A Community Mental Health Integrated Disaster Preparedness Intervention for Bushfire Recovery in Rural Australian Communities: Protocol for a Multimethods Feasibility and Acceptability Pilot Study.

BACKGROUND: Natural hazards are increasing in frequency and intensity due to climate change. Many of these natural disasters cannot be prevented; what may be reduced is the extent of the risk and negative impact on people and property. Research indicates that the 2019-2020 bushfires in Australia (also known as the "Black Summer Bushfires") resulted in significant psychological distress among Australians both directly and indirectly exposed to the fires. Previous intervention research suggests that communities impacted by natural hazards (eg, earthquakes, hurricanes, and floods) can benefit from interventions that integrate mental health and social support components within disaster preparedness frameworks. Research suggests that disaster-affected communities often prefer the support of community leaders, local services, and preexisting relationships over external supports, highlighting that community-based interventions, where knowledge stays within the local community, are highly beneficial. The Community-Based Disaster Mental Health Intervention (CBDMHI) is an evidence-based approach that aims to increase disaster preparedness, resilience, social cohesion, and social support (disaster-related help-seeking), and decrease mental health symptoms, such as depression and anxiety. OBJECTIVE: This research aims to gain insight into rural Australian's recovery needs post natural hazards, and to enhance community resilience in advance of future fires. Specifically, this research aims to adapt the CBDMHI for the rural Australian context and for bushfires and second, to assess the acceptability and feasibility of the adapted CBDMHI in a rural Australian community. METHODS: Phase 1 consists of qualitative interviews (individual or dyads) with members of the target bushfire-affected rural community. Analysis of these data will include identifying themes related to disaster preparedness, social cohesion, and mental health, which will inform the adaptation. An initial consultation phase is a key component of the adaptation process and, therefore, phase 2 will involve additional discussion with key stakeholders and members of the community to further guide adaptation of the CBDMHI to specific community needs, building on phase 1 inputs. Phase 3 includes identifying and training local community leaders in the adapted intervention. Following this, leaders will co-deliver the intervention. The acceptability and feasibility of the adapted CBDMHI within the community will be evaluated by questionnaires and semistructured interviews. Effectiveness will be evaluated by quantifying psychological distress, resilience, community cohesion, psychological preparedness, and help-seeking intentions. RESULTS: This study has received institutional review board approval and commenced phase 1 recruitment in October 2022. CONCLUSIONS: The study will identify if the adapted CBDMHI is viable and acceptable within a village in the Northern Tablelands of New South Wales, Australia. These findings will inform future scale-up in the broader rural Australian context. If this intervention is well received, the CBDMHI may be valuable for future disaster recovery and preparedness efforts in rural Australia. These findings may inform future scale-up in the broader rural Australian context. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/53454.

PlasmaBlade-assisted surgical septal myectomy: technique and our experience.

Background: The pulsed-electron avalanche knife (PEAK) PlasmaBlade provides an atraumatic, scalpel-like cutting precision and electrocautery-like hemostasis. PlasmaBlade operates near body temperature, and its long, thin, and malleable tip can overcome the limitations of a surgical knife. In this study, we aimed to evaluate our clinical experience and histopathological outcomes of septal myectomy using PlasmaBlade. Methods: Electronic medical records were reviewed for preoperative, operative, and follow-up data of the patients who underwent septal myectomy using PEAK PlasmaBlade at our institute between January 2019 and December 2022. Histopathology of the myectomy specimens was reviewed for the depth of muscle necrosis and compared with the left atrial appendage (LAA) specimen. Results: Twenty-nine patients underwent septal myectomy using the PEAK PlasmaBlade. No mortality was reported. The mean age was 60.6 ± 12.5 years, and 58.6% of patients were male. Peak left ventricular outflow tract (LVOT) gradients were 40.5 ± 34.9 mmHg at rest and 56.5 ± 34.9 mmHg after provocation. Concomitant procedures performed were LAA ligation in 20 (69.0%), aortic valve replacement in 5 (17.2%), and coronary artery bypass grafting in 3 (10.3%) patients. Postoperative complications were complete heart block in one (3.4%) and ventricular septal defect in two (6.9%) patients. Both the ventricular septal defects were identified intraoperatively and repaired. Histopathology of myectomy specimens demonstrated cautery artifact limited to <50 µm depth compared to >1,000 µm with conventional electrocautery. At a mean follow-up of 8.4 ± 10.3 months, the mean LVOT gradient was 4.4 ± 5.8 mmHg at rest and 9.5 ± 3.3 mmHg after provocation. All patients were alive and in New York Heart Association class I/II. No patient developed complications or required reintervention or reoperation. Conclusion: Adequate septal myectomy can be precisely and safely performed using the PEAK PlasmaBlade with minimal collateral damage.

Climate change anxiety positively predicts antenatal distress in expectant female parents.

Clinical and subclinical levels of anxiety and depression are common experiences during pregnancy for expectant women; however, despite rising awareness of significant climate change anxiety around the world, the extent to which this particular type of anxiety may be contributing to overall antenatal psychological distress is currently unknown. Furthermore, the content of concerns that expectant women may have for their existing or future children remains unexplored. To address this gap in knowledge, 103 expectant Australian women completed standardised assessments of antenatal worry and depression, climate change anxiety, and perceived distance to climate change, and responded to several open-ended questions on concerns they had for their children. Results indicated that climate change anxiety accounted for significant percentages of variance in both antenatal worry and depression scores and, unexpectedly, neither child number nor perceived distance to climate change moderated these relationships. Content analysis of qualitative data highlighted the significant health-related anxieties for participants' children related to climate change (e.g., disease, exposure to extreme weather events, food/water insecurity). Given the escalating nature of climate change, further investigation of this relatively new stressor contributing to the experience of anxiety and distress, particularly in uniquely vulnerable groups such as expectant women, is urgently needed.

'All we found were bones': Veterinary workers' distress and trauma after Australia's Black Summer bushfires.

BACKGROUND: Australia's 2019/2020 Black Summer bushfires affected billions of animals, many of which were rescued and cared for by veterinary and animal care workers (VACWs). Little is known about VACWs' disaster-related experiences and how these experiences may affect them. METHODS: We used a convergent mixed-methods design to explore how a variety of VACWs experienced the Black Summer bushfires. Data were gathered between April and July 2020. Participants (N = 93) were recruited via Facebook posts and emails that contained a link to an online survey. The survey included open-ended questions about VACWs' bushfire-related experiences and quantitative measures of posttraumatic stress disorder symptoms, psychological distress, burnout and grief. RESULTS: Participants reported a variety of bushfire-related experiences and described several ways the disaster affected their work, personal lives and communities. Overall, participants scored highly on measures of psychological ill-health. LIMITATIONS: Our cross-sectional design and use of non-probability sampling limited the generalisability of the results and may have introduced a response bias. CONCLUSION: Our results contribute new information on the experiences of VACWs during and after bushfires and the psychological hazards they may face due to the extreme and prolonged stressors produced by such disasters. Implications for policy and veterinary practice are discussed.

In Situ Provisioning Wildlife with Food, Water, or Shelter after Bushfires: Using a One Welfare Framework to Guide Responses.

Australia's 2019-2020 bushfires had a devastating impact on animals, humans, and ecosystems. They also demonstrated the lack of evidence or guidance for wildlife provisioning in response to severe fire events when volunteers and wildlife organisations rose to respond. In addition, the unprecedented scale and intensity of the fires and an absence of institutional support for wildlife provisioning meant that well-intentioned interventions were largely uncoordinated and lacked clear short-term, mid-term, and long-term objectives. Fundamentally, a lack of consensus was revealed on whether any such interventions are advisable. Given the strong evidence indicating that future bushfire seasons will become longer and more intense in Australia and elsewhere, the welfare and survival of millions of wild animals are at risk every year. Understanding the impacts of supplementary resource interventions and contributing to the development of best practice information is crucial to inform the response to the next major fire event. Here, we contextualize the arguments for and against provisioning within a 'One Welfare' framework that recognizes that animal welfare, biodiversity, and the environment are intertwined with human welfare and community resilience. We propose that the One Welfare approach can facilitate appropriate consideration of the extant scientific and lay literature; local legislation; views of stakeholders; emerging data; and modelling from historic fire events. As a further step, we see merit in engaging with wildlife provisioners and the broader conservation community to build an evidence base for future wildlife provisioning activities. From an informed position, we can encourage beneficial interventions and reduce the risk of negative outcomes. Finally, we propose controlled experiments (e.g., using hazard reduction burns), ongoing data collection using emergent technology, and longitudinal analysis to address shifting research priorities as the climate changes. We conclude that the ordered collection of the necessary evidence relevant to each of the three stakeholder groups in the One Welfare framework has the greatest potential to support an informed policy platform on wildlife provisioning across Australia that is feasible, legal, and sustainable.

Case report: Heart transplant for persistent right heart failure after complete surgical repair and percutaneous closure of post-myocardial infarction ventricular septal rupture.

The incidence of post-acute myocardial infarction ventricular septal rupture (post-AMI VSR) has decreased; however, mortality after surgical repair of post-AMI VSR remains high. Patients who are not surgical candidates can be managed by heart transplant with a good outcome. A heart transplant in a patient after successful repair of VSR has never been reported. We report a patient who had persistent right heart failure after the successful repair of VSR and underwent a heart transplant with a good outcome.

Attachment styles, continuing bonds, and grief following companion animal death.

The death of a companion animal can cause severe grief, yet previous research investigating factors predicting grief has been hampered by limitations. We explored how attachment styles, continuing bonds, and time since loss interacted to predict grief severity in a large sample of individuals grieving the loss of a variety of companion animals. Participants (n = 496) aged between18 and 79 years (Mage = 41.60, SD = 13.62) who had lost a companion animal in the previous three years completed a continuing bonds questionnaire, and animal-oriented assessments of grief and attachment styles online. After controlling for time since loss, higher attachment anxiety predicted more severe grief, a relationship partially moderated by continuing bonds, whereas attachment avoidance predicted less severe grief irrespective of continuing bonds. We recommend reconsideration of the non-human animal exclusion in prolonged grief disorder, and suggest that bereavement supports embrace targeted approaches that consider attachment styles.

Australian Youth Mental Health and Climate Change Concern After the Black Summer Bushfires.

Climate change and its effects present notable challenges for mental health, particularly for vulnerable populations, including young people. Immediately following the unprecedented Black Summer bushfire season of 2019/2020, 746 Australians (aged 16-25 years) completed measures of mental health and perceptions of climate change. Results indicated greater presentations of depression, anxiety, stress, adjustment disorder symptoms, substance abuse, and climate change distress and concern, as well as lower psychological resilience and perceived distance to climate change, in participants with direct exposure to these bushfires. Findings highlight significant vulnerabilities of concern for youth mental health as climate change advances.

Purchasing sustainable palm oil products: narrowing the intention-behavior gap.

Experts on palm oil production and utilization emphasize the role of consumer purchasing power in dealing with the environmental and social impacts of the palm oil crisis -that by increasing the demand for sustainable palm oil (SPO), greater supply will follow. However, research has identified a persistent intention-behavior gap. Even knowledgeable consumers do not always follow through on their intentions to purchase SPO. Utilizing the Capability-Opportunity Motivation model of Behavior (COM-B), this article reviews important variables contributing to this intention-behavior gap. While knowledge about palm oil and SPO (capability), perceived product availability (opportunity), and pro-green consumption attitudes (motivation) are important predictors of SPO purchasing intentions, increasing these factors has been insufficient in narrowing the intention-behavior gap. Campaigns can increase knowledge about palm oil and SPO, as well as build motivation around making the 'sustainable' choice, but are inadequate in addressing barriers around opportunity (e.g., ease of access to SPO products). In expressing their intent to purchase SPO products, consumers may underestimate the difficulties in being able to identify these consumables (e.g., palm oil often is not clearly labeled, sustainability status may not be obvious), and locate them. In this review, we argue that while consumer behavior is important, it is insufficient to power industry-wide change toward the utilization of SPO. Greater corporate responsibility is needed to increase use of SPO in products, and make consumables containing SPO more available, identifiable, and affordable for consumers. We also suggest that national procurement policies for SPO are likely to produce longer-lasting change.

Successful management of complex haemorrhagic pericardial cyst with cirrhosis of liver: a case report.

Haemorrhagic pericardial cysts are rare and may be complicated by encasement of the heart, right heart failure and, rarely, cardiac cirrhosis. Surgical management of complicated cysts is challenging and has poor outcomes. We report a case of successful surgical management of a complicated pericardial cyst presenting with cardiac cirrhosis and the challenges associated with this condition.

Why take the risk? Exploring the psychosocial determinants of floodwater driving.

As anthropogenic climate change progresses, there is an increasing need for individuals to make appropriate decisions regarding their approach to extreme weather events. Natural hazards are involuntary risk environments (e.g., flooded roads); interaction with them cannot be avoided (i.e., a decision must be made about how to engage). While the psychological and sociocultural predictors of engagement with voluntary risks (i.e., risk situations that are sought out) are well-documented, less is known about the factors that predict engagement with involuntary risk environments. This exploratory study assessed whether mental health (depression, anxiety, and stress symptoms), personality traits, and cultural worldviews combine to predict engagement with involuntary risk, using the situation of floodwater driving. An Australian sample (N = 235) was assessed via questionnaire and scenario measures. Results were analyzed in a binomial logistic regression assessing which individual factors predicted decision-making in a proxy floodwater driving scenario. Agreeableness and gender were individually significant predictors of floodwater driving intention, and four factors (named "affect," "progressiveness," "insightfulness," and "purposefulness") were derived from an exploratory factor analysis using the variables of interest, though only two ("progressiveness" and "insightfulness") predicted floodwater driving intention in an exploratory binomial logistic regression. The findings highlight the need for further research into the differences between voluntary and involuntary risk. The implication of cultural worldviews and personality traits in interaction with mental health indicators on risk situations is discussed.

Palm oil: Understanding barriers to sustainable consumption.

Palm oil is relatively inexpensive, versatile, and popular, generating great economic value for Southeast Asian countries. However, the growing demand for palm oil is leading to deforestation and biodiversity loss. The current study is the first to employ a capability-opportunity-motivation (COM-B) framework in green consumerism, to determine which capability, opportunity, and motivation factors strongly predict the intentional purchasing of sustainable palm oil products by Australian consumers (N = 781). Exploratory factor analysis revealed four main types of predictors of SPO purchasing-Pro-Green Consumption Attitudes, Demotivating Beliefs, Knowledge and Awareness, and Perceived Product Availability. Multiple regression revealed that these four factors explained 50% of the variability in SPO purchasing behaviour, out of which Knowledge and Awareness accounted for 18% of the unique variance. Perceived Product Availability and Pro-Green Consumption Attitudes were also significant predictors but accounted for only 2% and 1% of unique variance, respectively. These results provide a valuable foundation for designing behaviour change interventions to increase consumer demand for sustainable palm oil products.

Baby boomers' attitudes to maintaining sexual and intimate relationships in long-term care.

OBJECTIVES: Australian aged care policy is wholly focused on individual "consumers" and consequently neglects the needs of dyadic partners. This paper highlights partnered baby boomers' attitudes to maintaining sexual and intimate relationships in residential care. METHODS: In 2016, cross-sectional data were collected using an online survey of partnered baby boomers recruited using social media. Qualitative data were analysed using word frequency, keywords-in-context and thematic analysis. Descriptive statistics were generated from quantitative data. RESULTS: There were 168 participants (85% female), aged 51-71 years. Many reported that remaining together and continuing physical and sexual contact were important in aged care contexts-necessitating private couple's suites, shared beds, access to condoms, lubricants and sexual health professionals. CONCLUSIONS: Considerable cultural change will be required to raise residential aged care to the standard expected by some partnered baby boomers. Shifting to a more couple-centred approach may benefit partnered residents' health and well-being.

Happily partnered older adults' relationship-enhancing behaviours.

OBJECTIVE: Relationship-enhancing behaviours that contribute to older adults' well-being are scarcely considered in "active ageing" discourses despite relationship quality having been repeatedly linked to health outcomes. This paper explores such behaviours in older adults. METHODS: Cross-sectional data were collected in 2016 from 168 partnered baby boomers (born 1946 to 1965) using an online survey. The 36 qualitative and quantitative questions were analysed using mixed methods. RESULTS: Participants were predominantly women (85%), with a mean age of 62 years (SD = 5.2). Relationship-enhancing behaviours included verbal and non-verbal cues, physical affection and pleasurable sexual activities. A couple's shared bed was an important relationship setting. CONCLUSION: For happily partnered older adults, relationship quality improves personal well-being. As a social determinant of healthy ageing, health policies and programs are needed to support older adults' relationship quality. To this end, the development of targeted relationship interventions for delivery in health settings is warranted.

To Vaccinate or Not: The Relative Impact of Attitudes toward Autism Spectrum Disorders and the Ability to Interpret Scientific Information on Vaccination Decisions.

BACKGROUND: This pilot study investigated vaccine decision making, i.e., the relationships between knowledge and attitudes towards autism spectrum disorders (ASD), scientific literacy, attitudes toward the (MMR) vaccine, and children's MMR vaccination status. METHODS: A sample of 132 parents and expectant parents (mean age 38.40 years; >60% with university education) participated in a survey where they were asked about their knowledge of ASD, attitudes towards ASD and MMR, and their children's MMR vaccine status. The participants also completed a standardized science test (The American College Test) to test their scientific literacy. RESULTS: Knowledge of ASD was positively correlated with attitudes towards ASD. Attitudes towards ASD were positively correlated with scientific literacy and attitudes towards MMR. Attitudes towards MMR were positively correlated with MMR vaccine status (i.e., vaccination decision). DISCUSSION: Factors other than scientific literacy seem to contribute towards children's MMR vaccine status such as attitudes towards MMR. However, these are preliminary findings and need to be interpreted with caution.

Do Bisexuals Have a Bisexual Viewing Pattern?

Past visual attention research appears to show that bisexual men and women view erotic images differently compared to heterosexual and gay/lesbian men and women. However, none of these studies have employed analytic approaches required to determine whether these apparent bisexual viewing patterns are due to averaging together heterosexual and gay/lesbian type viewing patterns, or rather are because bisexual-identified individuals possess unique viewing patterns which are distinct from heterosexual and gay/lesbian individuals. In the current eye-tracking study, we aimed to address this question. Visual attention of 60 men (24 heterosexual, 19 gay, 17 bisexual) and 54 women (21 heterosexual, 10 lesbian, 23 bisexual) was tracked, while they viewed erotic images of nude men and women. Applying analytic approaches capable of detecting bisexual responding revealed that bisexual men, but not bisexual women, had a unique bisexual controlled attention pattern, and that neither bisexual men nor women demonstrated a unique bisexual pattern of initial attention. Our findings provide mixed evidence for a unique bisexual attentional profile in men and women.

Visual Attention to Sexual Stimuli in Mostly Heterosexuals.

Individuals who report mostly heterosexual orientations (i.e., mostly sexually attracted to the opposite sex, but occasionally attracted to the same sex) outnumber all other non-heterosexual individuals combined. The present study examined whether mostly heterosexual men and women view same- and other-sex sexual stimuli differently than exclusively heterosexual men and women. A novel eye-tracking paradigm was used with 162 mostly and exclusively heterosexual men and women. Compared to exclusively heterosexual men, mostly heterosexual men demonstrated greater attention to sexually explicit features (i.e., genital regions and genital contact regions) of solo male and male-male erotic stimuli, while demonstrating equivalent attention to sexually explicit features of solo female and female-female erotic stimuli. Mediation analyses suggested that differences between mostly and exclusively heterosexual profiles in men could be explained by mostly heterosexual men's increased sexual attraction to solo male erotica, and their increased sexual attraction and reduced disgust to the male-male erotica. No comparable differences in attention were observed between mostly and exclusively heterosexual women-although mostly heterosexual women did demonstrate greater fixation on visual erotica overall-a pattern of response that was found to be mediated by reduced disgust.

Relationship Quality and Perceived Partner's Body Appreciation Is Related to Women's Own Body Appreciation and Sexual Functioning.

Research on body appreciation is limited, especially when examining its relationship to sexual functioning. The aim of this study was to explore the relationship between body appreciation and sexual functioning, while measuring perceived partner's body appreciation and general relationship quality. A sample of 244 women aged 18 to 30 completed measures of sexual functioning, relationship quality, and body image online. General relationship quality and perceived partner's appreciation of one's body predicted levels of sexual functioning. Levels of body appreciation did not predict sexual functioning over and above general relationship quality and perceived partner's appreciation of one's body. This study is the first to demonstrate the significance of general relationship quality and perceived partner's body appreciation in relation to levels of body appreciation and sexual functioning. The findings highlight the importance of understanding body appreciation and its role in buffering the harmful impacts of viewing idealized images within the media.

Hypersexuality: A Critical Review and Introduction to the "Sexhavior Cycle".

An empirical review of hypersexuality is timely as "compulsive sexual behavior" is being considered as an impulse control disorder for inclusion in the forthcoming International Classification of Diseases, 11th ed. Specifically, hypersexuality has been conceptualized in the literature as the inability to regulate one's sexual behavior that is a source of significant personal distress. Various theoretical models have been posited in an attempt to understand the occurrence of hypersexuality, although disagreement about these divergent conceptualizations of the condition has made assessment and treatment of hypersexual clients more challenging. Theories of sexual compulsivity, sexual impulsivity, dual control (sexual inhibition/excitation), and sex addiction are critically examined, as are the diagnostic criteria for clinically assessing hypersexuality as a sexual disorder. Our discussion of hypersexuality covers a diversity of research and clinical perspectives. We also address various challenges associated with reliably defining, psychometrically measuring, and diagnosing hypersexuality. Furthermore, literature is reviewed that expresses concerns regarding whether hypersexuality (conceptualized as a disorder) exists, whether it is simply normophilic behavior at the extreme end of sexual functioning, or alternatively is a presenting problem that requires treatment rather than a clinical diagnosis. Following our literature review, we developed the "sexhavior cycle of hypersexuality" to potentially explain the neuropsychology and maintenance cycle of hypersexuality. The sexhavior cycle suggests that, for some hypersexual persons, high sexual arousal may temporarily and adversely impact cognitive processing (cognitive abeyance) and explain a repeated pattern of psychological distress when interpreting one's sexual behavior (sexual incongruence). We also suggest that further research is required to validate whether hypersexuality is a behavioral disorder (such as gambling), although some presentations of the condition appear to be symptomatic of a heterogeneous psychological problem that requires treatment.