Behavioural activation for people in custody with depression: A protocol for a feasibility randomised controlled study.

People in custody are at high risk of developing depression. Accessing psychological treatments in a prison setting is a particular challenge, in part, due to difficulties accessing specialist mental health workers. Behavioural Activation (BA) may be helpful in improving health outcomes for people in custody experiencing depressive symptoms. The aim of this study is to establish the feasibility and acceptability of custodial health nurses delivering BA to improve depressive symptoms of people in custody. We will conduct a pilot randomised controlled trial with process observation examining the feasibility and acceptability of BA in treating people in custody with depressive symptoms. 60 people in custody presenting with depressive symptoms will be randomised to receive BA plus treatment as usual (TAU) or TAU provided by custodial health nurses. Eight custodial health nurses will be recruited, trained, and deliver BA. BA will be delivered twice a week for six weeks, with sessions lasting up to 30 minutes. Changes in depression and quality of life (QoL) will be assessed at baseline, 6 weeks, and 3 months post-intervention. Participants will be interviewed to understand feasibility and acceptability of BA in prison settings. The findings will inform the design of a randomised controlled trial to test the efficacy of BA for people in custody with depression. Findings will help determine whether BA for depression is suited to prison health care system and services. Improving depressive symptoms in people in custody has benefits beyond prison settings. The Central Adelaide Local Health Network Human Research Ethics Committee and University of South Australia Human Research Ethics Committee have approved the study. The trial results will be disseminated through peer-reviewed journals and scientific conferences and reported to local stakeholders and policy makers. If feasibility and acceptability is demonstrated, we will seek to progress to an effectiveness study. A potential strength of the trial model proposed, is in its scalability, with potential to increase the trial sites and locations. This trial has been prospectively registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12623000346673p). Trial registration ACTRN12623000346673p.

Self-compassion Education for Health Professionals (Nurses and Midwives): Protocol for a Sequential Explanatory Mixed Methods Study.

BACKGROUND: A few recent studies have reported that having the ability to provide self-compassion can reduce health professionals' levels of anxiety and stress, the risk of compassion fatigue, and burnout, and it can generally improve their well-being. Therefore, there is evidence to support further research into the investigation and exploration of self-compassion education and training for health professionals. OBJECTIVE: This study aims to increase the knowledge and understanding of self-compassion and how this may enhance the health and well-being of health professionals. METHODS: The proposed research study will adopt a sequential explanatory mixed methods design. This study will be conducted in 3 phases. Phase 1 will use a pre-educational self-compassion questionnaire (web-based survey) to collect data from participants at 3 time points (before, immediately after, and after follow-up at 6-8 weeks) after they have attended a self-compassion education and training program. Phase 2 will use an interview schedule to explore the participants' views and experiences through a follow-up focus group or individual interview. Finally, phase 3 will include data integration and dissemination of key findings and recommendations. RESULTS: This study was approved by the Women's and Children's Health Network Human Research Ethics Committee and the Human Research Ethics Committee at the University of South Australia on June 26, 2021 (ID: 204,074). A scoping review was conducted to inform this research study (focusing on nurses and midwives). The preparatory phase was completed in April 2021. Phase 1 is expected to be completed by June 2022 and phase 2 will commence in July 2022. CONCLUSIONS: The key findings from the data integration for this research project will provide in-depth details and insights to broaden the discussion about self-compassion and its influence on health professionals' health and well-being. Health professionals (nurses and midwives) may benefit from self-compassion education and training programs to improve their health and well-being. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/34372.

The implementation of best practice in medication administration across a health network: a multisite evidence-based audit and feedback project.

BACKGROUND: Medication errors present a significant risk to patient safety. The "rights" of medication administration represent one approach to potentially reducing this risk. OBJECTIVES: The aim of this project was to implement an evidence-based audit and feedback project to improve compliance with best practice in this area across a health network. METHODS: A baseline audit was conducted to determine compliance with evidence-based standards by trained observers. The results of this audit were analysed and fed back to staff. An analysis of barriers to compliance was undertaken by key staff within the organization, which was followed by the implementation of targeted strategies to improve compliance. A follow-up audit was conducted and the results compared to the baseline audit. RESULTS: There were improvements in the percentage of compliance across all of the eight criteria audited, with statistically significant improvements found in six of the eight. In general, compliance with the criteria was high in both the baseline and follow-up audits. CONCLUSION: This audit and feedback implementation project was successful in increasing compliance and knowledge in this area and providing future direction for sustaining evidence-based practice change. It is now planned to use this approach for rolling out future implementation projects within this health system.

Is pressure stressful? The impact of pressure on the stress response and category learning.

We examined the basic question of whether pressure is stressful. We proposed that when examining the role of stress or pressure in cognitive performance, it is important to consider the type of pressure, the stress response, and the aspect of cognition assessed. In Experiment 1, outcome pressure was not experienced as stressful but did lead to impaired performance on a rule-based (RB) category-learning task, but not on a more procedural information-integration (II) task. In Experiment 2, the addition of monitoring pressure resulted in a modest stress response to combined pressure and impairment on both tasks. Across experiments, higher stress appraisals were associated with decreased performance on the RB, but not on the II, task. In turn, higher stress reactivity (i.e., heart rate) was associated with enhanced performance on the II, but not on the RB, task. This work represents an initial step toward integrating the stress cognition and pressure cognition literatures and suggests that integrating these fields may require consideration of the type of pressure, the stress response, and the cognitive system mediating performance.

Unsupervised category learning with integral-dimension stimuli.

Despite the recent surge in research on unsupervised category learning, the majority of studies have focused on unconstrained tasks in which no instructions are provided about the underlying category structure. Relatively little research has focused on constrained tasks in which the goal is to learn predefined stimulus clusters in the absence of feedback. The few studies that have addressed this issue have focused almost exclusively on stimuli for which it is relatively easy to attend selectively to the component dimensions (i.e., separable dimensions). In the present study, we investigated the ability of participants to learn categories constructed from stimuli for which it is difficult, if not impossible, to attend selectively to the component dimensions (i.e., integral dimensions). The experiments demonstrate that individuals are capable of learning categories constructed from the integral dimensions of brightness and saturation, but this ability is generally limited to category structures requiring selective attention to brightness. As might be expected with integral dimensions, participants were often able to integrate brightness and saturation information in the absence of feedback--an ability not observed in previous studies with separable dimensions. Even so, there was a bias to weight brightness more heavily than saturation in the categorization process, suggesting a weak form of selective attention to brightness. These data present an important challenge for the development of models of unsupervised category learning.

Endovascular stent graft repair of a persistent sciatic artery aneurysm.

An 88-year-old female presented with a large, painful, pulsatile buttock mass. Computed tomographic angiogram with three-dimensional reconstruction and lower extremity arteriogram revealed a 5 cm sciatic artery aneurysm. We report a case of successful repair of a sciatic artery aneurysm with endovascular stent graft.