Pre-term or full-term childbirth can be experienced as physically or psychologically traumatic. Cumulative and trans-generational effects of traumatic stress on both psychological and physical health ...indicate the ethical requirement to investigate appropriate preventative treatment for stress symptoms in women following a routine traumatic experience such as childbirth.
The objective of this review was to investigate the effectiveness of early psychological interventions in reducing or preventing post-traumatic stress symptoms and post-traumatic stress disorder in post-partum women within twelve weeks of a traumatic birth.
Randomised controlled trials and pilot studies of psychological interventions preventing or reducing post-traumatic stress symptoms or PTSD, that included women who had experienced a traumatic birth, were identified in a search of Cochrane Central Register of Randomised Controlled Trials, MEDLINE, Embase, Psychinfo, PILOTS, CINAHL and Proquest Dissertations databases. One author performed database searches, verified results with a subject librarian, extracted study details and data. Five authors appraised extracted data and agreed upon risk of bias. Analysis was completed with Rev Man 5 software and quality of findings were rated according to Grading of Recommendation, Assessment, Development, and Evaluation.
Eleven studies were identified that evaluated the effectiveness of a range of early psychological interventions. There was firm evidence to suggest that midwifery or clinician led early psychological interventions administered within 72 hours following traumatic childbirth are more effective than usual care in reducing traumatic stress symptoms in women at 4-6 weeks. Further studies of high methodological quality that include longer follow up of 6-12 months are required in order to substantiate the evidence of the effectiveness of specific face to face and online early psychological intervention modalities in preventing the effects of stress symptoms and PTSD in women following a traumatic birth before introduction to routine care and practice.
CRD42020202576, https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=202576.
Abstract Vertebral fractures are common and can result in acute and chronic pain, decreases in quality of life, and diminished lifespan. The identification of vertebral fractures is important because ...they are robust predictors of future fractures. The majority of vertebral fractures do not come to clinical attention. Numerous modalities exist for visualizing suspected vertebral fracture. Although differing definitions of vertebral fracture may present challenges in comparing data between different investigations, at least 1 in 5 men and women aged >50 years have one or more vertebral fractures. There is clinical guidance to target spine imaging to individuals with a high probability of vertebral fracture. Radiology reports of vertebral fracture need to clearly state that the patient has a “fracture,” with further pertinent details such as the number, recency, and severity of vertebral fracture, each of which is associated with risk of future fractures. Patients with vertebral fracture should be considered for antifracture therapy. Physical and pharmacologic modalities of pain control and exercises or physiotherapy to maintain spinal movement and strength are important components in the care of vertebral fracture patients.
Background: Reducing bisphosphonate dosing frequency may improve suboptimal adherence to treatment and therefore therapeutic outcomes in postmenopausal osteoporosis. Once-monthly oral ibandronate has ...been developed to overcome this problem. Objective: To confirm the 1 year results and provide more extensive safety and tolerability information for once-monthly dosing by a 2 year analysis. Methods: MOBILE, a randomised, phase III, non-inferiority study, compared the efficacy and safety of once-monthly ibandronate with daily ibandronate, which has previously been shown to reduce vertebral fracture risk in comparison with placebo. Results: 1609 postmenopausal women were randomised. Substantial increases in lumbar spine bone mineral density (BMD) were seen in all treatment arms: 5.0%, 5.3%, 5.6%, and 6.6% in the daily and once-monthly groups (50 + 50 mg, 100 mg, and 150 mg), respectively. It was confirmed that all once-monthly regimens were at least as effective as daily treatment, and in addition, 150 mg was found to be better (p<0.001). Substantial increases in proximal femur (total hip, femoral neck, trochanter) BMD were seen; 150 mg produced the most pronounced effect (p<0.05 versus daily treatment). Independent of the regimen, most participants (70.5–93.5%) achieved increases above baseline in lumbar spine or total hip BMD, or both. Pronounced decreases in the biochemical marker of bone resorption, sCTX, observed in all arms after 3 months, were maintained throughout. The 150 mg regimen consistently produced greater increases in BMD and sCTX suppression than the 100 mg and daily regimens. Ibandronate was well tolerated, with a similar incidence of adverse events across groups. Conclusions: Once-monthly oral ibandronate is at least as effective and well tolerated as daily treatment. Once-monthly administration may be more convenient for patients and improve therapeutic adherence, thereby optimising outcomes.
We report the discovery and constrain the physical conditions of the interstellar medium of the highest-redshift millimeter-selected dusty star-forming galaxy to date, SPT-S J031132−5823.4 (hereafter ...SPT0311−58), at . SPT0311−58 was discovered via its 1.4 mm thermal dust continuum emission in the South Pole Telescope (SPT)-SZ survey. The spectroscopic redshift was determined through an Atacama Large Millimeter/submillimeter Array 3 mm frequency scan that detected CO(6-5), CO(7-6), and (2-1), and subsequently was confirmed by detections of CO(3-2) with the Australia Telescope Compact Array and with APEX. We constrain the properties of the ISM in SPT0311−58 with a radiative transfer analysis of the dust continuum photometry and the CO and line emission. This allows us to determine the gas content without ad hoc assumptions about gas mass scaling factors. SPT0311−58 is extremely massive, with an intrinsic gas mass of . Its large mass and intense star formation is very rare for a source well into the epoch of reionization.
The numerical kernel approach to difference imaging has been implemented and applied to gravitational microlensing events observed by the PLANET collaboration. The effect of an error in the ...source-star coordinates is explored and a new algorithm is presented for determining the precise coordinates of the microlens in blended events, essential for accurate photometry of difference images. It is shown how the photometric reference flux need not be measured directly from the reference image but can be obtained from measurements of the difference images combined with the knowledge of the statistical flux uncertainties. The improved performance of the new algorithm, relative to isis2, is demonstrated.
ABSTRACT
Gravitational waves provide a unique tool for observational astronomy. While the first LIGO–Virgo catalogue of gravitational-wave transients (GWTC-1) contains 11 signals from black hole and ...neutron star binaries, the number of observations is increasing rapidly as detector sensitivity improves. To extract information from the observed signals, it is imperative to have fast, flexible, and scalable inference techniques. In a previous paper, we introduced bilby: a modular and user-friendly Bayesian inference library adapted to address the needs of gravitational-wave inference. In this work, we demonstrate that bilby produces reliable results for simulated gravitational-wave signals from compact binary mergers, and verify that it accurately reproduces results reported for the 11 GWTC-1 signals. Additionally, we provide configuration and output files for all analyses to allow for easy reproduction, modification, and future use. This work establishes that bilby is primed and ready to analyse the rapidly growing population of compact binary coalescence gravitational-wave signals.
Summary
Stopping denosumab after 8 years of continued treatment was associated with bone loss during a 1-year observation study in patients who were not prescribed osteoporosis treatment. Bone loss ...was attenuated in patients who began another osteoporosis therapy. Treatment to prevent bone loss upon stopping denosumab should be considered.
Introduction
This study aimed to understand osteoporosis management strategies during a 1-year observational follow-up after up to 8 years of denosumab treatment in a phase 2 study.
Methods
During the observational year, patients received osteoporosis management at the discretion of their physician and returned to the clinic for BMD assessment and completion of an osteoporosis management questionnaire. Incidence of serious adverse events and fractures was collected. Analyses were descriptive.
Results
Of 138 eligible patients, 82 enrolled in and completed the observation study. Most (65 79%) did not receive prescription osteoporosis medication, with “my doctor felt I no longer needed a medication” being the most common reason (23 35%). Of the 17 patients who took osteoporosis medications, 8 discontinued therapy during the observation study. In patients treated with denosumab for 8 years (
N
= 52), BMD decreased during the 1-year observation study (6.7% lumbar spine, 6.6% total hip). Those who took osteoporosis medication during the observation study showed a smaller decline in BMD than those who did not. No new safety concerns were identified. Eight patients (9.8%), all of whom had at least one predisposing risk factor, experienced 17 fractures. This included seven patients who experienced one or more vertebral fractures.
Conclusions
Consistent with denosumab’s mechanism of action, treatment cessation led to reversal of the drug’s effect on BMD and perhaps fracture risk. For patients who took osteoporosis therapy, bone loss was attenuated. For patients at high fracture risk, switching to another osteoporosis therapy if denosumab is discontinued seems appropriate.
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