A Systematic Review of Multisystemic Therapy in Adolescent Sex Offenders.

Multisystemic therapy (MST) is an intense, family-focused, community-based treatment designed for youth with criminal behaviors. Literature on its usefulness among juvenile sexual offenders (JSOs) remains limited. We conducted a systematic review of published studies assessing effectiveness of MST among JSOs. A comprehensive search of published studies, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, was undertaken using multiple databases. Search terms included "multisystemic therapy" or "multisystemic family therapy." A total of 542 articles were obtained on initial search. After excluding duplicates, 297 articles were included in further analysis that yielded 48 articles for full-text analysis. Six randomized controlled trials of MST, comprising 231 juvenile sex-offenders, were assessed for final review. MST performed favorably relative to alternative treatments among juvenile sex offenders while also demonstrating lasting treatment effect on sustained follow-up.

Performance enhancement of the solar still using textiles and polyurethane rollers.

The acquisition of clean drinking water in regions with limited power sources has been a challenge of paramount concern. Solar stills have emerged as a popular and sustainable option for obtaining clean water in such regions. This process involves employing solar radiation to heat up water, which is then condensed to obtain potable water. The present study introduces a solar still system that is both cost-effective and energy-efficient, while simultaneously ensuring sustainability. Fabric-coated polyurethane rollers with capillary action enhance evaporation area, leading to notable performance improvements. Water vapour condensed on the cooling chamber's inclined aluminium plate and collected in the distillate chamber within the solar still. The thermal, energetic, and economic performance and productivity of the proposed model were evaluated. The fabricated solar still boasted maximum instantaneous system efficiency and exergy efficiency of approximately 62.16% and 7.67%, respectively. This system's cost-effectiveness and performance improvements are particularly noteworthy. The daily average distillate productivity of the proposed still was estimated at 1.14 L/m2, resulting in an annual production rate of 416.54 L/year. The estimated cost of producing 1 L of distillate was 0.023 $.

Stercoral colitis in the emergency department: a review of the literature.

BACKGROUND: Stercoral colitis (SC) is a rare but potentially life-threatening inflammatory colitis caused by the accumulation of impacted fecal material. Despite reported associations with bowel perforation and high mortality rates, stercoral colitis remains a poorly defined and underrecognized diagnosis in the emergency department (ED). OBJECTIVE OF THE REVIEW: This review aims to summarize and synthesize existing literature on SC to guide its recognition and management in the ED. DISCUSSION: SC primarily occurs in elderly or bedbound patients with chronic constipation; however, it does occur in younger patients with comorbidities at increased risk for fecal impaction. Patients may present acutely with abdominal pain and distension, but clinical presentation is often nonspecific and varied, and there are no established diagnostic criteria for SC to date. CT is therefore crucial for diagnosis, revealing key findings such as fecaloma, colonic dilatation, and fat stranding. Treatment depends on severity of illness, ranging from manual disimpaction and other conservative measures for most cases, to surgical intervention for complicated cases, such as stercoral perforation. CONCLUSIONS: SC can be a challenging diagnosis in the ED, often requiring multidisciplinary collaboration. Timely recognition and appropriate treatment are essential to reduce morbidity and mortality associated with this condition. Further research is needed to establish diagnostic criteria and clear management algorithms.

A Literature Review Examining Virtual Reality Exposure Therapy for Individuals Diagnosed With Social Anxiety Disorder.

ABSTRACT: Social anxiety disorder (SAD) is a specific subtype of anxiety disorder where individuals experience uncomfortable social situations that induce anxious feelings including nervousness and panic. Computer technology has been applied in interventions for many mental health disorders. We aim to understand and explore the use of virtual reality exposure therapy (VRET) to treat adults with SAD. We conducted a literature search using relevant mesh keywords in PubMed and PsycINFO. Six studies met inclusion criteria in our final qualitative synthesis review. Results showed a significant reduction in SAD symptom severity based on primary measures in all studies, suggesting that VRET is an effective option in treating SAD. Studies have shown the success of VRET in formats such as a single-user implementation, one-session treatment, and self-training intervention. In conclusion, VRET is effective in reducing SAD symptoms. The limitations of most studies included a small sample size and weak ecological validity. Future research can examine VRET with a more extensive clinical sample and broader social behaviors.

The Utility of a Virtual Emergency Medicine Elective for Visiting Medical Students.

Background Away rotations allow emergency medicine (EM)-bound fourth-year medical students to experience a residency program's educational culture and influence the ranking of residency programs. The financial cost and geographic distance have limited student participation in away electives. In recent years, COVID-19 pandemic-related restrictions on away rotations resulted in the creation of multiple virtual courses. Despite the lifting of restrictions, these courses may still have utility in helping students circumvent barriers to away rotations. Limitations of previously described courses include insufficient student-faculty interaction, which influences students' understanding of the educational environment. We sought to develop and evaluate a virtual EM elective for fourth-year medical students, focused on student-faculty interaction including precepted patient contact. Methodology We developed a two-week virtual EM elective for fourth-year medical students incorporating teaching sessions designed to optimize student-faculty interactions and attending-supervised telemedicine visits. After completion of the course, students completed an anonymous course evaluation. Results Course evaluations showed that the course improved students' understanding of our residency's educational environment by providing students with access to our residency program. The most frequently cited factors preventing participation in a traditional away elective were financial cost, limit in the allowed number of away rotations, and challenges in finding housing. Conclusions We believe this course may be an effective way of improving visiting students' understanding of the educational culture of our EM residency program. Thus, although pandemic-related restrictions have been lifted, this course may serve as a valuable adjunct to the traditional away EM rotation.

Ocular injuries: emergency department strategies.

Ocular injuries are common in the emergency department, and they are the most frequent cause of noncongenital monocular blindness in children and adults. Systematic evaluation and management of ocular trauma patients will ensure these patients have the best chance for a favorable final visual outcome. This review provides evidence-based recommendations for the diagnosis, treatment, and disposition of patients with traumatic ocular injuries, including retrobulbar hemorrhage, traumatic hyphema, open globe injuries, ocular chemical burns, and corneal abrasions. The use of bedside ultrasound, antibiotics, cycloplegics, steroids, antifibrinolytics, and patching are also discussed.

Examining Risk Factors for Suicidality in Adolescents and Adults Experiencing Their First Episode of Psychosis.

This narrative review aimed to identify the risk factors associated with suicidality in adolescents and adults with first-episode psychosis. The review included studies that examined various factors such as psychiatric, familial, and social factors, as well as previous self-harm, suicidal ideation, and comorbid mental health disorders. A comprehensive literature search was conducted across three publicly available databases (Embase, American Psychological Association PsycINFO, and PubMed) using specific search terms related to first-episode psychosis, suicide, self-harm, and children/adolescents and adults. The inclusion criteria included original articles focusing on prospective and retrospective cohort trials, with substantial data on first-episode psychosis and self-harm, measuring both suicidal intent and outcome. Non-original studies, case reports, case series, non-English-language publications, and studies examining violence and self-harm related to substance-induced psychosis were excluded. After manual screening and removing duplicate articles, 13 articles met the established criteria for inclusion in this review. Included studies adhered to similar inclusion and exclusion criteria, had long-term follow-up, and assessed outcomes at least twice. The findings suggest that depressive symptoms, substance use disorders, previous self-harm or suicidal ideation, and longer duration of untreated psychosis are associated with an increased risk of suicidality. However, insights into psychosis and premorbid intellectual functioning did not show a direct association with suicidality.