Evaluation of psychological support for victims of sexual violence in a conflict setting: results from Brazzaville, Congo

ABSTRACT: BACKGROUND: Little is known about the impact of psychological support in war and transcultural contexts and in particular, whether there are lasting benefits. Here, we present an evaluation of the late effect of post-rape psychological support provided to women in Brazzaville, Republic of Congo. METHODS: Women who attended the Médecins Sans Frontières program for sexual violence in Brazzaville during the conflict were selected to evaluate the psychological consequences of rape and the late effect of post-rape psychological support. A total of 178 patients met the eligibility criteria: 1) Women aged more than 15 years; 2) raped by unknown person(s) wearing military clothes; 3) admitted to the program between the 1/1/2002 and the 30/4/2003; and 4) living in Brazzaville. RESULTS: The initial diagnosis according to DSM criteria showed a predominance of anxious disorders (54.1%) and acute stress disorders (24.6%). One to two years after the initial psychological care, 64 women were evaluated using the Trauma Screening Questionnaire (TSQ), the Global Assessment of Functioning scale (GAF) and an assessment scale to address medico-psychological care in emergencies (EUMP). Two patients (3.1%) met the needed criteria for PTSD diagnosis from the TSQ. Among the 56 women evaluated using GAF both as pre and post-test, global functioning was significantly improved by initial post-rape support (50 women (89.3%) had extreme or medium impairment at first post-rape evaluation, and 16 (28.6%) after psychological care; p = 0.04). When interviewed one to two years later, the benefit was fully maintained (16 women (28.6%) presenting extreme or medium impairment). CONCLUSION: We found the benefits of post-rape psychological support to be present and lasting in this conflict situation. However, we were unable to evaluate all women for the long-term impact, underscoring the difficulty of leading evaluation studies in unstable contexts. Future research is needed to validate these findings in other settings

Imaging Neuroscience opening editorial

In this editorial we introduce a new non-profit open access journal, Imaging Neuroscience. In April 2023, editors of the journals NeuroImage and NeuroImage:Reports resigned, and a month later launched Imaging Neuroscience. NeuroImage had long been the leading journal in the field of neuroimaging. While the move to fully open access in 2020 represented a positive step toward modern academic practices, the publication fee was set to a level that the editors found unethical and unsustainable. The publisher of NeuroImage, Elsevier, was unwilling to reduce the fee after much discussion. This led us to launch Imaging Neuroscience with MIT Press, intended to replace NeuroImage as our field’s leading journal, but with greater control by the neuroimaging academic community over publication fees and adoption of modern and ethical publishing practices

Connaissances, attitudes et pratiques des adolescents de la ville de Brazzaville en matiere de la prevention du COVID-19 : Knowledge, attitudes and practices of adolescents in the city of Brazzaville with regard to the prevention of COVID-19

Contexte : Les nombres de cas confirmés de COVID-19 et de décès dus à cette pandémie ne cessent d’augmenter. En République du Congo, Brazzaville est le plus grand foyer de contamination. L’objectif de cette étude est de déterminer les connaissances, attitudes et pratiques de la population jeune face à cette épidémie de COVID-19. Méthode : Une étude transversale, descriptive et analytique a été menée auprès de 323 adolescents de 14-18 ans. Les données ont été recueillies par un questionnaire en ligne. Résultats : Parmi les 323 participants à l’étude, plus de la moitié déclaraient avoir reçu des informations sur le COVID-19. La majorité des participants avaient répondu que les principaux symptômes de la COVID-19 étaient la fièvre, la toux sèche, le mal de gorge, la fatigue, les difficultés respiratoires, et le nez qui coule. Les modes de transmission de la COVID-19 étaient connus : le contact direct avec une personne atteinte, les gouttelettes respiratoires d’un sujet infecté et les objets contaminés. Quant aux attitudes et pratiques, la plupart des participants se lavaient les mains régulièrement au savon. Peu d’entre eux respectaient la distanciation sociale d’au moins 1 m dans les milieux publics, toussaient dans le creux du coude et dans un mouchoir jetable. Les sujets portaient régulièrement les masques de protection artisanaux. Conclusion : Brazzaville est le plus grand foyer de contamination en République du Congo. Les résidents adolescents adoptent des attitudes et pratiques parfois défavorables malgré leur niveau bon de connaissance sur la COVID-19. Une intervention à l’éduction pour la santé plus efficace à cette population parait nécessaire et urgente afin de réduire le risque de contamination cette pandémie. Background: The number of confirmed cases and deaths due to this pandemic continues to increase. In the Republic of Congo, Brazzaville is the largest source of contamination. The objective of this study is to determine the knowledge, attitudes and practices of the youth population with regard to this COVID-19 epidemic. Method: A cross-sectional, descriptive and analytical study was conducted with 323 adolescents aged 14-18 years. Data were collected through an online questionnaire. Results: Of the 323 participants in the study, more than half reported receiving information about COVID-19. The majority of participants responded that the main symptoms of COVID-19 were fever, dry cough, sore throat, fatigue, difficulty breathing, and runny nose. The modes of transmission of COVID-19 were known direct contact with an infected person, respiratory droplets from an infected subject and contaminated objects. In terms of attitudes and practices, most participants washed their hands regularly with soap. Few of them respected the social distance of at least 1 m in public places, coughed in the crook of the elbow and in a disposable handkerchief. Subjects regularly wore the homemade protective masks. Conclusion: Brazzaville is the largest outbreak in the Republic of Congo. Adolescent residents sometimes adopt unfavourable attitudes and practices despite their good level of knowledge about VIDOC-19. A more effective health education intervention for this population seems necessary and urgent to reduce the risk of contamination of this pandemic

Digital health interventions for the management of mental health in people with chronic diseases: a rapid review

Objective: Determine the effectiveness of digital mental health interventions for individuals with a concomitant chronic disease. Design: We conducted a rapid review of systematic reviews. Two reviewers independently conducted study selection and risk of bias evaluation. A standardised extraction form was used. Data are reported narratively. Interventions: We included systematic reviews of digital health interventions aiming to prevent, detect or manage mental health problems in individuals with a pre-existing chronic disease, including chronic mental health illnesses, published in 2010 or after. Main outcome measure: Reports on mental health outcomes (eg, anxiety symptoms and depression symptoms). Results: We included 35 reviews, totalling 702 primary studies with a total sample of 50 692 participants. We structured the results in four population clusters: (1) chronic diseases, (2) cancer, (3) mental health and (4) children and youth. For populations presenting a chronic disease or cancer, health provider directed digital interventions (eg, web-based consultation, internet cognitive–behavioural therapy) are effective and safe. Further analyses are required in order to provide stronger recommendations regarding relevance for specific population (such as children and youth). Web-based interventions and email were the modes of administration that had the most reports of improvement. Virtual reality, smartphone applications and patient portal had limited reports of improvement. Conclusions: Digital technologies could be used to prevent and manage mental health problems in people living with chronic conditions, with consideration for the age group and type of technology used

The impact of technology systems and level of support in digital mental health interventions: a secondary meta-analysis

Abstract Background The majority of people with a chronic disease (e.g., diabetes, hypertension, COPD) have more than one concurrent condition and are also at higher risk for developing comorbidities in mental health, including anxiety and depression. There is an urgent need for more relevant and accurate data on digital interventions in this area to prepare for an increase demand for mental health services. The aim of this study was to conduct a meta-analysis of the digital mental health interventions for people with comorbid physical and mental chronic diseases to compare the effect of technology systems and level of support. Methods This secondary meta-analysis follows a rapid review of systematic reviews, a virtual workshop with knowledge users to identify research questions and a modified Delphi study to guide research methods: What types of digital health interventions (according to a recognized categorization) are the most effective for the management of concomitant mental health and chronic disease conditions in adults? We conducted a secondary analysis of the primary studies identified in the rapid review. Two reviewers independently screened the titles and abstracts and applied inclusion criteria: RCT design using a digital mental health intervention in a population of adults with another chronic condition, published after 2010 in French or English, and including an outcome measurement of anxiety or depression. Results Seven hundred eight primary studies were extracted from the systematic reviews and 84 primary studies met the inclusion criteria Digital mental health interventions were significantly more effective than in-person care for both anxiety and depression outcomes. Online messaging was the most effective technology to improve anxiety and depression scores; however, all technology types were effective. Interventions partially supported by healthcare professionals were more effective than self-administered. Conclusions While our meta-analysis identifies digital intervention’s characteristics are associated with better effectiveness, all technologies and levels of support could be used considering implementation context and population. Trial registration The protocol for this review is registered in the National Collaborating Centre for Methods and Tools (NCCMT) COVID-19 Rapid Evidence Service (ID 75)