Repeat procedures, adhesions, and obesity prolonged the time taken for cesarean delivery. Nevertheless, the effect of these factors on the 5-minute Apgar score was minimal.
Adolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.Declaration of interestNone.
Attention-deficit/hyperactivity disorder (ADHD) is among the most prevalent disorders of childhood and adolescence worldwide. Teachers are likely to play an important role in multiple stages of the help-seeking process (e.g., problem recognition) for children with ADHD. This study examined the relationship of prior exposure and ADHD training with teachers’ knowledge and misconceptions of the disorder in a multinational sample. Teachers ( N = 2,307) from 9 countries (Czech Republic, Germany, Greece, Iraq, the Republic of Korea, Saudi Arabia, South Africa, United States, and Vietnam) completed measures of ADHD knowledge, prior exposure, and education or training related to ADHD. There was considerable variability in overall levels of knowledge and specific misconceptions across the countries sampled. Although the predictors of ADHD knowledge varied considerably across countries, some form of professional training and prior exposure to ADHD was associated with greater knowledge in the majority of countries. Implications for teacher training and the role teachers can play in the help-seeking process are discussed.
BackgroundThere is a dearth of empirical evidence on the effectiveness of pharmacological and nonpharmacological treatments for adolescents with post-traumatic stress disorder (PTSD) in developing country settings. The primary aim of this study was to demonstrate that Prolonged Exposure Treatment for Adolescents (PE-A) and supportive counselling (SC) are implementable by nurses in a South African context. A secondary aim was to perform a preliminary analysis of the effectiveness of registered nurses delivering either PE-A or SC treatment to adolescents with PTSD. It is hypothesised that PE-A will be superior to SC in terms of improvements in PTSD symptoms and depression.MethodA pilot, single-blind, randomised clinical trial of 11 adolescents with PTSD. Nurses previously naïve to Prolonged Exposure (PE) Treatment and SC provided these treatments at the adolescents’ high schools. Data collection lasted from March 2013 to October 2014. Participants received twelve 60–90-min sessions of PE (n = 6) or SC (n = 5). All outcomes were assessed before treatment, at mid-treatment, immediately after treatment completion and at 12-month follow-up. The primary outcome, PTSD symptom severity, was assessed with the Child PTSD Symptom Scale–Interview (CPSS-I) (range, 0–51; higher scores indicate greater severity). The secondary outcome, depression severity, was assessed with the Beck Depression Inventory (BDI) (range, 0–41; higher scores indicate greater severity).ResultsData were analysed as intention to treat. During treatment, participants in both the PE-A and SC treatment arms experienced significant improvement on the CPSS-I as well as on the BDI. There was a significant difference between the PE-A and SC groups in maintaining PTSD and depression at the 12-month post-treatment assessment, with the participants in the PE-A group maintaining their gains both on PTSD and depression measures.ConclusionThe treatment was adequately implemented by the nurses and well-tolerated by the participants. Preliminary results suggest that the delivery of either intervention led to a significant improvement in PTSD and depression symptoms immediately post treatment. The important difference was that improvement gains in PTSD and depression in the PE-A group were maintained at 12-month follow-up. The results of this pilot and feasibility study are discussed.Trial registrationPan African Clinical Trials Registry: PACTR201511001345372, registered on 11 November 2015.
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