The relationship between child neglect and adolescent interpersonal functioning:A systematic review

Background Neglect is a highly prevalent, yet historically understudied form of maltreatment. Recent research has revealed the far reaching and unique effects that neglect has on subsequent cognitive, behavioural and socio-emotional development, and on long-term physical and mental health outcomes. Adolescent interpersonal functioning is important to explore given the significant relational transitions that occur during this stage of development, and the known impact that these social changes can have on future life outcomes. Objective This systematic review synthesises the literature exploring the relationship between neglect and adolescent interpersonal functioning in peer relationships. Methods Seven databases and three grey literature sites were systematically searched, and identified records screened against inclusion criteria. Results Twenty-one articles were included in the final sample, exploring five different indicators of adolescent interpersonal functioning. Around half of the papers investigating quality of peer relationships found that neglect, particularly emotional neglect, is associated with reduced relationship quality, and there is consistent evidence that neglect increases the risk of gang involvement and deviant peer affiliation. Conclusions These findings may be used to strengthen a trauma-informed approach to work with adolescents. Research on neglect and adolescent romantic relationships is sparse. Overall, the literature is varied and further research using longitudinal data and consistent measures of neglect would be of value

Association between urinary sodium, creatinine, albumin, and long term survival in chronic kidney disease

Dietary sodium intake is associated with hypertension and cardiovascular risk in the general population. In patients with chronic kidney disease, sodium intake has been associated with progressive renal disease, but not independently of proteinuria. We studied the relationship between urinary sodium excretion and urinary sodium:creatinine ratio and mortality or requirement for renal replacement therapy in chronic kidney disease. Adults attending a renal clinic who had at least one 24-hour urinary sodium measurement were identified. 24-hour urinary sodium measures were collected and urinary sodium:creatinine ratio calculated. Time to renal replacement therapy or death was recorded. 423 patients were identified with mean estimated glomerular filtration rate of 48ml/min/1.73m<sup>2</sup>. 90 patients required renal replacement therapy and 102 patients died. Mean slope decline in estimated glomerular filtration rate was -2.8ml/min/1.73m<sup>2</sup>/year. Median follow-up was 8.5 years. Patients who died or required renal replacement therapy had significantly higher urinary sodium excretion and urinary sodium:creatinine but the association with these parameters and poor outcome was not independent of renal function, age and albuminuria. When stratified by albuminuria, urinary sodium:creatinine was a significant cumulative additional risk for mortality, even in patients with low level albuminuria. There was no association between low urinary sodium and risk, as observed in some studies. This study demonstrates an association between urinary sodium excretion and mortality in chronic kidney disease, with a cumulative relationship between sodium excretion, albuminuria and reduced survival. These data support reducing dietary sodium intake in chronic kidney disease but further study is required to determine the target sodium intake

Psychotherapy to treat consequences of interpersonal violence suffered in childhood and adolescence in Latin America:A systematic review

Introduction/Objective. As in the rest of the world, in Latin America there is a high prevalence of interpersonal violence (IV) in childhood and adolescence, which is associated with psychological consequences in the short, medium and long term. At the international level, progress has been made in the recognition of evidence-based psychotherapies, but the situation in Latin America is unknown. The objective of this systematic review of the literature is to identify which models or modalities of psychotherapy have been shown to be effective in Latin America. Methods. A systematic search of five databases was carried out with search terms relating to psychosocial interventions people exposed to IV during childhood, based in Latin America. Studies on Latino populations based in United States were excluded.Results. 14 papers describing 13 studies and one follow-up were identified. Individual and group interventions (mainly cognitive-behavioural and with psychodynamic influence) were included. Although all showed clinically or statistically significant changes in symptoms of post-traumatic stress, anxiety and depression, most were pilot studies with important methodological limitations and high risk of bias.Conclusions. It is necessary to progress clinical practice in Latin America with more robust research (i.e. controlled and randomized clinical trials) that produce more reliable evidence of the effectiveness of psychosocial interventions for IV in children and adolescents in in the Latin American context

The dynamics of racism and anti-racism in a Scottish charity

This research explored how staff and families using a Scottish trauma-informed charity. striving to enact anti-racism, understand and approach race and anti-racism in services for families of colour. Thematic analysis was applied to data from ten interviews with six staff participants and four families. Six interlinking themes emerged. Staff identified the charity as a ‘white organisation’ and sought ‘a common frame of reference’ with families, whilst families expressed overwhelming ‘gratitude’ to staff. ‘Identities were owned and disowned,’ with participants using ‘colour-blind’ racial ideologies. Staff ‘located responsibility’ for bridging cultural gaps in families of colour. White staff, whilst well-intentioned, did not express a fundamental understanding of racism, impeding their ability to enact anti-racism. This reflected wider Scottish policy and lay beliefs of being a post-racist society and challenged organisational attempts to fully embody trauma-informed practice. Challenges and recommendations for researching racism in the third sector are discussed

Complications of Open Approaches to the Skull Base in the Endoscopic Era

Objective It is important to characterize the developing complication profile of the open approach as it becomes reserved for more complex disease during the endoscopic era. Our objective was to characterize complication rates of current open skull base surgery