Self-compassion in Acceptance and Commitment Therapy for chronic pain: a pilot study.

OBJECTIVES: Evidence shows that Acceptance and Commitment Therapy (ACT) is an empirically supported psychological approach for chronic pain (CP) management. Although self-compassion is not explicitly a target of ACT, it seems to be one mechanism of change in ACT for CP. However, research is lacking on the benefits of including explicit self-compassionate exercises in ACT for CP. The current study pilot tested a Compassionate ACT 8-session group program (COMP.ACT; n=9), as well as an ACT-only 8-session group program (ACT; n=7), in a sample of women with CP. METHODS: The current study follows a quasi-experimental design, and conducts Reliable and Significant Change analyses comparing pre- to post-intervention scores of self-report measures. RESULTS: No differences were found between conditions at baseline, nor between completers and drop-outs. Although preliminary, results showed COMP.ACT led to greater clinical improvements in depression and anxiety, while ACT led to greater improvements in stress and uncompassionate self-responding. Reliable and Significant Change analysis showed that some participants improved significantly (in psychopathological symptoms, valued living and uncompassionate self-responding) in both conditions, while the majority did not change significantly. CONCLUSIONS: More research is needed to conclude whether explicit self-compassion exercises are useful in ACT for CP. Limitations and implications are further discussed.

Above and beyond emotional suffering: the unique contribution of compassionate and uncompassionate self-responding in chronic pain.

Objectives Studies have shown that self-compassion plays a protective role against depression in women with chronic pain (CP). However, the majority of studies in CP have used the total score of the self-compassion scale (SCS), which have raised concerns due to potential overlap, not only between the uncompassionate self-responding factors and psychopathology, but also between self-compassion as a whole and other well-known psychological processes (e.g., mindfulness, acceptance, psychological flexibility). This calls for a more nuanced understanding of which components of (un)compassionate self-responding adds to better mental health in CP. Methods This study explores the unique contribution of compassionate and uncompassionate self-responding to depressive symptoms in women with CP undergoing pain consultation (n = 49). Results Correlation analyses suggest that compassionate self-responding only significantly correlates with progress in valued living, while the uncompassionate self-responding significantly correlates with pain fusion, pain avoidance, obstructions to valued living and depression. Multiple regression analysis showed that self-compassion contributes to depressive symptoms (R2 = 8%) above and beyond pain intensity and disability (R2 = 12%) and psychological (in) flexibility processes (R2 = 31%), and uncompassionate (but not compassionate) self-responding uniquely contributes to depressive symptoms (sr 2  = 18%). Conclusions Findings suggest that uncompassionate self-responding is a stronger contributor to depression in CP than compassionate self-responding. Clinical implications are further discussed.

Site-specific hydrolysis of chlorogenic acids by selected Lactobacillus species.

Hydroxycinnamic acids are a major group of phenolic compounds widely distributed in plants. Among them, chlorogenic acids and caffeic acid have been in the focus of interest due to their impact on food quality and their putative health benefits. Numerous microorganisms like lactic acid bacteria are able to hydrolyze chlorogenic acids by cinnamoyl esterase enzymes. Data on the specificity of theses enzymes regarding the cleavage of distinct isomers of mono- or dichlorogenic acids is lacking. Lactobacillus reuteri, Lactobacillus helveticus, and Lactobacillus fermentum were screened for their ability to hydrolyze chlorogenic acid isomers in culture medium. Concentrations of chlorogenic acids and the released caffeic acid were determined by UHPLC-ESI-MS. The highest hydrolysis rate (100%) was observed for the hydrolysis of 5-CQA by Lactobacillus helveticus. A so far unknown metabolic pathway for the cleavage of 4-CQA is proposed including isomerization to 5-CQA and 3-CQA followed by hydrolysis.

New system for neonatal hearing screening based on auditory steady state responses.

NEURONIC-A 6.0 is a system for objective detection of hearing loss by means of the recording and analysis of auditory steady state responses. The system generates digitally Amplitude Modulated tones of different frequencies, allowing the mix of these and the simultaneous presentation through different transducers (earphone and bone vibrator) at different intensities. The system also includes a procedure for artefacts rejection based on the trajectory of variation of the residual noise through time and quantitative indicators or statistics, calculated in the frequency domain, to control the acquisition of the response process and detect automatically the presence or absence of the same. The whole working procedure is automated, which means that once the recording has started, a final result can be obtained in binary form (pass or fail) without the intervention of the examiner.

Predictive value of the Bayley scales of infant development on development of very preterm/very low birth weight children: a meta-analysis.

BACKGROUND AND AIMS: The Bayley scales of infant development (BSID) is the most widely used measure to assess neurodevelopment of very preterm (gestational age ≤32 weeks) and very low birth weight (VLBW, ≤1500 g) infants in the first three years of life. This meta-analysis determines the predictive value of the mental developmental index (MDI) and the psychomotor developmental index (PDI)/motor composite, collectively referred to as Bayley motor scale, of the BSID-I, -II and Bayley-III for later cognitive and motor functioning in very preterm/VLBW children. METHODS: Cochrane Library, PubMed, PsychINFO and CINAHL were searched for English-language peer-reviewed studies published before March 2013. Studies were included if they reported odds ratios or correlations between the MDI or Bayley motor scale scores obtained in the first three years of life, and standardized cognitive or motor assessment obtained later in life in very preterm/VLBW children. Meta-analytic methods were applied to aggregate available data. RESULTS: A total of 16 studies met inclusion criteria. Across 14 studies (n=1330 children), MDI scores were strongly predictive for later cognitive functioning, r=0.61 (95% CI: 0.57-0.64), explained variance 37%, p<.001. The relationship between MDI scores and later cognitive function was not mediated by birth weight (p=.56), gestational age (p=.70), and time interval between assessments (p=.55). Across five studies (n=555 children), Bayley motor scale scores were moderately predictive for later motor function, r=0.34 (95% CI: 0.26-0.42), explained variance 12%, p<.001. CONCLUSIONS: In very preterm/VLBW children, MDI scores explain 37% of the variance in later cognitive functioning, whereas Bayley motor scale scores explain 12% of later motor function. Thus a large proportion of the variance remains unexplained, underlining the importance of enhancing prediction of developmental delay in very preterm children.

Neuroborreliosis presenting as acute disseminated encephalomyelitis.

We report a case of a 5-year-old boy with acute disseminated encephalomyelitis as the initial presentation of neuroborreliosis. Parents report an upper-airway infection a few days before the development of acute encephalopathy, mild facial palsy, and seizures. The patient needed mechanical ventilation for 10 days, and after extubation, he presented hypotonia, ataxia, dysarthria, as well as weak gag and cough reflexes. Brain magnetic resonance imaging showed hyperintense lesions on T2- and fluid-attenuated inversion recovery sequences on the right subcortical occipital and parietal region, left posterior arm of the internal capsule, and in the medulla oblongata. Borrelia burgdorferi was identified in the plasma and cerebrospinal fluid by polymerase chain reaction and in the plasma by Western blotting. He was treated with ceftriaxone, methylprednisolone, and human immunoglobulin. Recovery was partial.

Basic numerical capacities and prevalence of developmental dyscalculia: the Havana Survey.

The association of enumeration and number comparison capacities with arithmetical competence was examined in a large sample of children from 2nd to 9th grades. It was found that efficiency on numerical capacities predicted separately more than 25% of the variance in the individual differences on a timed arithmetical test, and this occurred for both younger and older learners. These capacities were also significant predictors of individual variations in an untimed curriculum-based math achievement test and on the teacher scores of math performance over developmental time. Based on these findings, these numerical capacities were used for estimating the prevalence and gender ratio of basic numerical deficits and developmental dyscalculia (DD) over the grade range defined above (N = 11,652 children). The extent to which DD affects the population with poor ability on calculation was also examined. For this purpose, the prevalence and gender ratio of arithmetical dysfluency (AD) were estimated in the same cohort. The estimated prevalence of DD was 3.4%, and the male:female ratio was 4:1. However, the prevalence of AD was almost 3 times as high (9.35%), and no gender differences were found (male:female ratio = 1.07:1). Basic numerical deficits affect 4.54% of school-age population and affect more boys than girls (2.4:1). The differences between the corresponding estimates were highly significant (α < .01). Based on these contrastive findings, it is concluded that DD, defined as a defective sense of numerosity, could be a distinctive disorder that affects only a portion of children with AD.

[Polytraumatism in childhood - it can be more than it seems!]. / Criança politraumatizada - nem sempre é só o que parece!

Thoracic injuries can occur in 50% of polytraumatized children, but rupture of the airway is extremely rare. We describe the case of a three-year-old child victim of fall of fourth floor, with head, spine, thoracic and abdominal trauma. On admission she had left side hemothorax and hypertensive pneumothorax and a chest drainage was inserted. Imagiological studies showed left lung contusion, fracture of L1-L4 with spinal cord bone splint and spinal cord injury (D11-L3). On day 3, because of hematic chest drainage and persistent left lung opacity, a bronchoscopy was performed and showed total section of the left main bronchus. She underwent surgical reconstruction of the bronchial tree with atypical resection of the lower lobe of the left lung, with good recovery. This case demonstrates the complexity and the importance of the multidisciplinary approach to the polytraumatized child.

Changes in reading strategies in school-age children.

Learning to read is one of the most important cognitive milestones in the human social environment. One of the most accepted models explaining such process is the Double-Route Cascaded Model. It suggests the existence of two reading strategies: lexical and sublexical. In the Spanish language there are some contradictions about how these strategies are applied for reading. In addition, there are only a few studies dealing with the analysis of shifts between them, achieving a fluent reading process. In this paper we use a reading task including words and pseudowords for characterizing the cost of shifting between reading strategies in children with developmental dyslexia and normal controls. Our results suggest the presence of both strategies in these two experimental groups. In controls, both strategies become more efficient in correspondence to the increased exposition to written material. However, in children with developmental dyslexia only the lexical strategy exhibits such improvement. Their also point to a low cost for shifting between strategies in controls and a much more significant one in children with developmental dyslexia, differentiating subgroups with distinct shifting patterns.

Changes in Reading Strategies in School-Age Children

Learning to read is one of the most important cognitive milestones in the human social environment.One of the most accepted models explaining such process is the Double-Route Cascaded Model. It suggests the existence of two reading strategies: lexical and sublexical. In the Spanish language there are some contradictions about how these strategies are applied for reading. In addition, there are only a few studies dealing with the analysis of shifts between them, achieving a fluent reading process. In this paper we use a reading task including words and pseudowords for characterizing the cost of shifting between reading strategies in children with developmental dyslexia and normal controls. Our results suggest the presence of both strategies in these two experimental groups. In controls, both strategies become more efficient in correspondence to the increased exposition to written material. However, in children with developmental dyslexia only the lexical strategy exhibits such improvement. Their also point to a low cost for shifting between strategies in controls and a much more significant one in children with developmental dyslexia, differentiating subgroups with distinct shifting patterns (AU)

El aprendizaje de la lectura constituye uno de los hitos cognitivos más importantes del entorno social humano. Uno de los modelos de lectura más aceptados ha sido el Modelo de Doble Ruta en Cascada que sugiere la existencia de dos estrategias de lectura: lexical y sublexical. En el idioma español existen datos contradictorios acerca de cómo se aplican estas estrategias y no hay estudios que describan cómo se realizan los cambios de una a otra para lograr una lectura fluida. En este trabajo utilizamos una tarea de lectura de palabras y pseudopalabras para caracterizar el costo de cambio de una a otra estrategia en niños buenos lectores y niños con dislexia del desarrollo. Nuestros resultados sugieren la presencia de ambas estrategias en los dos grupos. En los niños buenos lectores ambas estrategias se hacen más eficientes con el grado de exposición a la lectura. Sin embargo, en los niños disléxicos esto solo ocurre en la estrategia lexical. Además, indican que los niños buenos lectores desarrollan un bajo costo en el cambio de estrategia de lectura mientras que un subgrupo de niños disléxicos presenta un costo mayor, conformándose subgrupos con patrones diferentes de afectación selectiva (AU)

[Poisoning with methanol and carbamates]. / Intoxicação com metanol e carbamatos.

We describe the case of a eleven years old boy with a simultaneous intentional poisoning with methanol and carbamates. The symptomatology was biphasic due to the addition of the symptomatology of both intoxications. Therapeutic measures included gastrointestinal decontamination, sodium bicarbonate, atropine, ethanol administration and hemodialysis.