La terapia con perros mejora la autoestima en adolescentes con anorexia

El Hospital Infantil Universitario Niño Jesús de Madrid ha llevado a cabo un estudio pionero en España sobre los efectos de las intervenciones asistidas con animales para adolescentes con anorexia y bulimia nerviosa que ha detectado mejoras y aumentos en la autoestima de los pacientes. La iniciativa, que ha contado con la colaboración de la Universidad Rey Juan Carlos y PURINA, se llevó a cabo con 17 adolescentes de entre 13 y 17 años, con el objetivo de investigar los beneficios que los perros de terapia brindan a jóvenes con trastornos de la conducta alimentaria (TAC). Los TAC afectan en España a casi 200.000 menores, y un 20 % de ellos podrían convertirse en enfermos crónicos. Los resultados preliminares del estudio señalan que las emociones agradables suben 46 puntos en los momentos posteriores a las sesiones, pasando del 16 % del inicio al 62 % del final de las mismas. Disminuyen, también, los niveles de ansiedad y depresión de los pacientes y las emociones desagradables se reducen 43 puntos entre el momento previo de la sesión (47 %) y el posterior (4 %). Además, se han observado mejoras en el funcionamiento psicosocial de los menores, con aumentos en su autonomía y en sus niveles de responsabilidad. En el estudio han participado los 17 adolescentes, repartidos en dos grupos, que siguen su tratamiento en la Unidad de Trastornos de la Conducta Alimentaria (UTCA) del hospital. Ha constado de 18 sesiones de frecuencia semanal de 50 minutos, llevadas a cabo durante marzo de 2018 y mayo de 2019. Cada semana, se contó con un psicólogo y dos técnicos, todos ellos expertos en intervención asistida con animales, y dos perros. Durante las sesiones, los adolescentes realizaron diversas dinámicas con los animales, para trabajar sobre su ansiedad, su autoestima o su autonomía. A medida que pasaban las sesiones, el protagonismo de los perros decaía, con el fin de generalizar las habilidades entrenadas. Según la jefa del servicio de psiquiatría y psicología del Hospital Niño Jesús, la doctora Montserrat Graell, «estas conclusiones preliminares nos ayudan a saber que vamos por el camino correcto y que debemos de seguir recorriéndolo para ayudar a más jóvenes». Aunque admite que «aún es necesario mejorar la eficacia de los tratamientos e implementar nuevas intervenciones para nuevos diagnósticos como los trastornos por atracón y trastorno por evitación y restricción de la ingesta, mejorar las técnicas de psicoterapia, analizar el papel de la neurociencia en el tratamiento y explorar la intervención de los agentes sociales».
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Twenty percent of independent bookstores across the country are in danger of closing, the ABA says. Between mid-April and June, the Book Industry Charitable Foundation (BINC) distributed $2.7 million to store owners in need. “That equals the distribution that we had had in the previous eight years,” said executive director Pamela French. The individual grants it gives out have increased 443 percent over last year. The level of need has subsided somewhat since the peak of the pandemic, but it’s remained consistently elevated, even with many stores now open. A number of bookstores shut their doors voluntarily before any government lockdowns were imposed. “We were one of the first places in our town to close down,” said Suedee Hall-Elkins, manager of Dickson Street Bookshop in Fayetteville, Arkansas. Her store’s aisles are very narrow, so they felt the need to close “for morally responsible reasons.” Closing off browsing meant a seismic shift in bookstore business models. Kris Kleindienst’s shelves at Left Bank Books in St. Louis, Missouri, were fully stocked with newly released books in March. “All of a sudden, they just became décor,” she said. Still, owners pivoted as quickly as they could. “These independent bookstore owners are just tenacious,” French said. Owners suddenly found themselves arranging curbside pickups, shipping thousands of online orders, and staging completely virtual events. Many factors boosted sales just when stores needed them. Customers flooded online ordering systems, many in the hope of helping their local stores, others simply desperate for something to read during lockdown. Amazon started prioritizing essential goods over things like books, giving an edge to independent stores. Annie Philbrick’s online orders at Bank Square Books in Mystic, Connecticut, and Savoy Bookshop & Café in Westerly, Rhode Island, are about 10 times what they were each year for the past five. 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View this post on Instagram A post shared by Powell's Books (@powellsbooks) on Oct 6, 2020 at 12:30pm PDT Philbrick took it upon herself to pick up books from her two stores and drive them to customers’ homes. “I was a UPS driver for a month or so,” she said. She would hang bags of books on their doors, ring the bell, and walk back to her car. She even drove an hour and a half out of town to bring books to a couple who would leave her snack bags in thanks. “That was a pleasure,” she said. In many ways, online ordering is the antithesis of what independent bookstores are. “We are a community space that thrived with that in-person, face-to-face conversation about ideas and literature,” said Hilary Gustafson, owner of Literati Bookstore in Ann Arbor, Michigan. Her store typically stages 300 events a year, and the in-store ones pack 50 people “elbow to elbow,” she said. Now, she’s been entirely focused on online orders, which requires “10 times as much work for a sale of one book.” Stores like Gustafson’s quickly moved their programming — author events, book clubs, classes — to online platforms. But it’s a difficult and often money-losing way to do them. Stores typically make money from free events when people buy books, often getting them autographed. Online, it’s different. “Sales are down even though audience levels are, in some cases, up,” Graham said. Readers also now have a vast array of stores’ events to choose from because they’re all online. “The competition has just become fierce,” Philbrick said. Despite the many hurdles small-business owners faced in getting PPP loans, all of the stores I spoke to were able to secure loans, and the money was vital. “The thing that got us this far and avoided bankruptcy was the PPP money,” said Bradley Graham, co-owner of Politics and Prose in Washington, DC. Even so, it was gone within a couple of months. Other money came from unexpected places. Philbrick got $5,000 from Spanx, which was offering grants to women-owned businesses. That, she said, was a turning point of sorts, when she realized that not only would she have a cushion to get through, but “we’re all in this together trying to figure this out.” Some customers even gave their local bookstores donations in the hope of keeping them alive. Gustafson’s store launched a GoFundMe, which was a “lifeline,” she said. She raised more there than she got in PPP money. But at this point, most of the money has dried up. “Given the current level of economic activity, it’s not realistic to think that bookstores or other retail businesses can, on their own, make a go of it,” Graham said with a heavy sigh. “More federal assistance is needed so long as the pandemic persists.” “We want to survive, so it’s like, ‘How do we make this work?’” Some stores are doing as well as they would otherwise expect thanks to loyal customers and a thirst for books as people stay closer to home. But those factors aren’t making the numbers work for everyone. Vroman’s, which bills itself as the oldest and largest independent bookstore in Southern California, has warned that without a significant increase in sales, its 126-year tenure will come to a close. Powell’s has exhausted its PPP loan and isn’t making enough in sales to support the business. Politics & Prose is still not breaking even, and the store will need to make enough in the next few months to have a cushion headed into 2021. “It’s not a sustainable position to continue to operate in the red,” Graham said. Laughing, he added, “You don’t need a degree in anything to understand that fact.” A number of stores have opened their doors simply to remain as financially solvent as possible. When we spoke, Gustafson was preparing to open with limited hours and days. “Our rent is still due and we still have payables,” she said. “We want to survive, so it’s like, ‘How do we make this work?’” “We face this tension between the need to welcome in more customers for the holiday shopping season in order to at least get back in the black,” Graham said, “while at the same time being very careful not to create a public health hazard.” Public health has been at the forefront of the minds of owners who have reopened as fully as possible. All stores have reduced their hours as well as their capacity. Everyone has installed Plexiglas barriers at cash registers and hand sanitizing stations throughout their stores. There’s crowd control not just to limit the number of shoppers but to ensure that masks are worn correctly. Many stores have rearranged their layouts so customers don’t have to squeeze by each other in tight aisles. Hall-Elkins went even further, installing UV lights and ionizing cleaners in all three of her HVAC units, putting fans around the store, and keeping the door open as much as possible to better ventilate. She replaced her old carpets and installed touchless credit card systems. ANGELA WEISS/AFP via Getty Images Books Are Magic in Brooklyn, New York, in May 2020, before reopening at limited capacity. Owners have found themselves in entirely new roles, worried not just about their business’s finances but the health of their employees, their customers, and their own families. Hall-Elkins finds herself up late reading medical articles. “I’m in a heightened state of anxiety for sure,” she said. Laughing, she added, “I feel responsible for everybody’s life, and that’s a really weird thing to feel as a manager of a bookstore.” Some have kept their doors closed. When we spoke in the first week of October, Kleindienst said she was planning to open that weekend by appointment and only after 6 pm. “Our staff really did not feel like they wanted people to be just walking in off the street and wandering around,” she explained. “It just didn’t seem like it was worth risking our lives.” She’s hoping that allowing a very select group of customers back in will be enough to keep the store afloat. But, she added, “I don’t see us opening the doors to walk-in traffic for quite a while.” The holiday season will be crucial. Nearly every bookstore owner mentioned how important the season is normally — and therefore what it will mean now. Graham said the store typically makes anywhere from a quarter to a third of the whole year’s sales in December alone. “It’s an absolutely critical period.” To help stores that need to see high sales without big crowds, the American Booksellers Association has begun a campaign urging consumers to shop early called “October Is the New December.” Other things will have to change, too. Normally, Salardino’s store offers gift-wrapping for a fee, and he’d have a long line of people waiting to have books wrapped. That’s not possible now. One book could make or break the future for many stores: The first volume of President Barack Obama’s memoir will be released November 17. Not only is it destined to be a bestseller — the publisher ordered a first printing of 3 million copies — but it’s pricey, coming in at $45. “I literally think that that book is going to save a lot of stores,” Fusco-Straub said. His store will be ordering a whole pallet. The future, of course, remains completely uncertain. It’s difficult just to plan ahead. Philbrick noted she’s ordering paperback copies of hardcover books that she struggled to sell during the shutdown, which means the data she typically relies on to predict future sales are almost useless. “As a business person, we’re all used to being able to forecast,” Powell said. But now, “we can’t see beyond a 30-day time horizon.” “Books aren’t … groceries or rent. How much will people be willing to come out to our stores?” Hall-Elkins worries that a virus spike or just cold weather will keep people home from holiday shopping. Then there’s what could happen with the election or the economy. The immediate pandemic-caused contraction appears to be turning into a full-blown recession. “We don’t know how much folks will be able to shop,” Powell noted. “Books aren’t ... groceries or rent. How much will people be willing to come out to our stores?” Few owners were willing to contemplate what another complete shutdown would mean. “I don’t even know what we would do,” Hall-Elkins said. “We would probably be in pretty big trouble.” Losing an independent bookstore is a huge blow to a community. “These are places where folks can come together to discuss what’s going on in the world, to also have a safe haven and a safe place for exploring new ideas,” French said. Bookstores “provide everything from sanctuary to just meditative spaces.” And they help keep an economy humming, retaining money in the local community and generating jobs and tax revenue. Still, independent bookstores have been through a lot, including competition from big chains and Amazon. “People have been predicting the end of indie bookstores since the Great Depression,” said Kate Weiss, programs manager at BINC. Even with a pandemic, 30 bookstores have opened this year so far, although that’s still a far cry from the 104 that opened in 2019. “We’re a stalwart bunch,” Philbrick said. “We’re just going to keep going. We’re not dead.” Help keep Vox free for all Millions turn to Vox each month to understand what’s happening in the news, from the coronavirus crisis to a racial reckoning to what is, quite possibly, the most consequential presidential election of our lifetimes. Our mission has never been more vital than it is in this moment: to empower you through understanding. But our distinctive brand of explanatory journalism takes resources. Even when the economy and the news advertising market recovers, your support will be a critical part of sustaining our resource-intensive work. If you have already contributed, thank you. If you haven’t, please consider helping everyone make sense of an increasingly chaotic world: Contribute today from as little as $3.
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