Coping styles associated with post-traumatic stress and depression symptoms following childbirth in croatian women

Childbirth is a normative event in a woman's life and is considered as a positive event. However, one in three women perceive childbirth as a physical threat to themselves or their new-born and 3% of women develop posttraumatic stress disorder (PTSD) following childbirth. Poor coping strategies have been associated with PTSD following childbirth. However, previous studies mainly utilised unidimensional measures of coping strategies, therefore, it remains to be investigated which specific dimensions of coping are more predictive of PTSD after childbirth. The aims of this study were to explore whether women in Croatia report PTSD symptoms following childbirth, and how different coping styles were related to PTSD and depression symptoms. Women (N = 160) who gave birth in the last two years, completed an online questionnaire measuring PTSD symptoms (Impact of Event Scale – IES), postnatal depression symptoms (Edinburgh Postnatal Depression Scale – EPDS) and coping styles (Brief Cope). In this sample, 1.9% reported severe PTSD symptoms following childbirth and 21.9% reported depression symptoms. Many women (66.7%) with PTSD symptoms reported depression symptoms. On the other hand, 28.6% of women with depression symptoms also reported PTSD symptoms, showing that there is a higher co-morbidity of PTSD and depression than vice versa. Avoidant coping styles, specifically, denial and self-blame were positively correlated with both PTSD and depression symptoms. Moreover, of avoidant coping styles, behavioural disengagement was positively correlated with PTSD symptoms only, while self-distraction was positively correlated with depression symptoms only. Also, lower levels of planning and higher levels of emotional support were related to higher levels of depression. However, after controlling for postnatal psychopathology symptoms, coping styles were not significant predictors of PTSD symptoms, but self-blame was a significant predictor of depression symptoms. Psychopathological symptoms following childbirth are reported by Croatian women and are related to coping styles. The avoidant coping style, self-blame, is particularly associated with depression symptoms. Future studies should explore predictors of postpartum PTSD in Croatian women in more representative samples during pregnancy and with the follow-up after childbirth. Also, screening for postnatal psychopathological symptoms should be performed both for depression and PTSD symptoms

Personal growth in UK and Croatian women following childbirth: A preliminary study

Objective: The aim of this study was to examine growth in UK and Croatian women following childbirth and to identify correlates of personal growth after birth, specifically focusing on sociodemographic, obstetric and coping variables. Background: Childbirth is a significant and challenging life event for many women with the potential for both positive and negative psychological changes. Research is increasingly exploring growth in different cultures. No studies have explored growth in Croatian women following childbirth. Methods: UK (N = 193) and Croatian (N = 160) women who had given birth within the last two years completed online questionnaires measuring growth, depression, posttraumatic stress symptoms and coping strategies. Results: Approximately 44% and 35% of UK and Croatian women, respectively, reported a moderate level of growth after childbirth. Hierarchical multiple regression analyses showed that younger women in both countries reported more growth. In the UK sample, coping strategies were related to higher growth. In the Croatian sample, higher posttraumatic stress symptoms and the avoidant coping strategy of denial were associated with higher levels of growth. Conclusion: This study suggests that many women report positive changes as a result of their birth experience. Further research is needed to explore how cultural elements are manifested in the experience of growth

The Relationship between the UniProt Knowledgebase (UniProtKB) and the IntAct Molecular Interaction Databases

IntAct provides a freely available, open source database system and analysis tools for protein interaction data. All interactions are derived from literature curation or direct user submission and all experimental information relating to binary protein-protein
interactions is entered into the IntAct database by curators, via a web-based editor. Interaction information is added to the SUBUNIT comment and the RP line of the relevant publication within the UniProtKB entry. There may be a single INTERACTION comment present within a UniProtKB entry, which conveys information relevant to binary protein-protein interactions. This is automatically derived from the IntAct database and is updated on a triweekly basis. Interactions can be derived by any appropriate experimental method but must be confirmed by a second interaction if resulting from a single yeast2hybrid experiment. For large-scale experiments, interactions are considered if a high confidence score is assigned by the authors. The INTERACTION line contains a direct link to IntAct that provides detailed information for the experimental support. These lines are not changed manually and any discrepancy is reported to IntAct for updates. There is also a database crossreference line within the UniProtKB entry i.e.: DR IntAct _UniProtKB AC, which directs the user to additional interaction data for that molecule. 
UniProt is supported by grants from the National Institutes of Health, European Commission, Swiss Federal Government and PATRIC BRC.
IntAct is funded by the European Commission under FELICS, contract number 021902 (RII3) within the Research Infrastructure Action of the FP6 "Structuring the European Research Area" Programme

Evaluating the CYP-IAPT transformation of child and adolescent mental health services in Cambridgeshire, UK: a qualitative implementation study

Abstract: Background: The Children and Young People’s Improving Access to Psychological Therapies (CYP-IAPT) programme was introduced to transform Child and Adolescent Mental Health Services (CAMHS) across England. The programme comprised a set of principles that local CAMHS partnerships were expected to operationalise and embed with the aim of increasing access to services and improving the quality of care. This study explored how the implementation of the CYP-IAPT programme was executed and experienced by CAMHS professionals in the county of Cambridgeshire (UK), and the extent to which the CYP-IAPT principles were perceived to be successfully embedded into everyday practice. Methods: We analysed 275 documents relating to the CYP-IAPT programme issued between 2011 and 2015. We also conducted a thematic analysis of 20 qualitative interviews, undertaken at two time points, with professionals from three CAMHS teams in Cambridgeshire. Analysis was informed by implementation science frameworks. Results: Document analysis suggested that the CYP-IAPT programme was initially not clearly defined and lacked guidance on how to operationalise key programme principles and apply them in everyday practice. There was also a degree of programme evolution over time, which made it difficult for local stakeholders to understand the scope and aims of CYP-IAPT. Interviews with staff showed low coherent understanding of the programme, variable levels of investment among stakeholders and difficulties in collaborative working. Barriers and facilitators to programme implementation were identified at individual, service and strategic levels. These in turn impacted the local implementation efforts and sustainability of the programme in Cambridgeshire. Conclusions: We identified factors relating to programme design and national and local implementation planning, as well as features of inner and outer context, which impacted on the delivery and sustainability of the programme. These findings can be drawn upon to inform the development and delivery of other local and national quality improvement (QI) initiatives relating to children and young people’s mental health

Police referrals for domestic abuse before and during the first COVID-19 lockdown: An analysis of routine data from one specialist service in South Wales

Background COVID-19 lockdown measures may have led to more, and increasingly severe, domestic abuse. This study examines police referrals to a specialist domestic abuse service in Wales, UK before and during the first lockdown. Methods Routine data relating to 2292 police referrals for female adult victim-survivors from December 2019 until July 2020 were analysed and presented in the form of descriptive statistics to monitor changes in referral rates and the profile of those referrals. Results There was little increase in the overall volume of police referrals during lockdown, but the proportion assessed as high risk increased, and children became the primary source of third-party referrals, with a higher proportion of reports made by other third parties as restrictions eased. Police reports for cases of Child/Adolescent to Parent Violence (C/APV) occurred almost exclusively during lockdown. Conclusions The increase in risk level despite less clear increase in volume may suggest unmet need, with victims less likely to seek help during lockdown other than for more severe instances. Increased reports by children suggest increased exposure of children to domestic abuse during school closure. Unmet need for women and children may have been made visible to services, and acquaintances, as measures began to ease

Determining stakeholder priorities and core components for school-based identification of mental health difficulties: A Delphi study

Only approximately half of children and young people (CYP) with mental health difficulties access mental health services in England, with under-identification of need as a contributing factor. Schools may be an ideal setting for identifying mental health difficulties in CYP, but uncertainty remains about the processes by which these needs can best be identified and addressed. In this study, we conducted a two-round, three-panel Delphi study with parents, school staff, mental health practitioners, and researchers to inform the development of a program to identify mental health difficulties in primary schools. We aimed to assess and build consensus regarding (a) the aims of such a program, (b) identification model preferences, (c) key features of the identification model, and (d) key features of the implementation model. A total of 54 and 42 participants completed the Round 1 and 2 questionnaires, respectively. In general, responses indicated that all three panels supported the idea of school-based identification of mental health difficulties. Overall, 53 of a possible 99 items met the criteria for inclusion as program core components. Five main priorities emerged, including that (a) the program should identify children experiencing mental health difficulties across the continuum of severity, as well as children exposed to adversity, who are at greater risk of mental health difficulties; (b) the program should train staff and educate pupils about mental health in parallel; (c) parental consent should be obtained on an opt-out basis; (d) the program must include clear mechanisms for connecting identified pupils to care and support; and (e) to maximize implementation success, the program needs to lie within a school culture that values mental health and wellbeing. In highlighting these priorities, our study provides needed stakeholder consensus to guide further development and evaluation of mental health interventions within schools

Lifetime revision risk for medial unicompartmental knee replacement is lower than expected

Purpose: Unicompartmental knee replacement (UKR) is widely considered to be a pre-total knee replacement (TKR) particularly in the young. The implication of this is that it is sensible to do a UKR, even though it will be revised at some stage, as it will delay the need for a TKR. The chance of a UKR being revised during a patient’s life time has not previously been calculated. The aim of this study was to estimate this lifetime revision risks for patients of different ages undergoing UKR. Methods: Calculations were based on data from a designer series of 1000 medial Oxford UKR with mean 10-year follow up. These UKR were implanted for the recommended indications using the recommended surgical technique. Parametric survival models were developed for patients of different ages based on observed data, and were extrapolated using a Markov model to estimate lifetime revision risk. Results: The estimated lifetime revision risk reduced with increasing age at surgery. Lifetime revision risk at age 55 was 15% (95% CI 12–19), at 65 it was 11% (8–13), at 75 it was 7% (5–9), and at 85 it was 4% (3–5). Conclusion: Provided UKR is used appropriately, the lifetime revision risk is markedly lower than expected. UKR should be considered to be a definitive knee replacement rather than a Pre-TKR even in the young. These lifetime estimates, alongside established benefits for UKR in speed of recovery, morbidity, mortality and function, can be discussed with appropriate patients when considering whether to implant a UKR or TKR. Level of Evidence:III.</p

Our experience in developing and operating the Airway Intervention Registry for Recurrent Respiratory Papillomatosis (AIR-RRP): national data collection

Copyright: \ua9 2023 Sims A et al. Recurrent respiratory papillomatosis (RRP) is characterised by benign wart-like growths in the respiratory tract caused by the human papillomavirus (HPV). These warts vary in size and grow quickly, causing voice changes and airway obstruction. Whilst the condition is rare, RRP is more common and aggressive in children. There is currently no curative treatment for HPV, therefore RRP is managed by maintaining a safe airway and a serviceable voice by repeated surgery to remove the growths. A lack of specific diagnostic codes prevents reliable case ascertainment of RRP from routine administrative databases such as Hospital Episode Statistics. In 2017 a cross-sectional survey identified 918 RRP patients in the UK, half of whom had received surgical intervention for RRP in the previous 12 months with 16 different interventions. Randomised controlled trials for RRP interventions are difficult due to the rarity of the disease, variation in severity and progression and non-standard care across the NHS. Consequently, there is a lack of definitive efficacy and safety evidence. The only national guidance for RRP interventions is “Radiofrequency cold ablation for respiratory papillomatosis” (NICE IPG434, 2017) which recommended further data collection due to lack of evidence. However, due to the wide variation in RRP management across the NHS, clinical opinion favoured that any data collection should include a comparison of safety and efficacy of all RRP interventions in order to advise which improved patient outcomes and quality of life. To address lack of evidence, and inform the future care of RRP patients, we developed a registry and used it to collect real-world data from patients receiving treatment for RRP in NHS hospitals across the UK. The purpose of this paper is to share lessons learned from this national data collection exercise to inform future clinical registry development