Be a Mom: Formative Evaluation of a Web-Based Psychological Intervention to Prevent Postpartum Depression

A formative evaluation (consisting of two phases: a scoping literature review and a focus group with mental health professionals) was conducted to inform the design of a web-based intervention to prevent postpartum depression, in terms of its characteristics and content: the Be a Mom program. The results showed that the web-based intervention should be short-term, delivered postnatally, and grounded in cognitive-behavior therapy principles. Moreover, the intervention should include weekly sessions targeting basic contents: motherhood changes, reorganizations and emotional experience; cognitions, self-criticism, and self-compassion; parenting values, social support, and assertive communication skills; couple relationship, negotiation and conflict resolution skills; and postpartum depression signs and professional help-seeking. These results may improve the Be a Mom’s adequacy, implementation success, and effectiveness.     

Development and Feasibility of a Group Cognitive-Behavioral Therapy for Fear of Cancer Recurrence

This paper describes the development, content, and preliminary results of a group cognitive-behavioral therapy (CBT) for fear of cancer recurrence (FCR). A manualized CBT intervention was developed and offered to 38 patients with various cancer types and stages in two hospitals. Four weekly group CBT sessions were administered by two licensed psychologists as part of routine care. Patients completed self-report scales before the first treatment session and, a second time, 1 month after the last session.Overall, 33 patients had clinical levels of FCR at baseline. The participants’ satisfaction toward the group CBT for FCR was high. Significant reductions on the total score and most subscales of the Fear of Cancer Recurrence Inventory (FCRI) were observed, as well as significant improvements on most of the other psychological variables measured (i.e., insomnia, anxiety, depression, dysfunctional beliefs about cancer, and intolerance of uncertainty). In addition, 52% of the patients with clinical levels of FCR (FCRI-severity subscale score ≥ 13) at baseline no longer reached this clinical threshold at posttreatment.These preliminary results suggest that our group CBT for FCR is well accepted and feasible, and shows promising efficacy for decreasing FCR and improving other psychological variables among cancer patients. The next step is to investigate the efficacy of this minimal intervention in larger and controlled clinical trials, as well as its usefulness as part of a stepped care approach.This low-cost intervention is easy to implement in various clinical settings and has a strong potential to help large numbers of patients with FCR.     

Effective interactions: Communication and high levels of marital satisfaction

Of all the significant relationships in the lives of human-beings, the marital relationship remains one of the most central and important to their well-being. For this rapid review the authors accessed four online databases (PsycINFO, PsychARTICLES, JSTOR Journals, and ScienceDirect) to examine the evidence on aspects of communication which contribute to high levels of marital satisfaction and to synthesise these findings. The search yielded 103 unique articles, of which 15 were ultimately included. Principal results found the following activities to relate to high marital satisfaction: 1) communication activities such as engaging in small talk and providing verbal and non-verbal messages of affection; 2) “positive” exchanges which include any interactions perceived by both parties as constructive; 3) effective conflict management including the use of responses of recalibration and reaffirmation (R-R response), the use of we-pronouns, and the Listener-Speaker technique; 4) possessing and implementing effective communication skills such as using “I” instead of “you” messages; and 5) using “positive” communication skills such as clarification to elicit “positive” affect such as feeling understood. The evidence suggests that mental health professionals working with married couples should seek to promote quality dyadic communication as part of treatment interventions.     

Portugal’s Immigration and Integration Policies: a Case Apart?

Most countries in Europe have seen the rise of anti-immigrant political parties in recent years and many have implemented more restrictive immigration measures. Portugal has moved in the opposite direction, seeking to produce some of the best practices and laws on immigration and immigrant integration. Traditional theories of immigration policy fail to account for the Portuguese case, and regional models of immigration overlook ways in which Portugal diverges. Instead, Portuguese policies are best understood as the product of (1) a political consensus on immigration that derives in part from Portugal’s social-revolutionary democratic transition; (2) innovative institutions that enjoy both autonomy and political support, enable a “whole-of-government” approach, and mediate social pressures created by immigration; and (3) leadership choices made by politicians, bureaucrats, and civil society groups to forge consensus and seek inclusion. The Portuguese case signals the importance of adopting other lenses for the comparative study of immigration policies that go beyond regional models and highlight policy similarities among countries from distinct regions.     

Non-binary youth: Access to gender-affirming primary health care

ABSTRACT

Background: Transgender (trans) youth who identify outside the gender binary are a growing subpopulation. In this article, we document differences in access to gender-affirming health care between binary and non-binary identified trans youth and explore ways of meeting the health needs of non-binary youth within primary care settings.

Methods: The Canadian Trans Youth Health Survey is a national online survey of trans youth, 14–25 years, conducted in 2013–2014. Among the 839 participants who responded to gender identity items in the survey, 41% identified as non-binary. We compared demographic, health outcome, and health care access responses between non-binary and binary (trans girls/women and trans boys/men) youth.

Results: Non-binary and binary youth were similar in most demographics, including age, geographic distribution, and ethnocultural backgrounds, however a larger proportion (82%) of non-binary youth were assigned female at birth. Older non-binary youth (aged 19–25) were significantly more likely to forego needed healthcare than older binary youth; no significant differences were found between younger (14–18) non-binary and binary youth in foregoing healthcare. Overall, non-binary youth (13%) were significantly less likely than binary youth (52%) to access hormone therapy, but they were more likely than binary youth to report experiencing barriers to accessing hormone therapy when needed.

Conclusions: Non-binary trans youth in Canada report challenges in accessing needed gender-affirming healthcare. Primary care providers are well-situated to integrate a broad range of gender-affirming care services into practice in order to address the unique needs of non-binary youth. Future research is warranted to explore experiences of non-binary youth related to barriers to care and to explore how services can be designed and delivered to better meet the needs of non-binary youth seeking gender-affirming primary care.     

Internationally adopted children’s cognitive and social-emotional development during the first post-adoption year: A longitudinal study

Research is consistent in showing that international adoption is an intervention leading to great recovery for adopted children, but there is a need of research on factors associated with recovery. The present study is aimed at: (a) assessing children’s cognitive skills and social-emotional dimensions on their arrival to their new family; (b) evaluating their development after one year; (c) identifying which factors influence development, taking into account children’s gender, age, health status on arrival, years of institutionalization, and the initial psychological delay. Participants were 53 internationally adopted children (30 boys and 23 girls), aged 5.68 years old on average at placement (range 2–14). Results showed that children’s development one year after adoption was extraordinary, both in cognitive skills and in social-emotional dimensions. The children more delayed on arrival showed the larger progress over time, and their recovery was greater in cognitive skills than in social-emotional dimensions.     

Determinants of Quality of Life in Pre-Frail Older Adults According to Phenotypic Criteria: the VERISAUDE Study

Frailty is a dynamic clinical syndrome considered as part of an age-associated continuum of severity, including pre-frailty as an intermediate frailty status with potential reversibility to robustness. The main purpose of this study was to analyse the relationship between the different domains of quality of life, functional dependence and depressive symptomatology in older adults diagnosed as pre-frail, before progression to frailty occurs. Logistic regression analyses were conducted to examine whether sex, age, level of education and scores in the Geriatric Depression Scale 15-item Short Form (GDS-SF) and the Instrumental Activities of Daily Living Lawton scale determine the worst score in the WHOQOL-BREF (World Health Organization Quality of Life) in older adults meeting one or two frailty phenotypic criteria. Depressive symptomatology (GDS-SF score) was the main determinant of poor quality of life in both groups, and in all areas of WHOQOL-BREF. Age was only associated with poor satisfaction with own health. Female sex and low educational level were linked to low physical QOL and poor self-rated health, respectively, but only in older adults meeting one frailty criterion. Association between functional status and WHOQOL-BREF scores was only found in the univariate analysis. These results underline the importance of identifying multiple aspects, but mainly the presence of depressive symptomatology, as risk factors for all dimensions of quality of life in the pre-frailty process, where interventions might be targeted to reduce the progression of pre-frailty and frailty in older adults.     

Thermal sensitivity and cardiovascular reactivity to stress in healthy males

This paper examines the association of cardiovascular reactivity with thermal thresholds (detection and unpleasantness). Heart period (HP), systolic (SBP) and diastolic (DBP) blood pressure of 42 health young males were recorded during a cardiovascular reactivity task (a videogame based upon Sidman's avoidance paradigm). Thermal sensitivity, assessing detection and unpleasantness thresholds with radiant heat in the forearm was also estimated for participants. Participants with differential scores in the cardiovascular variables from base line to task > or = P65 were considered as reactors and those how have differential scores < or = P35 were considered as non-reactors. Significant differences were observed between groups in the unpleasantness thresholds in blood pressure (BP) but not in HP. Reactors exhibited significant higher unpleasantness thresholds than non-reactors. No significant differences were obtained in detection thresholds between groups.     

Evaluating reading and metacognitive deficits in children and adolescents with attention deficit hyperactivity disorder

The reading achievement of children and adolescents with Attention Deficit Hyperactivity Disorder (ADHD) has scarcely been explored in research conducted in the Spanish language and when it has, the results have been contradictory. The focus of the present research is to analyze participants' reading competency and metacognitive strategies as they carry out reading comprehension tasks. The sample was comprised of 187 Argentine schoolchildren aged 9 to 13 years old. 94 constituted the control group and the clinical group consisted of 93 schoolchildren diagnosed with ADHD. The metacognitive assessment was made up of two metacognitive tests, the Reading Awareness Scale (ESCOLA; acronym in Spanish) and a Spanish adaptation of Metacognitive Awareness of Reading Strategies Inventory (MARSI), and one test of reading comprehension, the Evaluation of Reading Processes for Secondary Education Students (PROLEC-SE; acronym in Spanish). Students with ADHD had lower achievement on tests o reading comprehension compared to the control group. Nevertheless, our results suggest their difficulties did not stem from readin comprehension problems, but rather from alterations in their Executive Functions, because when subjects' reading comprehensio was equalized, students with ADHD still exhibited a lower level of Metacognition, particularly when it came to planning.     

Doping in sport and enhancement medicine

The reason that gives doping in sport a deeper philosophical and ethical dimension is the emergence of a new medical paradigm: enhancement medicine. The question of enhancing performance in sport has become part of a broader societal debate on human enhancement. The gradual blurriness of the boarders between therapeutic medicine and enhancement medicine constitutes the most spectacular and the most troublesome form of these modifications. In the contemporary biomedicine, the new medicines and technologies can be used not only to cure the patients but also to enhance human capacities. This evolution represents a paradigmatic change in the medical practice: it is not the mere restoration of health which is expected anymore, nor the promotion of health. What is required is the improvement of performance and the perfectibility of the human being, including in the field of sport. Competitive sport could become the main laboratory of enhancement medicine. The intersection of science and sport raises fundamental philosophical, ethical and policy issues that cannot be answered easily. The prohibition and the war on doping is not the only solution.