Cognitive Behavioural Therapy for schizophrenia - outcomes for functioning, distress and quality of life : A meta-analysis

Background: The effect of cognitive behavioural therapy for psychosis (CBTp) on the core symptoms of schizophrenia has proven contentious, with current meta-analyses finding at most only small effects. However, it has been suggested that the effects of CBTp in areas other than psychotic symptoms are at least as important and potentially benefit from the intervention. Method: We meta-analysed RCTs investigating the effectiveness of CBTp for functioning, distress and quality of life in individuals diagnosed with schizophrenia and related disorders. Data from 36 randomised controlled trials (RCTs) met our inclusion criteria- 27 assessing functioning (1579 participants); 8 for distress (465 participants); and 10 for quality of life (592 participants). Results: The pooled effect size for functioning was small but significant for the end-of-trial (0.25: 95% CI: 0.14 to 0.33); however, this became non-significant at follow-up (0.10 [95%CI -0.07 to 0.26]). Although a small benefit of CBT was evident for reducing distress (0.37: 95%CI 0.05 to 0.69), this became nonsignificant when adjusted for possible publication bias (0.18: 95%CI -0.12 to 0.48). Finally, CBTp showed no benefit for improving quality of life (0.04: 95% CI: -0.12 to 0.19). Conclusions: CBTp has a small therapeutic effect on functioning at end-of-trial, although this benefit is not evident at follow-up. Although CBTp produced a small benefit on distress, this was subject to possible publication bias and became nonsignificant when adjusted. We found no evidence that CBTp increases quality of life post-intervention.Peer reviewedFinal Published versio

THE REPRESENTATION OF GENDER IN DISNEY’S SNOW WHITE AND THE SEVEN DWARFS AND MIRROR MIRROR MOVIE

The present study entitled The Representation of Gender in Disney’s Snow White and the Seven Dwarfs and Mirror Mirror Movie aims at investigating the gender stereotypes representation in both of the movies using the chosen theory of gender stereotypes aspects by Golombok and Fivush (1994), also analyzing the gender development traits ascribed to character of Snow White in the movies. This study uses descriptive qualitative approach in relation to investigate and analyze the object material which are Snow White and the Seven Dwarfs (1937) and Mirror Mirror (2012) movies. The data were gained by doing observation. And to figure out the research question, the writer uses content analysis and employs the theory of gender stereotypes aspects (Golombok and Fivush, 1994) which are physical appearance, personality traits, attitudes and interest, social relations and occupation. This study uncovers the gender representation ascribed to Snow White in two version of the movies. The result shows that, in the first version, Snow White and the Seven Dwarfs (1937) is still presented gender stereotypes by ascribing femininity to Snow White, the character imaged as domestic, dependent and weak character. And Snow White experienced the gender development representation and the changing image of woman in Mirror Mirror (2012), on the movie Snow White is no longer images as before,dependent and weak but more likely to have a strong and brave character. Keywords: gender representation, woman image, Snow White, content analysi

THE CONTEMPORARY POLICING CONCEPT: HOW THE GLOBALISATION AFFECTED THE NEW CONCEPT OF INDONESIAN POLICING ON PREDICTIVE POLICING OF “PRESISI”

This research is to examine how globalisation affects the concept of policing in Indonesia. The concept of globalisation that affects the development of crime and accelerates the development of the concept of policing to address crime issues is expected to be able to support the transformation of the INP (Indonesia National Police) in combating crimes. The research method used in this study is qualitative. The research technique is library research or literature review which is a research technique that analyses data related to problems, with data collection techniques from literature in the form of books, newspaper magazines and visits to internet sites and other sources that support research. There is a fundamental misconception of the predictive policing concept in most of the INP police member, and there is no specific single bureau that able to manage big data for predictive policing. Predictive policing may not be the ultimate answer for crime prevention. Actual evaluations of the usage of these models in practice lead to mixed results. to aim this, it needed to apply the theory collaborating with the local norms to get the optimal result

Compliance with IFA & Vitamin C Tablet Consumption among Pregnant Women in Mekargalih, Sumedang, Indonesia, in 2014

Based on Demographic and Health Survey (SDKI) 2012 in Indonesia, maternal mortality rate reached 359 per 100.000 births. In Indonesia, maternal mortality rate is caused by anaemia, it reached 37.1% in pregnant women. Government programs to give iron folic acid(IFA) tablets for pregnant women have not increased their awareness, as only 33,3% of them consume IFA ≥ 90 tablets during their pregnancy (RISKESDAS, 2013). This study was aimed to investigate compliance of IFA and Vitamin C tablets consumption among pregnant woman based on gravidity in Mekargalih Village, Sumedang. This study is a descriptive quantitative methods using cross-sectional design. Total sample is 50 pregnant women who were selected based on inclusioncriteria and using univariate analysis. Result showed that 52% of pregnant women complied IFA tablets, while 22% of them complied vitamin C. In the meantime, their compliance in taking IFA tablets based on gravidity were 50% in primigravida and 53 % in multigravida pregnancy, compliance in taking Vitamin C tablets based ongravidity were 25% in primigravida and 21% in multigravida pregnancy. Based on the result, it can be concluded that half of the pregnant women complied in taking IFA, only a small number taking Vitamin C tablets. As health-care professionals, we should be able to give interventions in the form of communication, information, and education for the pregnant women, as well as involving their family members in terms of monitoring their IFA tablets and Vitamin C consumption Keywords: Pregnant woman, Compliance, IFA, Vitamin C tablet

Takotsubo Syndrome and COVID-19: Associations and Implications.

Incidence of cardiovascular complications has increased during the COVID-19 (Coronavirus disease 2019) pandemic, both population-wide and in patients diagnosed with the disease. This increase has presented complications in patient care, leading to increased hospitalizations, adverse outcomes, and medical costs. A condition of interest is takotsubo syndrome, which may be associated with the novel coronavirus. To understand this connection, a narrative review was performed by analyzing primary studies and case reports available. The findings showed increased incidence of takotsubo cardiomyopathy in both the general population and COVID-19 patients. Proposed mechanisms for the linkage include generalized increases in psychological distress, the cytokine storm, increased sympathetic responses in COVID-19 patients, and microvascular dysfunction. Moreover, natural disasters are noted as likely being associated with increases of takotsubo syndrome. As the pandemic continues, treating COVID-19 as a systemic condition is imperative, with the increase in takotsubo syndrome marking a significant impact of the novel coronavirus

A critique of narrative reviews of the evidence-base for ECT in depression

© The Author(s), 2022. Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/)There has been recent debate regarding the efficacy of electroconvulsive therapy in the treatment of depression. This has been based on narrative reviews that contradict existing systematic reviews and meta-analyses. In this special article, we highlight the mistakes that occur when interpreting evidence using narrative reviews, as opposed to conventional systematic reviews and meta-analyses.Peer reviewedFinal Published versio

Pulmonary Embolism in Patients Hospitalized With COVID-19 (From a New York Health System)

© 2020 Elsevier Inc. Pulmonary embolisms (PEs) in coronavirus disease 2019 (COVID-19) have increasingly been reported in observational studies. However, limited information describing their clinical characteristics and outcomes exists. Our study aims to describe clinical features and risk stratification strategies of hospitalized COVID-19 patients with PE. We retrospectively analyzed 101 hospitalized patients with COVID-19 infection and acute PE. Clinical outcomes measured were intensive care unit admission, mechanical ventilation, bleeding and transfusion events, acute kidney injury (AKI) and mortality. Pulmonary severity index (PESI) scores were used for risk stratification. The most common comorbidities were hypertension (50%), obesity (27%) and hyperlipidemia (32%) among this cohort. Baseline D-dimer abnormalities (4,647.0 ± 8,281.8) were noted on admission with a 3-fold increase at the time of PE diagnosis (13,288.4 ± 14,917.9; p 85), which portended a worse prognosis with higher mortality rate and length of stay. In conclusion, this study provides characteristics and early outcomes for hospitalized patients with COVID-19 and acute pulmonary embolism. PESI scores were utilized for risk stratifying clinical outcomes. Our results should serve to alert the medical community to heighted vigilance of this VTE complication associated with COVID-19 infection

Usefulness of Elevated Troponin to Predict Death in Patients with COVID-19 and Myocardial Injury.

Elevations in troponin levels have been shown to predict mortality in patients with coronavirus disease 2019 (COVID-19). The role of inflammation in myocardial injury remains unclear. We sought to determine the association of elevated troponin with mortality in a large, ethnically diverse population of patients hospitalized with COVID-19, and to determine the association of elevated inflammatory markers with increased troponin levels. We reviewed all patients admitted at our health system with COVID-19 from March 1 to April 27, 2020, who had a troponin assessment within 48 hours of admission. We used logistic regression to calculate odds ratios (ORs) for mortality during hospitalization, controlling for demographics, comorbidities, and markers of inflammation. Of 11159 patients hospitalized with COVID-19, 6247 had a troponin assessment within 48 hours. Of these, 4426 (71%) patients had normal, 919 (15%) had mildly elevated, and 902 (14%) had severely elevated troponin. Acute phase and inflammatory markers were significantly elevated in patients with mildly and severely elevated troponin compared to normal troponin. Patients with elevated troponin had significantly increased odds of death for mildly elevated compared to normal troponin (adjusted OR, 2.06; 95% CI, 1.68-2.53; P \u3c .001) and for severely elevated compared to normal troponin (OR, 4.51; 95% CI, 3.66-5.54; P \u3c .001) independently of elevation in inflammatory markers. In conclusion, patients hospitalized with COVID-19 and elevated troponin had markedly increased mortality compared to patients with normal troponin levels. This risk was independent of cardiovascular comorbidities and elevated markers of inflammation

Impact of the COVID-19 pandemic on interventional cardiology fellowship training in the New York metropolitan area: A perspective from the United States epicenter

© 2020 Wiley Periodicals, Inc. Background: The healthcare burden posed by the coronavirus disease 2019 (COVID-19) pandemic in the New York Metropolitan area has necessitated the postponement of elective procedures resulting in a marked reduction in cardiac catheterization laboratory (CCL) volumes with a potential to impact interventional cardiology (IC) fellowship training. Methods: We conducted a web-based survey sent electronically to 21 Accreditation Council for Graduate Medical Education accredited IC fellowship program directors (PDs) and their respective fellows. Results: Fourteen programs (67%) responded to the survey and all acknowledged a significant decrease in CCL procedural volumes. More than half of the PDs reported part of their CCL being converted to inpatient units and IC fellows being redeployed to COVID-19 related duties. More than two-thirds of PDs believed that the COVID-19 pandemic would have a moderate (57%) or severe (14%) adverse impact on IC fellowship training, and 21% of the PDs expected their current fellows\u27 average percutaneous coronary intervention (PCI) volume to be below 250. Of 25 IC fellow respondents, 95% expressed concern that the pandemic would have a moderate (72%) or severe (24%) adverse impact on their fellowship training, and nearly one-fourth of fellows reported performing fewer than 250 PCIs as of March 1st. Finally, roughly one-third of PDs and IC fellows felt that there should be consideration of an extension of fellowship training or a period of early career mentorship after fellowship. Conclusions: The COVID-19 pandemic has caused a significant reduction in CCL procedural volumes that is impacting IC fellowship training in the NY metropolitan area. These results should inform professional societies and accreditation bodies to offer tailored opportunities for remediation of affected trainees

Management of Acute Myocardial Infarction During the COVID-19 Pandemic.

The worldwide pandemic caused by the novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) has resulted in a new and lethal disease termed coronavirus disease 2019 (COVID-19). Although there is an association between cardiovascular disease and COVID-19, the majority of patients who need cardiovascular care for the management of ischemic heart disease may not be infected with COVID-19. The objective of this document is to provide recommendations for a systematic approach for the care of patients with an acute myocardial infarction (AMI) during the COVID-19 pandemic. There is a recognition of two major challenges in providing recommendations for AMI care in the COVID-19 era. Cardiovascular manifestations of COVID-19 are complex with patients presenting with AMI, myocarditis simulating a ST-elevation MI presentation, stress cardiomyopathy, non-ischemic cardiomyopathy, coronary spasm, or nonspecific myocardial injury and the prevalence of COVID-19 disease in the US population remains unknown with risk of asymptomatic spread. This document addresses the care of these patients focusing on 1) the varied clinical presentations; 2) appropriate personal protection equipment (PPE) for health care workers; 3) role of the Emergency Department, Emergency Medical System and the Cardiac Catheterization Laboratory; and 4) Regional STEMI systems of care. During the COVID-19 pandemic, primary PCI remains the standard of care for STEMI patients at PCI capable hospitals when it can be provided in a timely fashion, with an expert team outfitted with PPE in a dedicated CCL room. A fibrinolysis-based strategy may be entertained at non-PCI capable referral hospitals or in specific situations where primary PCI cannot be executed or is not deemed the best option