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The large-scale Russian invasion of Ukraine in early 2022 resulted in a humanitarian crisis with hundreds of thousands of children exposed to traumatic events. To date, trauma-focused evidence-based treatments (EBTs) for children and youth have not been systematically evaluated and implemented in Ukraine. This study aims at evaluating 1) the feasibility of a training program for Ukrainian therapists on Trauma-Focused Cognitive Behavioural Therapy (TF-CBT) and 2) the feasibility and effectiveness of the treatment for children, youth, and their families in and from Ukraine during the ongoing war.
Methods
The project “TF-CBT Ukraine” was implemented between March 2022 and May 2024, in close collaboration with local and international partners. Therapists completed questionnaires before/after the training, and patients were asked to complete a measure on PTSD before and after treatment.
Results
Altogether 138 therapists started the training program and 44.9% were certified as TF-CBT therapists. The program completers reported overall high satisfaction with the training program, a positive change in their attitude towards EBTs and trauma-related knowledge gain. The patients (age 3–21, 37% male) reported significant improvement in symptoms of PTSD at the end of treatment with large pre-post effect sizes for DSM-5 PTSD (dselfreport = 2.36; dcaregiverreport = 2.27), ICD-11 PTSD (dselfreport = 1.97; dcaregiverreport = 1.77), ICD-11 CPTSD (dselfreport = 2.04; dcaregiverreport = 1.99), and DSM-5 pre-school PTSD (dcaregiverreport = 3.14).
Conclusions
The results of this study are promising in regard to the general implementation of trauma-focused EBTs in active conflict areas. Future studies need to replicate these findings in a randomized controlled study design.
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
Patient safety is the avoidance of unintended or unexpected harm to people during the provision of health care. Anaesthetists have been leaders in patient safety for decades. In the United Kingdom, wholesale reform of children’s surgical delivery was undertaken after review of paediatric surgical outcomes in the 1990s, and in cardiac surgery, after an anaesthetist noted poor patient outcomes in children undergoing the arterial switch operation (see Kennedy 1996 in ‘Further Reading’).
Edited by
James Ip, Great Ormond Street Hospital for Children, London,Grant Stuart, Great Ormond Street Hospital for Children, London,Isabeau Walker, Great Ormond Street Hospital for Children, London,Ian James, Great Ormond Street Hospital for Children, London
This chapter describes the principles and practice of anaesthesia for craniofacial surgery. A comprehensive account of the assessment, planning and conduct of anaesthesia is given. Commonly performed craniofacial procedures will be considered in detail, along with specific anaesthetic considerations.
This article explores the notion of worship as a natural and universal disposition, described by Thomas Aquinas in ST II-II, q.81. Worship, however, is for Aquinas most relevant in the context of divine friendship or caritas with God, which Aquinas describes in ST II-II, q.23. This article, therefore, explains a possible connection between worship and love. How can the task to worship God grounded in the debt to God qua creator and the appreciation of the excellence of God be reconciled with the proximity and closeness with God that caritas implies? Drawing from Jewish philosophy, especially Martin Buber’s I-Thou relationships, and new findings in experimental psychology, in particular joint attention, a second-personal model of worship can be developed. This form of worship encompasses, on the one hand, the intimacy and sense of presence of God that worship can involve, and on the other hand, the distinctiveness and pre-eminence of God, essential for a worshipful attitude. The aim of this article is to explore how second-personal relatedness with God is possible in worship directed to God. Since God seems to be present in worship in a twofold manner, the interest is in the role the Holy Spirit can play in worship.
British left-wing politics does not know what to think about mothers. In left-wing women’s movements, motherhood has been recognised as essential and difficult; necessary for future revolutions, not least in raising future revolutionaries. In less radical circles, it has been understood as a crucial contribution to the functioning of society, often forming the basis of women’s claims to citizenship and maternalist forms of politics. On the other hand, motherhood has been seen as a ‘natural’ function of women and a private responsibility, rather than a public good or a collective act which needs comprehensive state support. The family, in this reading, is a rather conservative force, better left to social reactionaries. Mothering has added additional hurdles to the gendered obstacles women already face in pursuing politics as activists or elected representatives. Perhaps because of this, many mothers in politics have sought to downplay or distance themselves from their roles as mothers, emphasising instead their contributions as workers and activists who can be fully committed to the left cause. Feminist historians have often followed their lead and have tended to write around political mothers’ maternal roles in their scholarship. This roundtable develops themes first explored in our November 2023 workshop, generously supported by the Royal Historical Society.
There is no regular, routine measurement of food and nutrient intake undertaken regionally in the UK. This makes evaluation of local public health interventions challenging. Consumers want to be more sustainable in what they are eating. Social media penetration in the UK is 90%(1), with ∼47m people using Facebook, a potential route to study recruitment. Nutritional analysis software with accurate underpinning food composition and sustainability data could enable quick and easy large scale data collection. This study aimed to collect diet and sustainability measures using online tools and to test the feasibility of using social media to obtain a large, regionally focused sample in a short time.
We undertook a rapid, time limited, regional (Yorkshire and Humber) food and nutrient tracking survey ‘One day: Diet in Yorkshire and Humber’ for use with policy makers(2). A Facebook (FB) boost approach was used to recruit a regional sample of adults. Participants completed a brief online demographic survey and used myfood24® to give a detailed measure of their food intake for the previous day. myfood24® generic and branded databases were used(3) which include sustainability metrics.
The FB posts were boosted for 21 days and reached 76.9k individuals. Just under £1,000 was spent on 3 FB boosts and 1,428 participants completed the questionnaire. 673 participants also completed the one-day diet diary. Hull, Barnsley and Doncaster had the highest rates of overweight and obesity in the region. Overall nutrient values recorded were similar to national survey data for older women. Intakes of fibre (mean 18g, SD 11) and iron (mean 9.6mg, SD 5.0) were low. For the first time, measures of sustainability from the diet were calculated from myfood24®.
The mean greenhouse gas emissions (GHGE) were 5.9(kg CO2 eq/day) (95% CI 5.6, 6.1); land use 9.0 (m2year/day) (95% CI 7.6, 10.3) and water use 582 (l/day) (95% CI 551, 611). Regression analysis showed that for each additional 100kcal consumed there was a significant increase in GHGE of 0.9 (kg CO2 eq/day) (95% CI 0.8, 1.1). Land and water use were also significantly increased with increasing energy intake. Adjusting for total energy, protein intake was positively associated with all 3 metrics. Carbohydrate was inversely associated with GHGE and land use. However, fat intake was not associated with any of the sustainability measures. Portions of fruit and vegetables consumed were positively associated with water use only.
Diet is clearly linked to sustainability. The mean GHGE from diet is equivalent to driving an average car ∼22km/day. We successfully recruited a large sample in a short timeframe using FB. Participants were able to use online tools to report food intakes. This data is relevant to local and national policy makers to monitor and evaluate public health programmes.
As the US Supreme Court was preparing to overturn Roe v. Wade, the Mexican Supreme Court issued a series of sweeping rulings to liberalize abortion—part of a larger trend across Latin America (Daby and Moseley 2022; Fernandez Anderson 2017; Reuterswärd 2020; Ruibal 2014). Mexico has created a nationwide standard of access to abortion services, whereas the United States has abandoned universal legal abortion and embraced a patchwork system in which each state has different laws regulating reproductive healthcare. Why are these two neighbors on such divergent paths? This contribution to the symposium compares the ways that federalism and judicial politics have interacted in Mexico and the United States to explain the different trajectories of abortion policy. The divergent paths of the United States and Mexico can be explained by the two countries’ different experiences with democracy and political and institutional differences between the judiciaries. A different civil-society and constitutional context also has played a role.
The Mediterranean-Dietary Approach to Stop Hypertension (DASH) Intervention for Neurodegenerative Delay (MIND) diet is a dietary pattern designed to prevent cognitive decline. Dietary adherence is assessed with the MIND diet scoring system, which is currently based on the American diet and serving sizes. It is known that serving sizes and consumed food products differ between countries. Existing literature lacks reporting on food products included within the MIND diet and weight or volume equivalents corresponding to MIND diet servings, impeding accurate comparisons across studies. This study sought to overcome these limitations by evaluating MIND food products consumed in the Dutch context and developing a scoring system based on consumed quantities in weight or volume amounts rather than in standard serving amounts. The third objective was to modify an existing Dutch brief FFQ (Eetscore-FFQ) to evaluate adherence to the MIND diet. We translated nine of the fifteen MIND food groups directly to grams and volumes using the United States Department of Agriculture measurement conversion table. For the remaining food groups, we employed indirect translation to align them as closely as possible to the original MIND diet. These translated quantities in weight and volumes amounts were subsequently rounded to the nearest Dutch household measures, resulting in the culturally adapted MIND-NL diet scoring. The development of the MIND-NL-Eetscore-FFQ, comprising seventy-two food items (forty-one questions), is described. Our adaption approach is reproducible and can be used to customize the MIND diet scoring system to other cultures.
A substantial international body of evidence links housing to health outcomes. In 2021, the World Health Organisation (WHO) evaluated a small selection of policies from its six geographic regions and found that, in Australia as in the rest of the world, existing healthy housing measures fall short of the systemic response required to address health impacts and inequities. This paper takes the novel step of applying Bacchi’s (2009) ‘What is the Problem Represented to Be?’ approach to a wide-ranging thematic analysis of over 300 Australian policies across the domains of health and housing and related policy areas. In so doing, it offers an overview of existing healthy housing policy as well as illuminating the conceptual understandings and priorities of policy makers, shedding light on the policy paradigms that see housing under-utilised as a preventive health and health equity measure.
A gap in the literature exists pertaining to a global research nurse/research midwife resources and communication skill set necessary to engage with participants of diverse populations and geographic regions in the community or home-based conduct of decentralized clinical trials.
Aims:
An embedded mixed methods study was conducted to examine research nurse/research midwife knowledge base, experiences, and communication skill sets pertaining to decentralized trials across global regions engaged in remote research: the USA, Republic of Ireland, United Kingdom, and Australia.
Methods:
An online survey was deployed across international research nurse/research midwife stakeholder groups, collecting demographics, decentralized trial experience, barriers and facilitators to optimal trial conduct, and the self-perceived communication competence (SPCC) and interpersonal communication competence (IPCC) instruments.
Results:
86 research nurses and research midwives completed the survey across all countries: The SPCC and IPCC results indicated increased clinical research experience significantly correlated with increased SPCC score (p < 0.05). Qualitative content analysis revealed five themes: (1) Implications for Role, (2) Safety and Wellbeing, (3) Training and Education, (4) Implications for Participants, and (5) Barriers and Facilitators.
Conclusions:
Common trends and observations across the global sample can inform decentralized trial resource allocation and policy pertaining to the research nurse/research midwife workforce. This study demonstrates shared cultural norms of research nursing and midwifery across varied regional clinical trial ecosystems.
In this pioneering book, David Beer redefines emergent algorithmic technologies as the new systems of knowing. He examines the acute tensions they create and how they are changing what is known and what is knowable.
This is the revised transcript of a roundtable on the death of Queen Elizabeth II, presented at the North American Conference on British Studies in Chicago in November 2022. It includes an account of the many meanings of Queen Elizabeth II for her subjects and discussion of why so many at home and in the Commonwealth were devoted to her. The panel also touches on the significance for the monarchy of Elizabeth's passing, the meaning of queenship, and the importance of Elizabeth's gender for British women. An account of the queen and the Commonwealth focuses particularly on imperial optics and the queen's desire to be seen as the ruler of the Commonwealth. The panel concludes with the personalized account of a transnational scholar regarding the degree to which the media manufactured the appearance of grief over the queen's passing.
Management of total anomalous pulmonary venous connections has been extensively studied to further improve outcomes. Our institution previously reported factors associated with mortality, recurrent obstruction, and reintervention. The study purpose was to revisit the cohort of patients and evaluate factors associated with reintervention, and mortality in early and late follow-up.
Methods:
A retrospective review at our institution identified 81 patients undergoing total anomalous pulmonary venous connection repair from January 2002 to January 2018. Demographic and operative variables were evaluated. Anastomotic reintervention (interventional or surgical) and/or mortality were primary endpoints.
Results:
Eighty-one patients met the study criteria. Follow-up ranged from 0 to 6,291 days (17.2 years), a mean of 1263 days (3.5 years). Surgical mortality was 16.1% and reintervention rates were 19.8%. In re-interventions performed, 80% occurred within 1.2 years, while 94% of mortalities were within 4.1 months. Increasing cardiopulmonary bypass times (p = 0.0001) and the presence of obstruction at the time of surgery (p = 0.025) were predictors of mortality, while intracardiac total anomalous pulmonary venous connection type (p = 0.033) was protective. Risk of reintervention was higher with increasing cardiopulmonary bypass times (p = 0.015), single ventricle anatomy (p = 0.02), and a post-repair gradient >2 mmHg on transesophageal echocardiogram (p = 0.009).
Conclusions:
Evaluation of a larger cohort with longer follow-up demonstrated the relationship of anatomic complexity and symptoms at presentation to increased mortality risk after total anomalous pulmonary venous connection repair. The presence of a single ventricle or a post-operative confluence gradient >2 mmHg were risk factors for reintervention. These findings support those found in our initial study.
Cancer has been associated with lower risk of dementia, although methodological issues raise concerns about the validity of this association. We recruited 31,080 men aged 65–85 years who were free of cancer and dementia, and followed them for up to 22 years. We used health record linkage to identify incident cases of cancer and dementia, and split time span to investigate this association. 18,693 (60.1%) and 6897 (22.2%) participants developed cancer and dementia during follow-up. The hazard ratio (HR) of dementia associated with cancer was 1.13 (95% CI = 1.07, 1.20) and dropped to 0.85 (95% CI = 0.80, 0.91) when 449 participants who developed dementia within 2 years were excluded. The diagnosis of cancer seems to facilitate the early detection of dementia cases. Older participants who survive cancer for 2 or more years have lower risk of receiving the diagnosis of dementia over time. The factors that mediate this association remain unclear.
For an increasing proportion of Australian households, the Australian dream of home ownership is no longer an option. Neoliberal housing policy and the financialisation of housing has resulted in a housing affordability crisis. Historically, Australian housing policy has afforded only a limited role to local government. This article analyses the results of a nation-wide survey of Australian local governments’ perceptions of housing affordability in their local government area, the possibilities for their meaningful intervention, the challenges they face, the role of councillors and councils’ perceptions of what levels of government should take responsibility for housing. Almost all of the respondents from Sydney and Melbourne councils were clear that there is a housing affordability crisis in their local government area. We apply a framework analysing housing policy in the context of neoliberalism and the related financialisation of housing in order to analyse the housing affordability crisis in Sydney and Melbourne. We conclude that in order to begin resolving the housing crisis in Australia’s two largest cities there has to be an increasing role for local government, a substantial increase in the building of social and affordable housing and a rollback of policies that encourage residential property speculation.