Plant-based and Early Time-restricted Eating for Prevention and Treatment of Type 2 Diabetes in Adults: A Narrative Review.

Type 2 diabetes (T2D) is a significant public health challenge for which effective lifestyle interventions are needed. A growing body of evidence supports the use of both plant-based eating patterns and early time-restricted eating (eTRE) for the prevention and treatment of T2D, but research has not yet explored the potential of these dietary strategies in combination. In this narrative review we assessed the evidence by which plant-based diets, in conjunction with eTRE, could support T2D care. The electronic databases MEDLINE and the Web of Science were searched for relevant articles published throughout the last decade. Observational research has shown that healthy plant-based eating patterns and eTRE are associated with reductions in T2D risk. Interventional trials demonstrated that plant-based diets promote improvements in glycated hemoglobin, insulin resistance, glycemic control, and cardiometabolic risk factors. These changes may be mediated, in part, by reductions in oxidative stress, dietary acid load, and hepatocellular and intramyocellular lipids. The eTRE strategies were also shown to improve insulin resistance and glycemic control, and mechanisms of action included enhanced regulation of circadian rhythm and increased metabolic flexibility. Integrating these dietary strategies may produce additive benefits, mediated by reduced visceral adiposity and beneficial shifts in gut microbiota composition. However, potential barriers to concurrent implementation of these interventions may exist, including social challenges, scheduling constraints, and tolerance. Prospective trials are needed to examine their acceptability and clinical effects.

Occupational Balance and Emotional Regulation in People With and Without Serious Mental Illness.

Background. Serious mental illness affects daily functioning, including occupational balance. Purpose. This study aims to compare occupational balance and emotional regulation between people with serious mental illness and the healthy population and to examine the relationship between occupational balance and emotional regulation. Method. A cross-sectional study was performed. Occupational balance and emotional regulation were measured using the Occupational Balance Questionnaire and the Emotional Regulation Questionnaire, respectively. A multivariate analysis (analysis of covariance) was conducted. Findings. The sample consisted of 112 individuals, divided into two groups: the serious mental illness group (n = 55); and the healthy group (n = 57). People with serious mental illness reported lower occupational balance and lower cognitive reappraisal than the healthy population. Furthermore, the higher cognitive reappraisal, the higher the occupational balance, and the higher the expressive suppression, the lower the occupational balance. Conclusion. The results provide preliminary evidence of the relationship between occupational balance and emotional regulation.

Relationship between sitting time and health status in patients with heart failure.

OBJECTIVE: To describe self-reported sitting time (ST), and determine the factors associated with health status (HS) among patients with heart failure (HF). METHODS: A cross-sectional study design was used in this study. Outcome measures included an international physical activity questionnaire and a self-report health status questionnaire. The data assessments were examined using the Pearson correlation coefficient, t-test, one-way ANOVA, and Hierarchical multiple regression. RESULT: 180 respondents joined this study. The mean age was mean 59.92 (SD= 11.90) years old, and 60% were male. The mean score of HS was mean 9.43 (SD= 2.16). The HS had a significant correlation with age (r= .17, p< .05), Hemoglobin (r= -.46, p< .01), HF medications (r= .31, p< .01), length of diagnostic HF (r= .35, p< .01), and comorbidity (r= .25, p< .01), and the HS was associated with the NYHA Classification (F= 203.43, p< .001), and the ST (F= 73.97, p< .001). Four variables were significant predictors of HS such as comorbidity (ß = .14), NYHA Class I (ß= -2.22), ST 6 to 8 hours/day (ß= 1.27), and ST > 8 hours/day (ß= 3.03), and they were predicted 75.1% of the variance in HS. CONCLUSION: High amounts of ST and high NYHA classifications were associated with decreased HS in patients with HF, Moreover, HS is independently associated with comorbidities status and length of diagnostic HF.

Screen Time and Socioemotional and Behavioural Difficulties Among Indigenous Children in Canada: Temps d'écran et difficultés socio-émotionnelles et comportementales chez les enfants autochtones du Canada.

OBJECTIVES: To describe screen time levels and determine their association with socioemotional and behavioural difficulties among preschool-aged First Nations, Métis, and Inuit children. METHOD: Data were taken from the Aboriginal Children's Survey, a nationally representative survey of 2-5-year-old Indigenous children in Canada. Socioemotional and behavioural difficulties were defined using parent/guardian reports on the Strengths and Difficulties Questionnaire. Multiple linear regression analyses were conducted separately for First Nations, Métis, and Inuit participants, and statistically adjusted for child age, child sex, and parent/guardian education. Statistical significance was set at P < 0.002 to adjust for multiple comparisons. RESULTS: Of these 2-5-year-old children (mean [M] = 3.57 years) 3,085 were First Nations (53.5%), 2,430 Métis (39.2%), and 990 Inuit (7.3%). Screen time exposure was high among First Nations (M = 2 h and 58 min/day, standard deviation [SD] = 1.89), Métis (M = 2 h and 50 min [SD = 1.83]), and Inuit children (M = 3 h and 25 min [SD = 2.20]), with 79.7% exceeding recommended guidelines (>1 h/day). After adjusting for confounders, screen time was associated with more socioemotional and behavioural difficulties among First Nations (total difficulties ß = 0.15 [95% CI, 0.12 to 0.19]) and Métis (ß = 0.16 [95% CI, 0.12 to 0.20]) but not Inuit children (ß = 0.12 [95% CI, 0.01 to 0.23]). CONCLUSIONS: Screen time exposure is high among Indigenous children in Canada, and is associated with more socioemotional and behavioural difficulties among First Nations and Métis children. Contributing factors could include enduring colonialism that resulted in family dissolution, lack of positive parental role models, and disproportionate socioeconomic disadvantage. Predictors of poor well-being should continue to be identified to develop targets for intervention to optimize the health and development of Indigenous children.

Modelling Age-Varying Associations among Group Memberships, Neighborhood Connectedness, and Well-Being.

Individuals who maintain group memberships in their community tend to experience improved well-being relative to those who participate in few or no groups. There are, however, few investigations targeting variability in the correlates of group membership across the lifespan. The present examination probed age-related variability in the association between group memberships and subjective connectedness as well as well-being. Participants included 3,940 (mean age = 45.61 years, standard deviation [SD] = 15.62) Canadian and American respondents who completed an online survey during August of 2020 (i.e., amidst the COVID-19 pandemic). Time-varying effects modelling was used to estimate coefficients for group membership at each age within the sample. Memberships in social groups positively predicted connectedness, and this association was strongest in middle-to-older age; a similar association was also evident when predicting well-being. Connectedness was also a positive predictor of well-being throughout most ages. These findings build on emerging research conveying how group memberships have significance for people currently in middle-to-older age.

Physical activity level and sedentary time determinants among Moroccan hypertensive patients.

INTRODUCTION: Hypertension is closely associated with an inactive lifestyle. Physical activity and/or exercise have been shown to delay the development of hypertension. This study aimed to assess the level of physical activity and sedentary time, and its determinants among Moroccan Hypertensive patients. PATIENTS AND METHODS: A cross-sectional study was conducted between March and July 2019 including 680 hypertensive patients. We administered international physical activity questionnaire in face-to-face interview to assess the level of physical activity and sedentary time. RESULTS: The results showed that only 43.4% of participants met recommended physical activity levels (≥ 600 MET min/week). Adherence to physical activity recommendations was observed more in male participants (p = 0.035), in participants aged less than 40 years (p = 0.040) and those aged between 41 and 50 years (p = 0.047). The average sedentary time was 37.19 ± 18.92 hours per week. This time was significantly longer in people aged 51 and over, in married, divorced, and widowed people, and in those with low levels of physical activity. CONCLUSIONS: The level of physical inactivity and the sedentary time was high. In addition, participants with a high-level sedentary lifestyle had a low level of physical activity. Educational actions should be undertaken among this group of participants to prevent the risks associated with inactivity and sedentary behavior.

The impact of temperament on functional and symptomatic relief and satisfaction after carpal tunnel release.

The aim of this study was to compare the symptomatic, functional and satisfaction outcomes of patients with different temperaments undergoing carpal tunnel surgery by a single surgeon. Dominant temperaments of 171 patients with carpal tunnel syndrome were determined using the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire (TEMPS-A). Patients were divided into six temperament groups, and the impact of their respective group measured against preoperative and postoperative symptom severity and functional capacity using the Boston Carpal Tunnel Questionnaire (BCTQ] and satisfaction using the Patient Evaluation Measure (PEM). Patients in the depressive group had the largest improvement in symptoms (BCTQ score change, -2.2) as well as a significant improvement in function (BCTQ score change, -2.1), yet had the lowest postoperative satisfaction (mean PEM score 9). Determination of patient temperament before surgery for carpal tunnel syndrome (CTS) may be useful as an ancillary technique to help predict postoperative satisfaction, which may in turn help guide preoperative communication and expectation setting.Level of evidence: III.

Plan quality score to evaluate the dwell time deviation restricted inverse planning by simulated annealing and graphically optimized treatment plans for template based interstitial brachytherapy.

PURPOSE: To evaluate the impact of dwell time deviation constraint (DTDC) on the quality of IPSA-optimized treatment plans in comparison with graphical plans using plan quality scores (PQS). MATERIAL AND METHODS: Seventy optimized plans (graphical & IPSA with different DTDC values) of ten cervical cancer patients were generated. Various DVH parameters like D90, V100, V150, V200, V300 were compared to evaluate the impact of DTDC on target coverage and high dose regions inside target for different plans. Similarly, for the OAR dose, values of D2cc were compared. Various planning parameters like CI, COIN, DHI, DNR, ODI, EI and gain factor (GF) for different OARs were calculated. Based on these indices a plan quality score (PQS) was formulated and calculated. PQS values were used to see the impact of DTDC on plan quality of IPSA in comparison with dosimetric quality of graphical plan. RESULTS: We have found that target coverage is similar for IPSA and graphically optimized treatment plans. However, dose homogeneity was improved in IPSA compared to graphical optimization whereas conformality was better in graphically optimized plans. OAR dose was less in IPSA plans. High-dose regions inside the target were also reduced in IPSA comparatively. However, IPSA plans optimized with various values of DTDC did not necessarily reduce high-dose regions beyond 0.6. Plan quality scores (PQS) were 6.31, 6.31, 6.34, and 6.17 for the graphically optimized plan, IPSA with DTDC values of 0.0, 0.4, and 1.0 respectively. CONCLUSION: We found that IPSA is dosimetrically advantageous over graphical optimization. IPSA with a DTDC value of 0.4 improved overall plan quality. However, DTDC value beyond 0.6 produces dosimetrically sub-optimal plans hence the use of DTDC should be very selective and limited.

The Impact of Affective Temperaments on Suicidal Ideation and Behaviors: Results from an Observational Multicentric Study on Patients with Mood Disorders.

Suicide ideation and behaviors are major health issues in the field of mental health. Several psychological and psychosocial factors have been taken into account as possible predictors of suicidality. Only recently affective temperaments have been considered as possible factors linked to suicide. This study aims to investigate the relationship between affective temperaments and suicidality, including the lifetime onset of suicide ideation, lifetime presence of suicide attempts and the total number of lifetime suicide attempts. This is a naturalistic multicentric observational study, involving outpatient units of seven University sites in Italy. Patients were administered with the short version of TEMPS-M and the Columbia Suicide Severity Rating Scale. A total of 653 participants were recruited, with a diagnosis of bipolar (55.7%), unipolar (35.8%) and cyclothymic disorder (8.4%). Regression models showed that the presence of lifetime suicide behaviors was increased in patients presenting trait related impulsivity (p < 0.0001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.01), higher number of hospitalizations (p < 0.0001), cyclothymic and irritable affective temperaments (p < 0.05 and p < 0.05, respectively). Conversely, the presence of hyperthymic affective disposition reduced the likelihood of having suicidal behaviors (p < 0.01). Lifetime suicidal ideation was associated with trait-related impulsivity (p < 0.001), poor free-interval functioning (p < 0.05), higher number of affective episodes (p < 0.001) and of hospitalizations (p < 0.001). Depressive temperaments increased the likelihood of presenting suicidal ideation (p < 0.05), along with irritable temperaments (p < 0.01), contrary to hyperthymic affective (p < 0.05). Results of the present study confirm that affective disposition has a significant impact on the onset of suicidal ideation and behaviors, and that affective dispositions should be assessed in clinical settings to identify people at risk of suicide. Moreover, a wider clinical evaluation, including different clinical psychopathological dimensions, should be taken into consideration to develop effective preventive interventions.

Validation of the Arabic version of the 35-item TEMPS-M in a community sample of adults.

BACKGROUND: To our knowledge, no brief version of the Temperament Evaluation in Memphis Pisa and San Diego (TEMPS-M) is available so far in the Arabic language, which might have resulted in limited research in this field from Arab countries. We aimed through this study to validate the 35-item TEMPS-M into the Arabic language in a sample of non-clinical Lebanese adults. METHODS: We used an online cross-sectional survey targeting non-clinical Lebanese adults from the general population. A confirmatory factor analysis was conducted to test the factorial structure of the TEMPS-M. RESULTS: All five temperament subscales achieved good/very good internal consistencies in the present study (depressive: α = 0.78, cyclothymic: α = 0.86, hyperthymic: α = 0.83, irritable: α = 0.87, and anxious: α = 0.87). The five-factor solution of the TEMPS-M displayed a good CFI of 0.94, TLI of .94 and a GFI of .95, but a poor RMSEA of .10 [90% CI .10, .11]. The five affective temperaments showed positive correlations with personality dysfunction domains, thus attesting for convergent validity. In addition, positive correlations between all affective temperament dimensions and anxiety/depression scores were found. We also tested for gender invariance, and found that configural, metric, and scalar invariance were supported across gender. CONCLUSION: Our data suggest that the psychometric properties of the Arabic TEMPS-M are good. Making this scale available in Arabic will hopefully encourage Arab researchers to investigate this under-explored topic in their countries, and advance knowledge on how culture impacts the prevalence, development and course of temperament.

Sobre o pássaro e o peixe: o tempo na fotografia e na psicanálise / About the bird and the fish: Time in Photography and Psychoanalysis / Sobre el pájaro y el pez: el tiempo en la fotografía y el psicoanálisis / À propos de l'oiseau et du poisson: le temps dans la photographie et la psychanalyse

Neste ensaio, proponho uma interlocução entre fotografia e psicanálise. Dentre as diversas análises possíveis acerca deste encontro, inquieta-me, sobretudo, a dimensão do tempo. Com o intuito de pensar a temporalidade pela perspectiva da fotografia, parto, inicialmente, de algumas provocações de Barthes e Soulages, estendendo-as a outros autores que contribuíram com este debate. Para explorá-la a partir da psicanálise, examino algumas contribuições de Freud, Winnicott e Lacan. Por fim, busco tecer, a partir da apresentação de uma vinheta clínica, algumas aproximações entre os dois campos, apontando que os papéis desempenhados pelo instante e pela duração representam temas essenciais para ambos.

En este ensayo, propongo una interlocución entre la fotografía y el psicoanálisis. Entre los diversos análisis posibles de este encuentro, mi principal preocupación es la dimensión del tiempo. Para pensar la temporalidad desde la perspectiva de la fotografía, parto, inicialmente, de algunas provocaciones de Barthes y Soulages, extendiéndolas a otros autores que contribuyeron a este debate. Para explorarlo desde el psicoanálisis, examino algunas aportaciones de Freud, Winnicott y Lacan. Por último, intento tejer, a partir de la presentación de una viñeta clínica, algunas aproximaciones entre los dos campos, señalando que los papeles desempeñados por el instante y por la duración representan temas esenciales para ambos.

In this essay, I propose an interlocution between photography and psychoanalysis. Among the various possible analyses of this encounter, my main concern is the dimension of time. In order to think temporality from the perspective of photography, I start, initially, with some provocations from Barthes and Soulages, extending them to other authors who contributed to this debate. To explore it from the psychoanalysis, I examine some contributions of Freud, Winnicott and Lacan. Finally, I seek to weave, from the presentation of a clinical vignette, some approximations between the two fields, pointing out that the roles played by the instant and by duration represent essential themes for both.

Dans cet essai, je propose une interlocution entre la photographie et la psychanalyse. Parmi les différentes analyses possibles de cette rencontre, ma principale préoccupation est la dimension du temps. Pour penser la temporalité du point de vue de la photographie, je commence, dans un premier temps, par quelques provocations de Barthes et Soulages, en les étendant à d'autres auteurs qui ont contribué à ce débat. Pour l'explorer à partir de la psychanalyse, j'examine certaines contributions de Freud, Winnicott et Lacan. Enfin, je cherche à tisser, à partir de la présentation d'une vignette clinique, quelques rapprochements entre les deux domaines, en soulignant que les rôles joués par l'instant et par la durée représentent des thèmes essentiels pour les deux.

Psicanálise, violências e o tempo: a construção coletiva de uma metodologia de trabalho / Psychoanalysis, violence and time: the collective construction of a work methodology / Psychanalyse, violence et temps: la construction collective d'une méthodologie de travail / Psicoanálisis, violencias y tiempo: la construcción colectiva de una metodología de trabajo

Resumo O presente ensaio pretende discutir alguns caminhos para o trabalho de psicanalistas diante de situações de violência e de violações de direitos, na escuta de sujeitos que passam por experiências traumáticas. Para isso, apresenta a relação entre trauma e temporalidade, e discorre sobre os desafios transferenciais da escuta nessas condições. As reflexões propostas partem da experiência com o projeto Casa dos Cata-Ventos, uma estratégia de atenção à infância e à adolescência ancorada na ética psicanalítica. É apresentada uma discussão acerca do método de trabalho desenvolvido, o qual se propõe a operar com o tempo em sua rearticulação. Destaca-se que tais estratégias construídas possibilitam a criação de um tempo narrativo, em que se pode falar e historicizar o que se viveu e, assim, oferecer um contraponto à temporalidade do trauma.

Abstract This essay discusses possible paths to the work of psychoanalysts in situations of violence and rights violations, in listening to individuals who undergo traumatic experiences. For this purpose, it presents the relationship between trauma and temporality, discussing the transferential challenges of listening under such conditions. The proposed reflections are based on the experience with Casa dos Cata-Ventos, a strategy for the care of children and adolescents anchored in psychoanalytic ethics. It discusses the work methodology developed, which proposes to operate with time in its rearticulation. Such strategies allow the creation of a narrative time, in which one can speak and historicize what was lived and, thus, offer a counterpoint to the temporality of trauma.

Résumé Cet essai discute de voies possibles pour le travail des psychanalystes dans des situations de violence et de violation des droits, dans l'écoute des individus qui subissent des expériences traumatiques. À cette fin, il présente la relation entre le traumatisme et la temporalité, en discutant les défis transférentiels de l'écoute dans de telles conditions. Les réflexions proposées se fondent sur l'expérience du projet Casa dos Cata-Ventos, une stratégie de soin des enfants et des adolescents ancrés dans l'éthique psychanalytique. Il aborde la méthodologie de travail développée, qui propose d'opérer avec le temps dans sa réarticulation. De telles stratégies construites permettent la création d'un temps narratif, dans lequel on peut parler et historiser ce qui a été vécu et, ainsi, offrir un contrepoint à la temporalité du traumatisme.

Resumen El presente ensayo pretende discutir algunos caminos para el trabajo de psicoanalistas ante situaciones de violencia y de violaciones de derechos, en la escucha de sujetos que pasan por experiencias traumáticas. Para esto, presenta la relación entre trauma y temporalidad y discurre acerca de los desafíos transferenciales de la escucha en esas condiciones. Las reflexiones propuestas parten de la experiencia con el proyecto Casa dos Cata-Ventos, una estrategia de atención a la infancia y a la adolescencia anclada en la ética psicoanalítica. Se presenta una discusión sobre el método de trabajo desarrollado, el cual se propone a operar con el tiempo en su rearticulación. Se resalta que dichas estrategias construidas permiten la creación de un tiempo narrativo, en el que se puede hablar e historizar lo que se vivió y, así, ofrecer un contrapunto a la temporalidad del trauma.

Trait-Related Impulsivity, Affective Temperaments and Mood Disorders: Results from a Real-World Multicentric Study.

Trait-related impulsiveness is highly prevalent in patients with mood disorders, being associated with negative outcomes. The predictive role of affective temperaments on trait-related impulsivity is still understudied. The aim of the present study is to investigate the relationship between impulsivity and affective temperaments in a sample of euthymic patients with mood disorders. This is a real-world multicentric observational study, carried out at the outpatient units of seven university sites in Italy. All patients filled in the short version of Munster Temperament Evaluation of the Memphis, Pisa, Paris and San Diego and the Barratt Impulsiveness Scale. The study sample included 653 participants, mainly female (58.2%), with a mean age of 46.9 (±14.1). Regression analyses showed that higher levels of trait-related impulsivity were associated to suicide attempts (p < 0.000), the presence of psychotic symptoms during acute phases (p < 0.05), a seasonal pattern (p < 0.05), a lower age at onset of the disorder (p < 0.05), cyclothymic (p < 0.01) and irritable temperaments (p < 0.01). The results of our study highlight the importance to screen patients with mood disorders for impulsivity and affective temperaments in order to identify patients who are more likely to present a worse outcome and to develop personalized and integrated early pharmacological and psychosocial treatment plans. Novelties of the present paper include the recruitment of patients in a stable phase, which reduced possible bias in patients' self-reports, and the multicentric nature of the study, resulting in the recruitment of a large sample of patients with mood disorders, geographically distributed across Italy, thus improving the generalizability of study results.

Korean Validation of the Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire.

OBJECTIVE: The Temperament Evaluation of Memphis, Pisa, Paris, and San Diego Autoquestionnaire (TEMPS-A) has been validated in more than 30 languages and is noted for its broad application in research and clinical settings. This study presents the first attempt to examine the reliability and validity of the TEMPS-A in Korea. METHODS: A total of 540 non-clinical participants completed the Korean TEMPS-A, which was adapted from the original English version via a comprehensive translation procedure. Reliability was assessed using Cronbach's α, and associations between temperaments were examined using Spearman's correlation coefficient. Exploratory factor analysis (EFA) was performed, and differences in TEMPS-A scores between the gender- and age-based groups were examined using Kruskal-Wallis analysis. RESULTS: The Korean TEMPS-A exhibited excellent internal consistency (0.70-0.91) and significant correlations between subscales. EFA resulted in a two-factor structure: Factor I (depressive, cyclothymic, irritable, and anxious) and Factor II (hyperthymic). Gender and age group differences were observed. CONCLUSION: Overall, our results suggest that TEMPS-A is a reliable and valid measure of affective temperaments for the Korean population. This study opens new possibilities for further research on affective temperaments and their related traits.

[Multiphasic time: Representations, modelisation and dynamics: Putting time back in motion after traumatic violence]. / Le temps multiphasique : représentations, modélisation et dynamique: De la remise en mouvement du temps dans les violences traumatiques.

A multiphasic time model, integrating the past, present and future in close interrelations, is first presented and offers a contextual approach to the perceptions and responses of an individual according to his/her personal history and environment. The present and future prospects are in continuity with the past and its consequences and effects. The past, even when it is not or no longer expressed, influences the present and the future, and this over several generations. Past life events and experiences, as well as psychological and biological states previously experienced by the individual (such as emotional states, illnesses, etc.) and his/her previous responses (adaptive or maladaptive responses, leading to failures or successes, etc.) modify, according to the individual' s personal history, his/her current perceptions and reactions to life events and environmental stimuli. In addition, some variables influence a person's current perceptions and reactions such as environmental moderator variables (social, cultural, physical environment), current psychobiological states of the individual (emotions, motivation, etc.), and characteristics of life events and environmental stimuli (depending on whether these life events are, for example, single or repeated, predictable or unpredictable). What matters is less the life event or environmental stimulus in itself, than the individual's perception and reactivity to this event/stimulus according to the context of his/her personal history, as well as his/her current environment and psychobiological state. Moreover, the perception of the present depends not only on the traces of the past but also on our ability to project ourselves into the future and to envision it. Thus, dreams of the future allow one to escape by introducing another temporality allowing a person to disconnect from the present, to create an internal reality replacing the external reality, and to live the present differently. But the memory of the past and the representations of the future are constantly constructed and reconstructed in the present according to the emotions of the individual and his/her environment. Based on the integrative approach proposed in the multiphasic time model, the trace of the past, as well as the dream of the future, contribute to writing the present and influence the future, but the nuances of the present participate also in the reconstruction of past memory and the projection into the future, with interrelationships where all times are closely intertwined in the individual's current representations. By relying on this multiphasic time model, new perspectives for understanding and treating traumatic violence are proposed. Indeed, the representations of time that we construct are sometimes related to the perception of a frozen time that no longer flows, especially after an experience of traumatic violence. The trauma breaks into the psychic life of the individual by causing a rupture, and the perception of time is then altered. Time stops, this is the time of trauma. There is no longer multiphasic time, but there remains monophasic time frozen on the traumatic event. It can then be difficult, if not impossible, to project oneself into the future or to remember the past prior to the traumatic event. The definitions of trauma are recalled in this article and the contribution of the media to the development of trauma is, in particular, questioned. Then, from the multiphasic time model previously described, the frozen time of the trauma is reconsidered by emphasizing the interest of summoning the past and the future in the therapeutic process in order to put the temporality of the individual back in motion and continuity. More precisely, the therapy and counseling work of the therapist allow, among other things, to pass from a monophasic suspended time in which it is often necessary to welcome the individual in his/her sensoriality and corporality, to a multiphasic dynamic time in which it becomes possible for the individual to project himself/herself into the future and remember the past. The role of the group, as a containing envelope, and collective memory in the (re)construction of individual memory and self-consciousness, is also discussed. Finally, the passage from sensory fright to narrative, from traumatic sensory "cyst" to psychic elaboration, from the frozen time of trauma to the time of psychic mobilization, is developed. It is necessary to have available various therapeutic tools adapted to these different times in order to be able to reestablish a temporal, psychic and existential continuity. The effectiveness of a therapeutic approach will depend on its coherence, both for the individual and the therapist, in the context of their temporalities, resources and singularity, and of the therapeutic alliance that can develop.

DIRECTIVE CLINIQUE CONJOINTE DE LA SOGC ET DE LA SCP: Directive clinique no 424 : Prise en charge du cordon ombilical chez le nourrisson prématuré ou à terme.

Objectif: Évaluer l'effet du clampage retardé du cordon et de la traite du cordon ombilical sur les risques de mortalité et de morbidité maternelles et néonatales en contexte de grossesses monofœtale ou gémellaire. Population cible: Femmes enceintes dont la grossesse monofœtale ou gémellaire est à terme ou avant terme. Bénéfices risques et coûts: Chez les prématurés de grossesse monofœtale, le clampage retardé de 60 à 120 secondes idéalement, mais d'au moins 30 secondes, réduit le risque de mortalité et de morbidité. Chez les jumeaux prématurés, le clampage retardé est associé à certains bénéfices. Chez les nourrissons de grossesse monofœtale à terme, le clampage retardé de 60 secondes améliore les paramètres hématologiques. Chez les grands prématurés, la traite du cordon ombilical augmente le risque d'hémorragie intraventriculaire. Données probantes: Une recherche a été effectuée au moyen des bases de données Medline, PubMed, Embase et Cochrane Library, de leur création jusqu'à mars 2020, à partir de termes MeSH et de mot-clés liés au clampage retardé du cordon et à la traite du cordon ombilical. Le présent document est un résumé des données probantes et non pas une revue méthodologique. Méthodes de validation: Les auteurs ont évalué la qualité des données probantes et la force des recommandations en utilisant le cadre méthodologique d'évaluation, de développement et d'évaluation (GRADE). Voir l'annexe A en ligne (tableau A1 pour les définitions et tableau A2 pour l'interprétation des recommandations fortes et conditionnelles [faibles]).

The relationship between therapeutic adherence and personality.

Inadequate adherence to long-term therapies significantly affects the course and outcome of the disease, and therefore poses a serious threat to both the effectiveness and success of treatment and the long-term well-being of patients. Therapeutic adherence is an extremely complex process, with a number of risk and protective factors identified, many of which underlie the psychological characteristics of the patient. A number of medication adherence models have been developed to take into account the psychological characteristics of patients, and recent research has examined the relationship between different personality models and adherence to therapeutic recommendations. In this review we aim to summarize current knowledge, adherence models, research findings on the relationship between personality and adherence, including implications for future research.

The association of objectively and subjectively measured physical activity and sedentary time with prediabetes and type 2 diabetes in adults: a cross-sectional study in Framingham Heart Study cohorts.

The purpose of this study was to examine whether using both objectively (accelerometer) and subjectively (questionnaire) measured moderate- to vigorous-intensity physical activity (MVPA) and sedentary time (SED) improves the prediction of prediabetes and type 2 diabetes (pre/T2D) using data from the Framingham Heart Study (n = 4200). Logistic regression was used to examine the odds ratio of pre/T2D in groups cross-classified by subjective and objective MVPA and SED. Less than half of participants fell into concordant categories of MVPA and SED using subjective and objective measures, with 7.0%-9.4% of participants in the extreme discordant categories of high-low or low-high subjective-objective MVPA or SED. Low objective MVPA, regardless of subjective MVPA status, was associated with a higher prevalence of pre/T2D (P < 0.05). When cross-classifying by MVPA and SED, the majority of participants fell into concordant categories of MVPA-SED, with <4% of participants in the extreme discordant categories of MVPA-SED. Low objective MVPA, regardless of objective SED, was associated with a higher prevalence of pre/T2D (P < 0.05). These findings suggest that low objectively measured MVPA appears more closely associated with pre/T2D risk compared with subjective measures, and there does not appear to be an additive effect of SED on pre/T2D risk after accounting for MVPA.

Sociodemographic Factors Associated With Objectively Measured Moderate- to Vigorous-intensity Physical Activity in Adults With Type 2 Diabetes: Cross-sectional Results From the Canadian Health Measures Survey (2007 to 2017).

OBJECTIVES: Individuals with type 2 diabetes should engage in ≥150 min of moderate- to vigorous-intensity physical activity (MVPA) weekly, but most do not meet this guideline. Understanding how social determinants correlate with physical activity in adults with type 2 diabetes may improve development and delivery of physical activity interventions. This study aimed to explore associations between objectively measured MVPA with sociodemographic characteristics in adults with type 2 diabetes. METHODS: Cross-sectional data from cycles 1 through 5 of the Canadian Health Measures Survey were analyzed. Participants (N=876) 20 to 79 years of age with type 2 diabetes and ≥4 days of valid activity monitor wear were included. Proportions with 95% confidence intervals for objectively measured MVPA were compared according to sociodemographic characteristics. Ordinal logistic regression was used. Secondary outcomes included light-intensity physical activity, screen time and proportion of activity monitor wear time spent sedentary. RESULTS: Only 15.5% of women and 26.2% of men met Diabetes Canada physical activity guidelines, and approximately 75% of activity monitor wear time was spent in a sedentary state. Higher odds of achieving low levels of physical activity were observed among women who were former or current smokers (odds ratio [OR], 4.51; p<0.001), and among men who were ≥65 years of age (OR, 2.92; p<0.001), of middle (OR, 2.20; p<0.05) and lowest (OR, 3.06; p<0.05) income tertiles and current or former smokers (OR, 3.01; p<0.05). CONCLUSIONS: Sociodemographic factors are strongly associated with levels of MVPA in adults with type 2 diabetes. Sociodemographic information should be routinely collected by clinicians and used to inform more tailored and effective interventions for this patient population.

[All about the Pancreas]. / Alles über das Pankreas.

All about the Pancreas Abstract. Ultrasound has made tremendous progress with the use of contrast media and elastography, particularly in patients with small, solid pancreatic lesions (SPL) <20mm and cystic tumors (CPL) of any size. In the case of solid and cystic pancreatic lesions, the differential diagnosis must first be evaluated after detection in order to define the indications for radical surgery, strategies for preserving the pancreatic parenchyma or simply for control examinations. Contrast-enhanced transcutaneous (TUS, CEUS) and endoscopic (EUS, CE-EUS) ultrasound and elastography facilitate further characterization of SPL and ZPL. Pancreatic ductal adenocarcinomas (PDAC) show hypoenhancement in contrast-enhanced ultrasound. The majority of the important differential diagnoses, on the other hand, are multi-enhancing. PDAC are almost always harder than healthy pancreatic parenchyma. In contrast, elastographically soft SPL are - with very few exceptions - benign. This review provides an overview of the use of modern ultrasound techniques to detect and characterize solid and cystic pancreatic lesions.