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Expressive Art Therapy is an unconventional therapeutic technique that can help individuals to heal emotionally. Music, art, and creative writing can help clients to re-align their emotions and bring forth healing within themselves. Music brings people together and may evoke different emotions in each person. Art represents the thoughts, feelings, and emotions of all people by using imagery rather than words. Finally, creative writing lets intrusive thoughts out of the mind and releases them onto paper. When clients reconnect their heads and their hearts, positive emotional changes can begin in their lives.

PurposeSevere community-acquired pneumonia (CAP) requiring intensive care unit admission is associated with significant acute and long-term morbidity and mortality. We hypothesized that downregulation of systemic and pulmonary inflammation with prolonged low-dose methylprednisolone treatment would accelerate pneumonia resolution and improve clinical outcomes.MethodsThis double-blind, randomized, placebo-controlled clinical trial recruited adult patients within 72-96 h of hospital presentation. Patients were randomized in 1:1 ratio; an intravenous 40 mg loading bolus was followed by 40 mg/day through day 7 and progressive tapering during the 20-day treatment course. Randomization was stratified by site and need for mechanical ventilation (MV) at the time of randomization. Outcomes included a primary endpoint of 60-day all-cause mortality and secondary endpoints of morbidity and mortality up to 1 year of follow-up.ResultsBetween January 2012 and April 2016, 586 patients from 42 Veterans Affairs Medical Centers were randomized, short of the 1420 target sample size because of low recruitment. 584 patients were included in the analysis. There was no significant difference in 60-day mortality between the methylprednisolone and placebo arms (16% vs. 18%; adjusted odds ratio 0.90, 95% CI 0.57-1.40). There were no significant differences in secondary outcomes or complications.ConclusionsIn patients with severe CAP, prolonged low-dose methylprednisolone treatment did not significantly reduce 60-day mortality. Treatment was not associated with increased complications.

Purpose To investigate the effect of prolonged glucocorticoid treatment for patients with acute respiratory distress syndrome (ARDS). Methods We conducted two sets of intention-to-treat analyses: (1) a primary analysis of individual patients' data (IPD) of four randomized controlled trials (RCTs) which investigated methylprednisolone treatment (n = 322) and (2) a trial-level meta-analysis incorporating four additional RCTs which investigated hydrocortisone treatment in early ARDS (n = 297). We standardized definitions to derive outcomes in all datasets. The primary outcome for the IPD analysis was time to achieving unassisted breathing (UAB) by study day 28. Secondary outcomes included mechanical ventilation (MV) and intensive care unit (ICU)-free days, hospital mortality, and time to hospital mortality by day 28. Results By study day 28, compared to the placebo group, the methylprednisolone group had fewer patients who died before achieving UAB (12 vs. 29 %; p < 0.001) and more patients who achieved UAB (80 vs. 50 %; p < 0.001). In the methylprednisolone group, time to achieving UAB was shorter [hazard ratio 2.59, 95 % confidence interval (CI) 1.95-3.43; p < 0.001], and hospital mortality was decreased (20 vs. 33 %; p = 0.006), leading to increased MV (13.3 ± 11.8 vs. 7.6 ± 5.7; p < 0.001) and ICU-free days (10.8 ± 0.71 vs. 6.4 ± 0.85; p < 0.001). In those patients randomized before day 14 of ARDS onset, the trial-level meta-analysis indicated decreased hospital mortality (36 vs. 49 %; risk ratio 0.76, 95 % CI 0.59-0.98, I.sup.2 = 17 %, p = 0.035; moderate certainty). Treatment was not associated with increased risk for infections (risk ratio 0.77, 95 % CI 0.56-1.08, I.sup.2 = 26 %; p = 0.13; moderate certainty). Conclusions Prolonged methylprednisolone treatment accelerates the resolution of ARDS, improving a broad spectrum of interrelated clinical outcomes and decreasing hospital mortality and healthcare utilization., Author(s): G. Umberto Meduri [sup.1], Lisa Bridges [sup.1], Mei-Chiung Shih [sup.2] [sup.3], Paul E. Marik [sup.4], Reed A. C. Siemieniuk [sup.5] [sup.6], Mehmet Kocak [sup.7] Author Affiliations: (1) grid.413847.d, 0000000404204721, [...]

In an attempt to devise a methodology for characterizing children's intuitive theories of drug action, 217 children in Grades 1 to 6 were interviewed about how two substances, alcohol and cocaine, cause behavioral changes in their users. Measures tapped both structure (Piagetian complexity of causal reasoning, coherence, and construction of a causal explanatory framework with nodes, links, and causal mechanisms) and content (a relevant biological ontology, mastery of propositions in a scientifically correct theory of drug action, and reliance on alternative theoretical models). Scores on all measures increased with age, especially between first and second grade and third and fourth grade. Growth between third/fourth and fifth/sixth grades was more evident for cocaine, the less familiar of the two substances. Measures of structure and content were correlated. Overall, elementary school age children appear capable of framing causal explanations of drug action and possess relevant biological knowledge, particularly about the central role of the brain in mediating the effects of drugs on behavior. It remains to be seen whether programs guided by an intuitive theories perspective and designed to increase children's understandings of how drugs alter behavior can contribute meaningfully to drug prevention efforts. (Contains 4 tables and 1 figure.)

Age-related differences in perceived competence, perceived control, and anxiety among 10- to 11-year-old boys and 12- to 13-year-old boys who participated in an American Youth Soccer Organization league were examined. Coaching behaviors thought to be related to these intrapersonal variables were also assessed, and the differences between the coaches in the two divisions were evaluated. There were no age-related differences in perceived competence. The children in the younger division endorsed both external perceptions of control and internal attributions for success more strongly than the older children did. The younger children in each division exhibited significantly more anxiety than their older teammates did, although there were no significant across-division effects. All the coaches exhibited more instructive behaviors than encouragement, and more individual-directed behaviors than team-direction behaviors, but the proportions of both instruction and individual-directed behaviors were relatively higher for the coaches in the older division than they were for the coaches in the younger division., ALTHOUGH RESEARCH ABOUT MOTIVATION has been focused on academic issues (Stipek & Mac Iver, 1989), there is a growing base of theoretical and empirical knowledge about motivation in sports. However, [...]

This study compared infant-mother attachment and mastery motivation in one-year-old babies born to adolescent and adult mothers. In the laboratory, the infants' mastery motivation was assessed in an experimenter-administered structured toy play session and infant-mother attachment was classified on the basis of the strange situation procedure. The results indicated that there were more, although not significantly so, securely attached infants among those born to adult t han to adolescent mothers (70% as compared to 53%). The relatively low number of securely attached infants in the adolescent mother group may reflect the fact that in many cases the mothers were not the primary caretakers. Among t he adolescents, the majority were living with their family of origin. Nevertheless, their infants' motivation to master the environment, assessed independently, compared favorably with that of the adult mother group. Infants of adolescent mothers were significantly more persistent than were those born to adult mothers, although they were affectively less positive during the toy play. It is suggested that the socioemotional development of infants born to adolescent mothers may be buffered by a network containing multiple caretakers. Finally, the relationship between attachment and mastery motivation was examined. The results showed that infants with an avoidant or secure attachment relationship were more persistent as well as competent than were ambivalent infants during free play.

Previously published data on infants aged 12 and 13 months who were observed in the Strange Situation with their mothers and fathers were reanalyzed using a component process approach. (PCB)

Study of 112 grade 4 and 6 children reveals that girls are less likely than boys to underrate their abilities assessed by test scores, but more likely to underrate teacher assessments of competence. Teachers rate boys who underrate themselves lower than they do boys who overrate themselves, but do the reverse for girls. (Author/BJV)