The Complex Journey of Traumatised Children: Discovering Safety in Order to Experience Comfort, Joy and Self-discovery

2015 ◽  
Vol 40 (2) ◽  
pp. 147-151 ◽  
Author(s):  
Daniel Hughes
Keyword(s):  
At Risk ◽  
High Risk ◽  
Eye Contact ◽  
Psychological Development ◽  
Social Effects ◽  
Secure Attachment ◽  
Reciprocal Interactions ◽  
Self Discovery ◽  
Comforting Touch

The neurological, psychological, emotional and social effects of abuse do not stop when the actual abuse has stopped. These affects are likely to be significant, pervasive, and long-lasting. Children who have experienced abuse at the hands of their parents tend to mistrust both their parents as well as subsequent carers who are making efforts to keep them safe. They avoid eye contact, comforting touch, reciprocal activities and communications that might facilitate a sense of safety and the development of a secure attachment. Those caring for such children need to find ways to patiently and gently help these children to begin to experience relaxed, reciprocal interactions with them along with the more intense experiences of comfort and joy.Finally, when children have begun to trust their carers, but are returned to those who previously abused them, only to be abused again, they are at high risk to have even greater difficulty learning to trust. These more severe symptoms secondary to repeated trauma then cause their subsequent carers much greater challenges in helping them to begin to trust once again. This places the carers at risk for developing blocked care which further compromises the child's psychological development.

scholarly journals FRI0155 Α MULTICENTER “AT-RISK” COHORT FOR THE DISCOVERY OF ENVIRONMENTAL, CLINICAL AND MOLECULAR PREDICTORS FOR THE TRANSITION INTO SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 661.1-661
Author(s):  
C. Adamichou ◽  
D. Nikolopoulos ◽  
M. Nikoloudaki ◽  
Z. Rahme ◽  
M. Fredi ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Mediterranean Diet ◽  
Lupus Erythematosus ◽  
Autoimmune Disorder ◽  
Classification Criteria ◽  
Renal Disorder ◽  
Clinical Criteria ◽  
Hematologic Disorder ◽  
Physical Activity Adherence

Background:SLE onset is preceded by a preclinical phase evidenced by the presence of anti-nuclear and other autoantibodies (autoAbs), which however, have low predictive value for development of clinical SLE.Objectives:To define the subgroup of autoAbs-positive individuals who are at high risk for progression into SLE by integrating environmental, clinical/serological, genetic and transcriptome data.Methods:A multicenter, across five European countries, inception cohort of autoAbs-positive individuals or first-degree relatives (FDRs) of SLE patients who are monitored prospectively over five years for possible transition to SLE according to the classification criteria. Structured data collection on demographics, family and medical history, clinical (criteria and selected non-criteria manifestations) and serological parameters, use of medications, hydroxyvitamin D levels and lifestyle (tobacco, alcohol use, physical activity, adherence to Mediterranean diet). Blood samples are stored for RNA-sequencing and genotyping.Results:A total 254 at-risk individuals (93% women, 99% Caucasians, aged [mean ± standard deviation] 36 ± 12 years) have been included and enrolment/monitoring is still ongoing. Forty individuals (16%) have FDR with SLE and 88 individuals (35%) have FDR with another autoimmune disorder. The frequency of active and past use of tobacco was 28% and 20%, respectively. Sedentary lifestyle (moving only for necessary chores or outdoor activity 1-2 times/week) was reported by 54% and adherence to the Mediterranean diet was low (3.4 ± 2.3, maximum score: 9). At enrolment, individuals had 1.9 ± 1.1 ACR-1997 classification criteria, with anti-nuclear antibodies (ANA) being the most frequent (88%), followed by synovitis (39%), photosensitivity (33%) and immunologic disorder (30%) (Table 1). During follow-up of 15.2 ± 7.2 months, a total 15 individuals (5.9%) have progressed into classified SLE, including cases with severe hematological and neurological disease.Table 1.Baseline characteristics of the at-risk for SLE cohortN (%) or mean ± SDACR 1997 classification criteria1.9 ± 1.1 Malar rash68 (27%) Discoid rash29 (11%) Photosensitivity83 (33%) Mucosal ulcers49 (19%) Synovitis100 (39%) Serositis30 (12%) Renal disorder28 (11%) Neurologic disorder31 (12%) Hematologic disorder58 (23%) Immunologic disorder77 (30%) ANA222 (88%)SLICC 2012 classification criteria Clinical criteria1.0 ± 0.9 Immunological criteria1.3 ± 0.9Conclusion:Among individuals with positive autoAbs or FDRs with SLE, the short-term risk for transition into clinical SLE is low. Following the study completion, clinical and lifestyle data will be combined with blood transcriptome to define a high-risk subgroup of individuals for progression into SLE.Acknowledgments:The study is supported by the Foundation for Research in Rheumatology (FOREUM; preclin016)Disclosure of Interests:Christina Adamichou: None declared, Dionysis Nikolopoulos: None declared, Myrto Nikoloudaki: None declared, Zahra Rahme: None declared, Micaela Fredi: None declared, Antigoni Pieta: None declared, ARGYRO REPA: None declared, Alice Parma: None declared, Eleni Kalogiannaki: None declared, Nestor Avgustidis: None declared, Nikolaos Kougkas: None declared, Aggelos Banos: None declared, Anastasios Eskitzis: None declared, Alessandra Bortoluzzi: None declared, Søren Jacobsen: None declared, Prodromos Sidiropoulos: None declared, Emmanouil Dermitzakis: None declared, Marta Mosca: None declared, Luís Inês: None declared, Laura Andreoli: None declared, Angela Tincani: None declared, Antonis Fanouriakis Paid instructor for: Paid instructor for Enorasis, Amgen, Speakers bureau: Paid speaker for Roche, Genesis Pharma, Mylan, George Bertsias Grant/research support from: GSK, Consultant of: Novartis

Peripheral levels of superoxide dismutase and glutathione peroxidase in youths in ultra-high risk for psychosis: a pilot study

CNS Spectrums ◽  
2017 ◽  
Vol 24 (03) ◽  
pp. 333-337 ◽  
Author(s):  
Maiara Zeni-Graiff ◽  
Adiel C. Rios ◽  
Pawan K. Maurya ◽  
Lucas B. Rizzo ◽  
Sumit Sethi ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
At Risk ◽  
Superoxide Dismutase ◽  
High Risk ◽  
Glutathione Peroxidase ◽  
Healthy Control Group ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Ultra High Risk ◽  
Healthy Control

IntroductionOxidative stress has been documented in chronic schizophrenia and in the first episode of psychosis, but there are very little data on oxidative stress prior to the disease onset.ObjectiveThis work aimed to compare serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GPx) in young individuals at ultra-high risk (UHR) of developing psychosis with a comparison healthy control group (HC).MethodsThirteen UHR subjects and 29 age- and sex-matched healthy controls (HC) were enrolled in this study. Clinical assessment included the Comprehensive Assessment of At-Risk Mental States (CAARMS), the Semi-Structured Clinical Interview for DSM-IV Axis-I (SCID-I) or the Kiddie-SADS-Present and Lifetime Version (K-SADS-PL), and the Global Assessment of Functioning (GAF) scale. Activities of SOD and GPx were measured in serum by the spectrophotometric method using enzyme-linked immunosorbent assay kits.ResultsAfter adjusting for age and years of education, there was a significant lower activity of SOD and lower GPX activity in the UHR group compared to the healthy control group (rate ratio [RR]=0.330, 95% CI 0.187; 0.584, p<0.001 and RR=0.509, 95% CI 0.323; 0.803, p=0.004, respectively). There were also positive correlations between GAF functioning scores and GPx and SOD activities.ConclusionOur results suggest that oxidative imbalances could be present prior to the onset of full-blown psychosis, including in at-risk stages. Future studies should replicate and expand these results.

Reducing the Risk of Alcohol-Exposed Pregnancies: A Study of a Motivational Intervention in Community Settings

PEDIATRICS ◽  
2003 ◽  
Vol 111 (Supplement_1) ◽  
pp. 1131-1135
Author(s):  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Alcohol Use ◽  
Contraceptive Use ◽  
Controlled Trial ◽  
Counseling Session ◽  
Community Settings ◽  
Motivational Intervention ◽  
Effective Contraception

Objectives. To test the feasibility and impact of a motivational intervention in reducing drinking and/or increasing effective contraception in women who are at risk for an alcohol-exposed pregnancy. Methods. A multisite single-arm pilot study was conducted in 6 community settings in 3 large cities. A total of 2384 women were screened for eligibility; 230 were eligible on the basis of their alcohol use and lack of contraception. Of the eligible women, 190 consented and were enrolled, and 143 (75.3%) completed the 6-month follow-up. The intervention consisted of 4 manual-guided motivational counseling sessions delivered by mental health clinicians and 1 contraceptive counseling session delivered by a family planning clinician. Outcome measures include intervention completion rates, alcohol use (frequency, quantity, and bingeing), contraceptive use and effectiveness, and risk for alcohol-exposed pregnancy. Results. Among women who completed the 6-month follow-up, 68.5% were no longer at risk of having an alcohol-exposed pregnancy; 12.6% of women who completed the program reduced drinking only; 23.1% used effective contraception only; and 32.9% reported both. Results were consistent across the 6 diverse high-risk settings. Conclusions. This study provides evidence that providing 4 sessions of motivational interviewing plus a contraception counseling session is feasible and strongly suggests that this intervention can decrease the risk of alcohol-exposed pregnancy in women in high-risk settings. Additional investigation in a randomized controlled trial is warranted.

Prevención de Caídas: ¿Quién está a riesgo?

EDIS ◽  
2006 ◽  
Vol 2006 (23) ◽  
Author(s):  
Sergio Romero
Keyword(s):  
At Risk ◽  
Food Safety ◽  
High Risk ◽  
Fall Prevention ◽  
Spanish Language ◽  
Risk Of Falling ◽  
Language Version

Revised! FCS2227-Span, a 1-page quiz by Sergio Romero, is a Spanish language version of "Fall Prevention: Who's at Risk?" Readers can take this yes-or-no quiz to determine if they are at high risk of falling. Published as part of the Elder Nutrition and Food Safety (ENAFS) program by the UF Department of Family Youth and Community Sciences, May 2006. FCS2227-Sp/FY857: Prevención de Caídas: ¿Quién está a riesgo? (ufl.edu)

Naïve rainforest frogs on Cape York, Australia, are at risk of the introduction of amphibian chytridiomycosis disease

2018 ◽  
Vol 66 (3) ◽  
pp. 174
Author(s):  
Conrad J. Hoskin ◽  
Harry B. Hines ◽  
Rebecca J. Webb ◽  
Lee F. Skerratt ◽  
Lee Berger
Keyword(s):  
At Risk ◽  
High Risk ◽  
Emergency Procedure ◽  
Eastern Australia ◽  
Risk Of Disease ◽  
Cape York

Amphibian chytridiomycosis disease has caused widespread declines and extinctions of frogs in cool, wet habitats in eastern Australia. Screening suggests that the disease does not yet occupy all areas modelled to be environmentally suitable, including rainforests on Cape York Peninsula. Cape Melville is an area of rainforest with several endemic frogs, including the stream-associated Melville Range treefrog (Litoria andiirrmalin), which is deemed at particular risk of disease impacts. We tested 40 L. andiirrmalin for chytrid infection by PCR and found them all to be negative. In conjunction with previous testing at another high-risk location, McIlwraith Range, this suggests that endemic rainforest frogs on Cape York have been spared the introduction of chytridiomycosis. We discuss how the disease could get to these areas, what can be done to reduce the risk, and suggest an emergency procedure should it be introduced.

scholarly journals Description of a pharmacist-led clinical video telehealth group clinic for opioid overdose prevention and naloxone education

2019 ◽  
Vol 9 (4) ◽  
pp. 294-297
Author(s):  
Aimee N. Jensen ◽  
Candace M. Beam ◽  
Amber R. Douglass ◽  
Jennifer E. Brabson ◽  
Michelle Colvard ◽  
...  
Keyword(s):  
At Risk ◽  
High Risk ◽  
Rural Areas ◽  
Urban Areas ◽  
Patient Specific ◽  
Opioid Overdose ◽  
Overdose Prevention ◽  
Innovative Practice ◽  
Risk Patients ◽  
Urban And Rural Areas

Abstract To achieve the nationwide goal of reducing opioid-related deaths, a clinical pharmacy specialist–led clinical video telehealth (CVT) clinic was created at a Veterans Affairs medical center (VAMC) to deliver opioid overdose prevention and naloxone education to at-risk patients. The purpose of this innovative practice was to improve access to this potentially life-saving intervention to patients across urban and rural areas. This study is a single-center, descriptive analysis of adult patients across 2 VAMC campuses and 4 community-based outpatient clinics from July 11, 2016, through December 31, 2016. The purpose of this innovative practice was to increase access to overdose education and naloxone distribution (OEND) to at-risk patients across urban and rural areas. Patient-specific factors were also examined among those receiving naloxone through the CVT clinic compared to other prescribers. During the first 6 months from the initiation of the clinic, 1 pharmacist prescribed 21% of the health care system's naloxone. These patients identified by the pharmacist-led CVT clinic were more likely to be considered high-risk due to concomitant use of opioids and benzodiazepines. In conclusion, the pharmacist-led CVT group clinic has been an efficient strategy to extend OEND services to high-risk patients beyond central, urban areas.

scholarly journals Some of the early help features for children with autism spectrum disorders

2017 ◽  
Vol 15 (2) ◽  
pp. 19-31
Author(s):  
S.A. Morozov ◽  
S.S. Morozova ◽  
T.I. Morozova
Keyword(s):  
At Risk ◽  
Autism Spectrum Disorders ◽  
High Risk ◽  
Risk Group ◽  
Children With Autism ◽  
Autism Spectrum ◽  
Children At Risk ◽  
Early Care ◽  
Spectrum Disorders ◽  
Autistic Disorders

Early help for children with autism spectrum disorders is the most effective way of intervention for disorders. In the process of identifying children at risk of autistic disorders, correctional work should begin before the official diagnosis has been made. It should start in the process of diagnosis, which leads to the risk of noting false-positive cases. The empirical and theoretical grounds for the necessity for early care in autism spectrum disorders are examined. Features of early care for children at high risk of developing disorders are also de¬scribed. The stages of early diagnosis of autism spectrum disorders are identified and compared with the stages of early care for such children. The strategy of early care methodological support for children at risk is defined. Propositions for practical realizations of the Concept of developing early support in Russian Federation in the period until 2020 for the risk group concerning autism spectrum disorders.

Sign in / Sign up

Export Citation Format

Share Document