Nevillevelling8720
Cognitive behavioral therapy (CBT) has received considerable empirical support for internalizing disorders including anxiety, depression, obsessive-compulsive disorder, and post-traumatic stress disorder in children and adolescents. However, there is less knowledge regarding how CBT performs when delivered in routine clinical care. A systematic review and meta-analysis was conducted of CBT for internalizing disorders in children and adolescents in routine clinical care. Ovid MEDLINE, Embase OVID, and PsycINFO were systematically searched for articles published until October 2019. The effectiveness of CBT, methodological quality, and moderators of treatment outcome were examined. The effects of CBT in routine clinical care were benchmarked by comparing with efficacy studies for the same disorders. Fifty-eight studies were included, comprising 4618 participants. Tacrolimus chemical structure Large effect sizes for outcome were detected at post-treatment (g = 1.28-2.54), and follow-up (g = 1.72-3.36). Remission rates across diagnoses ranged from 50.7% - 77.4% post-treatment, to 53.5% -83.3% at follow-up. Attrition rate across the disorders was 12.2%. Quality of the included studies was fair, and heterogeneity was high. Similarities between the effectiveness and efficacy studies were greater than the differences in outcome. CBT delivered in routine clinical care is efficacious in reducing internalizing disorders and symptoms. The outcomes are comparable with results obtained in efficacy studies. PROSPERO registration ID CRD42019128709.In the past decade, millions of children and adolescents have been forced to flee from protracted or newly erupted violent conflicts. Forcibly displaced children are particularly vulnerable for developing mental health problems. However, a timely and systematic review of the current evidence is lacking. We conducted a systematic review of factors contributing to the mental health of refugee children across different socio-ecological levels (individual, family, community, sociocultural). We systematically searched the databases Medline, PsycINFO, Web of Science, and Cochrane for English studies published in peer-reviewed journals between August 2010 and May 2020. Of the 2413 identified studies, 63 were included in the analyses. Only 24 studies were considered to be of high quality. Pre-migration individual (risk exposure to war-related trauma, female gender) and post-migration family factors (risk parental mental health problems and impaired parenting, protective family cohesion) currently have the best evidence base. Post-migration community (protective school connectedness, support by peers) and sociocultural factors (risk discrimination and acculturative stress, protective integrative acculturation) have gained some support in high-income settings. Prevention and intervention approaches should integrate factors across different socio-ecological levels. More longitudinal studies and research in low- and middle-income countries are needed to advance our knowledge on causal mechanisms behind factors contributing to refugee youth's mental health.
We aimed to evaluate the efficacy of vaginal disinfection using 10 % povidone-iodine on rates of endometritis from post-caesarean infectious diseases before elective caesarean section (CS).
A total of 270 pregnant women who chose to undergo elective CS were recruited for this prospective randomised controlled study. The experimental group comprised 130 patients who had preoperatively undergone vaginal disinfection with 10 % povidone-iodine for 30 s. The control group consisted of 140 patients who had not undergone any vaginal implication before CS. The primary outcome measure was the rate of postpartum endometritis for each group. Intraoperatively, all patients who had closed uterine cervical canals underwent a digital opening of the internal and external cervical canal to equalise the groups. All of the participants were checked for endometritis one week after CS at the hospital. Additionally, for the week before and after surgery, C-reactive protein (CRP) and white blood cell (WBC) values were assessed reduce post-caesarean endometritis rates; however, it does significantly reduce inflammatory markers such as CRP and WBC.
The Laparoscopic Approach to Cervical Cancer (LACC) trial recently showed a significant inferiority of the minimally invasive surgery when we considered them both equivalent in the treatment of cervical cancer. The objective of this article is to describe and discuss the interest of the Schautheim procedure.
The Schautheim is the association of a radical hysterectomy by laparoscopy/robot assisted or not as described by Wertheim after a primary vaginal closure, like the first step of Schauta's hysterectomy. This technique is described in ten steps, with a video material.
The return to open surgery could lead to a loss of benefits associated with the laparoscopic approach in terms of per and post-operative morbidity. One way to achieve similar results would be to prohibit the use of uterine manipulators and create a vaginal cuff.
Several authors suggest that early-stage cervical cancer patients could still be operated by laparoscopy without reducing overall survival or increasing risk of recurrence if certain measures are followed.
Several authors suggest that early-stage cervical cancer patients could still be operated by laparoscopy without reducing overall survival or increasing risk of recurrence if certain measures are followed.
To evaluate the effect of a 10 mg per day 12 week treatment of ulipristal acetate (UPA) on abnormal uterine bleeding due to adenomyosis.
A double-blind phase 2 randomized controlled pilot study.
From May 2015 to February 2018 in five teaching hospitals.
Premenopausal women with abnormal uterine bleeding (with a pictorial blood loss assessment score (PBAC) higher than 100 at inclusion) and a sonographic or MRI diagnosis of adenomyosis.
After random allocation, either UPA 10 mg or placebo were orally administered during 12 weeks. A 31 ratio was used.
The primary outcome was the rate of women with a PBAC score of less than 75 as evaluated over the 28 days following the 12-week treatment. Secondary outcomes included rate of amenorrhea, evolution of pain, quality of life and tolerance.
Thirty women were included in the UPA group and 10 in the placebo group. No woman in the placebo group versus 95.24 % of women in the UPA group had a PBAC score under 75 during the 28 day period following the 12-week treatment (p < 0.