Abstract Background Training schoolchildren to perform cardiopulmonary resuscitation is one possible method of increasing bystander CPR rates. We reviewed available literature to identify what ...methods of training children have been successful. Objectives and methods This review sought to evaluate evidence addressing the following PICO question: (P) In schoolchildren, (I) what types of CPR, AED and first aid training (C) when compared to no training and to each other (O) lead to ability to perform life saving measures? Searches were conducted in Ovid MEDLINE (1946 – August 2012), Ovid EMBASE (1974 – August 2012) and Ebscohost Cinahl (1981 – August 2012). Database specific subject headings in all three databases (MeSH in MEDLINE, Emtree in EMBASE, Cinahl Headings) were selected for the concepts of cardiopulmonary resuscitation (CPR) and education. The combined results were then limited by age to include all school aged children. The search yielded 2620 articles. From titles, abstract and key words, 208 articles described CPR, AED and/or first aid training in schoolchildren and were eligible for review. These were obtained in full, were unavailable or not published in English. We reviewed articles for publication type and relevance. 48 studies were identified. One additional study was included as an extension of a study retrieved within the search. Results The studies found by the search were heterogeneous for study and training methodology. Findings regarding schoolchild age and physical factors, the role of practical training, use of self-instruction kits, use of computer based learning, reduced training time, trainer type, AED training are presented. Conclusions Evidence shows that cardiopulmonary training, delivered in various ways, is successful in a wide age range of children. While older children perform more successfully on testing, younger children are able to perform basic tasks well, including use of AEDs. Chest compression depth correlates with physical factors such as increasing weight, BMI and height. Instruction must include hands on practice to enable children to perform physical tasks. Repeated training improves performance and retention but the format and frequency of repeated training is yet to be fully determined. Types of training that may reduce the main obstacles to implementation of such training in schools include use of self-instruction kits, computer based learning and use of teacher and peer tutor trainers, but again, need further exploration. As starting points we recommend legislative and funded mandates to provide such training to schoolchildren, and production and use of a framework which will delineate longitudinal delivery of training over the school career. Further research should have some uniformity in terms of assessment methodology, look at longer outcomes, and ideally will evaluate areas that are currently poorly defined.
Abstract
Study Objectives
To prospectively examine changes in adolescent sleep before and during the COVID-19 pandemic in adolescents with and without ADHD.
Methods
Participants were 122 adolescents ...(ages 15–17; 61% male; 48% with ADHD). Parents reported on adolescents’ sleep duration and difficulties initiating and maintaining sleep (DIMS); adolescents reported on sleep patterns, sleep duration, delayed sleep/wake behaviors, and daytime sleepiness before (September 2019 to February 2020) and during (May–June 2020) COVID-19. Adolescents also reported on their health behaviors, COVID-19-related negative affect, and difficulties concentrating due to COVID-19.
Results
Parents reported adolescents had more DIMS during COVID-19 than before COVID-19, with clinically elevated rates increasing from 24% to 36%. Both bedtimes and waketimes shifted later during COVID-19, and adolescents reported more delayed sleep/wake behaviors. Adolescents also reported less daytime sleepiness and longer school night sleep duration during COVID-19. In considering differences between adolescents with and without ADHD, adolescents with ADHD did not experience an increase in school night sleep duration and were less likely to obtain recommended sleep duration during COVID-19. In the full sample, controlling for ADHD status, COVID-19-related sadness/loneliness was associated with increases in DIMS, and spending less time outside and more COVID-19-related worries/fears were associated with increases in delayed sleep/wake behaviors during COVID-19.
Conclusions
COVID-19 had negative and positive impacts on adolescent sleep. Adolescents with ADHD did not experience the benefit of increased school night sleep duration during COVID-19 like adolescents without ADHD. Negative affect and health behaviors may be useful intervention targets for reducing negative impacts of COVID-19 for adolescent sleep.
Background
The relationship between attachment and paranoia is now well established. There is good theoretical reason and evidence to indicate that attachment style affects cognitive, affective, and ...behavioural processes which, in turn, contribute to the maintenance of paranoia, but this research has not been integrated. We critically and systematically review research that examines relevant cognitive, affective, and behavioural processes, which may explain how attachment insecurity leads to paranoia and constitute key targets in psychotherapeutic interventions for people with psychosis.
Method
We conducted three systematic searches across six databases (PsycINFO, CINAHL, Medline, Web of Science, Embase, and Google Scholar), from inception to September 2021, to investigate key cognitive, affective, and behavioural processes in the attachment–paranoia association.
Results
We identified a total of 1930 papers and critically reviewed 16. The literature suggests that negative self‐ and other‐beliefs, inability to defuse from unhelpful cognitions, and use of maladaptive emotion regulation strategies mediate the association between attachment insecurity and paranoia in people with psychosis/psychotic experience. Attachment‐secure people with psychosis are more likely to seek help and engage with services than attachment‐insecure people.
Conclusions
Attachment styles impact help‐seeking behaviours in people with psychosis and are likely to influence paranoia via self‐ and other‐beliefs, cognition fusion, and emotion regulation – these candidate mechanisms may be targeted in psychological therapy to improve clinical outcomes for people with psychosis, characterized by paranoia.
Practitioner points
Insecure attachment is likely to lead to paranoia via negative beliefs about self and others, cognitive fusion, and use of maladaptive emotion regulation strategies. These mechanisms can be targeted in psychotherapeutic interventions for psychosis, such as cognitive behaviour therapy, to improve clinical and recovery outcomes.
People with psychosis who are attachment‐secure are more likely to seek help and engage with services than those who are attachment‐insecure (particularly avoidant). Attachment style can be assessed to predict service engagement and help‐seeking behaviours in people with psychosis.
Attachment styles are important predictors of key cognitive, affective, and behavioural processes in people with psychosis. These processes can be assessed and incorporated into individualised formulations, and then targeted in therapy to effect psychotherapeutic change.
Abstract Purpose Many people with psychosis do not seek help which delays access to recommended treatments. Duration of untreated psychosis is associated with poor healthcare outcomes and increased ...risk of relapse. The reasons why people delay accessing treatment remain unclear. This is the first systematic review to synthesise the literature examining professional and non‐professional help‐seeking in psychosis across clinical and subclinical populations. Methods We searched four databases (APA PsycINFO, APA PsycArticles, Medline and British Library EThOS) to generate a comprehensive account of the quantitative literature. Heterogeneity of measures precluded a meta‐analysis. Results We identified 19 articles (including 9686 participants) that met criteria for the review. Help‐seeking in psychosis is associated with being female, having a higher level of education, and experiencing more than one symptom. People with psychosis report stigma, poor mental health literacy and lack of family support as key barriers. Clinicians report childhood physical abuse, insecure attachment and severity of psychosis as additional barriers. We also found differences in preferred sources of help across cultures. There is currently no consensus on reliable help‐seeking measures. Conclusions This is the first systematic review to examine help‐seeking behaviour in psychosis. Assertive and culturally sensitive engagement efforts should be targeted towards people with a history of early adversity, poor mental health literacy, limited social support and more severe psychosis.
Abstract Objectives People with psychosis delay accessing recommended treatments, resulting in poor healthcare outcomes and increased risk of relapse. Means of improving help‐seeking and ...help‐acceptance could reduce duration of untreated psychosis (DUP). This study examined the role of attachment style in help‐seeking and help‐acceptance in psychosis. Design We used an experimental design to test the effect of attachment imagery priming on help‐seeking and help‐acceptance intentions, in a sample with self‐reported psychosis. The independent variables were attachment imagery condition (secure vs. avoidant) and time (pre‐ vs. post‐prime). The dependent variables were state paranoia, help‐seeking intentions and help‐acceptance intentions. Methods We used an online research platform to recruit people with psychosis ( n = 61). Participants were randomly allocated to the secure or avoidant attachment priming condition. All completed measures of state paranoia, help‐seeking, and help‐acceptance, before and after priming. Results In comparison with the avoidant condition, secure attachment imagery resulted in reduced paranoia and increased help‐seeking and acceptance intentions, all with large effect sizes. Conclusions This is the first study to use an experimental design to assess the role of attachment style in help‐seeking and help‐acceptance in a clinical sample. Attachment style is causally linked to behavioural intentions that contribute to DUP. Clinicians should assess attachment and help‐seeking and acceptance, highlight these in formulation, and prioritise in treatment planning. Interventions that enhance help‐seeking and acceptance could improve access to recommended treatments and reduce DUP.
This study investigated the root cause behind an observed free fatty acid particle formation and resulting Polysorbate 20 (PS20) loss for a sulfatase drug product upon long-term storage at 5 ± 3°C. ...Reversed- phase chromatography with mass spectrometric analysis as well as charged aerosol detection was used to characterize the peaks associated with the intact and degraded PS20. Additionally, a proteomics study was undertaken to identify the residual host cell proteins in the sulfatase drug substance. PS20 stability studies were conducted in the presence of sulfatase, a sulfatase inhibitor, putative phospholipase B-like 2, and mock drug substance produced using a null cell line vector under experimental conditions optimized for PS20 degradation. This study provides the first published evidence where the residual host cell protein present in the drug substance was identified and experimentally shown to catalyze the breakdown of PS20 in a protein formulation over time, resulting in free fatty acid particles and PS20 loss. This study demonstrates the importance of early detection of potential impurities in the protein drug substance that may contribute to polysorbate degradation to make a judicious selection of the surfactant and its optimized concentration for the final drug product.
Objectives
Paranoia describes unfounded and distressing interpersonal threat beliefs. Secure attachment imagery has been shown to attenuate paranoia and anxiety in non‐clinical and clinical groups, ...but little is known about the differential effects of anxious and avoidant imagery or mechanisms of change. In this study, we tested the impact of secure, anxious, and avoidant attachment imagery on paranoia, anxiety, and help‐seeking intentions. We also examined hypothesized mechanisms of change, specifically whether cognitive fusion and negative self‐ and other‐beliefs mediate these relationships.
Design
This study utilized an experimental, cross‐sectional design.
Methods
A large (N = 303), international general population sample with high levels of non‐clinical paranoia completed a series of measures before and after engaging in secure, anxious, or avoidant imagery.
Results
Relative to anxious and avoidant attachment imagery, secure attachment imagery reduced paranoia and anxiety and increased help‐seeking intentions. Cognitive fusion and negative self‐ and other‐beliefs mediated the impact of attachment imagery on paranoia and anxiety, but not help‐seeking.
Conclusions
In line with attachment and cognitive theory, secure attachment imagery is effective in reducing paranoia and anxiety and works by reducing cognitive fusion and negative self‐ and other‐beliefs. These novel findings suggest that the secure imagery task could be incorporated into cognitive and behavioural therapies to reduce distressing interpersonal threat beliefs and associated negative affect, and increase help‐seeking intentions.
Practitioner points
When working with people experiencing paranoia, secure attachment imagery may be effective in reducing state paranoia and anxiety and improving help‐seeking intentions.
Attachment imagery works by influencing beliefs about self and others, and the degree to which people are fused with their beliefs. In clinical practice, the rationale for the imagery task fits well with psychological models of paranoia and the secure imagery task can be introduced as a way to cope when struggling with distressing beliefs about self and others, and feeling overwhelmed by these fears.
Equine encephalids have high mortality rates and represent a significant zoonotic public health threat. Of these the most pathogenic viruses to equids are the alphaviruses in the family Togaviridae. ...The focus of this review Venezualen equine encephalitis virus (VEEV) has caused the most widespread and recent epidemic outbreaks of disease. Circulation in naturally occuring rodent-mosquito cycles, results in viral spread to both human and equine populations. However, equines develop a high titer viremia and can transmit the virus back to mosquito populations. As such, the early recognition and control of viral infection in equine populations is strongly associated with prevention of epidemic spread of the virus and limiting of disease incidence in human populations.
This review will address identification and pathogenesis of VEEV in equids vaccination and treatment options, and current research for drug and vaccine development.
Purpose
Insecure attachment may constitute a vulnerability factor for psychosis, and dissociation may be a key mechanism in the development of auditory hallucinations specifically. While there is ...good evidence for the role of these processes in isolation, it is unclear whether dissociation accounts for the association between insecure attachment and psychosis. This systematic review takes a theory‐driven approach to examine proposed causal relationships across the clinical and nonclinical literature.
Methods
We searched five databases (PubMeD, Web of Science, PsycINFO, CINAHL and ETHOS) for published and unpublished research examining attachment, dissociation and psychosis. Two independent reviewers extracted the data and assessed the quality of all included studies.
Results
We identified 242 potential articles and included 13 in the final review (2096 participants). We found that (1) disorganised attachment was consistently associated with dissociation and inconsistently associated with voices and paranoia, (2) dissociation was associated with voices and paranoia, and these links were stronger in clinical samples, and (3) dissociation played a role in the impact of insecure attachment on voice hearing and paranoia in clinical groups.
Conclusions
This is the first review to synthesise the research examining attachment, dissociation, and psychosis. The evidence is consistent with proposed causal hypotheses and raises conceptual and measurement issues, for example, the need to clarify the relative contributions of different insecure attachment styles, and utilise behavioural/observational measures to strengthen study designs. Most importantly, we need experimental and longitudinal studies to confirm causal links and targets for treatment.
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