Hypnosis Antenatal Training for Childbirth (HATCh): a randomised controlled trial [NCT00282204]

BACKGROUND: Although medical interventions play an important role in preserving lives and maternal comfort they have become increasingly routine in normal childbirth. This may increase the risk of associated complications and a less satisfactory birth experience. Antenatal hypnosis is associated with a reduced need for pharmacological interventions during childbirth. This trial seeks to determine the efficacy or otherwise of antenatal group hypnosis preparation for childbirth in late pregnancy. METHODS/DESIGN: A single centre, randomised controlled trial using a 3 arm parallel group design in the largest tertiary maternity unit in South Australia. Group 1 participants receive antenatal hypnosis training in preparation for childbirth administered by a qualified hypnotherapist with the use of an audio compact disc on hypnosis for re-enforcement; Group 2 consists of antenatal hypnosis training in preparation for childbirth using an audio compact disc on hypnosis administered by a nurse with no training in hypnotherapy; Group 3 participants continue with their usual preparation for childbirth with no additional intervention. Women > 34 and < 39 weeks gestation, planning a vaginal birth, not in active labour, with a singleton, viable fetus of vertex presentation, are eligible to participate. Allocation concealment is achieved using telephone randomisation. Participants assigned to hypnosis groups commence hypnosis training as near as possible to 37 weeks gestation. Treatment allocations are concealed from treating obstetricians, anaesthetists, midwives and those personnel collecting and analysing data. Our sample size of 135 women/group gives the study 80% power to detect a clinically relevant fall of 20% in the number of women requiring pharmacological analgesia – the primary endpoint. We estimate that approximately 5–10% of women will deliver prior to receiving their allocated intervention. We plan to recruit 150 women/group and perform sequential interim analyses when 150 and 300 participants have been recruited. All participant data will be analysed, by a researcher blinded to treatment allocation, according to the "Intention to treat" principle with comprehensive pre-planned cost- benefit and subgroup analyses. DISCUSSION: If effective, hypnosis would be a simple, inexpensive way to improve the childbirth experience, reduce complications associated with pharmacological interventions, yield cost savings in maternity care, and this trial will provide evidence to guide clinical practice

A Reinserção Social da População Idosa Reclusa

A presente investigação tem como objetivo estudar a problemática da reinserção social da população idosa detida nos estabelecimentos prisionais em Portugal. Esta é uma realidade que está em crescimento, contudo as informações disponíveis, nomeadamente na área da Reinserção Social, são escassas. O estudo foi realizado através de uma análise documental da legislação Portuguesa, da lei Portuguesa, nomeadamente o Regulamento Geral dos Estabelecimentos Prisionais (Decreto-lei n.º 51/2011, de 11 de abril), o Código da Execução das Penas e Medidas Privativas da Liberdade (Decreto-lei n.º 115/2009, de 12 de outubro), estatísticas da justiça, relatórios das prisões e programas disponíveis no site da Direção-Geral de Reinserção e Serviços Prisionais (DGRSP), da PORDATA, do Council of Europe - Annual Penal Statistics, dissertações de mestrados nacionais relativas ao tema em análise, relatórios estrangeiros que avaliam a condição da população idosa reclusa em França e nos Estados Unidos, os quais permitiram uma abordagem ampla e pertinente relativamente aos problemas da reinserção social destes idosos. Uma das primeiras conclusões é o não consenso na idade das pessoas consideradas, na sociedade atual, como pessoas idosos, assim, optamos por adotar o conceito/idade que figura nas estatísticas oficiais da Direção-Geral de Reinserção e Serviços Prisionais - 60 anos ou mais. O processo de envelhecimento na prisão é analisado através dos problemas de saúde do recluso, das atividades desenvolvidas no meio prisional e as consequências da sua saída para a sociedade, ou seja, os problemas que o recluso terá que enfrentar após o cumprimento da pena, como por exemplo, as relações familiares e o alojamento. Com o aumento da população idosa nos estabelecimentos prisionais e com a inexistência de programas adequados a pessoa idosa, parece-nos que ainda existe muito a fazer no que diz respeito ao cumprimento da pena por parte dos idosos e como lhes é preparada a sua saída. / The present investigation aims to study the problem of social reintegration of the elderly population detained in prisons in Portugal. This is a reality that is growing, however the information available, namely in the area of Social Reinsertion, is scarce. The study was carried out through a documentary analysis, based on the DGRSP website, under Portuguese law, namely the General Regulation of Prison Establishments (Decree-Law nº 51/2011, of 11 April) and the Code of Execution of Penalties and Measures Deprived of Freedom (Decree-Law nº 115/2009, of 12 October), statistics of justice provided by the PORDATA website, Council of Europe - Annual Penal Statistics, dissertations of national masters related to the subject under analysis, foreign reports that assess the condition of the elderly population in prison in France and the United States, which allowed a broad and pertinent approach to the problems of social reintegration of these elderly people. One of the first conclusions is the lack of consensus on the concept of being elderly, so we chose to adopt the concept of PORDATA - 60 years or more. The aging process in prison is analyzed through the health problems of the prisoner, the activities developed in the prison environment and the consequences of his departure for society, that is, the problems that the prisoner will have to face after serving his sentence, as for example, family relationships and housing. It seems to us that there is still a lot to be done with regards to serving the sentence by the elderly and how they are prepared to leave

Arboviruses of Oceania

Arboviruses present an ongoing challenge to Oceanic nations. Viruses including Ross River, Barmah Forest and Murray Valley encephalitis are endemic to the region and are responsible for occasional outbreaks. Recent epidemics of chikungunya, Zika and dengue viruses across many nations demonstrate the vulnerability of this region to globally emergent arboviruses. In addition to global disease trends, the emergence of these viruses is largely driven by human influences such as water and waste management, air travel and land use. Limited public health resources and infrastructure, dispersed populations and the complexity of arbovirus ecologies complicate mitigation and management strategies in the Western Pacific. A regional collaborative approach augments the surveillance and response capability of individual nations, but the challenge of managing arbovirus risk with limited resources remains. In the absence of specific disease treatments and feasible vaccination solutions, mosquito control and personal protective measures are the mainstay of management programmes, albeit with variable success. In the long term, the development and integration of novel surveillance, diagnostic and mosquito control technologies will improve the capacity to prevent and respond to arbovirus threats