Cognitive behavioral therapy (CBT) designed to target generalized anxiety disorder (GAD) in youth was examined in a pilot feasibility trial. Participants (aged 10-18 years) were randomized to either 10 weeks of individual CBT (n = 20) or supported wait-list (n = 20). Diagnostic status (primary outcome) was assessed blindly at post-treatment for both groups, and at a 3-month follow-up for treated participants. Two participants failed to complete CBT and retained their GAD during the trial. Intention-to-treat analyses revealed large between-group differences in favor of CBT at post-treatment for remission from GAD (80% vs 0%) and comorbid disorders (83% vs 0%), and for all secondary outcomes (child and parent-reported). All gains were maintained at 3-month follow-up in the CBT group. Consistent with the treatment model, significant pre-to post-treatment reductions in several cognitive processes were found for CBT but not wait-listed participants, with these gains maintained at follow-up. Further investigations are warranted. Trial registry: ISRCTN.com Identifier ISRCTN50951795
A review of the neglected area of the relationship between loss and grief and the less well-documented areas of discrimination in relation to age, disability and sexuality. • Findings: There is an extensive and long-standing literature base relating to loss and grief. However, the major focus of such work is predominantly psychological and individualistic in its focus. Only recently a solid body of work relating to the sociological dimensions of loss and grief has begun to build up. This new literature has largely followed the pattern of the development of anti-discriminatory practice in social work, with a major emphasis on class, race and gender, and little attention paid to the less well-established forms of discrimination such as ageism, disablism and heterosexism. • Applications: This article explores the relationship between these three forms of discrimination and loss and grief, with a view to establishing the importance of developing a broad-based anti-discriminatory practice in this important area of social work.
Keywords ageism disablism grief heterosexism lossThe sociological basis of loss and grief has tended to be neglected (Field et al., 1997a). Indeed, a strong argument can be made to the effect that the professional literature has focused primarily on the psychological aspects. The need to take account of the broader social aspects can therefore be seen as a basic starting point for developing a more sophisticated theoretical understanding of loss experiences and the associated grief reactions. As Field et al.(1997a: xi) argue: 'While death and dying have been a focus for research among theorists and practitioners from many fields, it is timely and indeed appropriate that social scientists for whom social differences are stock-in-trade should
Background
Osteogenesis imperfecta (OI) is an inherited disorder, which causes brittle bones resulting in recurrent fractures. The associated poor mobility of children with OI increases susceptibility to obesity, and obesity further dramatically limits mobility and increases fracture risk.
Objectives
The aim of this report was to describe outcomes of weight loss surgery (WLS) in two adolescents with severe obesity and OI.
Setting
Two University Hospitals (in the United Kingdom and in the United States).
Methods
Two cases of OI treated with WLS were identified. Pre- and post-operative anthropometric and biochemical data and clinical course were reviewed.
Results
In these 2 cases, preoperative Body Mass Index (BMI) values were 38 and 46 kg/m2. Following laparoscopic sleeve gastrectomy (LSG), BMI decreased by 55% and 60% by 26 and 24 months, respectively. There were no surgical complications and both patients experienced improvement in their mobility and ability to perform activities of daily living.
Conclusions
WLS effectively treated severe obesity in two OI patients and substantially improved mobility and quality of life, theoretically reducing fracture risk.
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