVPA and executive function, independent of the duration of illness. For individuals with < 15 years of illness, there was a significant association between weekly MVPA and working memory performance.
CONCLUSION: PA appears to be associated with executive function in some, but not all, individuals with schizophrenia.
Descriptors: Accelerometry; executive function; physical activity; schizophrenia
OBJECTIVE: Experiencing romantic love is an important part of individual development. Here, we investigated stability and change in romantic love and psychological correlates, including mood states, anxiety, and sleep, among Iranian adolescents over a period of 8 months.
METHOD: Two hundred and one adolescents who had taken part in a previous study were contacted; 157 responded. Participants completed a questionnaire covering sociodemographic data, current state of love, and mood, including symptoms of depression, anxiety (state and trait), and hypomania. They also completed a sleep and activity log.
RESULTS: Of 64 participants formerly in love, 45 were still in love; of 86 participants not in love at baseline, 69 were still not in love (overall stability, 76%); 17 had fallen in love recently while 19 were no longer in love. Significant and important changes in mood and anxiety were observed in that experiencing romantic love was associated with higher anxiety scores. Hypomania scores increased in those newly in love, and decreased in those in a longer-lasting romantic relationship. Sleep and sleep-related variables were not associated with romantic love status.
CONCLUSION: These findings suggest that, among Iranian adolescents, the state of love is fairly stable, and that love status seems to be associated with specific states of mood and anxiety.
Descriptors: Adolescents; romantic love; stability; change; state anxiety; hypomania; sleep
OBJECTIVE: Considering the scarcity of reports from intertropical latitudes and the Southern Hemisphere, we aimed to examine the association between meteorological factors and suicide in São Paulo.
METHOD: WEEKLy suicide records stratified by sex were gathered. Weekly averages for minimum, mean, and maximum temperature (oC), insolation (hours), irradiation (MJ/m2), relative humidity (%), atmospheric pressure (mmHg), and rainfall (mm) were computed. The time structures of explanatory variables were modeled by polynomial distributed lag applied to the generalized additive model. The model controlled for long-term trends and selected meteorological factors.
RESULTS: The total number of suicides was 6,600 (5,073 for men), an average of 6.7 suicides per week (8.7 for men and 2.0 for women). For overall suicides and among men, effects were predominantly acute and statistically significant only at lag 0. Weekly average minimum temperature had the greatest effect on suicide; there was a 2.28% increase (95%CI 0.90-3.69) in total suicides and a 2.37% increase (95%CI 0.82-3.96) among male suicides with each 1 oC increase.
CONCLUSION: This study suggests that an increase in weekly average minimum temperature has a short-term effect on suicide in São Paulo.
Descriptors: Suicide; meteorological factors; São Paulo; time series; epidemiology
OBJECTIVE: Trypophobia refers to the fear of, or aversion to, clusters of holes. We assessed clinical features of trypophobia and investigated whether it most resembled a specific phobia or obsessive-compulsive disorder.
METHODS: An online survey was conducted to gather information on sociodemographic variables, course and duration, severity, associated features, comorbid psychiatric diagnoses, and levels of psychological distress and impairment in individuals with trypophobia. The survey also explored whether such individuals experienced more fear or disgust, and whether symptoms showed more resemblance to a specific phobia or to obsessive-compulsive disorder. Associations of symptom severity and duration with degree of impairment were investigated.
RESULTS: One hundred and ninety-five individuals completed the questionnaire. Symptoms were chronic and persistent. The most common associated comorbidities were major depressive disorder and generalized anxiety disorder. Trypophobia was associated with significant psychological distress and impairment. The majority of individuals experienced disgust rather than fear when confronted with clusters of holes, but were more likely to meet DSM-5 criteria for specific phobia than for obsessive-compulsive disorder. Symptom severity and duration were associated with functional impairment.
CONCLUSIONS: Given that individuals with trypophobia suffer clinically significant morbidity and comorbidity, this condition deserves further attention from clinicians and researchers.
Descriptors: Trypophobia; specific phobia; obsessive-compulsive disorder; internet survey


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Wondering if anyone knows of a good (business dinner - price is not a concern) restaurant in the Grand Central area that would offer a private dining room? Or if not private, some place that is a good setting for quiet, discreet conversation, for a small party, 4 people.
Thanks in advance for any suggestions.


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"Decent experience"
- Work/Life Balance
- Culture & Values
- Career Opportunities
- Comp & Benefits
- Senior Management
I have been working at Atrenta full-time (More than 3 years)
Good exposure to customer base
Very low manager to engineer ratio
Advice to Management
Top heavy
Still operates as startup and so you get a chance to work in lot of functional areas
too much management hierarchy, signficant mgmt overhead when you compare ratio of employees to managers, lot of partiality in promotions and recognition. Too many inexperienced managers ;
Advice to Management
reduce the mgmt overhead and follow industry guidelines; you dont have to promote 5yrs exp to mgr; they cannot guide and mentor the team..no need to act big like 5th largest ; have to show that in revenue and direction. Proper lack of vision is also hurting ; it wasnt like this before...ajoy needs to take charge and bring atrenta back to its good old days...
Atrenta is still a startup. Hence, there is chance to stand out from the crowd. Plus, you will have the satisfaction of knowing that you are developing something that is useful to semiconductor engineers.
In recent years the firm has become risk averse. It seems that the management has to show yearly revenue increases to investors. Which means that the work environment now prefers individuals who will tow the line and not rock the boat. If you believe in "if it ain't broken, don't fix it" dictum, then you would fit in in Atrenta. If not, then Atrenta of today could be a bit frustrating. It really is a pity because Atrenta wasn't always like this.
Advice to Management
Stop being so risk-averse and stop incorporating big company processes. Atrenta is a startup and startups need to take risks. If you want to stand on your own as a product company, then at some point of time you will have to say no to the first eager customer that comes your way. Have some conviction in your original conviction of "predictive analysis". It was a great place to go to. What is not is developing custom tools for big clients.


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Easton Motors
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"Called in the morning to get an oil change got me right in just this plant in and out within a half an..."
Review for Easton Motors
DEIDRE G. on 03/01/2014
"Service and staff Great"
They are friendly, you feel like you're not getting things that aren't needed. the same man works on my car each time he is so nice and friendly, LOVE the pickup service they offer during the work day!
Vehicle: Kia Sportage
Service Date: 02/28/2014
Review Created: 03/01/2014 07:09 AM


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Replacement impeller for Hagen 802 Powerhead
Features: Suitable for the Fluval 802 Powerhead
Standard Delivery
Once we have processed your order, this product will then be despatched on a Next Working Day Delivery service for customers within mainland UK. (As specified by our couriers)For more information about delivery timings for specific postcodes please see our Delivery Information Page.
This service is charged at £2.95.
Product delivery charges are calculated by price bracket, products purchased with multiple price brackets will be charged the one delivery charge at higher product price bracket.
All parcels require a signature upon delivery, meaning that our courier is unable to leave an item without a signature.
For all our other delivery terms and conditions, please see the Terms and Conditions Page.


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Communication Part 4
How Do We Use Our Radios In A Cohesive and Efficient Manner Once They Are the Only Form of Communicating
You have your neighborhood group. You've been meeting on a fairly regular basis so you know each other, how to contact each other and you've run a couple of tests to iron out the kinks in your phone calling circle. How long did it take to get one message to every member and have the originating person who initiated the test get a call from the last person? Did you improve on your time during your second trial run?
What? You haven't gotten that far yet? Or maybe it just seems "kinda dumb" or you'd feel "kinda funny" doing a trial run of a calling circle? It is a hugely telling exercise and well worth the effort. If you won't do that, what else won't you do?
Here's the thing: all of this is out of your regular "box", out of your comfort zone, for most people anyway. So we can't let our personality decide what to do, we have to use our Observer. Exercises like this can have a tendency to bring up fear in the personality – to the personality, getting a CB or Ham radio means no regular phones and no cell phones. To the personality this equals "scary" or "bad", so the ever-helpful (not!) personality will try to get you to postpone taking any action along these lines so it doesn't have to look at "scary" or "bad". So we have to just observe what the personality does with this info, and then use our Observer to decide our course of action.
OK, so let's say that there is one person in your immediate neighborhood group that has gotten a 10 meter (ham/shortwave radio), which they've had tweaked so it will function as a SSB CB radio, and there are a few members in your group that have SSB CBs. Picture that this group, whether is it a group of folks along a certain road, or in a 1-1.5 mile radius, is a circle on a map with the ham radio as the center of the circle.
There will be adjacent circles of people, each with at least one person with a stronger radio than the others need (it is OK if several people have the more powerful radios, but it is good if at least one does). It doesn't need to be WAY stronger; it just needs to be able to talk to the radio team leads of the adjacent circles.
There will be people with very robust ham radios who have gotten their ham radio licenses who can talk on the shortwave/ham radio bands – others can listen but not participate in the conversations. They will also be able to communicate with other radio team leads from quite a distance away (on CB and shortwave).
What we decided to do back after 9/11 should we be without conventional communications is to all turn on our radios at about 10 till 6 (pm). Then, in the same order as the calling circle list (hello! Here it is again – you don't want to be the clueless one now do you?), we would do a brief "check in": This is Sally & Bob, we're fine here. This is Beth W, I'm good. This is Sue & Tom and we had a tree go down in last night's windstorm and need someone with a chain saw help to clear our drive. This is Ted, we're right here, mate (he's from Australia ;o) And so on, until all have checked in.
If someone hasn't checked in the person tracking the check in will ask "Does anyone know about Lisa M?" And her immediate neighbor can say that she knows that Lisa rode over to her friend's for 3 days and will be home Sunday.
After the Check In, the person tracking the peoples' check will ask "Who can go help Sue & Tom with that tree?" People volunteer, and Sue & Tom are taken care of.
Anything else? This is where Sally can say "Hey, Beth, Sally, meet me over on channel 39 – I have some canning questions". This way they can go chat in private, and everyone else can log off for the day.
Now, let's say you've had an intruder break into your home and they are holding you hostage against your will. You tell them that you absolutely HAVE to check in at 6pm or the neighbors will become suspicious. So the intruder says "OK, but NO funny stuff or I'll hurt you! Grrr!" You agree to not say any funny stuff.
This is where you are very happy that your group has come up with a secret code phrase which is NEVER EVER discussed over the radio! Because if who you are talking to can hear you, then so can bad guys who might be listening in – and I am not talking government conspiracy here. I am talking unsavory locals that are up to no good. (and this is nothing against locals – they are just the only ones near enough to mess with you.)
The phrase you pick should be short, in keeping with the other short phrases that people are saying to indicate that they are OK, but it must be a short phrase indicating you are OK that is ONLY used if you and your life are in peril. It is the signal to all your neighbors that you are in dire straits (great name for a band) and you need their help desperately. I would give examples but not in a public forum like this.
Everyone finishes up the entire Check In routine as usual. No one can switch to another channel to discuss this because the intruder might flip around channels because he thinks the radio is a cool toy and he might hear you.
You have to have a plan ahead of time. Then "the rescue team" will set out to rescue you, and rescue you they will. Bad guys don't expect aware, knowledgeable, trained people coming to rescue their victim. I will talk more about this part a little later – remember what Forrest Gump said: Stupid is as stupid does. A flock of stupid people are not going to sneak up on and overcome a bad guy, no matter how good their intentions. And when I say stupid, I mean people that have had no training in how to do a rescue properly. No training = stupid (in that area). Luckily, that is fixable.
Your 'Road group' or 'neighborhood group' or 'local pod' might be comprised of anywhere from 3 or 4 people to 40 people. In the larger groups, it is good for each household to know the 3 (or so) neighbors to each side of them, because these people will be the First Responders in time of need. These would be the people that could hear me if I stood on my front porch and blew a super loud whistle or rang a brass hand bell. Something that won't carry a mile away but would over 5 or 10 acres. We'll be doing some testing on that and I'll report back to you (I've got a couple of wicked powerful whistles, and have to pick up the brass hand bell).
So now, your group has a designated person (or maybe 2) that represent the group members. This is the person that will interface with the designated people from the other groups. Except you don't have a group yet, or one that is just starting to form. And we don't have a bunch of other groups yet (and they don't have their designated people yet).
Because all of this is still in the formative state (somewhat akin to the gelatinous goo of the dreaming caterpillar before it transforms into oriental fans and long black stockings) this is what we need to address now:
Start a neighborhood group, no matter how small. Just start. Now. The fall equinox and Elenin will be here before you know it (Elenin as in Nibiru, Marduk, etc).
Even before you have radios, no matter how unformed your group is, pick the person who is the list maker, the researcher, the communicator and nominate him or her to be the 'designated person' (at least for the moment) to interface with the other groups.
If you want to start a group and aren't sure how to do it, email me. If it seems expedient we can have a meeting for people that want some guidance in starting a group. I can go over the basics, show you how to look stuff up online, etc.
I have a radio but will be getting a beefier one along with a long antenna. I know a few people who have radios that I can contact, so that we can start working on doing some testing. I bet there are others who have the radios whom I don't know. It would be dandy to them join in as well.
I believe there is someone in Olympia that has a radio but I don't have any contact info on them. There is also a man that I spoke with after I did a presentation on Neighborhood Communication at the Rainier School back several months ago for the Hour4Hour Time Bank – very knowledgeable about radio communications and electronics – if you read this, call or email me please.
The MastersConnection is going to put the word out to students in other countries. This is exciting. This is way double cool. It is moving into the Unknown (but in a baby-step safe way ;o)
There is a Ham Radio Technician Licensing Class this upcoming weekend June 11 & 12 put on by the Radio Club of Tacoma. You take a 15-20 minute test at the end of the day on Sunday, and Poofa! You can talk on the ham radio legally. While not everyone wants to have a license, some will, and those of us who have it can practice before stuff hits the proverbial fan. The sign up info is at http://www.w7dk.org/newham.htm#TECH Class Lic just scroll down to the bottom of the page.
Sherry M took the class a couple of weeks ago and got her license. I believe it is $40 for the class, book and handout materials (Sherry said the instructor gives you lots of stuff and he is known to be one of the best instructors around). Then the test is $15.
I am looking forward to hearing from you :-D Let's ratchet this up a notch and get the ball rolling.
PS Remember the part about Stupid Is As Stupid Does from earlier in the article? And I said I'd address that later? That would mean in another issue of the MastersConnection newsletter. Until then….
Teri Simpson
Optimum Preparedness
Optimum Preparedness
- Details
- Category: Preparedness


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Car windows smashed in Wennington Road Southport
A number of car windows were smashed in Wennington Road, Southport, at about 8:30pm last night (Sunday 13th July 2014).
One male out of a group of teenagers was responsible for the damage to the vehicles.
Police have been informed.
Submit News Contact us with your community, business or sport news. Phone 07930717137 Email firstname.lastname@example.com
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After work I got some low lights! They look darker in this picture than in person, however, they are darker than I wanted. Oh well!
Girlfriend loved the football game at Chris's school/alma mater. It was the first home game and game of the season. Football gets me excited for fall. That and my low lights – ha!
Kendall & Chris! This was the best picture of them I could get!
We may go to another game this season, I'd be lying if I said taking a toddler to a football game was easy!


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The execution of projects at RAGA is done with customer guidance and as per customer requirement withoutcompromising quality.
We have contemporary best-in-class equipment to support our activity frommanufacturing to production of components. Raga also ensures documentation of procedures across the value chain like controlplan, process flow, FMEA starting from material test certificate to packing & forwarding and logistics.


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One thing I have noticed this year is how aggressively Nokia and Microsoft have marketed their products (Windows Tablets and Lumia devices), you will them a Windows Surface Tablet or a Lumia phone is just about every TV Show or Music video.
Nokia's been able to snap up English sensation Ellie Goulding to shoot a Nokia Lumia 1020 TV ad, sorry I got that all mixed up, I meant the Lumia 1020 is featured in an Ellie Goulding's music video...
After watching the video, you can see how I could easily have mistaken it for a Nokia Lumia 1020 TV ad, rather than an actual music video.
There are very few music video where the theme is centered around a Lumia phone from start to finish; It features Ellie and her love driving through town and taking photos of their time together, photos shot with the Lumia 1020 of course.
If you are a fan of Ellie Goulding and have never heard of the Lumia 1020, I bet you would be googling what phone that was.


text: Videos The Ultimate "A Guy Walks Into A Bar" Joke by PGP Intern Apr 02, 2014 0 Comments • 3 Labor through the beginning and watch until the end. Trust me. Nice Work3 Respond Email this to a friend Hey, I saw this on Post Grad Problems. Check it out.


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Siegfried Motor Co417 W. Kenosha
Broken Arrow, OK 74012
View on Google Map
Contact Us
Call Us Now
(918) 258-5285
Estimated By E.P.A.
We are offering a beautiful QX56 with great service history and Carfax certified. This well equipped Infiniti has it all, Nav, Entertainment, front and rear heated seats and much much more. Come in for a test drive and you will want to own this SUV. We are a 3rd generation family dealership that has served the Tulsa area since 1936. You will enjoy our no pressure no hassle sales professionals with no additional fees added at the end of th sale. Financing available through Western Sun Federal CU.
Text to 918-630-8872 for assistance
Visit us at www.siegfriedmotorco.com for additional information
Carfax Certified.
Bank and Special financing available. Please call Kerry Siegfried @ 918-258-5285 for assistance. We are located in Broken Arrow at 417 W Kenosha (1 block East of Elm, 161st E Ave on Kenosha, 71st Street on the Southside of the street next to QT).
Up to 4 year unlimited mile CARS warranty available on all vehicles.
At Siegfried Motor Co, we are here to make purchasing your vehicle as easy as possible. We have partnered with some of the leading financing institutions to assist in financing your next vehicle.
Please apply directly with the following institutions.
Of course, if you need further help, do not hesitate to contact us and we will do everything we can to help you get approved.


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Groupon is, of course, an extremely popular coupon / daily deals website. However the stock has done nothing but crash since the company went public. So far the collapse has been even worse than Facebook's plummet when the went public. Groupon, ticker GRPN, is down over 50%, after going public, and now trades under $10. So what are investor's opinions on this one? Is it a good buy now that it's under $10 or will this thing go down even more?
sort by best latest
Like most tech stocks it could go either way. Groupon has the benefit of being a household name, so the chances of it tanking completely are slim, but unless they make some revolutionary change I don't forsee the stock skyrocketing any time soon.
The fact that it's under $10 makes it a tempting purchase. If you already have a decent portfolio it may be worth picking up a couple shares just to see what happens...
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The Watertown School Committee met on Tuesday evening at the Phillips School to discuss a few small matters in preparation for the coming school year.
The Watertown School Committee met on Tuesday evening at the Phillips School to discuss a few small matters in preparation for the coming school year. With the 2012 budget coming to a close, the committee is preparing to manage the state's new budget to be issued for 2013.
There may be additional money for spending due money received from the state in the form of a circuit breaker. Among the potential priorities for spending would include hiring a part time music teacher at the elementary level, as well as adding music electives for students at the high school.
The committee also approved a new list of rental rates for school buildings. Rental rates have not been changed since 2004.
- The auditoriums at Hosmer, and the middle and high school will remain at $140 per hour while the auditorium at Cunniff has moved up to $75 per hour.
- The cafeterias at Cunniff, Hosmer, Lowell and the middle and high school will now be rented at $70 per hour.
- Gymnasiums at Hosmer, Lowell, the middle school (big gym), and the high school will remain at $85 per hour. Gyms at Cunniff, Phillips, middle school (small) and Hosmer (small) will also stay at $75 per hour.
Libraries and classrooms at all schools remain at $40 per hour.
- Kitchen fees will start at a base of $100 plus $25 per hour for Watertown Food Service employee on site. - The A/V equipment fee will be $35 per hour for Watertown school personnel.
- Custodians, working a 3-hour minimum, will receive compensation of $50 per hour.
- Additionally, the committee approved three policy changes in regards to hall rentals. Buildings will be opened 5 minutes before a group's rental time. Entertainment permits from the police department are mandatory for all auditorium events. There will also be a cancelation fee of $150 if notice is not given at least 24 hours prior to the event.
All changes will be in effect starting September 1st. The date for next school meeting has yet to be decided. On the agenda for said meeting will include superintendent evaluation and more budget talks.


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Our Artisan Cross Over Apron is at its best slipped on at first light, when a day of gentle pleasures lies ahead. A morning spent pottering in the garden; an afternoon of kneading bread and baking, a final curtain hem to attend to as the day draws to a close. Our soft, linen apron features deep pockets for a day of constant wear, regardless of your activity. The classic shape hangs beautifully and wraps around the body so lightly, you might just forget you have it on. All manner of useful tools and gadgets can be stored in the pockets of this pinafore, for easy use as you go about your day
As seen in
- One size (94cm length)
- 100% European washed linen
- Machine washable
- Available in 4 colourways


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This property has been removed by the agent. It may be sold or temporarily removed from the market
1 bedroom flat for saleSt. Albans Road, Watford, WD25
Sold STC £215,000
Property Description
Key features
- EPC Grade B
- First Floor Apartment
- Small Block Of 9 Flats
- Good Condition
- Double Glazing
- Lounge/Diner
- New Lease Upon Completion
Full description
Located in a small block of 9 apartments is this first floor apartment offered to the market in excellent condition throughout, with double glazing and allocated parking. There is a large lounge/diner with a bay window, fitted kitchen, good sized bedroom with a recess for wardrobes and a fitted bathroom. A copy of the EPC is available on request. EPC Grade B.
This great property is ideally situated for local schools and is within easy reach of both the M1, M25 and A41 motorways. Local shops, restaurants, leisure centre and cinema are also close by with bus and train services running regularly to and from Watford town centre.
Our View
A great first time buy or investment, being sold with an extended lease upon completion. This small block is located in Garston, a short distance away from the motorway network, has double glazing and allocated parking.
Lounge / Diner 16' 8" x 10' 7" (5.08m x 3.23m )
Kitchen 8' 7" x 5' 3" (2.62m x 1.6m )
Bedroom 13' 6" x 9' 8" (4.11m x 2.95m )
We endeavour to make our sales particulars accurate and reliable, however, they do not constitute or form part of an offer or any contract and none is to be relied upon as statements of representation or fact. Any services, systems and appliances listed in this specification have not been tested by us and no guarantee as to their operating ability or efficiency is given. All measurements have been taken as a guide to prospective buyers only, and are not precise. Please be advised that some of the particulars may be awaiting vendor approval. If you require clarification or further information on any points, please contact us, especially if you are traveling some distance to view. Fixtures and fittings other than those mentioned are to be agreed with the seller.
More information from this agent
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Disclaimer - Property reference 528567080. The information displayed about this property comprises a property advertisement. Rightmove.co.uk makes no warranty as to the accuracy or completeness of the advertisement or any linked or associated information, and Rightmove has no control over the content. This property advertisement does not constitute property particulars. The information is provided and maintained by Your Move , Garston. Please contact the selling agent or developer directly to obtain any information which may be available under the terms of The Energy Performance of Buildings (Certificates and Inspections) (England and Wales) Regulations 2007 or the Home Report if in relation to a residential property in Scotland.
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