A national survey of the availability of intensity-modulated radiation therapy and stereotactic radiosurgery in Canada

<p>Abstract</p> <p>Background</p> <p>The timely and appropriate adoption of new radiation therapy (RT) technologies is a challenge both in terms of providing of optimal patient care and managing health care resources. Relatively little is known regarding the rate at which new RT technologies are adopted in different jurisdictions, and the barriers to implementation of these technologies.</p> <p>Methods</p> <p>Surveys were sent to all radiation oncology department heads in Canada regarding the availability of RT equipment from 2006 to 2010. Data were collected concerning the availability and use of Intensity Modulated Radiation Therapy (IMRT) and stereotactic radiosurgery (SRS), and the obstacles to implementation of these technologies.</p> <p>Results</p> <p>IMRT was available in 37% of responding centers in 2006, increasing to 87% in 2010. In 2010, 72% of centers reported that IMRT was available for all patients who might benefit, and 37% indicated that they used IMRT for "virtually all" head and neck patients. SRS availability increased from 26% in 2006 to 42.5% in 2010. Eighty-two percent of centers reported that patients had access to SRS either directly or by referral. The main barriers for IMRT implementation included the need to train or hire treatment planning staff, whereas barriers to SRS implementation mostly included the need to purchase and/or upgrade existing planning software and equipment.</p> <p>Conclusions</p> <p>The survey showed a growing adoption of IMRT and SRS in Canada, although the latter was available in less than half of responding centers. Barriers to implementation differed for IMRT compared to SRS. Enhancing human resources is an important consideration in the implementation of new RT technologies, due to the multidisciplinary nature of the planning and treatment process.</p

Paucity of intervention research in childhood maltreatment contrasts with the long known relation with mental health disorders: is trauma research translational enough?

The damaging consequences of child abuse and neglect for child development and psychiatric disorders have been known for decades. However, there would be a relative paucity of translational research on childhood maltreatment in comparison to the numerous correlational studies in the field. To assess the extent to which previous research on childhood maltreatment addressed intervention, we reviewed all articles on child abuse and neglect published in 2016 and evaluated the main objective of each study. References were identified through PsycINFO (ƙ = 2139) and Medline (ƙ = 2955). Of the 3792 studies retained after removal of overlapping references, 1157 met inclusion criteria. The main objective of each study was coded according to one of the following categories: Consequences, Mechanisms, Intervention, Prevention and Others. The review showed that half of the studies (ƙ = 572; 50%) described the damaging consequences of child abuse and neglect. A mere 19% of the studies (ƙ = 225) aimed to identify mediators or moderators of the association between childhood maltreatment and outcome. Only 6% (ƙ = 66) of studies reported on treatments and 2% (ƙ = 29) on preventive interventions. The remaining articles (23%, ƙ = 265) focused on other topics, such as the assessment of childhood trauma (ƙ = 33), epidemiology (ƙ = 118) and legal or organizational issues (ƙ = 114). Our results revealed an unquestionable paucity of research published on interventions and a relatively scarce number of mechanistic studies that nonetheless may provide meaningful practical orientations for clinical practice and future research

Evaluation of the acceptability of a prenatal program for women with histories of childhood trauma: The program STEP

Background: Childhood trauma would negatively affect pregnant women's mental health and would have intergenerational repercussions. However, there is a paucity of prenatal interventions specifically designed for women exposed to childhood trauma. The study aims to evaluate the acceptability of STEP, a manualized group intervention designed for pregnant women having experienced early life adversity. Methods: The acceptability of STEP was assessed in four phases. In Phase 1, six experts evaluated whether the program activities were pertinent and trauma sensitive. In Phase 2, three parents read the intervention manuals and evaluated whether they considered each session relevant, interesting, and clear. In Phase 3, the program was briefly presented by phone to 309 pregnant women from the community. Women were inquired about their interest in the program, and the reasons for their lack of interest were assessed. In Phase 4, 30 pregnant women exposed to childhood trauma participated in the program and completed anonymous satisfaction questionnaires after each session. Psychological distress was also measured before and after the program. Results: All activities were rated by independent experts as highly pertinent, adequate, and sufficiently safe to be offered to pregnant women. Parents who read through the intervention manuals also considered that the sessions were relevant, clear, and interesting. About half of the pregnant women from the community showed interest in the program. Participants reported very high levels of satisfaction and a significant decrease in psychological distress during the program. Conclusions: Our findings show a high level of convergence among various indicators of program acceptability

Une intervention de groupe brève pour favoriser le bien-être des femmes enceintes pendant la pandémie de COVID-19 et soutenir la résilience des familles

Contexte: La pandémie de COVID-19 a été associée à une augmentation de la détresse psychologique chez les femmes enceintes. Le présent article vise à évaluer l’acceptabilité du programme STEP-COVID (Soutenir la Transition et l’Engagement dans la Parentalité dans le contexte de la pandémie de COVID-19), une intervention prénatale de groupe en ligne, en mode synchrone, visant à soutenir le bien-être, la mentalisation et la résilience. Méthode: Vingt et une femmes enceintes québécoises ont participé au programme et ont complété des mesures des symptômes psychologiques et de la mentalisation avant et après l’intervention ainsi qu’une échelle évaluant leur perception de changements sur des domaines associés à la résilience. Après chaque rencontre, elles ont rempli un questionnaire évaluant leur appréciation du programme. Résultats: Les 18 participantes (86&nbsp;%) ayant complété le programme ont rapporté de hauts taux de satisfaction après chacune des rencontres et au terme de l’intervention. Une diminution des symptômes anxio-dépressifs et des symptômes de stress post-traumatiques et une amélioration des fonctions réflexives sont observées entre le début et la fin du programme. Les participantes ont également rapporté des changements positifs sur des sphères de fonctionnement associées à la résilience. Conclusion: Les résultats soutiennent l’acceptabilité du programme STEP-COVID et suggèrent que l’offre d’une intervention de groupe brève en ligne est appréciée par les participantes, semble favoriser une diminution de la détresse psychologique et une amélioration de la mentalisation et pourrait contribuer à la résilience dans le contexte de la pandémie de COVID-19

Spillover effects on the relationship with the partner of a mentalization-based intervention for pregnant women

Abstract The birth of a child has been associated with a decline in couple satisfaction, which has implications for the child's social-emotional development. This study investigated the potential spillover effect on pregnant women's perceptions of their relationships with their partners of the Supporting the Transition to and Engagement in Parenthood (STEP) program, a brief trauma-informed mentalization-based prenatal group intervention. Participants (94% White) were recruited in prenatal clinics and through online advertisements in Quebec, Canada. Both quantitative and qualitative data were collected from participants assigned to the STEP program (n = 42) and those receiving treatment-as-usual (TAU; n = 125). Women participating in STEP reported significant improvements in their relationships with their partners compared to those assigned to TAU. More precisely, they reported higher couple satisfaction, enhanced communication, and increased interest in their partners’ emotional experience. The qualitative analysis further substantiated these results, with participants reporting having involved their partners in their pregnancy, shared their insights about themselves with their partners and gained fresh perspectives on their relationships. Participants in STEP also expressed sharing program materials with their partners and considered that such interventions should be extended to expecting fathers. This study underscores the potential of mentalization-based interventions to indirectly contribute to couple relationships, which may have positive implications for parenting and the infant

Centerscope

Centerscope, formerly Scope, was published by the Boston University Medical Center "to communicate the concern of the Medical Center for the development and maintenance of improved health care in contemporary society.