A scoping review of therapies used to treat psychological trauma post perinatal bereavement.

BACKGROUND: Up to 39% of women who experience perinatal bereavement proceed to develop Post-Traumatic-Stress-Disorder (PTSD), with this large proportion meriting treatment. Before setting-up a treatment service for postnatal women who are experiencing psychological trauma, it is important to identify what therapies have been used in-the-past to address this problem. AIM: To scope for research that has implemented therapies to treat psychological trauma post perinatal bereavement, for potential inclusion in a flexible treatment package. METHOD: A scoping review mapped coverage, range, and type of research that has reported on prior therapies used to treat psychological trauma post perinatal bereavement. FINDINGS: Due to the dearth of papers that directly addressed perinatal bereavement, we widened the scope of the review to view what treatments had been used to treat psychological trauma post-childbirth. Out of 23 studies that report on effectiveness of therapies used to treat psychological trauma post-childbirth, only 4-focused upon treating PTSD post perinatal bereavement (3 effective/1 ineffective). Successful treatments were reported by Kersting et al. (2013), who found CBT effective at reducing PTSD symptoms post-miscarriage, termination for medical reasons, and stillbirth (n = 33 & n = 115), and Navidian et al. (2s017)) found that 4-sessions of grief-counselling reduced trauma symptoms post-stillbirth in (n = 50) women. One study by Huberty et al. (2020found on-line yoga to be ineffective at reducing PTSD symptoms post-stillbirth. CONCLUSIONS: A dearth of research has explored effectiveness of therapies for treating psychological trauma post perinatal bereavement and post-childbirth, with need to develop and test a research informed flexible counselling package.

Can Scotland achieve its aim of narrowing health inequalities in a post-pandemic world?

In this commentary we explore the potential for the devolved Scottish Government to achieve its stated aim of narrowing health - and broader societal (including economic) - inequalities within both the restrictions of limited devolved powers, and in the context of post-pandemic uncertainty. We do so by focussing on two questions: first, where were we with regards to inequalities policy in Scotland before the pandemic? And second, what are the likely implications of the pandemic for inequalities, and inequalities policymaking, in the country?

A study of urinary endogenous gamma-hydroxybutyrate (GHB) levels.

In recent years, the use of gamma-hydroxybutyrate (GHB), as a recreational drug has prompted forensic toxicology laboratories to incorporate the analysis for GHB into their routine screening procedures. GHB, being a natural occurring constituent of the human body, presents a challenge for forensic toxicologists in that endogenous levels and exogenous levels of GHB need to be differentiated in case samples. This study was designed to determine typical urinary endogenous levels of GHB in humans based on the analysis of urine samples voluntarily provided by 55 male and female subjects ranging in age from 6 to 59 years. All samples were initially screened for the presence of GHB utilizing a hydrolysis method designed to quantitatively convert the GHB in urine samples to gamma-butyrolactone (GBL) followed by the liquid-liquid extraction and analysis of any GBL present by gas chromatography-mass spectrometry (GC-MS). As a confirmation test, samples were then extracted by a solid-phase extraction technique, derivatized to GHB di-TMS, and analyzed by GC-MS. The median concentration determined for the 55 subjects was 1.3 mg/mL (mean = 1.65 microg/mL, range 0.9 microg/mL to 3.5 microg/mL, standard deviation 0.68 microg/mL). The results of this study confirm the previously suggested cutoff of 10 microg/mL for routine forensic analyses.