Couple Therapy for Sexual Dysfunction

2020 ◽  
pp. 139-158
Author(s):  
Talia I. Zaider ◽  
David W. Kissane
Keyword(s):  
Couple Therapy ◽  
Coping Styles ◽  
Good Death ◽  
Sexual Intimacy ◽  
Presenting Problems ◽  
Couple Communication ◽  
Cancer Setting ◽  
Meta Analyses ◽  
Therapy Strategies ◽  
Over Time

Relational strain can be activated by cancer or the effects of its treatment, reducing couple communication and marital satisfaction over time, especially when sexual intimacy declines. Meta-analyses show a modest benefit from couple therapy, with some evidence suggesting better outcomes for couples where one or both partners have greater distress or cancer-related concerns. Presenting problems can include role or transition challenges, communication failure, loss of mutual consensus and conflict, boundary violations, fractures and frustration with sexuality or intimacy. Assessment of the couple includes understanding their experience of the oncology diagnosis and its treatment, their family-of-origin and relational background, coping styles, impact on communication, cohesion, and sexuality alongside any agendas they bring. Behavioral couple therapy strategies can facilitate constructive communication and problem solving to restore intimacy and connectedness during and after treatment. In the advanced cancer setting, existentially oriented models examine grief, death talk, caregiving, and preparation for dying. A search for continued meaning and purpose can empower the couple to live life out to the full, while also preparing for a good death and considering bereavement needs for the survivor.

Psychological and Cognitive Aspects of Borderline Intellectual Functioning

2017 ◽  
Vol 22 (3) ◽  
pp. 159-166 ◽  
Author(s):  
Bastianina Contena ◽  
Stefano Taddei
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Intellectual Functioning ◽  
Clinical Impact ◽  
Review Of The Literature ◽  
Borderline Intellectual Functioning ◽  
General Quality ◽  
Meta Analyses ◽  
Over Time

Abstract. Borderline Intellectual Functioning (BIF) refers to a global IQ ranging from 71 to 84, and it represents a condition of clinical attention for its association with other disorders and its influence on the outcomes of treatments and, in general, quality of life and adaptation. Furthermore, its definition has changed over time causing a relevant clinical impact. For this reason, a systematic review of the literature on this topic can promote an understanding of what has been studied, and can differentiate what is currently attributable to BIF from that which cannot be associated with this kind of intellectual functioning. Using Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) criteria, we have conducted a review of the literature about BIF. The results suggest that this condition is still associated with mental retardation, and only a few studies have focused specifically on this condition.

Psychotherapy with couples

2012 ◽  
pp. 1369-1380
Author(s):  
Michael Crowe
Keyword(s):  
Couple Therapy ◽  
Controlled Trials ◽  
Individual Psychotherapy ◽  
Simple Relationship ◽  
Presenting Problems ◽  
Self Help ◽  
Treatment Of Depression ◽  
Proven Efficacy ◽  
Psychiatric Conditions ◽  
Anxiety Depression

The field of couple therapy is a wide and varied one, and there are almost as many different approaches to treatment as in individual psychotherapy. The relatively brief therapeutic method presented here, behavioural systems couple therapy, is an eclectic one, taking techniques from two approaches of proven efficacy and combining them into a flexible and versatile therapy capable of being used in a wide variety of presenting problems. These include simple relationship problems, psychosexual problems, and such psychiatric conditions as anxiety, depression, and morbid jealousy. It is relatively easy to teach, and although it has not yet been subjected to controlled trials it can be assumed to be no less effective than its component therapies which are both effective. It has recently also been recommended in a package for self-help with homework exercises and theoretical explanations to be used without the intervention of a therapist. There are few contraindications for the therapy, and it can be used both as a therapy in its own right or as an adjunctive therapy in, for example, the treatment of depression, psychosis or sexual dysfunctions. It can thus be a useful addition to the various methods available for the reduction of distress, whether in couples or individuals.

Therapeutic Bone-Modifying Agents in the Nonmetastatic Breast Cancer Setting: The Controversy and a Value Assessment

2017 ◽  
pp. 116-122
Author(s):  
Michael Gnant ◽  
Catherine Van Poznak ◽  
Lowell Schnipper
Keyword(s):  
Breast Cancer ◽  
Bisphosphonate Therapy ◽  
Value Assessment ◽  
A Value ◽  
Breast Cancer Outcomes ◽  
Primary Endpoints ◽  
Adjuvant Breast Cancer ◽  
Pros And Cons ◽  
Cancer Setting ◽  
Meta Analyses

Clinical trials and meta-analyses investigating bisphosphonates as an adjuvant breast cancer therapy have shown a consistent trend, with postmenopausal women and women receiving ovarian suppression with gonadotropin-releasing hormone therapy gaining improved breast cancer outcomes with the use of adjuvant bisphosphonate therapy. The interpretation of these data is controversial, because the primary endpoints of the majority of adjuvant bisphosphonate studies have been negative. Pros and cons as well as the value of adjuvant bisphosphonate therapy are discussed here.

scholarly journals Pearls for Interpreting Neurosurgical Systematic Reviews and Meta-Analyses: Lessons From a Collaborative Effort

Neurosurgery ◽  
2020 ◽  
Vol 87 (3) ◽  
pp. 435-441 ◽  
Author(s):  
Victor M Lu ◽  
Christopher S Graffeo ◽  
Avital Perry ◽  
Michael J Link ◽  
Fredric B Meyer ◽  
...  
Keyword(s):  
Systematic Reviews ◽  
Evidence Based Medicine ◽  
Lessons Learned ◽  
Evidence Based ◽  
Cranial Neuralgia ◽  
The Individual ◽  
Meta Analyses ◽  
Based Medicine ◽  
Over Time

Abstract Systematic reviews and meta-analyses in the neurosurgical literature have surged in popularity over the last decade. It is our concern that, without a renewed effort to critically interpret and appraise these studies as high or low quality, we run the risk of the quality and value of evidence-based medicine in neurosurgery being misinterpreted. Correspondingly, we have outlined 4 major domains to target in interpreting neurosurgical systematic reviews and meta-analyses based on the lessons learned by a collaboration of clinicians and academics summarized as 4 pearls. The domains of (1) heterogeneity, (2) modeling, (3) certainty, and (4) bias in neurosurgical systematic reviews and meta-analyses were identified as aspects in which the authors’ approaches have changed over time to improve robustness and transparency. Examples of how and why these pearls were adapted were provided in areas of cranial neuralgia, spine, pediatric, and neuro-oncology to demonstrate how neurosurgical readers and writers may improve their interpretation of these domains. The incorporation of these pearls into practice will empower neurosurgical academics to effectively interpret systematic reviews and meta-analyses, enhancing the quality of our evidence-based medicine literature while maintaining a critical focus on the needs of the individual patients in neurosurgery.

scholarly journals Clinical Behavior of Ceramic, Hybrid and Composite Onlays. A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (20) ◽  
pp. 7582
Author(s):  
Naia Bustamante-Hernández ◽  
Jose María Montiel-Company ◽  
Carlos Bellot-Arcís ◽  
José Félix Mañes-Ferrer ◽  
María Fernanda Solá-Ruíz ◽  
...  
Keyword(s):  
Systematic Review ◽  
Survival Rate ◽  
Meta Analysis ◽  
Posterior Region ◽  
Publication Date ◽  
Clinical Behavior ◽  
Lower Survival Rate ◽  
Meta Analyses ◽  
Over Time

A systematic review and meta-analysis was performed to analyze the survival of onlay restorations in the posterior region, their clinical behavior according to the material used (ceramic reinforced with lithium disilicate, conventional feldspathic ceramic or reinforced with leucite; hybrid materials and composite), possible complications, and the factors influencing restoration success. The systematic review was based on the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, without publication date or language restrictions. An electronic search was made in the PubMed, Scopus, Embase, and Cochrane databases. After discarding duplicate publications and studies that failed to meet the inclusion criteria, the articles were selected based on the population, intervention, comparison, outcome (PICO) question. The following variables were considered in the qualitative and quantitative analyses: restoration survival rate (determined by several clinical parameters), the influence of the material used upon the clinical behavior of the restorations, and the complications recorded over follow-up. A total of 29 articles were selected for the qualitative analysis and 27 for the quantitative analysis. The estimated restoration survival rate was 94.2%. The predictors of survival were the duration of follow-up (beta = −0.001; p = 0.001) and the onlay material used (beta = −0.064; p = 0.028). Composite onlays were associated with a lower survival rate over time. Onlays are a good, conservative, and predictable option for restoring dental defects in the posterior region, with a survival rate of over 90%. The survival rate decreases over time and with the use of composite as onlay material.

Living with advanced colorectal cancer: How prepared are informal caregivers to care for their loved ones?

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 179-179
Author(s):  
Marc Kerba ◽  
Shireen Kassam ◽  
Crystal Beaumont ◽  
Patricia Biondo ◽  
Madalene Earp ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Advanced Colorectal Cancer ◽  
Informal Caregivers ◽  
Emotional Needs ◽  
Caregiver Health ◽  
Perceived Preparedness ◽  
Emotional Aspects ◽  
Cancer Setting ◽  
One Year ◽  
Over Time

179 Background: The ‘Living with Colorectal Cancer’ prospective cohort study seeks to characterize the experiences of patients diagnosed with advanced colorectal cancer and their caregivers, in order to inform care improvements. Here we describe informal caregivers’ perceived preparedness for caregiving. Methods: Eligible patients were identified by oncologists in Alberta, Canada’s two tertiary cancer centers. Consenting patients were given the option to invite a caregiver to participate. Caregivers’ preparedness for caregiving was assessed at enrollment and every 3 months thereafter using the Preparedness for Caregiving survey. This survey assesses levels of preparedness using 5-point Likert scales for 8 caregiving domains (e.g. caring for the patient’s physical and emotional needs, finding and setting up services, stress of caregiving, responding to emergencies), and one open-ended question. Results: In one year of recruitment, 55 caregivers in Calgary and Edmonton were enrolled, of which 65% were female, and 80% lived with the patient. Caregiver preparedness decreased over time from months 1 to 7 of follow-up, across all categories. Caregivers were least prepared for the stress of caregiving and caring for the patient’s emotional needs. They were most prepared for taking care of the patient’s physical needs at enrollment. Open-ended comments on specific preparedness needs were numerous and extensive. A range of topics were reported, the top three being: caregiver health (physical, mental, self-care), emotional aspects (preparing children and family, feeling alone) and end of life (hospice, palliative care, transitioning). Conclusions: Our data suggest that in the advanced cancer setting, caregiver perceived preparedness declines, with increasing stress and emotional distress over time. This may be related to patient illness progression. The open-ended qualitative comments on the Preparedness for Caregiving survey were particularly useful in understanding specific caregiver concerns. Caregiver experience, including sense of preparedness, is often under evaluated and this study suggests more attention is needed. Clinical trial information: NCT03572101.

Methodological quality of meta-analyses: matched-pairs comparison over time and between industry-sponsored and academic-sponsored reports

2013 ◽  
Vol 4 (4) ◽  
pp. 342-350 ◽  
Author(s):  
Peter W. Lane ◽  
Julian P.T. Higgins ◽  
Betsy Anagnostelis ◽  
Judith Anzures-Cabrera ◽  
Nigel F. Baker ◽  
...  
Keyword(s):  
Methodological Quality ◽  
Matched Pairs ◽  
Meta Analyses ◽  
Over Time

scholarly journals Bacterial Sensitivity To Chlorhexidine and Povidone-Iodine Antiseptics Over Time: A Systematic Review and Meta-Analysis of Human-Derived Data

2022 ◽  
Author(s):  
Raiyyan Aftab ◽  
Vikash H Dodhia ◽  
Christopher Jeanes ◽  
Ryckie G Wade
Keyword(s):  
Povidone Iodine ◽  
Meta Analysis ◽  
First Choice ◽  
Skin Antisepsis ◽  
The Mean ◽  
Bacterial Sensitivity ◽  
Meta Analyses ◽  
Complication Of Surgery ◽  
Derived Data ◽  
Over Time

Abstract Background Surgical site infection (SSI) is the most common complication of surgery, increasing healthcare costs and hospital stay. Chlorhexidine (CHX) and povidone-iodine (PVI) are used for skin antisepsis, minimising SSIs. There is increasing concern of developing resistance to topical biocides, though clinical implications remain unclear. Outcomes: Determining whether the Minimum Bactericidal Concentration (MBC) for topical preparations of CHX or PVI have changed over time, in microbes relevant to SSI. Methods We included studies reporting the mean bactericidal concentration (MBC) of laboratory and clinical isolates of common microbes to CHX and PVI. Excluding non-human samples and studies using antimicrobial solvents or mixtures with other active substances. MBC was pooled in random effects meta-analyses. Change in MBC over time was explored using meta-regression. Results 79 studies were including, analysing 6218 microbes over 45 years. Most used CHX (93%), with insufficient data for meta-analysis of PVI. There was no change in MBC of CHX to Staphylococci (β 0.12 [-1.13, 1.37]; I2 99%) or Streptococci (β 0.13 [-0.35, 0.62]; I2 97%). Conclusions There is no evidence of reduced susceptibility of common SSI-causing microbes to CHX over time. Providing reassurance that the worldwide guidance that CHX should remain the first-choice agent for surgical skin antisepsis.

scholarly journals Peptide Characterization and Functional Stability of a Partially Hydrolyzed Whey-Based Formula over Time

Nutrients ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 3011
Author(s):  
Tristan Bourdeau ◽  
Michael Affolter ◽  
Lénaïck Dupuis ◽  
Alexandre Panchaud ◽  
Sabine Lahrichi ◽  
...  
Keyword(s):  
Infant Formula ◽  
Oral Tolerance ◽  
Allergic Sensitization ◽  
Tolerance Induction ◽  
Specific Ige ◽  
Size Exclusion ◽  
Preclinical Model ◽  
Meta Analyses ◽  
Oral Tolerance Induction ◽  
Over Time

Human clinical trials have shown that a specific partially hydrolyzed 100% whey-based infant formula (pHF-W) reduces AD risk in the first yeast of life. Meta-analyses with a specific pHF-W (pHF-W1) confirm a protective effect while other meta-analyses pooling different pHF-W show conflicting results. Here we investigated the molecular composition and functional properties of the specific pHF-W1 as well as the stability of its manufacturing process over time. This specific pHF-W1 was compared with other pHF-Ws. We used size exclusion chromatography to characterize the peptide molecular weight (MW), a rat basophil degranulation assay to assess the relative level of beta-lactoglobulin (BLG) allergenicity and a preclinical model of oral tolerance induction to test prevention of allergic sensitization. To analyze the exact peptide sequences before and after an HLA binding assay, a mass cytometry approach was used. Peptide size allergenicity and oral tolerance induction were conserved across pHF-W1 batches of production and time. The median MW of the 37 samples of pHF-W1 tested was 800 ± 400 Da. Further oral tolerance induction was observed using 10 different batches of the pHF-W1 with a mean reduction of BLG-specific IgE levels of 0.76 log (95% CI = −0.95; −0.57). When comparing pHF-W1 with three other formulas (pHF-W2 3 and 4), peptide size was not necessarily associated with allergenicity reduction in vitro nor oral tolerance induction in vivo as measured by specific IgE level (p < 0.05 for pHF-W1 and 2 and p = 0.271 and p = 0.189 for pHF-W3 and 4 respectively). Peptide composition showed a limited overlap between the formulas tested ranging from 11.7% to 24.2%. Furthermore nine regions in the BLG sequence were identified as binding HLA-DR. In conclusion, not all pHF-Ws tested have the same peptide size distribution decreased allergenicity and ability to induce oral tolerance. Specific peptides are released during the different processes used by different infant formula producers.

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