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Background Little is understood about child welfare involvement (CWI) in cases where the birth mother has experienced human trafficking. Objectives The aim of this study was to explore provider perceptions of the impact of CWI for the trafficked mother. Methods Participants were selected among providers caring for trafficked birth mothers. Semi-structured interviews were conducted with providers and qualitative content analysis was conducted. Results Interviewees reported reasons for CWI, positive and negative impacts of CWI and provided recommendations for systems improvement. Conclusion for Practice Recommendations from this exploratory study include mechanisms to support trafficked mothers, train hospital social workers, and systems change. During the prenatal period, strategies to support the trafficked mother may include addressing gaps in social determinants of health, ensuring appropriate medical and mental health care, early screening and referral to substance use treatment services, enhancing community support, and working to develop safety plans for survivors and their families. Enhanced engagement of social workers and all providers to improve understanding of the unique complexity of trafficked mothers is needed. Education should include an understanding that judgement of a caretaker's ability to parent should be current and holistic and not reflexive based on history in the electronic medical record. An exploration of the child welfare system itself should also be undertaken to identify and modify discriminatory laws and policies. Finally, efforts to address social determinants of health in the community and enhance the trauma-informed nature of child welfare referrals could improve the lives of trafficked mothers., Author(s): Hanni Stoklosa [sup.1] [sup.2] , Lujain Alhajji [sup.3] , Lindsey Finch [sup.4] , Sacha Williams [sup.5] , Jaya Prakash [sup.6] , Anna K. Sfakianaki [sup.7] , Lunthita M. Duthely [...]

The standard of care for treatment of advanced-stage epithelial ovarian cancer is primarily surgery followed by platinum-based chemotherapy, with the operative goal to achieve complete gross resection. Cytoreductive surgeries for epithelial ovarian cancer historically were performed via open laparotomy; however, as minimally invasive techniques became more widely accepted within gynecologic oncology, interest in employing this approach in the setting of cytoreductive surgery for epithelial ovarian cancer has grown. The purpose of this review was to examine the current debate between the use of minimally invasive surgery versus laparotomy as an approach to interval cytoreductive surgery in advanced epithelial ovarian cancer. While numerous retrospective and feasibility studies have found comparable outcomes with respect to complete gross residual disease, progression-free survival, and overall survival between minimally invasive and laparotomy approaches to interval cytoreductive surgery for epithelial ovarian cancer, methodological challenges limit the utility of these data. Given potential risks of underestimating disease burden and failing to achieve complete resection using a minimally invasive approach, further rigorous studies are needed to evaluate the safety and efficacy of minimally invasive surgery in this setting and to better define the subset of patients who would receive the greatest benefit from a minimally invasive approach. [ABSTRACT FROM AUTHOR]

Recent educational policies have altered scholastic experience. It is the contention of the authors that contemporary school experience may therefore, for some individuals, be distressing. This study is concerned with the identification of stress-related behaviours of sixth-form pupils within female single-sex, selective, scholastic environments. The sample consisted of 420 girls drawn from two comparable schools. The study was conducted using qualitative and quantitative methods. Administration of a questionnaire at three intervals within one academic year permitted sustained reflection upon responses. The qualitative questionnaire findings permitted generation of themes, later investigated through focus groups. SPSS was used to analyse responses to scaled questions. The keeping of a research diary served to illuminate meaning and to capture anecdotal evidence, which is so easily lost within a busy school environment. In addition, the opinions of a number of relevant professionals were sought. The study concluded that some members of the sample population encounter demands emanating not only from assessment incidents, but also from a range of other sources inherent to the system of sufficient magnitude, duration and intensity to engender school-related stress. Within the study the ways in which school-related stress may present are identified; these include, for example, physical effects, subjective effects, effects upon work and effects upon relationships. An evaluation of current relevant support mechanisms is offered and recommendations for change are made. (Contains 1 table and 8 figures.)