Mothers who score between twelve and nineteen on the EPDS are offered two types of support. The mothers are offered LV treatment provided by a nurse in the NICU and they can be referred to the mental health professional services. If a mother receives a three on item number ten of the EPDS they are immediately referred to the social work team as they may be suicidal.It is critical to acknowledge the diversity of patient populations diagnosed with postpartum depression and how this may impact the reliability of the screening tools used. There are cultural differences in how patients express symptoms of postpartum depression; those in non-western countries exhibit more physical symptoms, whereas those in western countries have more feelings of sadness. Depending on ones cultural background, symptoms of postpartum depression may manifest differently, and non-Westerners being screened in Western countries may be misdiagnosed because their screening tools do not account for cultural diversity. Aside from culture, it is also important to consider ones social context, as women with low socioeconomic status may have additional stressors that affect their postpartum depression screening scores. Prevention
A 2013 Cochrane review found evidence that psychosocial or psychological intervention after childbirth helped reduce the risk of postnatal depression. These interventions included home visits, telephone-based peer support, and interpersonal psychotherapy. Support is an important aspect of prevention, as depressed mothers commonly state that their feelings of depression were brought on by "lack of support" and "feeling isolated.
A distichia is an eyelash that arises from an abnormal part of the eyelid. This abnormality, attributed to a genetic mutation, is known to affect dogs and humans. Distichiae usually exit from the duct of the meibomian gland at the eyelid margin. They are usually multiple, and sometimes more than one arises from a duct. They can affect either the upper or lower eyelid and are usually bilateral. The lower eyelids of dogs usually have no eyelashes.Distichiae usually cause no symptoms, because the lashes are soft, but they can irritate the eye and cause tearing, squinting, inflammation, corneal ulcers and scarring. Treatment options include manual removal, electrolysis, electrocautery, CO2 laser ablation, cryotherapy, and surgery. Commonly affected breeds
In veterinary medicine, some canine breeds are affected by distichiasis more frequently than others:

Cocker Spaniel
Dachshund (especially the miniature longhaired Dachshund)
Bulldog
Pekingese
Yorkshire Terrier
Flat-Coated Retriever
Shetland Sheepdog
Boxer
Poodle

Ectopic cilia
An ectopic cilia is a special type of distichia usually found in younger dogs. Commonly affected breeds include Poodles, Golden Retrievers, and Shih Tzus. The eyelash exits through the conjunctiva of the eyelid facing toward the eye, usually at the middle of the upper eyelid. It can cause intense pain and corneal ulcers. Treatment is surgery or cryotherapy. See also
Trichiasis
Lymphedema distichiasis

References


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