Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 6 Articles
Background: Up to 60% of children with Attention-Deficit/Hyperactivity Disorder (ADHD) meet diagnostic criteria\nfor at least one anxiety disorder, including Social, Generalized and/or Separation Disorder. Anxiety in children with\nADHD has been shown to be associated with poorer child and family functioning. Small pilot studies suggest that\ntreating anxiety in children with ADHD using cognitive-behavioral therapy (CBT) has promising benefits. In a fully\npowered randomized controlled trial (RCT), we aim to investigate the efficacy of an existing CBT intervention\nadapted for children with ADHD and comorbid anxiety compared with usual care.\nMethods: This RCT is recruiting children aged 8â??12 years (N = 228) from pediatrician practices in Victoria, Australia.\nEligibility criteria include meeting full diagnostic criteria for ADHD and at least one anxiety disorder (Generalized,\nSeparation or Social). Eligible children are randomized to receive a 10 session CBT intervention (Cool Kids) versus\nusual clinical care from their pediatrician. The intervention focuses on building child and parent skills and strategies\nto manage anxiety and associated impairments including cognitive restructuring and graded exposure. Minor\nadaptations have been made to the delivery of the intervention to meet the needs of children with ADHD\nincluding increased use of visual materials and breaks between activities. The primary outcome is change in the\nproportion of children meeting diagnostic criteria for an anxiety disorder at 5 months randomization. This will be\nassessed via diagnostic interview with the childâ??s parent (Anxiety Disorders Interview Schedule for Children V)\nconducted by a researcher blinded to intervention condition. Secondary outcomes include a range of child\n(e.g., anxiety symptoms, ADHD severity, behavior, quality of life, sleep, cognitive functioning, school attendance) and\nparent (e.g., mental health, parenting behaviors, work attendance) domains of functioning assessed at 5 and 12\nmonths post-randomization. Outcomes will be analyzed using logistic and mixed effects regression....
Background: China has the worldâ??s largest aging population and the number of empty-nest older adults is on the\nrise. In comparison to the aging population in general, empty-nest older adults have a lower level of subjective\nwell-being and poorer mental health status due to a lack of emotional support from their children. The aim of this\nstudy is to conduct an empirical study to evaluate the efficacy of the â??Path-oriented Psychological Self-help\nInterventionâ?? (P-oPSI) led by nurses on the mental health of empty-nest older adults in the community, to provide a\nscientific foundation for improving their quality of life.\nMethods: A Quasi-Experimental controlled intervention study was conducted from 2015 to 2017.\nA total of 76 empty-nest older adults from 2 districts were recruited using a convenience sampling and assigned to\n2 groups based on their residential communities in the city of Chifeng in the Inner Mongolia Autonomous Region,\nChina. The wait list control group participated in a mental health lecture to gain knowledge and learn techniques\nof mental health promotion. The intervention group additionally received 1 month of training in a nurse-led â??P-oPSIâ??\nfor a month. Both groups were followed-up for 3 months. Mental health status, coping styles, and psychological\nself-help ability of the participating empty nest older adults were assessed at the baseline, 1 month, and 3-months\nfollow up, respectively. Two-way analysis of variance and a simple effect test were used to analyse the differences\nof the two groups.\nResults: The P-oPSI yielded a greater benefit for the mental health status, coping styles, and psychological self-help\nability of the participants in the intervention group. Combined with a simple effect test, the scores of the mental\nhealth status, positive coping style, and psychological self-help ability of those in the intervention group significantly increased at 1 month after the baseline (F mental health status = 7.59, F positive coping F psychological\nself-help ability = 7.07); and the sustainable effect of this program lasted for 3 months after the intervention (F mental health status = 13.24, F positive coping F psychological self-help ability = 10.45), which reached statistical significance\n(P < 0.01).\nConclusions: The P-oPSI program significantly improved the level of mental health of empty-nest older adults in\nChina. This intervention provides a new approach of self-management to improve mental health of older adults in\ncommunity settings....
Background: Peer-delivered services potentially provide broad, multifaceted benefits for persons suffering severe\nmental illness. Most studies to date have been conducted in countries with well-developed outpatient mental\nhealth systems. The objective of this study was to examine the feasibility for developing a community-based peer\nservice in China.\nMethods: Thirteen peer service providers and 54 consumers were recruited from four communities in Beijing. We\ninitiated the program in two communities, followed by another two in order to verify and add to our\nunderstanding of potential scalable feasibility. Semi-structured face-to-face interviews were conducted 12 month\nafter initiation at each site to measure satisfaction and perceived benefits from perspectives of peer service\nproviders, and consumers and their caregivers.\nResults: Key stakeholders reported that peer support services were satisfying and beneficial. Eleven of 13 peer\nservice providers were willing to continue in their roles. Ten, 8, and 7 of them perceived improvements in working\nskills, social communication skills, and mood, respectively. Among consumers, 39 of 54 were satisfied with peer\nservices. Improvements in mood, social communication skills, illness knowledge, and illness stability were detected\namong 23, 18, 13, and 13 consumers, respectively. For caregivers, 31 of 32 expressed a positive view regarding peer\nservices. Caregivers reported improvement in their own mood, confidence in recovery of their family members, and\nreduction in caretaker burdens.\nConclusions: The findings highlight that peer-delivered services have promise in China for benefiting persons with\nsevere mental illness and their family caregivers, as well as the peer service providers themselves....
Objective: To evaluate the factors affecting the surgical outcome of traumatic\nintracranial hematoma. Patient and Methods: This study was retrospectively\nconducted on 60 patients with traumatic intracranial hematoma admitted to\nthe Neurosurgery Department, Al-Azhar University Hospital and underwent\nsurgical management. Results: The age range was 10 - 58 years, mean age was\n31.50 years, male-to-female ratio was 3:1. The causative trauma was road traffic\naccident (45%), direct trauma to the head (30%) and fall from height\n(FFH) (25%) of all studied patients. Morbidity and/or mortality was reported\nin 38.3% and unfavorable outcome was significantly associated with longer\ndelay time (time from injury to surgery), increased operative time, long duration\nof hospital stay and lower Glasgow coma scale at admission and discharge.\nOtherwise, the unfavorable outcome although increased with old age,\nthere was no significant association. Conclusion: Head trauma is considered\nas a frequent cause of death and disability. Time consuming to reach the hospital,\noperative time, length of stay in hospital and Glasgow coma score of the\npatient on admission and discharge markedly determine the surgical outcome\nof traumatic intracranial hematoma....
Introduction: The exact pathophysiology of spontaneous CSF rhinorrhea is\nnot always understood in some patients. Idiopathic intracranial hypertension\n(IIH) is now recognized as one of the causes of spontaneous CSF leak in the\nneurosurgical and ENT literature. Our aim was to set a management protocol\nfor such cases according to the same setting intracranial tension (ICT). Methods:\nWe prospectively managed patients with spontaneous CSF rhinorrhea\nwho were admitted to our hospital between 1st of January 2014 and 31st of\nDecember 2017 with a prespecified treatment algorithm. Patients with a history\nof previous cranial or nasal surgery, trauma, skull base congenital malformations\nwere excluded from the study. The patientâ??s demographics, clinical\ndata, comorbidities, body mass index (BMI), first time or recurrent leakage\nand duration of the leak were collected. ..............................
Introduction: Tumors of the central nervous system are the most common\ngroup of solid neoplasm in children and account for 20% to 25%. They are\ncommon in Sub-Saharan countries, despite the insufficiency of histological\ndiagnosis. No study has been performed concerning the pediatric brain tumors\nin the Republic of Congo. The aim of this study was to describe the\nconditions of neurosurgical management of pediatric tumors in Brazzaville.\nMaterials and Methods: We performed a retrospective and descriptive\nstudy, from January 2014 to December 2017 (48 months), into the neurological\nunit of the surgical department of Brazzaville. We included all patients\naged from 17 years old and below, hospitalized for a brain tumor. Results:\nWe have identified 11 cases of brain tumors. The average age was 8.1 ± 4.3\nyears old, a sex ratio of 0.57. Ten out of the eleven patients of our series have\nintracranial hypertension. We found six cases of infratentorial tumors and\nfive of supratentorial location. Only three cases had histology. Ten patients\nwere operated, limited by ventriculoperitoneal shunt in 6 cases, surgical resection\nin three cases, biopsy in one case. There were no possibilities of radiotherapy\nand chemotherapy during this period of study. Conclusion: A multidisciplinary\nteam must be organized to improve the management of pediatric\nbrain tumors in our context. Histological diagnosis and possibilities of\nradiotherapy are imperatively needed....
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