The effectiveness of compassion focused therapy with clinical populations: A systematic review and meta-analysis.

BACKGROUND: Over the last 20 years, compassion focused therapy (CFT) has gained popularity as an emerging 'third wave' intervention. Although previous reviews indicated its potential benefits, a systematic review and meta-analysis of CFT in those with mental health difficulties has yet to be conducted. METHODS: A systematic search of five databases was undertaken, focusing on randomised controlled trials and randomised pilot/feasibility studies of CFT only. No language restrictions were implemented. A narrative synthesis was conducted. Random effects meta-analyses were measured on levels of self-compassion, self-criticism/self-reassurance, fears of compassion and clinical symptomology. RESULTS: Fifteen studies from 2013 to 2022 were included. Findings suggested that CFT was effective in improving compassion-based outcomes and clinical symptomology from baseline to post-intervention and compared to waitlist control. A range of small to large effect sizes were reported for improvements in self-compassion (0.19-0.90), self-criticism (0.15-0.72), self-reassurance (0.43-0.81), fear of self-compassion (0.18), depression (0.24-0.25) and eating disorders (0.18-0.79). Meta-analyses favoured CFT in improving levels of self-compassion and self-reassurance than control groups. LIMITATIONS: The methodological quality of many of the included studies (7/15) was rated as 'unclear' due to a lack of information. There was a distinct gender gap, with 74.88% identifying as female participants. CONCLUSIONS: This review was the first to examine the effectiveness of CFT in clinical populations. The results indicate that CFT has promising clinical implications, suggesting that the intervention increases compassion-based outcomes and reduces clinical symptomology in those with mental health difficulties. However, future research is required into the long-term effects of CFT.

Health professionals' experiences of and attitudes towards mental healthcare for migrants and refugees in Europe: A qualitative systematic review.

Migrants living in Europe constitute over half of the world's international migrants and are at higher risk of poor mental health than non-migrants, yet also face more barriers in accessing and engaging with services. Furthermore, the quality of care received is shaped by the experiences and attitudes of health professionals. The aim of this review was to identify professionals' attitudes towards migrants receiving mental healthcare and their perceptions of barriers and facilitators to service provision. Four electronic databases were searched, and 23 studies met the inclusion criteria. Using thematic synthesis, we identified three themes: 1) the management of multifaceted and complex challenges associated with the migrant status; 2) professionals' emotional responses to working with migrants; and 3) delivering care in the context of cultural difference. Professionals employed multiple strategies to overcome challenges in providing care yet attitudes towards this patient group were polarized. Professionals described mental health issues as being inseparable from material and social disadvantage, highlighting a need for effective collaboration between health services and voluntary organizations, and partnerships with migrant communities. Specialist supervision, reflective practice, increased training for professionals, and the adoption of a person-centered approach are also needed to overcome the current challenges in meeting migrants' needs. The challenges experienced by health professionals in attempting to meet migrant needs reflect frustrations in being part of a system with insufficient resources and without universal access to care that effectively stigmatizes the migrant status.

Infant Effortful Control Mediates Relations Between Nondirective Parenting and Internalising-Related Child Behaviours in an Autism-Enriched Infant Cohort.

Internalising problems are common within Autism Spectrum Disorder (ASD); early intervention to support those with emerging signs may be warranted. One promising signal lies in how individual differences in temperament are shaped by parenting. Our longitudinal study of infants with and without an older sibling with ASD investigated how parenting associates with infant behavioural inhibition (8-14 months) and later effortful control (24 months) in relation to 3-year internalising symptoms. Mediation analyses suggest nondirective parenting (8 months) was related to fewer internalising problems through an increase in effortful control. Parenting did not moderate the stable predictive relation of behavioural inhibition on later internalising. We discuss the potential for parenting to strengthen protective factors against internalising in infants from an ASD-enriched cohort.

Preliminary evidence for neural responsiveness to infants in mothers with schizophrenia and the implications for healthy parenting.

Schizophrenia is a severe mental illness that may significantly affect maternal sensitive behaviour. Neural correlates of maternal behaviour represent a potentially valuable means of differentiating objectively between healthy mothers expressing variations in maternal sensitivity. As mothers with schizophrenia (MWS) show deficits in behavioural responses to infants compared to healthy mothers, we explored whether maternal brain responses to infant stimuli would be significantly reduced in MWS. We also examined whether differences in maternal behaviour between healthy and ill mothers (during play interactions with own infant) were associated with differences in brain activation to infant stimuli. We found no evidence of differential 'maternal brain' responses or 'maternal behavioural' responses in 11 new MWS compared to 20 healthy new mums; neither were neural responses to infants linked to behavioural or cognitive aspects of the mother's relationship with her infant in MWS. These preliminary findings suggest maternal sensitivity differences between MWS and healthy mothers, suggested in previous studies, may be reversible in stable treated MWS.

Removal of manganese ions from synthetic groundwater by oxidation using KMnO(4) and the characterization of produced MnO(2) particles.

The aim of this study is to investigate the conditions for the removal of manganese ions from synthetic groundwater by oxidation using KMnO(4) to keep the concentration below the allowed level (0.05 mg/L). The process includes low-level aeration and addition of KMnO(4) in a Jar test system with Mn(2 + ) concentration of 0.50 mg/L, similar to that of natural groundwater in Taiwan. Different parameters such us aeration-pH, oxidant dose, and stirring speed were studied. Aeration alone was not sufficient to remove Mn(2 + ) ions completely even when the pH was increased. When a stoichiometric amount of KMnO(4) (0.96 mg/L) was used, a complete Mn(2 + ) removal was achieved within 15 min at an optimum pH of 8.0. As the amount of KMnO(4) was doubled, lower removal efficiency was obtained because the oxidant also generated manganese ions. The removal of Mn(2 + ) ions could be completed at pH 9.0 using an oxidant dose of 0.48 mg/L because Mn(2 + ) could be sorbed onto the MnO(2) particles. Finally, The MnO(2) particles were characterized using scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDX).

Rainwater harvesting in schools in Taiwan: system characteristics and water quality.

In order to understand the current status of rainwater harvesting (RWH) practices in Taiwan's schools, a study was carried out to examine the RWH system performance, water usage, and water quality in these sites. A total of 29 schools in various regions were selected for this investigation, including 7 in the northern, 7 in the central, 8 in the southern, and 7 in the eastern regions of Taiwan. Water quality indicators tested were: pH, temperature, conductivity, oxidation-reduction potential, suspended solid, total organic carbon, fecal coliform, and total coliform. From this study, it was found that RWH systems in these sites generally had two different designs: one that collected rainwater only, and one that collected both rainwater and grey water. From statistical analysis, it was found that water quality indicators such as suspended solids, total organic carbon, and fecal coliform were significantly affected by the water source and site location. Fecal coliforms in most of the sites we studied were high and not qualified for toilet flushing. The average water retention time of 2.4 months was long and considered to be the main reason to cause high fecal coliform counts. Finally, the benefit analysis was conducted to evaluate economic feasibility of rainwater harvesting for these schools. It turned out that 20% of them were able to gain economic benefits from using rainwater.

Once-daily initiation with biphasic insulin aspart 30 versus insulin glargine in patients with type 2 diabetes inadequately controlled with oral drugs: an open-label, multinational RCT.

OBJECTIVES: To assess the efficacy and safety of biphasic insulin aspart 70/30 (BIAsp 30) and insulin glargine, administered once daily in subjects with type 2 diabetes inadequately controlled with oral anti-diabetic drugs. RESEARCH DESIGN AND METHODS: In this 26-week, open-labeled, randomized, parallel-group, multinational, treat-to-target trial, 480 insulin-naïve subjects were randomized to receive either BIAsp 30 before dinner or insulin glargine at bedtime, both in combination with metformin and glimepiride. TRIAL REGISTRATION: NCT00469092, ClinicalTrials.gov. RESULTS: A total of 433 subjects completed the trial. Estimated mean reduction in HbA(1c) from baseline to end of treatment was -1.41% with BIAsp 30 and -1.25% with insulin glargine (BIAsp 30 - insulin glargine = -0.16%, 95% CI [-0.30; -0.02], p = 0.029). At the end of treatment, mean HbA(1c) was 7.1% and 7.3% for BIAsp 30 and insulin glargine, respectively. Significantly lower plasma glucose levels were observed with BIAsp 30 post-dinner (BIAsp 30 - insulin glargine = -0.52 mmol/L, 95% CI [-1.02; -0.03], p = 0.04) and at bedtime (BIAsp 30 - insulin glargine = -0.78 mmol/L, 95% CI [-1.25; -0.31], p < 0.01). The relative risk (RR) of experiencing a nocturnal hypoglycemic episode (00:00-06.00 a.m.) was significantly higher with BIAsp 30 than with insulin glargine (1.1 versus 0.5 episodes/year, RR = 2.41, 95% CI [1.34; 4.34], p = 0.003), but overall hypoglycemia rates were low. There were three major hypoglycemic episodes in each group. CONCLUSIONS: With respect to HbA(1c), BIAsp 30 fulfilled the statistical criteria for non-inferiority and superiority to insulin glargine and, according to pre-defined criteria, the improvements in HbA(1c) are considered clinically equivalent. Subjects had an increased risk of minor nocturnal hypoglycemia with BIAsp 30. There were no differences in treatment satisfaction between the two groups.

Morphological and functional differentiation of Kirsten murine sarcoma virus-transformed rat adrenocortical cell lines.

This study was undertaken to examine relationships of the phenotype of malignant cells to target cell properties and to events early in the transformation process. Eighteen transformed lines were obtained by Kirsten murine sarcoma virus infection of cells from adrenal glands of rats ages 4 to 30 weeks, at first or second passages in culture. They were grown either as fibroblastic adrenocortical stem cells or as more differentiated epithelial cells, depending on culture conditions. Of 14 lines examined for their capacity to synthesize corticosteroids, 11 converted [14C]pregnenolone to progesterone, and one converted to deoxycorticosterone. In vivo, seven lines produced tumors resembling pleomorphic carcinomas, six lines grew as sarcomas, four grew as mixed tumors, and one line produced anaplastic tumors. Distinguishing features in culture of the carcinoma-producing lines were early onset and rapid progression of morphological transformation, a noncohesive epithelial cell form in some lines, lack of extracellular matrix, and, possibly, and origin in older animals. In contrast, sarcoma-producing cells were fibroblastic and cohesive, produced extracellular matrix, and transformed morphologically after longer and less well-defined periods in culture. The variation in histopathology was unrelated to the differentiation of the target cells and to the capacity of the transformed cells to synthesize corticosteroids. The results show that adrenocortical cells, transformed by Kirsten murine sarcoma virus after short-term culture, usually retain some functional differentiation and sometimes resemble human adrenocortical carcinomas histologically. The susceptibility of adrenocortical cells to Kirsten murine sarcoma virus raises the possibility that mesodermally derived epithelia in general may be target tissues for C-type sarcoma viruses.