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To examine the two-year outcomes for depression, anxiety, cognitive and global social functioning after cognitive behavioural therapy (CBT) and metacognitive therapy (MCT) for depression.
Participants were 31 adults with a diagnosis of major depressive disorder in a randomised pilot study comparing MCT and CBT. Therapy modality differences in change in depression and anxiety symptoms, dysfunctional attitudes, metacognitions, rumination, worry and global social functioning were examined at the two-year follow-up for those who completed therapy.
Significant improvements, with large effect sizes, were evident for all outcome variables. There were no significant differences in outcome between CBT and MCT. The greatest change over time occurred for depression and anxiety. Large changes were evident for metacognitions, rumination, dysfunctional attitudes, worry and global social functioning. Sixty-seven percent had not experienced a major depression and had been well during all of the past year, prior to the e status.
Persistence is said to be a feature of personality disorder, but there are few long-term prospective studies of the condition. A total of 200 patients with anxiety and depressive disorders involved in a randomised controlled trial initiated in 1983 had full personality status assessed at baseline. We repeated assessment of personality status on three subsequent occasions over 30 years.
Personality status was recorded using methods derived from the Personality Assessment Schedule, which has algorithms for allocating Diagnostic and Statistical Manual of Mental Disorders (DSM) and the 11th International Classification of Diseases (ICD-11) categories. The category and severity of personality diagnosis were recorded at baseline in the randomised patients with DSM-III anxiety and depressive diagnoses. The same methods of assessing personality status was repeated at 2, 12 and 30 years after baseline.
Using the ICD-11 system, 47% of patients, mainly those with no personality disturbance at baseline, retained ths in frequency as people age.
Only a small proportion of individuals with an eating disorder will receive targeted treatment for their illness. The aim of this study was to examine the length of delay to treatment-seeking and determine the barriers preventing earlier access and utilisation of eating disorder treatment for each diagnostic group - anorexia nervosa, bulimia nervosa, binge eating disorder and other specified feeding or eating disorder.
Participants were recruited as part of the TrEAT multi-phase consortium study. One hundred and nineteen Australians (13-60 years; 96.9% female) with eating disorders currently accessing outpatient treatment for their illness completed an online survey comprised of self-report measures of eating disorder severity, treatment delay and perceived barriers to treatment-seeking. The treating clinician for each participant also provided additional information (e.g. body mass index and diagnosis).
Overall, the average length of delay between onset of eating disorder symptoms and treatment-seekingired to investigate other factors contributing to this delay.
Family caregivers often experience guilt after nursing home placement. The aim of the present study was to describe family caregivers' guilt over time and assess the impact of conflicts with staff and satisfaction with care on guilt.
Data of 222 family caregivers at three assessments during one-year follow-up were used. In addition to caregivers' guilt and the variables conflicts with staff and satisfaction with the care, potential confounders were measured sociodemographic data, clinical characteristics of the person with dementia, and caregiver burden. Linear mixed model analyses were performed to examine the longitudinal relationships between variables.
Guilt remained stable over time. Unadjusted models showed that conflicts with staff were positively associated with guilt (
= 0.11;
< 0.001; 95% CI 0.06 to 0.16) and satisfaction with care showed a negative association with guilt (
= -0.10;
< 0.05; 95% CI -0.18 to -0.01). After adjusting for the confounders, only the positive association of guilt with conflicts with staff was similar as in the unadjusted analysis (
= 0.11;
< 0.001; 95% CI 0.05 to 0.16), whereas satisfaction with care was not significantly associated with guilt in the adjusted analyses (
= -0.07;
= 0.10; 95% CI -0.16 to 0.01).
More conflicts with staff are associated with stronger guilt feelings. Guilt feelings are experienced by caregivers even after the admission of the person with dementia, and they remain stable over time. Further studies should focus on how to address guilt in family caregivers of people with dementia living in nursing homes.
More conflicts with staff are associated with stronger guilt feelings. Guilt feelings are experienced by caregivers even after the admission of the person with dementia, and they remain stable over time. Further studies should focus on how to address guilt in family caregivers of people with dementia living in nursing homes.The evidence on whether high-dose new generation proton pump inhibitors (PPIs) including rabeprazole and esomeprazole achieve a higher eradication rate of Helicobacter pylori has not been assessed. The primary comparison was eradication and adverse events (AEs) rate of standard (esomeprazole 20 mg bid, rabeprazole 10 mg bid) versus high-dose (esomeprazole 40 mg bid, rabeprazole 20 mg bid) PPIs. Sub-analyses were performed to evaluate the eradication rate between Asians and Caucasians, clarithromycin-resistance (CAM-R) strains, and clarithromycin-sensitivity (CAM-S) strains of different dose PPIs. We conducted a literature search for randomized controlled trials comparing high-with standard-dose esomeprazole and rabeprazole for H. pylori eradication and AEs. A total of 12 trials with 2237 patients were included. The eradication rate of high-dose PPIs was not significantly superior to standard-dose PPIs regimens 85.3% versus 84.2%, OR 1.09 (0.86-1.37), P = 0.47. The high dose induced more AEs than those of the standard dose, but didn't reach statistical significance (OR 1.25, 95% CI 0.99-1.56, P = 0.06). Subgroup analysis showed that the difference in eradication rate of PPIs between high- and standard-dose groups were not statistically significant both in Asians (OR 0.99, 95% CI 0.75-1.32, P = 0.97) and Caucasians (OR 1.27, 95% CI 0.84-1.92, P = 0.26). Furthermore, there were similar eradication rates in CAM-S (OR 1.2; 95% CI 0.58-2.5; P = 0.63) and CAM-R strains (OR 1.08; 95% CI 0.45-2.56; P = 0.87) between the standard-and high-dose groups. High and standard dosages of new generation of the PPIs showed similar H. pylori eradication rates and AEs as well as between Asian versus Caucasian populations, with or without clarithromycin-resistance. However, further studies are needed to confirm.
Identifying women at risk of depression and anxiety during pregnancy provides an opportunity to improve health outcomes for women and their children. One barrier to screening is the availability of validated measures in the woman's language. Afghanistan is one of the largest source countries for refugees yet there is no validated measure in Dari to screen for symptoms of perinatal depression and anxiety. The aim of this study was to assess the screening properties of a Dari translation of the Edinburgh Postnatal Depression Scale.
This cross-sectional study administered the Edinburgh Postnatal Depression Scale Dari version to 52 Dari-speaking women at a public pregnancy clinic in Melbourne, Australia. A clinical interview using the depressive and anxiety disorders modules from the Structured Clinical Interview for the
(5th ed.) was also conducted. Interview material was presented to an expert panel to achieve consensus diagnoses. The interview and diagnostic process was undertaken blind to Edinburgh Posof a lowered cut-off score.
These results support the use of this Edinburgh Postnatal Depression Scale Dari version to screen for symptoms of depression and anxiety during pregnancy as well as the use of a lowered cut-off score.Tissue rearrangement (TR) is a basic oncoplastic technique to reshape the breast after breast conserving therapy (BCT). Tissue rearrangement can be combined with three-dimensional bioabsorbable markers (3DBM) as an easily adaptable technique to provide volume replacement and focused radiation. Since 3DBM can take time for absorption and symptoms related to its use have not been fully assessed, we evaluate patient's overall satisfaction and well-being after TR with 3DBM is performed. Cyclopamine We surveyed patients receiving BCT with adjuvant radiotherapy using BREAST-QTM BCT satisfaction and physical well-being surveys comparing patients receiving BCT alone to BCT with TR and/or 3DBM. Of 68 patients, 56 underwent BCT alone, 10 had BCT with TR + 3DBM, and 2 had BCT with TR. No significant difference was seen in physical well-being (P = .39), while overall satisfaction was significantly improved following TR + 3DBM (P = .0088). In summary, TR with use of 3DBM provides basic oncoplastic options to improve patient satisfaction without significantly changing symptoms.
This study aimed to evaluate choroidal thickness (CT) and choroidal vascularity index (CVI) in patients with Graves' disease (GD) without ocular involvement.
Fifty patients diagnosed with GD and 50 age and gender matched healthy control subjects were retrospectively evaluated. Measurements were taken from five different points on CT images. Choroid images were classified as lumen regions (LA) and stromal regions (SA) using the image binarization method. CVI was calculated by dividing LA by the total choroidal area (TCA). The effects of Thyrotropin Receptor Antibody (TRAb), age, GD duration, blood pressure, axial length measurements, and intraocular pressure were analyzed on CT and CVI measurements.
Mean age was 40.1 ± 13.5 years in the patient group and 39.3 ± 13.6 years in the control group (
= 0.89). There was no significant difference between the GD group and control group in terms of CT measurements. There was a significant difference between the mean CVI measurements of the GD group and control group (68.03 ± 3.41 and 66.62 ± 3.11, respectively) (
< 0.001). Univariate linear regression analysis revealed a positive correlation between TRAb and CVI (
= 0.013).
While there was no significant difference between the CT measurements of the GD group and the control group, the GD group had significantly higher CVI measurements.
While there was no significant difference between the CT measurements of the GD group and the control group, the GD group had significantly higher CVI measurements.
Standardized parental leave policies for medical trainees are lacking, and barriers may differ among specialties. We aimed to characterize experiences of physicians who became parents during training and to identify particular issues for surgical trainees compared to their non-surgical peers.
We distributed an electronic survey to physician parents via social media platforms from 10/2019 to 02/2020. Inclusion required becoming a parent during training. Responses were collected and standard descriptive and comparative analyses were performed.
Surveys were received from 64 physicians representing diverse specialties 48 (74%) non-surgical respondents (NSR) and 16 (26%) surgical respondents (SR). Among all respondents, 25 (39%) reported a formal institutional policy for parental leave and 49 (76%) wished for more time off. Overall, respondents took a mean of 7.5 ± 5.2 (range 0-14)weeks of parental leave. However, NSR took 8.7 ± 5.8weeks, while SR took 4.7 ± 2.7 (
= .006). Reported barriers to parental leave across specialties included graduation requirements (NSR 58% vs.
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