Search

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is an intervention that targets common mechanisms that maintain symptoms across multiple disorders. The UP has been shown to be effective across many disorders, including generalized anxiety disorder, major depressive episode (MDE), and panic disorder, that commonly codevelop following trauma exposure. The present study represented the first randomized controlled trial of the UP in the treatment of trauma-related psychopathology, including posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Adults (N = 43) who developed posttraumatic psychopathology that included PTSD, MDE, or an anxiety disorder after sustaining a severe injury were randomly assigned to receive 10-14 weekly, 60-min sessions of UP (n = 22) or usual care (n = 21). The primary treatment outcome was PTSD symptom severity, with secondary outcomes of depression and anxiety symptom severity and loss of diagnosis for any trauma-related psychiatric disorder. Assessments were conducted at intake, posttreatment, and 6-month follow-up. Posttreatment, participants who received the UP showed significantly larger reductions in PTSD, Hedges' g = 1.27; anxiety, Hedges' g = 1.20; and depression symptom severity, Hedges' g = 1.40, compared to those receiving usual care. These treatment effects were maintained at 6-month follow-up for PTSD, anxiety, and depressive symptom severity. Statistically significant posttreatment loss of PTSD, MDE, and agoraphobia diagnoses was observed for participants who received the UP but not usual care. This study provides preliminary evidence that the UP may be an effective non-trauma-focused treatment for PTSD and other trauma-related psychopathology.

Objective: Prolonged exposure (PE) therapy is an evidence-based psychological treatment of post-traumatic stress disorder (PTSD), yet uptake amongst practitioners is less than desirable. The aim of this study was to evaluate the efficacy of a PE training workshop plus intensive consultation programme to improve practitioners’ self-efficacy and outcome expectations as well as uptake of PE for emergency service patients with PTSD. Method: Forty-five psychologists attended a PE training workshop in Sydney. Participants completed questionnaires at pre- and post-workshop and six-month follow-up. Results: The findings suggest that participation in the programme was associated with improvements in practitioners’ beliefs in their ability to deliver PE to patients, an increase in their use of a range of PE components and an increase in their use of in vivo exposure with a greater proportion of patients. Conclusion: Effective training approaches for evidence-based treatments of PTSD should incorporate intensive consultation following training. Future studies should consider additional strategies to encourage practitioners to deliver PE to more patients with PTSD.

International audience; he application of biomolecular techniques to archaeological materials from the Balkans is providing valuable new information on the prehistory of the region. This is especially relevant for the study of the neolithisation process in SE Europe, which gradually affected the rest of the continent. Here, to answer questions regarding diet and subsistence practices in early farming societies in the central Balkans, we combine organic residue analyses of archaeological pottery, taxonomic and isotopic study of domestic animal remains and biomolecular analyses of human dental calculus. The results from the analyses of the lipid residues from pottery suggest that milk was processed in ceramic vessels. Dairy products were shown to be part of the subsistence strategies of the earliest Neolithic communities in the region but were of varying importance in different areas of the Balkan. Conversely, milk proteins were not detected within the dental calculus. The molecular and isotopic identification of meat, dairy, plants and beeswax in the pottery lipids also provided insights into the diversity of diet in these early Neolithic communities, mainly based on terrestrial resources. We also present the first compound-specific radiocarbon dates for the region, obtained directly from absorbed organic residues extracted from pottery, identified as dairy lipids.

Adolescents are considered as a nutritionally vulnerable subgroup because of their alimentary behaviours. Considering that alimentary habits are strongly influenced by knowledge about digestion, an experiment was conducted with aim to determine whether conceptual understanding and functionalization of this knowledge can be improved by the interdisciplinary teaching approach. The experiment encompassed 258 students attending the fourth year of high school. No statistically significant difference in the level of the previously acquired chemistry, biology and physics knowledge concerning digestion between the two groups was determined on the pre-test. Conversely, the students in the experimental group significantly outperformed those in the control group on the post-test that required a deep understanding and the application of knowledge about digestion in solving real-life problems. Therefore, it was concluded that high- school teachers can be advised to apply the interdisciplinary teaching approach in order to improve their students' knowledge about this process. Key words: conceptual understanding, process of digestion, functionalization of acquired knowledge, interdisciplinary teaching approach.

The use of third party services has become one of the main instruments for banks in achieving their strategic goals and business. The decision on externalization, ie outsourcing of business processes depends on many factors, and it is motivated primarily by retaining key processes in the organization, lower costs, aspirations towards highly skilled personnel and better efficiency of employees, as well as greater capital inflows, cooperation with world institutions and other benefits. On the other hand, outsourcing carries with it a number of risks that can endanger the business of the institution and which particularly come to terms with the expansion of the digitization process. As a result, this process is in banks under the strict control of the internal audit body and the risk management system. Implementation of the internal audit strategy over the outsourcing process implies its active participation in decision-making on the engagement of third parties, as well as the revision of already externalized processes. The latest regulatory changes in the area of internal control (new COSO framework) were made precisely in order to establish mechanisms for adequate risk management, with emphasis on the risk in dealing with third parties, thus enhancing the role of internal audit. The subject of the research is the critical points of outsourcing regarding their risk to the banks operations, as well as the activities and scope of work of the internal audit on this process, before and after introduction of the so-called „three lines of defense“. The aim of the research is to (1) point out practical problems in outsourcing processes in banks that lead to hidden costs of doing business; (2) clearly present the steps of internal audit in the process of identifying, preventing and removing these problems, but also its other activities in the critical segments of outsourcing, and (3) through practical techniques and methods, bring closer the new function of internal audit as a significant factor in supporting the management in achieving the strategic goals of the bank. This work contributes to a better understanding of the role of internal audit in the risk management process of outsourcing, which aims to indicate the necessity of its activities at all stages of the process in order to minimize operational risk.

IntroductionCommunity health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.MethodsA search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.ResultsThe search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.ConclusionThe results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.

Introduction Scott Aarskog syndrome is an X-linked disorder characterised by short stature, hypertelorism, shawl scrotum in boys and brachydactyly. Syndrome is a genetic abnormality and the condition cannot be cured by optimal way. Aims The aim of this paper is to describe an extremely rare syndrome especially with mild mental retardation. Methods In two cases, the twin brothers and cousins girls where genetically established Scott Aarskog syndrome were made IQ tests in relation to the age of the children. Normally at this syndrome is very rare mental retardation. Results Boys with Scott Aarskog syndrome have had a rounded face with a broad forehead, but girls has no had. IQ test results showed that the twins, seven years old had IQ 69 or 71, a girl six years ald girl cousin 78. Affected twin brothers also have an abnormally long groove in the upper lip or philtrum and a broad nasal bridge. Tissue webbing between fingers and joint hypermobility with a pronounced hyperextension, flexion of the interphalangeal joints and brachydactyly in girl and both boys. The major signs of this X-linked condition are short stature. Musculoskeletal anomalies such as cervical vertebral anomalies, discrete spina bifida occulta, mild pectus excavatum, milder genu recurvatum, moderate joint restriction were presented in all three children relatives. Conclusions The prognosis of this disease is very bad with something shorter life, reduced everyday abilities for regular jobs, and in this case less severe retardation with disabilities to attend regular school and obtaining the title of the working capacity. Usually IQ in children is normal so this is a rare case that still occurs in Scott Aarskog syndrome.

This paper deals with the use of an ortophotomosaic in terrestrial photogrammetry; precisely, it shows the possibility of the use of it on a high object which is a tower wall of an old castle in Momjan, Croatia. It explains the process of gaining an ortophotomosaic and it demonstrates filtering as one of the possible processes that may proceed in gaining the final product- the ortophotomosaic that might be used in automated processes.

Background Examples of semi-contact sports include karate and its benefite influence on asthma in childhood. Specific treatment for asthma will be determined by pediatrician based on children age, overall health, medical history, extent of the disease, tolerance for specific medications, procedures, or therapies and expectations for the course of the disease. Aims A target of this article is showing benefit of karate training in preschool ages on asthma management and course of disease. Methods To verify the efficacy of karate on asthma, a complex psychomotor activity that enhances pulmonary capacity and lungs volume, and breathing regulations, as an intervention for asthma curing, ten children with asthma, ranging in age from five to seven years, and meeting diagnostic criteria for children asthma disorder were studied during two years period 2010–2011. Results A higher prevalence of asthma has been reported in athletes specially in karate clubs for younger children but with better control of asthma. Risk ofasthma decreased with number of years of training (odds ratio 2.02; 95% confidence interval 1.60–3.03; p p =0.015) and rank, specifically brown green belt versus lower belts (odds ratio 3.53; CI 2.82–6.28; p =0.007). Conclusions Karate is a relatively safe sport for preschool children and younger schoolers when properly taught and optimize for asthma management. These training principles are perhaps most useful early in a children patient’s course when the setting of appropriate expectations is important in minimizing restrictions from treatment and karate activity.

Background The pediatrician plays an important role in contributing to the management of children with food allergies. Antihistamine drugs are used to control or alleviate the allergy symptoms like, skin rash or hives and breathing difficulties, by counteracting the effects of histamine. Dexamethasone is a potent corticosteroid and it acts as an anti-inflammatory and immunosuppressant. Adrenaline or epinephrine is the drug of choice for treating anaphylaxis.

Background: Obesity in childhood bodes ill for future cardiovascular risk. HMG-CoA reductase is an enzyme in the cholesterol biosynthetic pathway that catalyses the conversion of HMG-CoA to mevalonic acid. Statins are a class of drugs that lower the level of cholesterol in the blood by reducing the production of cholesterol by the liver. Aims: The most controversial change appears to have been the inclusion of statins as potential firstline pharmacologic agents in older children. Methods: High-risk children, include those who are obese or overweight and who also have high blood pressure, or diabetes, or a positive family history of either high cholesterol or early heart disease. The safety of statins in children and adolescents is based on trials that have ranged in duration from six months to one year. Results: Inhibition of this enzyme in the liver results in decreased cholesterol synthesis as well as increased synthesis of LDL receptors, resulting in an increased clearance of low-density lipoprotein (LDL) from the bloodstream. The first results can be seen after one week of use and the effect is maximal after four to six weeks. No serious laboratory adverse events were reported during follow-up, and statin treatment had no untoward effects on sexual maturation. Conclusion: The recommendation to use statins in childhood seems to have hit a collective nerve, perhaps awakening us to the fuller implications of the obesity epidemic. Statins exhibit action beyond lipid-lowering activity in the prevention of atherosclerosis.