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Therapy Technique Cuts Divorce/Separation Rate By Nearly 50 Percent
Four simple questions on well-being asked at the start of each session of ongoing couples therapy can greatly increase chances for reconciliation and improved relationships, according to a newly published study. The largest clinical trial with couples to date, it shows that divorce and separation rates for couples that used this feedback technique were 46.2 percent less than that of couples who received therapy as usual. The findings, published in the August 3, 2009, Journal of Consulting and Clinical Psychology, are the results of a 2-year study conducted at the Vestfold Family Counseling Center in Norway by a U.S.-Norwegian team of researchers.
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Radiofrequency Ablation Durable After 2 Years, Compares Favorably With Endoscopic Resection For Advanced Disease, Reduces Risk For Cancer Progression
Results from a number of clinical trials were presented during the Digestive Disease Week (DDW) in Chicago this week, revealing new outcomes data related to endoscopic radiofrequency ablation using the HALO ablation system for eradicating a pre-cancerous esophageal condition known as Barrett"s esophagus. Among them, reports included durability outcomes from a randomized sham-controlled trial, safety and efficacy outcomes from a large U.S. registry of 429 patients, a randomized trial comparing ablation to endoscopic resection, and the largest European series to date in patients with high-grade dysplasia and early cancer.
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To Flu Experts, 'Pandemic' Confirms The Obvious
"It came as no surprise on Thursday when the World Health Organization declared that the swine flu outbreak had become a pandemic," The New York Times reports. Swine flue has "reached 74 countries, and probably met the technical definition of a pandemic -- or global spread - weeks ago." Raising the alert from Phase 5 to Phase 6, the highest possible level, "does not mean that the illness, which has been mild in most people, has become any worse," because "the term pandemic reflects only the geographic spread of a new disease, not its severity." But it does "signal to countries to step up their efforts to deal with the disease," and it "also means that the health organization is asking drug makers to start making vaccine as quickly as possible." Dr. Margaret Chan, Director-General of the WHO, said while the disease has been mild so far, it "could change at any time and become more severe." It may also prove more deadly "when it reaches poor countries with higher rates of malnutrition, AIDS and other diseases that can lower people"s resistance to infection. Dr. Chan said rich countries should help poor ones less able to protect themselves" (McNeil and Grady, 6/11).
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Reduced-Dose Schedule For Pneumococcal Vaccine In Infants Shows Effectiveness

Infants who received two or three primary doses of the 7-valent pneumococcal conjugate vaccine (PCV-7) both had a decreased rate of carrying pneumococcal microorganisms that can cause pneumonia and other infections, compared to infants who were not vaccinated, according to a study in the July 8 issue of JAMA. Crowded infant vaccine schedules and less favorable cost-effectiveness calculations have prompted exploration of reduced-dose vaccine schedules other than the currently recommended 3 + 1-dose schedule of PCV-7, which consists of 3 primary doses before age 6 months followed up by a booster vaccination in the second year of life, according to background information in the article. Difficulty in implementing the 3 + 1-dose schedule in developing countries is another reason for exploring reduced schedules. The effects of reduced-dose schedules of PCV-7 on pneumococcal carriage in children are largely unknown. Elske J. M. van Gils, M.D., of the University Medical Center Utrecht, the Netherlands, and colleagues examined the effects of a 2-dose and 2 + 1-dose PCV-7 schedule on nasopharyngeal (upper part of the throat behind the nose) pneumococcal carriage in young children. The randomized trial included 1,003 healthy newborns and 1 of their parents in a general community in the Netherlands, with follow-up to age 24 months. Infants were randomly assigned to receive 2 doses of PCV-7 at 2 and 4 months; 2 + 1 doses of PCV-7 at 2, 4, and 11 months; or no dosage (control group). No significant differences in vaccine serotype (a strain of microorganisms having a set of antigens in common), nonvaccine serotype, and overall pneumococcal carriage were observed at 6 months in both vaccine groups compared with the control group. At 12 months, vaccine serotype carriage rates were significantly lower in both vaccine groups compared with the control group, with 25 percent in the 2-dose schedule group, 20 percent in the 2 + 1-dose schedule group, and 38 percent in the control group. A further decrease of vaccine serotype carriage was found at 18 months after 2 + 1-dose schedule and at 24 months after 2 primary doses compared with the control group. In analysis comparing the 2-dose and 2 + 1-dose schedules, the researchers observed a significant difference in vaccine serotype carriage at 18 months with 24 percent vaccine serotype carriage in the 2-dose schedule group compared with 16 percent in the 2 + 1-dose schedule group. At 24 months, the estimates for vaccine serotype carriage in both vaccine groups were at the same level with 15 percent in the 2-dose schedule group and 14 percent in the 2 + 1-dose schedule group, compared with 36 percent in the control group. "In conclusion, both 2-dose and 2 + 1-dose schedules of PCV-7 significantly reduce vaccine serotype pneumococcal carriage in children. This study supports future implementation of reduced-dose PCV-7 schedules," the authors write. JAMA. 2009;302[2]:159-167. Journal of the American Medical Association


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