Facteurs de risque et prise en charge de la rupture utérine dans une structure de 1ere référence du Mali: cas du district sanitaire de Bougouni / Risk factors and management of uterine rupture in a 1st reference structure in Mali: case of the Bougouni health district

L'objectif était d'évaluer les facteurs de risque de la RU et de proposer les aspects thérapeutiques. Matériels et méthodes : Nous avons réalisé une étude cas-témoins au centre de santé de Référence de Bougouni en 2019. Résultats : De janvier au 31 décembre 2019; sur 1161 accouchements 43 RU ont été enregistrées soit 3,7% correspondant à une RU pour 27 accouchements. Les patientes de 35 ans et plus ont été plus touchée par la RU (44,2%) avec ORaIC95%= 6,3 [1,5 - 26,3]. Les évacuations obstétricales avaient un ORaIC95%=25,6 [7,8- 83,7]. La totalité des patientes étaient des femmes au foyer (97,7%) des cas versus (82,3%) des témoins avec ORaIC95%= 8,9 (1,1-69). Les Paucipares et multipares avaient respectivement un ORaIC95%= 6,2 [1,8 - 20,3] et 4,1[1,3 - 12,9]. La cicatrice utérine (20,9%) des cas contre 8,1 % les témoins avait un ORaIC95%= 2,9 [1,1 - 8,7]. En effet l'absence de CPN étaient un facteur de risque, ORaIC95%= 3,0 [1,3 ­ 6,9]. Le délai de la RU était ˂ 6 heures chez 95%. En effet 34 RU complètes (79,1%) et 9 RU incomplètes (20,9%) ont été notées. Seulement 2,3 % des cas avaient accouché par voie basse. Le traitement de la RU reposait sur la chirurgie (100%) complétée par celui du choc (51,2%) des cas et de l'infection (100%) des cas. Conclusion: La RU est fréquente dans nos pays sous médicalisés. Sa prévention efficace passe par des stratégies visant à agir sur les facteurs de risque

The objective was to assess the risk factors for and to suggest therapeutic aspects. Materials and methods: We carried out a case-control study at the Bougouni Reference health center in 2019. Results: From January to December 31, 2019; out of 1161 deliveries, 43 uterine rupture were recorded, 3.7% corresponding to one uterine rupture for 27 deliveries. Patients 35 years and older were more affected by uterine rupture (44.2%) with ORaIC95% = 6.3 [1.5 - 26.3]. Obstetric evacuations had an ORaIC95% = 25.6 [7.8-83.7]. All of the patients were housewives (97.7%) versus (82.3%) controls with ORaIC95% = 8.9 (1.1-69). Pauciparous and multiparous had an ORaIC95% = 6.2 [1.8 - 20.3] and 4.1 [1.3 - 12.9], respectively. The uterine scar (20.9%) of cases versus 8.1% of controls had a 95% ORaIC95% = 2.9 [1.1 - 8.7]. Indeed the absence of ANC was a risk factor, ORaIC95% = 3.0 [1.3 - 6.9]. The time to uterine rupture was ˂ 6 hours in 95%. In fact 34 complete uterine rupture (79.1%) and 9 incomplete uterine rupture (20.9) were noted. Only 2.3% of cases gave birth vaginally. Treatment of uterine rupture was based on surgery (100%) supplemented by shock (51.2%) of cases and infection (100%) of cases. Conclusion: Uterine rupture is common in our countries under medical care. Its effective prevention involves strategies aimed at acting on risk factors.

Development and validation of Yoga Module for Anger Management in adolescents.

BACKGROUND: Development of anger management programs and in particular, yoga module for anger management has not been well researched. Being a complex emotion, anger poses serious challenges in developing a comprehensive anger management program. While various theories of anger are dealt in modern psychology, several anger management techniques are set forth in Indian traditional texts. Yoga, which is considered as a holistic and integrated approach is explored in this study to develop and validate a school-based yoga program for anger management in adolescence. MATERIALS AND METHODS: Integrated Approach to Yoga Therapy (IAYT) principles and literary review formed the basis for deriving the concepts of anger management. The methodology includes construction of the yoga module, validation of the module by 22 experts followed by a pilot non-randomised control study (n-50) to assess feasibility and initial effectiveness. Content Validity Ratio (CVR) and paired t-test were employed to analyse the experts' rating and pilot-study data respectively. RESULTS: Emergence of IAYT based yoga program for anger management. Based on CVR ratio, 16 out of 18 yogic techniques qualified for the final module. The pilot study revealed viability of the module and its recognition as an anger management program. Significant reduction of anger scores in yoga group substantiates initial effectiveness of the module. CONCLUSION: The developed and validated yoga module for anger management is recognised as a well-accepted and effective yoga program for anger management in adolescents.

The effect of adaptation theory-based therapeutic approach on adolescents anger management.

PROBLEM: Anger is usually defined as psychometric, rather than a theoretical model and generally, anger treatments have been developed for handling incompatible anger. Roy Adaptation Model-based intervention not only focuses on problematic behaviors but also on healthy behaviors and to evaluate the individual with a holistic perspective. The research aim was the examination of the effect of the Roy adaptation theory-based, cognitive-behavioral approach program on adolescent's anger management. METHODS: In this study, the pretest-posttest control group experimental design, interview, and observation techniques were used. Carried out in a vocational training center, with 60 participants (experimental group 30 and control group 30), who meet the research criteria. The semi-structured interview forms, the state-trait anger expression inventory, multidimensional anger scale, and brief symptom inventory were used for data collection. Results have been evaluated to the 95% confidence interval and p < .05 significance level. In data analysis; descriptive statistics, Pearson's χ2 test, Mann-Whitney U test, and Wilcoxon Sign tests were used. FINDINGS: There was a significant difference in anger management levels of the experimental group after the adaptation theory-based therapeutic approach program. CONCLUSION: Study results showed that the adaptation-base therapeutic approach is effective in adolescent's anger management. This program will contribute to theoretical and practical studies and field experts.

Effect and safety of acupuncture for Hwa-byung, an anger syndrome: a study protocol of a randomized controlled pilot trial.

BACKGROUND: Hwa-byung (HB) is an anger syndrome caused by an inadequate release of accumulated anger that leads to somatic and psychiatric symptoms. As HB results from long-term inadequately treated negative emotions, its symptoms are complex, intractable and concomitant with other psychiatric disorders. Therefore, studies aiming to develop effective and safe treatment options for HB are needed. We plan to conduct a pilot study for a future, full-scale, randomized controlled trial (RCT) of an optimal acupuncture procedure using semi-individualized acupuncture points that consider participants' personal disposition and type of emotional stress. METHOD/DESIGN: This randomized, sham-controlled, participant- and assessor-blinded pilot trial aims to determine the study feasibility of acupuncture for HB and to explore its clinical effects and safety. This clinical trial will be conducted with two groups: one treated with real acupuncture and the other with sham acupuncture for 10 sessions over 4 weeks. The experimental group (EG) will receive semi-individualized acupuncture, whereas the control group (CG) will receive sham acupuncture, namely minimal acupuncture on non-acupuncture points. The recruitment, compliance, and completion rate and clinical evaluations, including a Visual Analogue Scale (VAS), the Korean version of the Beck Depression Inventory (BDI), the short form of the Stress Response Inventory (SRI-short form) and the Instrument of the Oriental Medical Evaluation for HB (IOME-HB), will be assessed to evaluate feasibility and possible effects and safety. Four weeks after completing treatment, follow-up assessments will be performed. DISCUSSION: As this is a pilot study mainly aiming to investigate trial feasibility, the results of this study will be analyzed descriptively and interpreted for the study purposes. Cohen's d will be reported to determine the effect of acupuncture for HB and to enable comparisons with other treatment methods. This protocol is significant in that it provides optimal semi-individualized acupuncture treatment. We expect this study to offer information about the feasibility of this treatment and data about the possible effects and safety. TRIAL REGISTRATION: Clinical Research Information Service (CRIS), Republic of Korea: KCT0001732 . Registered on 14 December 2015.

The Impact of Self-directed Voice of Love Messages on Anger: A Pilot Study.

Context • Buddhist texts direct practitioners to generate a feeling of love to stop the affliction of anger. Modern self-help practices and clinical psychology have demonstrated that generating emotions of love can reduce anger. More studies are needed, however, to identify the active components of interventions and their applicability in clinical populations. Objective • The study investigated the hypothesis that enhancing self-love through frequent listening to recorded self-loving messages can reduce anger. Design • The pilot study was designed to measure changes in anger level between baseline and postintervention in the course of 12 wk. Setting • The study occurred at Moa Oasis, Israel. Participants • Participants were adults enrolled in a program of study on advanced Tibetan Buddhism. Intervention • Participants were directed to record statements expressing love and appreciation of themselves in their own voices, inserting their names as the recipients of the messages. Participants listened to their recording for 2 min every morning, for 12 wk. Outcome Measures • At baseline and postintervention, the participants completed a self-reported questionnaire, the clinical anger score (CAS). Every 2 wk, they completed the short dimensions of anger reactions (DAR-5) scale to assess temporal changes in anger. Results • Eighty-six participants, 69 women and 17 men with a median age of 45 y and a range from 20 to 70 y, enrolled in the study. Fifty-six completed all designated tests. The mean CAS score decreased significantly, from 10.4 to 6.7 (P < .001). The analysis of variance demonstrated a time-X-practice effect, with 6 wk of practice being necessary to achieve a significant reduction in the DAR-5 score. Conclusions • The present study provided encouraging preliminary evidence on the effectiveness of a daily regimen of listening to a short recording of self-love and appreciation in reducing anger. The findings indicate that the technique merits replication in larger controlled studies. If supported, it could be applied in conflict resolution.

Application of a relational frame theory account of psychological flexibility in young children.

BACKGROUND: Acceptance and commitment therapy (ACT) is a contextual behavior therapy based on relational frame theory (RFT), a functional-contextual approach to human language and cognition. The main aim of ACT is to promote psychological flexibility, which has been defined in middle-level terms. The current study proposes that a recently developed RFT account of psychological flexibility might facilitate the adaptation of ACT to the work with young children. METHOD: A case study with a 5-year-old boy presenting problematic anger is presented to illustrate the previous suggestion. The intervention consisted of a brief ACT protocol applied in four, 20-min sessions and a token economy at the service of promoting psychological flexibility. The ACT protocol involved a multiple-exemplar training in framing own ongoing experiences through deictic and hierarchical relations and transforming the discriminative functions of those experiences by relating them to rules that progressively specified longer term and symbolic, positive consequences. RESULTS: The intervention was shown to be highly effective in reducing the anger episodes, and the results were maintained during the one year of follow-up. CONCLUSIONS: This study supports the feasibility of the RFT account of psychological flexibility to adapt ACT to the work with young children.

Influence of Music Therapy on Coping Skills and Anger Management in Forensic Psychiatric Patients: An Exploratory Study.

The effect of music therapy on anger management and coping skills is an innovative subject in the field of forensic psychiatry. This study explores the following research question: Can music therapy treatment contribute to positive changes in coping skills, anger management, and dysfunctional behavior of forensic psychiatric patients? To investigate this question, first a literature review is offered on music therapy and anger management in forensic psychiatry. Then, an explorative study is presented. In the study, a pre- and post-test design was used with a random assignment of patients to either treatment or control condition. Fourteen participants' complete datasets were collected. All participants received "treatment as usual." Nine of the participants received a standardized, music therapy anger management program; the five controls received, unplanned, an aggression management program. Results suggested that anger management skills improved for all participants. The improvement of positive coping skills and diminishing of avoidance as a coping skill were measured to show greater changes in music therapy participants. When controlling for the exact number of treatment hours, the outcomes suggested that music therapy might accelerate the process of behavioral changes.