bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Association between the Perceived Adequacy of Workplace Infection Control Procedures and Personal Protective Equipment with Mental Health Symptoms: A Cross-sectional Survey of Canadian Health-care Workers during the COVID-19 Pandemic: L’association entre le caractère adéquat perçu des procédures de contrôle des infections au travail et de l’équipement de protection personnel pour les symptômes de santé mentale. Un sondage transversal des travailleurs de la santé canadiens durant la pandémie COVID-19
Authors: Smith Peter M. , Oudyk John , Potter Guy , Mustard Cameron 
Published: September 2020

Objectives: To examine the relationship between perceived adequacy of personal protective equipment (PPE) and workplace-based infection control procedures (ICP) and mental health symptoms among a sample of health-care workers in Canada within the context of the current COVID-19 pandemic. Methods: A convenience-based internet survey of health-care workers in Canada was facilitated through various labor organizations between April 7 and May 13, 2020. A total of 7,298 respondents started the survey, of which 5,988 reported information on the main exposures and outcomes. Anxiety symptoms were assessed using the Generalized Anxiety Disorder (GAD-2) screener, and depression symptoms using the Patient Health Questionnaire (PHQ-2) screener. We assessed the perceived need and adequacy of 8 types of PPE and 10 different ICP. Regression analyses examined the proportion of GAD-2 and PHQ-2 scores of 3 and higher across levels of PPE and ICP, adjusted for a range of demographic, occupation, workplace, and COVID-19-specific measures. Results: A total of 54.8% (95% confidence interval [CI], 53.5% to 56.1%) of the sample had GAD-2 scores of 3 and higher, and 42.3% (95% CI, 41.0% to 43.6%) of the sample had PHQ-2 scores of 3 and higher. Absolute differences of 18% (95% CI, 12% to 23%) and 17% (95% CI, 12% to 22%) were observed in the prevalence of GAD-2 scores of 3 and higher between workers whose perceived PPE needs and ICP needs were met compared to those who needs were not met. Differences of between 11% (95% CI, 6% to 17%) and 19% (95% CI, 14% to 24%) were observed in PHQ-2 scores of 3 and higher across these same PPE and ICP categories. Conclusions: Our results suggest strengthening employer-based infection control strategies likely has important implications for the mental health symptoms among health-care workers in Canada.
Effects of the Anti-stigma Workplace Intervention “Working Mind” in a Canadian Health-Care Setting: A Cluster-Randomized Trial of Immediate Versus Delayed Implementation
Authors: Dobson Keith S. , Markova Veronika , Wen Alainna , Smith Laura M. 
Published: September 2020

Objectives: The Working Mind is a program designed to reduce stigmatizing attitudes toward mental illness, improve resilience, and promote mental health in the general workplace. Previous research has revealed positive program effects in a variety of workplace settings. This study advances previous work in implementing randomization and a control group to assess the intervention’s efficacy. Methods: The program was evaluated using a cluster-randomized design, with pretest, posttest, and a 3-month follow-up in 2 implementation groups across 4 sites. Results: The Working Mind program was effective at decreasing mental health stigma and increasing self-reported resilience and coping skills at the pre–post assessment in both delivery groups. The program’s effects were maintained to the time of 3-month follow-up. Qualitative data provided further evidence that participants benefited from the program. Conclusions: This study represents an advancement over past research and provides further support for efficacy of the Working Mind program. Directions for future research, including replication using rigorous methodological procedures and examination of program effects over longer follow-up intervals, are discussed.
Reducing the Risk and Impact of Brachial Plexus Injury Sustained From Prone Positioning—A Clinical Commentary
Authors: Simpson Ashley I. , Vaghela Kalpesh R. , Brown Hazel , Adams Kate , Sinisi Marco , Fox Michael , Quick Tom 
Published: September 2020

Introduction: Prone positioning is deployed as a critical treatment for improving oxygenation in patients with Acute Respiratory Distress Syndrome. This regimen is currently highly prevalent in the COVID-19 pandemic. The pandemic has brought about increased concern about how best to safely avoid brachial plexus injuries when caring for unconscious proned patients. Methods: A review of the published literature on brachial plexus injuries secondary to proning ventilated patients was performed. This was combined with a review of available international critical care guidelines in order to produce a succinct set of guidelines to aid critical care departments in reducing brachial plexus injuries during these challenging times. Discussion: There is no one manner in which prone positioning an unconscious patient can be made universally safe. This paper provides 6 key steps to reducing the incidence of brachial plexus injuries while proning and suggests a safe and sensible management and referral pathway for the conscious patient in which a brachial plexus injury is identified. Conclusion: There is in truth no completely safe position for every patient and certainly there will be anomalies in anatomy that will predispose certain individuals to nerve injury. Thus the injury rate cannot be reduced to zero but an understanding of the principles of protection will inform those undertaking positioning.
Evaluation of a Resiliency Focused Health Coaching Intervention for Middle School Students: Building Resilience for Healthy Kids Program
Authors: Lee Joey A. , Heberlein Erin , Pyle Emily , Caughlan Thomas , Rahaman Darvi , Sabin Margaret , Kaar Jill L. 
Published: September 2020

Introduction: Youth mental health issues are a growing public health concern. Resilience has been identified as a mitigating factor for adverse mental health outcomes. Schools have shown an increasing interest in strategies to support students’ mental health. The purpose of this study was to evaluate a school-based 1:1 health coaching program designed to build resilience by teaching students coping skills and strategies to increase their self-efficacy. Study Design: Single group intervention study with pre/post measures. Setting/Participants: Sixth grade students (aged 11-12 years) attending an urban middle school. Intervention: Youth participated in up to 6 resiliency-focused, 1:1 health coaching sessions completed over 8 weeks and conducted during the school day. Health coaches utilized motivational interviewing techniques to set and work toward resilience-related goals focused on improving coping skills and self-efficacy with youth during the intervention (January through March 2020). Main Outcome Measures: The Child and Youth Resilience Measure-Revised and other mental health assessments were completed at baseline and immediately following completion of the intervention to evaluate outcomes. Paired sample t-tests and Hedges’ g effect sizes were conducted to evaluate intervention effectiveness. Student participation rates were assessed throughout the intervention. Results: 287 youth participated in the study (87% participation rate) and participated in over 85% of health coaching sessions offered. A paired samples t-test revealed the youth resilience significantly increased from pre ( M = 75.7, SD = 6.9) to post ( M = 77.6, SD = 6.8) intervention ( t[257] = 3.73, p < .001) and the size of the effect was medium ( g = 0.29, 95% CI = 0.11, 0.46). Conclusions: The findings demonstrate that health coaching can be an effective strategy for improving resiliency in youth. Future studies evaluating how to effectively disseminate this intervention strategy are planned.
Patterns of Psychoactive Medication Use in Community-Dwelling Older Adults in the US in 2016: A Descriptive Cross-Sectional Study
Authors: Bajracharya Rashmita , Qato Danya M. 
Published: September 2020

Objectives: We aim to quantify any use and long-term use patterns of psychoactive medications and explore differences in use by sociodemographic factors in older adults (60–85 years) using the 2016 Medical Expenditure Panel Survey. Methods: Prevalence estimates of any use and long-term use were calculated. Chi-square and crude odds ratios were calculated to estimate differences in any use and long-term use of psychoactive medication by sociodemographic characteristics of respondents. Results: Thirty percent of older adults in the US reported any use of psychoactive medications. Long-term use was significantly higher in women (28.3% [95% confidence interval: 26.5, 30.2]), white (27.8 [26.1, 29.7]), presently unmarried (27.5 [25.4, 29.7]), and low-income (30.3 [27.7, 32.9]) subgroups than in men (20.5 [18.4, 22.5]), Black (14.7 [12.3, 17.1]), presently married (22.8 [20.7, 24.9]), and high-income (21.1 [19.1, 23.1]) subgroups, respectively. Discussion: Despite continued risks associated with use, long-term use of psychoactive medications is prevalent in the older adult population in the US. Given the increased complexity of pharmacotherapy regimens in this population, enhanced efforts at improving use of psychoactive medications should be intensified.
Biologics targeting type I interferons in SLE: A meta-analysis and systematic review of randomised controlled trials
Authors: Koh Jeffery Wei Heng , Ng Cheng Han , Tay Sen Hee 
Published: September 2020

Objective The feed-forward loop of type I interferons (IFNs) production and subsequent immunopathology of systemic lupus erythematosus (SLE) has been hypothesised to be disrupted with inhibition of IFNα or type I IFN receptor subunit 1 (IFNAR). This systematic review and meta-analysis present the treatment efficacy and safety profile of monoclonal antibodies inhibiting IFNα or IFNAR. Methods A search was done using Medline, Embase and ClinicalTrials.gov for biologics targeting IFNα or IFNAR in SLE up to 3 Jan 2020. For the meta-analysis, analyses of binary variables were pooled using odds ratio (OR) with the Mantel Haenszel model. Results Anifrolumab 300 mg (n = 3 studies, 927 patients) was more effective than placebo in achieving SRI(4) (pooled OR = 1.91, CI 1.11-3.28, P = 0.02) and BICLA response (pooled OR = 2.25, CI 1.72-2.95, P < 0.00001). In SLE patients with high type I IFN gene signature, SRI(4) response was not achieved with anifrolumab in 2 studies, 450 patients. Treatment with IFNα and IFNAR inhibitors (n = 7 studies, 1590 patients) increased the risk of herpes zoster infection (pooled OR = 3.72, CI 1.88–7.39, P = 0.0002), upper respiratory tract infections, nasopharyngitis and bronchitis. Conclusion This meta-analysis substantiates IFNAR as a therapeutic target in SLE. Inhibition of type I IFNs predisposes to herpes zoster and other viral infections.
Differences in practice and preferences associated with truth-telling to cancer patients
Authors: Wu Jing , Wang Yan , Jiao Xiaodong , Wang Jingting , Ye Xuchun , Wang Bei 
Published: September 2020

Background: Doctors should disclose the diagnosis to patients according to the principle of autonomy. However, not disclosing the diagnosis and prognosis to cancer patients remains common in mainland China. Objective: The study explored the experiences and attitudes of patients with cancer, family members, and the medical staff in truth-telling. Research design: A quantitative survey with three closed-ended questionnaires was conducted. Participants: In all, 137 patients with cancer, 134 family members caring for cancer cases, and 54 medical staff were surveyed. Descriptive statistics were used to summarize all characteristics, and the chi-square test was performed to analyze group differences in attitudes toward cancer disclosure. Ethical considerations: This study was approved by the Committee on Ethics of Biomedicine Research, at the Second Military Medical University (HJEC-2018-YF-001). Informed consent was obtained from all participants prior to study commencement. Findings: A total of 59.8% of patients were informed about their diagnosis within 1 week, and 19.7% inferred theirs. The medical staff preferred to prioritize family members in informing about patient diagnosis while 77.4% of patients preferred to be told the whole truth at the time of initial diagnosis. More patients than family members and medical staff wanted the patients to be informed about the diagnosis ( p < 0.001). A significant difference was found between the patients and family members regarding who should tell the patients. Discussion: The willingness of patients in knowing the truth was underestimated by their family members as well as the medical staff. Guessing the truth indirectly may exert negative effects on the patients, and not telling the truth is inappropriate in patients who want to be informed. Conclusion: Disclosure of a cancer diagnosis is a complex process involving medical practice, as well as a range of cultural, ethical, and legal factors. The medical staff should first assess each patient’s willingness in truth-telling and inform about disease diagnosis with respect. Emotional support and comfort from family members are encouraged. Anyone in the patient’s care team, especially nurses, could be integrated in the process of truth-telling.
The cancer care observation: an empathy training experience
Authors: Dwyer Justin , O’Callaghan Clare , Ross Margaret 
Published: September 2020

Objective: A ‘cancer care observation’ (CCO) empathy training is described. This study examined psychiatry trainees’ experience of CCO and cancer patients’ experience of being observed. Method: Trainees were paired with consenting patients undergoing cancer treatment; they observed a number of cancer treatment sessions and chronicled their experiences. The observations were discussed in supervision. Semi-structured interviews were conducted with trainees and observed patients. Observation journals and transcribed interviews were analysed using qualitative description. Results: Seven trainees participated. Three themes emerged: patients used trainees to support themselves while trainees struggled with role identities; CCO extends trainees’ professional awareness and can benefit patients; and staff reactions were mixed. Trainees developed wide-ranging, empathic insights into cancer and hospital care experiences. No patient regarded CCO as intrusive. Conclusions: Trainees garnered insights from CCO as they generated clinical hypotheses, learnt about professional boundaries and gained first-hand experience of unconscious mental processes based on their empathic connections. CCO lends itself to psychiatry and, potentially, other medical trainees.
“Little more than a gut feeling?”—considerations when prescribing psychotropic medications to patients undergoing bariatric surgery
Authors: Braun Anastasia , Bruxner George 
Published: September 2020

Objective: Bariatric surgical procedures are being commonly performed increasingly, and many surgical candidates are concomitantly taking psychotropic medication. This paper aims to elucidate issues when prescribing psychiatric medication in this setting of substantial anatomical and physiological change. Method: A hand search of the literature to assess the current understanding of effects of various bariatric procedures on the bioavailability of psychotropic medication. Results: Predominantly malabsorptive bariatric procedures may reduce bioavailability of some but not all commonly used psychiatric medications. There is minimal information about the effects of the most commonly performed surgery, vertical sleeve gastrectomy. Lithium prescription and monitoring requires caution. Conclusions: There is limited guidance for prescription for psychotropic medication in the bariatric surgery patient group, and vigilance for unexpected adverse effects or altered efficacy is warranted.
l’Optimisme and youth mental health: has it attained Voltaire’s ‘best of all possible worlds’?
Authors: Allison Stephen , Bastiampillai Tarun , Looi Jeffrey CL 
Published: September 2020

Objective: Youth mental health has been politicised by high-profile health advocates, and often leads the Australian national policy agenda. The ensuing debate is being conducted at multiple levels: scientific, clinical, economic and political. These levels interact, and we explore how scholars’ experiences with early intervention (EI) shape their roles as health advocates and political lobbyists. Conclusions: Health advocacy influences major government decisions. EI researchers have been successful as health advocates in Australia, attracting substantial government funding for selected youth mental health programmes. Positive experiences with the short-term gains of EI might encourage the necessary optimism amongst researchers for successful health advocacy. However, as medical experts, clinicians are aware that most patients and carers face a huge burden from schizophrenia, even after high-quality EI. These patients require fully integrated and well-funded mental healthcare across the lifespan.
Emergency department mental health presentations before and during the COVID-19 outbreak in Western Australia
Authors: Dragovic Milan , Pascu Viki , Hall Tammy , Ingram Jesse , Waters Flavie 
Published: September 2020

Objective: Coronavirus (COVID-19) has led to high levels of psychological distress in the community. This study aimed to examine whether emergency departments (EDs) also recorded a rise in mental health presentations. Method: Changes in the number, and type, of mental health presentations to Western Australia EDs were examined between January and May 2020, and compared to 2019. Results: Data showed an unexpected decrease in the number of mental health presentations, compared to 2019, which was temporally coincident with the rise in local COVID-19 cases. Presentations for anxiety and panic symptoms, and social and behavioural issues, increased by 11.1% and 6.5%, respectively, but suicidal and self-harm behaviours decreased by 26%. Conclusion: A rise in local COVID-19 cases was associated with a decrease in mental health presentations to EDs. This has important implications for the planning and provision of healthcare services in the current pandemic.
Access Barrier in Rural Older Adults’ Use of Pain Management and Palliative Care Services: A Systematic Review
Authors: Suntai Zainab , Won Cho Rong , Noh Hyunjin 
Published: September 2020

Background: Pain and symptom management is critical in ensuring quality of life for chronically ill older adults. However, while pain management and palliative care have steadily expanded in recent years, many underserved populations, such as rural older adults, experience barriers in accessing such specialty services, in part due to transportation issues. The purpose of this systematic review is to examine the specific types of transportation-related barriers experienced by rural older adults in accessing pain and palliative care. Methods: Studies were searched through the following 10 databases: Abstracts in Social Gerontology, Academic Search Premier, CINAHL, MEDLINE, PsycINFO, SocINDEX with Full Text, Cochrane Database of Systematic Reviews, Nursing & Allied Health Database, Sociological Abstracts, and PubMED. Studies were chosen for initial review if they were written in English, full text, included older adults in the sample, and examined pain/palliative care/hospice, rural areas, and transportation. A total of 174 abstracts were initially screened, 15 articles received full-text reviews and 8 met the inclusion criteria. Results: Findings of the 8 studies identified transportation-related issues as major access barrier to pain and palliative care among rural older adults: specifically, lack of public transportation; lack of wheelchair accessible vehicles; lack of reliable drivers; high cost of transportation services; poor road conditions; and remoteness to the closest pain and palliative care service providers. Conclusion: Results suggest that rural older adults have unique transportation needs due to the urban-centric location of pain and palliative care services. Implications for practice, policy and research with older adults are discussed.
Performance Assessment of a Multifaceted Unfractionated Heparin Dosing Protocol in Adult Patients on Extracorporeal Membrane Oxygenator
Authors: Al-Jazairi Abdulrazaq , Raslan Shahad , Al-mehizia Rayd , Dalaty Hani Al , De Vol Edward B. , Saad Elias , Alanazi Mosleh , Owaidah Tarek 
Published: September 2020

Background The use of extracorporeal membrane oxygenator (ECMO) support devices are associated with complications, including bleeding and thrombosis. Unfractionated heparin (UFH) is the gold standard anticoagulant in ECMO patients. Clinically, UFH is monitored through activated clotting time (ACT), activated partial thromboplastin time (aPTT), and anti–factor Xa assay. It is unknown which assay best predicts anticoagulation effects in adults. Objective To assess the correlation of UFH dosing and monitoring using an established protocol. Methods A pilot, prospective cohort, historically controlled study was conducted at a tertiary care hospital. Patients ≥18 years-old who received ECMO on the multifaceted anticoagulation protocol were included and compared with those on the conventional method of anticoagulation. The primary end point was to assess the correlation between UFH dose and different monitoring methods throughout 72 hours using the new protocol guided by ACT and anti–factor Xa assay. Results In each arm, 20 patients were enrolled. The study revealed that anti–factor Xa assay had the largest number of “strong” correlations 11/20 (55%), followed by both aPTT and aPTT ratio 10/20 (50%), and, finally, ACT 2/20 (10%). Concordance between anti–factor Xa assay and the other monitoring parameters in the prospective arm was generally low: 31% with aPTT ratio, 26% with ACT, and 23% with aPTT. Conclusion and Relevance The adaption of a multifaceted anticoagulation protocol using anti–factor Xa assay may provide a better prediction of heparin dosing in adults ECMO patients compared with the conventional ACT-based protocol. Further studies are needed to assess the safety and different monitoring modalities.