There is an urgent, agreed need to improve participation outcomes and interventions for children and young people with neurodisability. We worked together with service users and providers to design research into participation outcomes and interventions in neurodisability. We built on existing evidence about participation outcomes and interventions and the WHO International Classification of Functioning, Disability and Health. We: (1) specified seven participation outcome categories for measurement; (2) prioritized these for improvement: self-care, friends and social, and physical activity ranked the highest; (3) identified 11 potential intervention categories for targeting the top priority, self-care, through eight hypothesized change mechanisms and agreed for the interventions to be delivered as a 'Menu of Interventions' for personalized self-care support; and (4) designed a before-and-after mixed methods feasibility study to evaluate the Menu with children and young people (0-12 years) and their parents and therapists.
Psychogenic nonepileptic seizures (PNES), somatoform symptoms that diminish quality of life, can be difficult to treat. A previously proposed conceptualization of PNES is further developed using grounded theory methodology to explore the understandings of therapists who successfully treated clients with PNES. Participants conceptualized PNES as nonverbal communication behaviors that usually evolved in traumatic, interpersonal systems in which verbal expression of affect was proscribed and nonverbal communication of affect was prescribed. Clients without significant trauma and psychiatric comorbidity were successfully treated by means of sensitive delivery of the diagnosis and brief cognitive interventions. Traumatized clients with compromised orientation to the present required a process of cultural transformation in a safe therapeutic relationship. Implications for clinical practice, research methodology, professional training, and service funding are discussed.
Psychogenic non-epileptic seizures (PNES) frequently present co-morbidly with a range of somatic and psychiatric conditions. This review discusses the relationship between PNES, a number of co-morbid psychiatric symptoms, early attachment trauma, and disruption of neurological development. We suggest that it may be clinically useful to understand PNES with reference to three patterns of co-morbidity and trauma history. In the first group, PNES are one symptom of a response to severe, chronic trauma and invalidation in attachment relationships, or a response to a recent event that overwhelms an emotion regulation system shaped by attachment trauma. For a second group, PNES occur in the context of ongoing interruptions to self and memory with or without a history of attachment trauma. For a third group, PNES occur in the absence of extensive co-morbidity and apparent trauma, primarily as a panic reaction, in a population with under-developed emotion regulation skills. Treatment approaches consistent with these conceptualizations are suggested.
The Eric Garner case was unique because this police-induced death was caught on video from before the moment of physical confrontation. A mixed-methods representative household survey and Garner's arrest video were used to determine NYS voters' opinions (n D 119) about police indictment and Governor Cuomo's request for expanded authority. Respondents were asked whether the officers should face indictment, shown the arrest video, and then asked again about indictment. Prior to the video, a majority of respondents (n D 86; 57.4%) believed involved officers should have been indicted. After viewing, the proportion increased by 13.7%. A majority supported Cuomo's call for expanded authority to appoint a special prosecutor in cases where police are involved in civilian deaths. Study limitations include prior exposure to the footage and a low response rate. NYS voters generally supported Cuomo's proposal for appointing a special prosecutor; however, a quarter of respondents disagreed with the method of reform and expressed a: 1) preference for every case to go to trial; 2) preference for a case-bycase basis; or 3) distrust in state-appointed special prosecutors. This research could inform discussions regarding proposed system reforms. Future research with a less well-circulated video is needed to determine the extent to which videos of police-induced deaths affect public opinion.
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