Health Care Utilization After Ventricular Tachycardia Ablation: A Propensity Score-Matched Cohort Study

Background

Catheter ablation of ventricular tachycardia (VT) can reduce the burden of ventricular arrhythmia (VA) but its effect on health care utilization and costs after such therapy is poorly known. We sought to compare the rates of cardiovascular (CV)-related hospitalizations, survival, and health care costs in patients with recurrent VT treated either with VT ablation or with medical therapy.

Proximal and distal determinants of community resilience under threats of terror

Community resilience (CR) is a positive trajectory of adaptation of a commune after a disturbance, stress, or adversity. Previous studies have successfully predicted CR in times of stress by distal factors, such as demographic characteristics of the community members and by their psychological attributes. We submit that since all these variables are distal predictors, which are not directly related to the actual stressful condition, CR would be predicted more readily by proximal factors, which portray people's responses to the investigated adversity (i.e., trust in the community emergency team). A sample of 1,515 adults, living in terror‐stricken border communities in northern Israel has been examined. Their perceived CR has been predicted concurrently by distal and by proximal factors. Results have supported the research hypotheses, indicating the importance of proximal variables in determining and promoting CR.     

Heart rate and heart rate variability parameters at rest,during activity and passive standing among children with cerebral palsy GMFCS IV–V

Aims: To describe and compare heart rate (HR) and heart rate variability (HRV) at rest, during active movements and passive standing among children with cerebral palsy (CP), with Gross Motor Function Classification System (GMFCS) levels IV and V, and to describe the association between daily physical activity and HRV. Methods: Thirty children with CP were included aged 6–12 years. HR and HRV parameters were recorded during rest, during Gross Motor Functional Measure (GMFM) assessment, during two minutes of repeated performance of the highest activity achieved in the GMFM, and during passive standing. Parents were asked to inform about any habitual physical activities their child participates outside school in the previous 4 months. Results: Children with GMFCS IV increased their HR and reduced HRV values during the GMFM assessment, the repeated task and during passive standing, while no such effect was noted among children with GMFCS V. Children participated in a limited range of activities with a median frequency of three times a week (range 1–6 times), with insignificant differences between GMFCS levels. No significant differences were noted in HR or HRV parameters based on activity level. Conclusions: Only children with GMFCS IV responded to passive and active manipulation of the cardiac autonomic system. This may imply that the HR autonomic regulation system has an opportunity to be influenced by training in this group of children.     

Foley catheter versus intravaginal prostaglandins E2 for cervical ripening in women at term with an unfavorable cervix: a randomized controlled trial

Objective: The objective of this study is to compare the efficacy of labor induction by Foley catheter balloon (FCB) insertion to intravaginal dinoprostone tablet placement in women with an unfavorable cervix.

Materials and methods: A prospective randomized controlled trial was conducted. Women were assigned to insertion of a FCB or placement of a vaginal dinoprostone tablets and their outcome were compared.

Results: The study comprised 300 women. The time to active labor was significantly shorter in the FCB compared with the dinoprostone group, but required more oxytocin administration. A lower rate of cesarean section was found only in nulliparous women in the FCB group. The neonatal outcome was favorable and similar in both groups.

Conclusion: Both methods had similar results regarding achieving vaginal delivery within 24?h and cesarean section rate. For nulliparous women, the FCB induction method had the advantage of a shorter time to active labor and a lower rate of cesarean section.     

Group cognitive behavioral treatment in female soldiers diagnosed with binge/purge eating disorders

ABSTRACT

Cognitive behavioral treatment (CBT) is the recommended intervention in bulimia nervosa (BN) and eating disorders not otherwise specified with binge/purge (EDNOS-B/P) symptoms. There are fewer data on its application in a group format. We sought to investigate the effect of group CBT in female soldiers with B/P symptomatology in an open trial design. For this purpose we assessed 64 female soldiers serving in the Israeli Defense Force diagnosed with BN and EDNOS-B/P who participated in a group CBT format of 16 weekly sessions and one follow-up session. In this study, 42 participants (65.6%) completed treatment and 22 participants (34.4%) did not. A total of 39 treatment completers (92.8% of treatment completers) and 19 non-completers (86.4% of treatment non-completers) were assessed around 12 months after treatment. Participants completed at baseline and following treatment questionnaires assessing eating-related symptoms, depression, anxiety, and overall functioning. At follow-up they were assessed for eating-related symptoms. Our findings show only minimal baseline differences between treatment completers and non-completers. Significant improvement from baseline to post-treatment was shown for B/P and restrictive symptoms, depression, anxiety, and overall functioning. At that time, more than a third of treatment completers were abstinent from binging and more than a half from vomiting. The improvement in B/P and restricting symptoms was maintained at 1 year follow-up for treatment completers. At that time around 60% were abstinent from binging and more than 70% from vomiting. Participants not completing treatment were also improved at follow-up but to a lesser extent. The findings of the present study suggest that group CBT may be effective for the treatment of female soldiers with BN and EDNOS-B/P.     

The quest for connection in interpersonal and therapeutic relationships

Objective: This paper focuses on the need for connection as a common core theme at the heart of both close relationships and therapeutic relationships and explores ways to connect these two research domains that have evolved as separate fields of study. Bowlby's attachment theory provides a strong conceptual and empirical base for linking human bonds and bonds in psychotherapy. Method: The growing body of research intersecting attachment and psychotherapy (1980–2014) is documented, and meta-analytic studies on attachment–outcome and attachment–alliance links are highlighted. Results: Five ways of studying attachment as a variable in psychotherapy are underscored: as moderator, as mediator, as outcome, client–therapist attachment match, and as process. By integrating conceptualizations and methods in studying relational narratives of client–therapist dyads (Core Conflictual Relationship Theme), measures of alliance, and client attachment to therapist during psychotherapy, we may discover unique client–therapist relational dances. Conclusions: Future fine-grained studies on how to promote core authentic relational relearning are important to clinicians, supervisors and trainers, who all share the common quest to alleviate interpersonal distress and enhance wellbeing. Directions for advancing research on interpersonal and therapeutic relationships are suggested. Learning from each other, both researchers of close relationships and of psychotherapy relationships can gain a deeper and multidimensional understanding of complex relational processes and outcomes.