Pandemic-Related Stress Symptoms Among Norwegian Parents of Adolescents in Grades 6 to 8

We investigated pandemic-related stress symptoms during the first COVID-19 lockdown period in spring 2020 among parents of adolescents that were 11 to 13 years old in the study period. We also investigated whether parental stress symptoms were associated with family situation and family activities during lockdown. Altogether 147 couples reported about their own trauma-related stress symptoms following the outbreak of the pandemic. Among the respondents, 9.5% of the mothers and 10.2% of the fathers had scores over cutoff on the screener (IES-6) measuring stress symptoms, a non-significant gender difference. Scores on the screener were not associated with family contamination or lockdown consequences. Family activities during lockdown did not impact the pandemic stress symptom levels. Whereas, the experience of the COVID-19 pandemic pose a stressor to most people, it is unlikely to be a criterion A event for other than directly affected families.publishedVersio

Study protocol for a randomized controlled trial of a group cognitive-behavioral course for depressed adolescents

BACKGROUND: School dropout is considered a serious problem in high schools in Norway. Despite studies which emphasize the importance of mental health as a unique risk factor for dropout, interventions have only taken this into account to a limited extent. Depression is one of the most prevalent mental health issues. Here we report the study protocol of a cluster randomized controlled trial of a group-CBT intervention, “Adolescent Coping with Depression Course” (ACDC) for depressed adolescents in upper secondary school. METHOD: The aim of this study is to investigate the extent to which ACDC can reduce depressive symptoms, prevent dropout and improve academic and social functioning among adolescents in upper secondary school. This study investigates the effectiveness of ACDC through a cluster randomized trial, in which course leaders are randomized to experimental or control conditions where the control groups receive usual care. DISCUSSION: The intervention is expected to reduce depressive symptoms among adolescents. The study will further investigate whether the intervention can prevent dropout and improve academic and social functioning among adolescents in upper secondary school. TRIAL REGISTRATION: ISRCTN registry ISRCTN19700389. Registered 6 October 2015. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12888-016-0954-y) contains supplementary material, which is available to authorized users

Bullying Victimization and Trauma

Bullying victimization and trauma research traditions operate quite separately. Hence, it is unclear from the literature whether bullying victimization should be considered as a form of interpersonal trauma. We review studies that connect bullying victimization with symptoms of PTSD, and in doing so, demonstrate that a conceptual understanding of the consequences of childhood bullying needs to be framed within a developmental perspective. We discuss two potential diagnoses that ought to be considered in the context of bullying victimization: (1) developmental trauma disorder, which was suggested but not accepted as a new diagnosis in the DSM-5 and (2) complex post-traumatic stress disorder, which has been included in the ICD-11. Our conclusion is that these frameworks capture the complexity of the symptoms associated with bullying victimization better than PTSD. We encourage practitioners to understand how exposure to bullying interacts with development at different ages when addressing the consequences for targets and when designing interventions that account for the duration, intensity, and sequelae of this type of interpersonal trauma

Depression symptoms, communication and cooperation skills, and friendship: longitudinal associations in young Norwegian children

IntroductionSymptoms of depression in early childhood have been linked to interpersonal difficulties, whereas friendships serve a protective function.MethodsIn the present study, we examined depression symptoms in preschool age (4 years) in relation to social skills (communication and cooperation), and friendships into early school age (Grades 1 and 2) in a large subsample (n = 943) of Norwegian children.ResultsThe results indicated that preschool depression symptoms negatively predicted Grade 1 communication skills, which in turn predicted Grade 2 depression symptoms. This pathway suggests that communication skills may be a maintenance factor for depression symptoms in young children. In addition, preschool depression symptoms predicted lower Grade 1 cooperation skills, which in turn predicted lower Grade 2 communication skills, suggesting that preschool depression symptoms may begin a cascade of social skill problems that affect cooperation and communication skills into early school years. Best friendships were negatively related to depression symptoms in preschool and Grade 2.DiscussionGiven that preschool depression symptoms impact the development of social skills and friendships, it is important to attend to depression symptoms in early childhood

Cardiac murmurs: echocardiography in the assessment of patients requiring antibiotic prophylaxis for dental treatment

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: Traditionally patients who indicate that they have a heart murmur or who indicate that they have had rheumatic fever are given antibiotic prophylaxis for dental treatment. This is commonly done without further assessment of the patient’s actual endocarditis risk. Echocardiography is a noninvasive method of assessing cardiac valve function and haemodynamics. Methods: Consecutive patients who were referred to a private practice oral and maxillofacial surgeon for dentoalveolar surgery and indicated that they had a cardiac problem and usually had antibiotic prophylaxis, were evaluated. Those with a clear indication for prophylaxis, for example had prosthetic heart valves or previous infective endocarditis, received antibiotic prophylaxis. Where there was uncertainty, they were referred for an echocardiogram, and if abnormal, a formal cardiology review. Results: Three hundred and seventy patients out of approximately 20 000 (1.85 per cent) indicated that they had a cardiac murmur and usually received antibiotic prophylaxis for dental treatment between 1 February 1997 and 1 February 2005. Two hundred and sixty-two (71 per cent) were female and 108 (29 per cent) were male; age range 0.7 to 98 years, average 37.6 years. Two hundred and seventy (72 per cent) had normal hearts with no indication for antibiotic prophylaxis. Of the 100 (28 per cent) patients with abnormal findings, they were on average older; 49.5 years, range 0.7 to 87 years. Of these, 50 (14 per cent) met current indications for antibiotic prophylaxis. Conclusion: Patients who present for dental treatment indicating that they require antibiotic prophylaxis for cardiac condition need to be fully evaluated. In this study only 50 of 370 patients (14 per cent) required antibiotic prophylaxis. The remaining 320 (86 per cent) would have no benefit but a risk of adverse reaction to the antibiotic.M. Ching, I. Straznicky and AN Gos

Justified Concern or Exaggerated Fear: The Risk of Anaphylaxis in Percutaneous Treatment of Cystic Echinococcosis—A Systematic Literature Review

Percutaneous treatment (PT) emerged in the mid-1980s as an alternative to surgery for selected cases of abdominal cystic echinococcosis (CE). Despite its efficacy and widespread use, the puncture of echinococcal cysts is still far from being universally accepted. One of the main reasons for this reluctance is the perceived risk of anaphylaxis linked to PTs. To quantify the risk of anaphylactic reactions and lethal anaphylaxis with PT, we systematically searched MEDLINE for publications on PT of CE and reviewed the PT-related complications. After including 124 publications published between 1980 and 2010, we collected a total number of 5943 PT procedures on 5517 hepatic and non-hepatic echinococcal cysts. Overall, two cases of lethal anaphylaxis and 99 reversible anaphylactic reactions were reported. Lethal anaphylaxis occurred in 0.03% of PT procedures, corresponding to 0.04% of treated cysts, while reversible allergic reactions complicated 1.7% of PTs, corresponding to 1.8% of treated echinococcal cysts. Analysis of the literature shows that lethal anaphylaxis related to percutaneous treatment of CE is an extremely rare event and is observed no more frequently than drug-related anaphylactic side effects

Patients with artificial joints: do they need antibiotic cover for dental treatment?

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.This study reviews whether patients with artificial joints need antibiotic cover for dental treatment. Generally in Australia the practice has developed of giving most patients with artificial joints antibiotic prophylaxis for a wide range of dental procedures. This is partly on anecdotal grounds, partly historical and partly for legal concerns. It has been encouraged by some guidelines. Scientifically, the risk and the benefit of each step in the process needs to be analysed. This review shows that the risk of an artificial joint becoming infected from a bacteraemia of oral origin is exceedingly low whereas the risk of an adverse reaction to the antibiotic prophylaxis is higher than the risk of infection. If all patients with artificial joints receive antibiotic prophylaxis then more will die from anaphylaxis than develop infections. Factors which balance the risk benefit are if the patient is seriously immunocompromised, if the joint prosthesis is failing or chronically inflamed and if the dental procedures, such as from extractions and deep periodontal scaling, produce high level bacteraemias. Recommendations to rationalize antibiotic prophylaxis for patients with artificial joints are presented.JF Scott, D Morgan, M Avent, S Graves and AN Gos

Antibiotic prophylaxis for endocarditis: time to reconsider

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Some cardiac conditions require antibiotic prophylaxis for some types of dental treatment to reduce the risk of infective endocarditis (IE). All medical and dental practitioners are familiar with this practice but tend to use different regimens in apparently similar circumstances. Generally, the trend has been to prescribe antibiotics if in doubt. This review explores the evidence for antibiotic prophylaxis to prevent IE: does it work and is it safe? The changing nature of IE, the role of bacteraemia of oral origin and the safety of antibiotics are also reviewed. Most developed countries have national guidelines and their points of similarity and difference are discussed. One can only agree with the authority who describes antibiotic guidelines for endocarditis as being ‘like the Dead Sea Scrolls, they are fragmentary, imperfect, capable of various interpretations and (mainly) missing!’ Clinical case-controlled studies show that the more widely antibiotics are used, the greater the risk of adverse reactions exceeding the risk of IE. However, the consensus is that antibiotic prophylaxis is mandatory for a small number of high-risk cardiac and high-risk dental procedures. There are a large number of low-risk cardiac and dental procedures in which the risk of adverse reactions to the antibiotics exceeds the risk of IE, where prophylaxis should not be provided. There is an intermediate group of cardiac and dental procedures for which careful individual evaluation should be made to determine whether IE or antibiotics pose the greater risk. These categories are presented. All medical and dental practitioners need to reconsider their approach in light of these current findings.J Singh, I Straznicky, M Avent and AN Gos

Incidência da sífilis congênita no Brasil e sua relação com a Estratégia Saúde da Família

OBJETIVO: Estimar a incidência da sífilis congênita e identificar sua relação com a cobertura da Estratégia Saúde da Família. MÉTODOS: Estudo ecológico observacional, com componentes descritivos e analíticos, desenvolvido por meio de duas abordagens: em série temporal (2003 a 2008) e focalizando dados de 2008. Os dados secundários utilizados (epidemiológicos, demográficos e socioeconômicos) foram obtidos do Departamento de Informática do Sistema Único de Saúde e Instituto Brasileiro de Geografia e Estatística. A análise de possíveis efeitos da implantação dessa Estratégia sobre a prevenção da sífilis congênita foi realizada em subgrupos selecionados de municípios, por meio de duas abordagens: a) variação média anual da taxa de incidência de sífilis congênita em diferentes estratos de cobertura da Estratégia, durante o período de 2003 a 2008, com cálculo do coeficiente de regressão linear simples; e b) análise de regressão binomial negativa, com dados de 2008, para controle de alguns fatores de confundimento. RESULTADOS: Há tendência de aumento das notificações de sífilis congênita no Brasil, com desigualdades sociais na distribuição dos casos. Observa-se uma associação negativa entre a incidência de sífilis congênita em municípios com altas coberturas da Saúde da Família; mas, após controle de covariáveis, esse efeito pode ser atribuível à cobertura de pré-natal e a características demográficas dos municípios nos quais essa Estratégia foi prioritariamente implantada. CONCLUSÕES: Apesar do aumento das coberturas de pré-natal, ainda se observa uma baixa efetividade dessas ações para a prevenção da sífilis congênita. Não foi identificada uma associação melhor entre o pré-natal realizado pelas equipes da Estratégia Saúde da Família e o controle da sífilis congênita do que aquela associação observada nas situações em que o pré-natal é realizado por outros modelos de atenção

Problemas de Conducta y Depresión entre Refugiados no Acom-pañados: La asociación entre el impacto del trauma pre-migratorio y la aculturación

There is scarce knowledge about the long term adaptation of children who migrate without the company of their legal guardians to apply for asylum in a foreign country. The present study investigated the combined effects of impact of premigratory war-related trauma, and indices of current acculturation (culture competence and ingroup / outgroup hassles) on conduct and depression problems. Participants were 566 refugees who had arrived in Norway as unaccompanied minor asylumseekers, were granted residence and resettled all over the country. They had a mean length of stay in Norway of 3.7 years and a mean age of 18.9 years. They gathered in groups in their home towns, and filled in questionnaires with information about pre- and post-migration experiences and mental health. The findings imply that while this group of young refugees reports few conduct problems, the level of depression is high. At the same time, their acculturation process is progressing, as they are achieving necessary culture competence to integrate into majority society and maintain contact with their culture of origin. A model assessing effects of culture competence and ingroup/outgroup hassles in combination with impact of war-related traumatic events, did not account for much of the individual differences in conduct problems. In contrast, when depressive problems were concerned, the included acculturation indices explained substantial variation in depression problems, over and above effects of impact of war-related traumatic events. It is concluded that ethnic and host culture competence should be the focus of interventions to promote socio-cultural integration and mental health.Hay escaso conocimiento sobre la adaptación a largo plazo de los niños menores de edad que emigran sin ser acompañados por sus padres para pedir asilo en un país extranjero. El presente estudio investigó los efectos combinados del impacto de haber tenido experiencias traumáticas relacionadas con la guerra antes de emigrar y los índices del proceso de aculturación actual (competencia cultural y problemas con endogrupos / exogrupos) sobre la depresión y los problemas conductuales.Los participantes fueron 566 refugiados menores no acompañados que habían llegado a Noruega buscando asilo y a los que se concedió la residencia y que estaban domiciliados por todo el país. Su estancia media en Noruega era de 3,7 años y su edad media era de 18,9 años. Se reunían en grupos en sus lugares de residencia y rellenaban cuestionarios con información acerca de sus experiencias pre y post- migratorias y de su salud mental.Los resultados encontrados indican que, aunque este grupo de jóvenes refugiados informa de pocos problemas de conducta, el nivel de depresión es alto. Sin embargo, a pesar de los problemas de depresión, su proceso de aculturación hace progresos, ya que están adquiriendo la competencia cultural necesaria para integrarse en la sociedad mayoritaria y mantener el contacto con su cultura de origen. Un modelo para evaluar los efectos de la competencia cultural y de los problemas con endogrupos/exogrupos en combinación con el impacto de experiencias traumáticas relacionadas con la guerra no explicaba gran parte de las diferencias individuales en los problemas de conducta. En cambio, los índices de aculturación explicaban una variación sustancial de los problemas de depresión, por encima de los efectos del impacto de experiencias traumáticas relacionadas con la guerra. Se concluye que la competencia cultural étnica y de la sociedad de acogida debe ser el enfoque  a seguir en las intervenciones para impulsar la integración socio-cultural y la salud mental