The comorbidity of chronic pain and opioid addiction is a serious problem that has been growing with the practice of prescribing opioids for chronic pain. Neuroimaging research has shown that chronic pain and opioid dependence both affect brain structure and function, but this is the first study to evaluate the neurophysiological alterations in patients with comorbid chronic pain and addiction. Eighteen participants with chronic low back pain and opioid addiction were compared with eighteen age- and sex-matched healthy individuals in a (...) pain-induction fMRI task. Unified structural equation modeling (SEM) with Lagrange multiplier (LM) testing yielded a network model of pain processing for patient and control groups based on 19 a priori defined regions. Tests of differences between groups on specific regression parameters were determined on a path-by-path basis using z-tests corrected for the number of comparisons. Patients with the chronic pain and addiction comorbidity had increased connection strengths; many of these connections were interhemispheric and spanned regions involved in sensory, affective, and cognitive processes. The affected regions included those that are commonly altered in chronic pain or addiction alone, indicating that this comorbidity manifests with neurological symptoms of both disorders. Understanding the neural mechanisms involved in the comorbidity is crucial to finding a comprehensive treatment, rather than treating the symptoms individually. (shrink)

Introduction: Schools have become a primary setting for providing mental health care to youths in the U.S. School-based interventions have proliferated, but their effects on mental health and academic outcomes remain understudied. In this study we will implement and evaluate the effects of a flexible multidiagnostic treatment called Modular Approach to Therapy for Children with Anxiety, Depression, Trauma, or Conduct Problems on students' mental health and academic outcomes.Methods and Analysis: This is an assessor-blind randomized controlled effectiveness trial conducted across five (...) school districts. School clinicians are randomized to either MATCH or usual care treatment conditions. The target sample includes 168 youths referred for mental health services and presenting with elevated symptoms of anxiety, depression, trauma, and/or conduct problems. Clinicians randomly assigned to MATCH or UC treat the youths who are assigned to them through normal school referral procedures. The project will evaluate the effectiveness of MATCH compared to UC on youths' mental health and school related outcomes and assess whether changes in school outcomes are mediated by changes in youth mental health.Ethics and Dissemination: This study was approved by the Harvard University Institutional Review Board. We plan to publish the findings in peer-reviewed journals and present them at academic conferences.Clinical Trial Registration:ClinicalTrials.gov ID: NCT02877875. Registered on August 24, 2016. (shrink)

A critical and constructive discussion of philosophical questions which have particular bearing on the formulation of educational aims.

This volume critically and constructively discusses philosophical questions which have particular bearing on the formulation of educational aims. The book is divided into three major parts: the first deals with the nature of education, and discusses the various general aims, such as 'mental health', 'socialization' and 'creativity' which have been thought to characterize it; the second section is concerned with the nature of reason and its relationship to feeling, will and action; finally the development of different aspects of reason in (...) an educational context is considered. (shrink)

In the autumn of 1912, C. G. Jung, then president of the International Psychoanalytic Association, set out his critique and reformulation of the theory of psychoanalysis in a series of lectures in New York, ideas that were to prove unacceptable to Freud, thus creating a schism in the Freudian school. Jung challenged Freud's understandings of sexuality, the origins of neuroses, dream interpretation, and the unconscious, and Jung also became the first to argue that every analyst should themselves be analyzed. Seen (...) in the light of the subsequent reception and development of psychoanalysis, Jung's critiques appear to be strikingly prescient, while also laying the basis for his own school of analytical psychology. This volume of Jung's lectures includes an introduction by Sonu Shamdasani, Philemon Professor of Jung History at University College London, and editor of Jung's Red Book. (shrink)

The treatment decisions of competent adults, especially treatment refusals, are generally respected. In the case of minors something turns on their age, and older minors ought increasingly to make their own decisions. On the other hand, parents decide on behalf of infants and young children. Their right to do so can best be justified in terms of the importance of preserving intimate family relationships, rather than in terms of the child's best interests, although the child's best interests will most often (...) follow from this arrangement. Nevertheless, there are and ought to be legal, ethical, and financial constraints on parental decision making. (shrink)

The density matrix ρ describing a decaying system can be expressed in terms of correlations among observables belonging to the subsystems. Due to this structure and to the difficulties in measuring higher rank tensors of decay products for a single decay event, it is found that the mean value of ρ cannot be determined, in general, from measurements on the decay products. We also discuss the consequences of this conclusion as far as tests of quantum mechanics are concerned.

Objectives Prompt Mental Health Care (PMHC) is the Norwegian version of the England’s Improving Access to Psychological Therapies (IAPT). Both programs have been associated with substantial symptom reductions from pre- to post-treatment. The present study extends these findings by investigating symptom levels at 12 months post-treatment, as well as treatment outcome in relation to low- vs. high-intensity treatment forms. Design and Outcome Measures A prospective cohort design was used. All participants ( n = 1530) were asked to complete the Patient (...) Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 questionnaire (GAD-7) at baseline, before each session during treatment, at final treatment, and at 12 months post-treatment. Cohen’s d was used as effect size measure. Sensitivity analyses were conducted to examine the impact of the high missing data rates at post-treatment (≈44%) and 12 months post-treatment (≈58%). Results A large symptom reduction was seen from baseline to 12 months post-treatment for both PHQ ( d = −0.98) and GAD ( d = −0.94). Improvements observed at post-treatment were largely maintained at 12 months post-treatment (PHQ (Δ d = 0.10) and GAD (Δ d = 0.09). Recovery rates decreased only slightly from 49.5% at post-treatment to 45.0% at follow-up. Both low- and high-intensity treatment forms were associated with substantial and lasting symptoms reductions (−1.26 ≤ d ≤ −0.73). Sensitivity analyses did not substantially alter the main results. Conclusion The findings suggest long-lasting effects of the PMHC program and encourage the use of low-intensity treatment forms in PMHC like settings. (shrink)

The concept of neutrosophic locally compact and neutrosophic compact open topology are introduced and some interesting propositions are discussed.

The "perspectivism" of the late Dr. McGilvary's 1939 Carus Lectures has two moments. On the one hand it is an examination of the implications of physical relativity for epistemology. In this area McGilvary is at his best--particularly in clearing up misunderstandings of Einstein. But perspectivism is also a revival of the "man the measure" doctrine, and this has less happy results. Viewing the philosopher's task as the making clear of his own postulates, McGilvary is led to beg many of the (...) questions one would like to see him discuss. If a philosophy is put forward postulationally and is to be more than an abstract schema, it must be formulated positively and it must be applied at every opportunity. Perspectivism does not meet either test very well.--R. F. T. (shrink)

John Stuart Mill's Utilitarianism continues to serve as a rich source of moral and theoretical insight. This collection of articles by top scholars offers fresh interpretations of Mill's ideas about happiness, moral obligation, justice, and rights. Applying contemporary philosophical insights, the articles challenge the conventional readings of Mill, and, in the process, contribute to a deeper understanding of utilitarian theory as well as the complexity of moral life.

Gender equality continues to be important because it strengthens society. One of the efforts to promote gender equality in Indonesia is gender equality education. For Catholics in Indonesia, the existence of the 2013 Curriculum Ethics and Catholic Education (PAK Kurtilas) had a strategic role in mainstreaming gender equality education. This research used library sources to research these textbooks with adequate ethical and multicultural analysis. Here, information was conveyed through a qualitative approach through annotations and descriptive data on the texts studied. (...) According to this study, the curriculum offers instructional materials on the value of gender equality in intercultural education, which used the critical discourse analysis (CDA) technique. The textbook analysis also recommended using gender-responsive learning approaches and methods so that students could comprehensively understand the material on gender equality.Contribution: This article uses a textual analysis with a religious socio-ethical viewpoint. This study could help to solve social problems through theological education. (shrink)

Background:Researchers study climate to gain an understanding of the psychological environment of organizations, especially in healthcare institutions. Climate is considered to be the set of recurring patterns of individual and group behaviour in an organization. There is evidence confirming a relationship between ethical climate within organizations and job satisfaction. Objectives: The aim of this study is to describe organizational climate for nursing personnel in public and private hospitals and to confirm the relationships among the climate variables of such hospitals. Materials (...) and methods: A correlational study was carried out to measure the organizational climate of one public hospital and two private hospitals in Granada. The Work Environment Scale was used for data collection. The Work Environment Scale includes 10 scales, ranging from 0 to 9, which were used to evaluate social, demographic and organizational climate variables. In this study, 386 subjects were surveyed in three hospitals. Results: A total of 87% of the participants were female and 16% were male. Most participants were nurses (65.6%), followed by nursing aides (20%), and technicians (14.4%). The results obtained reflected different patterns of organizational climate formation, based on hospital type (i.e. public or private) within the Spanish context. Most of the dimensions were below the midpoint of the scale. Discussion and conclusions: In conclusion, in public hospitals, there is a greater specialization and the organizational climate is more salient than in the private hospitals. In addition, in the public hospitals, the characteristics of the human resources and their management can have a significant impact on the perception of the climate, which gives greater importance to the organizational climate as decisive of the ethical climate. (shrink)