A comparison of the public's use of PPE and strategies to avoid contagion during the COVID-19 pandemic in Australia and Germany.

The SARS-CoV-2 or COVID-19 pandemic has raised public awareness around disease protection. The aims in this study were to recruit participants from Australia and Germany to determine their use of personal protective equipment and COVID-19 avoidance strategies using scales designed for this study. Principal components analysis with the Australian data revealed two factors in the Protection from Infection Scale, Self-Care and Protective Behaviors, and a single factor in the Infection Avoidance Scale, with each scale demonstrating strong internal reliability. Data from German participants were used to confirm the scales' structure using confirmatory factor analysis. A comparison of the two data sets data revealed that Australian participants scored higher overall on protection and avoidance strategies but at the item level there were several commonalities, including self-care behaviors people adopted to avoid contracting COVID-19. With no foreseeable end to this pandemic, it is important that follow-up studies ascertain whether the public continues to adopt high levels of PPE use and follows government advice or if pandemic fatigue sets in.

Psychological flexibility: positive implications for mental health and life satisfaction.

New wave therapies such as Acceptance and Commitment Therapy aim to cultivate people's psychological flexibility in order for them to live a satisfying life. Psychological flexibility has also a role in promoting mental health, which may mediate the relationship with life satisfaction. The aim of this study was to determine whether mental health mediates the effect of psychological flexibility on life satisfaction. A convenience sample of 140 adults (32 males, M = 36.50 years, SD = 12.22; 107 females, M = 38.46 years, SD = 12.81; and a 45-year-old person of unknown gender) completed an online questionnaire assessing psychological flexibility, mental health and life satisfaction. Three of the four hypothesized components of psychological flexibility (experiential acceptance, cognitive alternatives and cognitive control) contributed to the latent construct of psychological flexibility, but cognitive defusion failed to contribute. Psychological flexibility had a direct, positive effect on life satisfaction and the hypothesis that mental health would mediate this relationship was supported. The results suggest that psychological flexibility is important for one's mental health and that both are integral to life satisfaction. The results also support a continued focus on third-wave therapies in cultivating psychological flexibility.

Factors Influencing Adherence to Standard Precautions Scale: A psychometric validation.

Despite the mandated use of standard precaution guidelines to limit infection transmission in health-care settings, adherence by health-care professionals is suboptimal. There is currently no psychometrically-validated scale to assess influences on workers' adherence. After the data collection was conducted, Michinov et al. (2016) published a questionnaire to determine sociocognitive determinants of adherence to Standard Precautions. The aim of the present study was to develop and test the psychometric properties of such a scale. Forty nine items were derived from interviews with 29 nurses and tested across two studies. Study 1 was a repeated-measures survey using principal components analysis with data from 363 participants; a 29 item, five factor solution was extracted with good to acceptable internal reliabilities (α = .61-.85). Data from 122 of the original participants retested at 4 weeks showed intraclass correlations of .69-.84. Study 2, which was 6 months later, used confirmatory factor analysis with data from a second sample of 384 participants, and supported the five factor structure of leadership, justification, culture/practice, contextual cues, and judgement. The Factors Influencing Adherence to Standard Precautions Scale has good psychometric properties and stability across time and samples. The scale is suitable for use with nurses, and its validation with other health-care professionals and trainees is important in order to tailor effective interventions to promote adherence.

A multilevel longitudinal study of obsessive compulsive symptoms in adolescence: male gender and emotional stability as protective factors.

The severity of obsessive compulsive symptoms (OCS) is suggested to be normally distributed in the general population, and they appear to have an impact on a range of aspects of adolescent development. Importantly, there are individual differences regarding susceptibility to OCS. In the present repeated measures study, OCS were studied in relation to gender and emotional stability (as a personality trait) using a normative sample of 515 adolescents at ages 16 and 18 years. OCS were assessed with the relevant subscale of the SCL-90-R and emotional stability with the Five Factor Questionnaire. A three-level hierarchical linear model was calculated to longitudinally assess the over time variations of OCS and their over time links to gender and emotional stability, while controlling for random effects due to the nesting of the data. Experiencing OCS increased with age (between 16 and 18 years). Additionally, male gender and higher emotional stability were associated with lower OCS at 16 years and these remained stable over time. Results indicate age-related and between individual differences on reported OCS that need to be considered for prevention and intervention planning.

The Experiences of Young Adult Offenders Who Completed a Drug Court Treatment Program.

Although there has been a proliferation of studies on the effectiveness of drug court programs, these studies are largely quantitative in nature. Little is known about the experiences of persons who participate in drug court. In this study, we aimed to fill this knowledge gap by exploring experiences of young adults who completed an adult drug court treatment program. Nine semi-structured interviews were conducted, typed into a word-processing program, and then entered into a data analysis software program. Using grounded theory strategies, analysis revealed several emergent themes, which are presented chronologically to provide a narrative of study participants' experiences before, during, and after the program. Findings provide insights on how participants perceive drug courts and experiences that might facilitate or impede completion of drug court programs. Our findings are particularly important for drug court professionals as they attempt to develop appropriate recommendations for best practices and new policy initiatives.

The use of Likert scales with children.

OBJECTIVE: We investigated elementary school children's ability to use a variety of Likert response formats to respond to concrete and abstract items. METHODS: 111 children, aged 6-13 years, responded to 2 physical tasks that required them to make objectively verifiable judgments, using a 5-point response format. Then, using 25 items, we ascertained the consistency between responses using a "gold standard" yes/no format and responses using 5-point Likert formats including numeric values, as well as word-based frequencies, similarities to self, and agreeability. RESULTS: All groups responded similarly to the physical tasks. For the 25 items, the use of numbers to signify agreement yielded low concordance with the yes/no answer format across age-groups. Formats based on words provided higher, but not perfect, concordance for all groups. CONCLUSIONS: Researchers and clinicians need to be aware of the limited understanding that children have of Likert response formats.

Six-month outcomes of an integrated assertive community treatment team serving adults with complex behavioral health and housing needs.

Assertive community treatment (ACT) and integrated dual disorders treatment (IDDT) have individually proven effective for treatment of adults with complex behavioral health and housing needs. This study evaluated the effectiveness of an ACT team that delivered integrated care consistent with IDDT principles. Participants included 60 adults with a history of chronic homelessness and co-occurring mental health and substance use disorders. Measures assessing mental health, substance use, and residential stability were completed at intake to the program and then 6 months later. Participants reported statistically significant improvements in mental health symptomatology and residential stability over time, although there were no changes in substance use. Findings support the effectiveness of the intervention for improving mental health and housing stability among adults with complex behavioral health and housing needs. Fidelity data support the notion that multiple evidence-based interventions can be integrated while still maintaining adequate fidelity to individual components.

Socioecological factors influencing physical activity engagement for women across the menopausal transition: a systematic review.

IMPORTANCE: Physical activity during menopause can be effective in reducing the physiological changes associated with reproductive aging that increase risks for noncommunicable diseases, yet many women do not meet the recommendations for physical activity. OBJECTIVE: This study aimed to synthesize factors influencing physical activity for women across menopausal transition phases using a socioecological approach. EVIDENCE REVIEW: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis was used to systematically search 10 databases between 2001 and 2021. A comprehensive search strategy was used to identify studies on physical activity of women in various stages of menopause. A socioecological model was used to categorize the reported barriers and enablers. FINDINGS: Twenty studies met the inclusion criteria. The findings highlight several intrapersonal barriers such as existing health complaints versus enablers such as awareness of the health benefits of physical activity during menopause. Ensuring women's safety, preventing injury, and enhancing exercise self-efficacy were important components of programs. Social support was also an important enabler of women's engagement in activities. CONCLUSIONS AND RELEVANCE: Several barriers and enablers were identified and can inform practitioners and future interventions to encourage physical activity among women in various stages of menopause. For instance, when encouraging physical activity during menopause, practitioners should consider other health complaints, safety, and injury prevention while discussing the benefits of physical activity related to managing menopausal symptoms. There was a lack of theoretically informed studies exploring the barriers and enablers to physical activity for women in various stages of menopause; thus, research designs may not have fully accounted for influences. Future research that combines socioecological and individual theories of behavior is needed to comprehensively understand the complexity of physical activity among women across the menopausal transition.

COVID-19 distress and worries: The role of attitudes, social support, and positive coping during social isolation.

As the COVID-19 pandemic accelerates, one public health response has been for governments to impose quarantine 'lockdowns' which require people to socially isolate. In this study, we explored the level of psychological distress that people experienced in social isolation and the factors which might ameliorate or exacerbate it. Two hundred and thirteen participants (69% female) with a mean age of 37.82 years participated in an online study. They completed a series of questions designed as part of a larger cross-national study. A positive attitude towards social isolation introduced by government as a strategy to reduce the transmission of COVID-19 was predictive of positive coping strategies, and both attitude and coping predicted reduced psychological distress. Participants' worries about contagion of COVID-19, their financial status, and the economic and political impact of the COVID-19 pandemic predicted increases in their psychological distress. Social support from family and work colleagues was not significant in reducing worries or psychological distress but it did positively predict engagement in coping. The findings and recommendations are discussed. PRACTITIONER POINTS: Fostering a positive attitude towards social isolation in clients: reduces psychological distress, fosters engagement in positive coping behaviours. Enhancing clients' level of social support received will serve to increase positive coping and indirectly reduce psychological distress during social isolation. Strategies to reduce clients' COVID-19 worries are important as worry contributes to their overall level of psychological distress.

Recovery orientation of treatment, consumer empowerment, and satisfaction with services: a mediational model.

OBJECTIVE: This study explores the relationship between the recovery orientation of treatment and subjective experiences of consumer empowerment and satisfaction with services for individuals with severe and persistent mental illness. METHODS: Instruments measuring perceptions of empowerment, recovery orientation of treatment, and satisfaction with services were administered to 45 participants enrolled in two demographically similar mental health treatment programs in Tampa, Florida - a community mental health center and an Assertive Community Treatment team. Analyses were conducted according to traditional mediation models. Empowerment was expected to mediate the relationship between the recovery orientation of treatment and consumer satisfaction with services. RESULTS: A recovery-based treatment orientation significantly predicted both consumer empowerment and satisfaction with services. Empowerment mediated the relationship between treatment orientation and consumer satisfaction. CONCLUSIONS: These preliminary findings highlight the impact of the recovery orientation of treatment on empowerment and satisfaction with services among individuals with severe and persistent mental illness.

Relationship Between Substance Use, Bullying, and Other Delinquent Behaviors Among High School Students: a Secondary Analysis of the Florida Youth Substance Abuse Survey.

Substance use and bullying during adolescence are two prevalent problem behaviors associated with a broad array of adverse developmental outcomes. This study conducted a secondary analysis of high school data from Hillsborough County's 2014 Florida Youth Substance Abuse Survey to examine the relationship between substance use, criminal activity, bullying, and other deviant behaviors. Results indicated that past-month alcohol and marijuana use were associated with driving under the influence of marijuana or alcohol, riding with a driver under the influence of marijuana or alcohol, carrying a hand gun, gambling, selling illegal drugs, and the perpetration of bullying. Implications for prevention and intervention efforts are discussed.

Pathological hoarding.

BACKGROUND: Compulsive hoarding is defined, in most cases, as 'the inability to resist the urge to acquire possessions and to discard possessions'. Compulsive hoarding has an early age onset, chronic course and significant levels of comorbidity and morbidity. OBJECTIVE: This article outlines the essential features of compulsive hoarding occurring as a symptom factor of obsessive compulsive disorder (OCD) and alludes to hoarding co-occurring in a range of disorders other than OCD. A test screening for compulsive hoarding is provided. DISCUSSION: Compulsive hoarding occurs in illnesses other than OCD. Limited treatment studies have been completed only when compulsive hoarding is a symptom factor of OCD. These studies suggest that a pharmacological approach and multimodal cognitive behavioural therapy can achieve a moderate treatment outcome. The illness however is difficult to treat.

Infection prevention and control: Who is the judge, you or the guidelines?

OBJECTIVES: The aim of this study was to explore the attitudes and behaviours of registered nurses and their colleagues around the adoption of standard precautions in order to determine strategies to promote adherence. DESIGN: A qualitative exploratory descriptive design used interviews and focus group to collect data. SETTING: Registered nurses and registered midwifes from a tertiary metropolitan hospital took part in the study. PARTICIPANTS: A voluntary sample of 29 adults was recruited from the Australian nursing (n = 25) and midwifery (n = 4) workforce. There were six men (mean age = 36.83 years; SD = 8.93) and 23 women (mean age = 41.36 years; SD = 10.25). Participants were recruited through advertisement on notice boards and emails from unit managers. RESULTS: Thematic analysis revealed five themes but the focus here is on staff judgements which are against the guidelines. Participants indicated that where in their judgement the patient posed no risk and they judged themselves skilled in the procedure, they were justified in deviating from the guidelines. Some staff judgements appeared to be self-protecting, while others were irrational and inconsistent. CONCLUSIONS: Despite use of standard precautions being mandated, staff often deviated from them based on their own assessment of the situation or the patient. Any deviance from the guidelines is of concern but especially so when staff take it upon themselves to apply their own criteria or judgements. These results also suggest there may be some organisational inadequacies with regards to training and supervision of staff.

Internet Cognitive-Behavioral Therapy for Depression in Older Adults With Knee Osteoarthritis: A Randomized Controlled Trial.

OBJECTIVE: To determine the efficacy of an internet-based cognitive-behavioral therapy (iCBT) program for depression in older adults with osteoarthritis (OA) of the knee and comorbid major depressive disorder (MDD). METHODS: We conducted a randomized controlled trial in 69 adults (ages ≥50 years) meeting criteria for MDD and OA of the knee with 1-week postintervention (week 11) and 3-month followup (week 24) end points. Patients were allocated to either a 10-week iCBT program for depression added to treatment as usual (TAU) or to a TAU control group. Primary outcomes were depression symptoms (9-Item Patient Health Questionnaire [PHQ-9]) and psychological distress (Kessler-10 [K-10]). Secondary outcomes included arthritis self-efficacy (Arthritis Self-Efficacy Scale [ASES]), OA pain, stiffness, physical function (Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC]), and physical and mental health (Short Form 12-Item health survey physical component and mental component summaries). Depression status was assessed by blinded diagnostic interview (the Mini-International Neuropsychiatric Interview) at intake and followup. RESULTS: Intent-to-treat analyses indicated between-group superiority of iCBT over TAU on the primary outcomes (PHQ-9: Hedges g = 1.01, 95% confidence interval [95% CI] 0.47, 1.54; K-10: Hedges g = 0.75, 95% CI 0.23, 1.28), at postintervention and 3-month followup (PHQ-9: Hedges g = 0.90, 95% CI 0.36, 1.44; K-10: Hedges g = 0.94, 95% CI 0.41, 1.48), and on secondary OA-specific measures (ASES: Hedges g = -0.81, 95% CI -0.29, -1.33; WOMAC: Hedges g = 0.56-0.65, 95% CI 0.04, 1.18) at the 3-month followup. The majority of iCBT participants (84%) no longer met diagnostic criteria at 3-month followup. CONCLUSION: Results support the efficacy of an iCBT program (requiring no face-to-face contact) for depression in individuals with comorbid depression and OA of the knee. Importantly, the benefits of the program extended beyond reduced depressive symptoms and distress to include increased self-efficacy and improved pain, stiffness, and physical function at followup.

Biopsychosocial predictors of depressive mood in people with Parkinson's disease.

The incidence of depressive mood among people with Parkinson's disease (PD) is well documented, yet less is known about the biopsychosocial correlates of this low mood state. In this study, 82 people with PD (M age = 68 years, SD = 9.4) completed questionnaires related to the duration of their illness, social support, coping, relationship satisfaction, and depression. The authors entered variables that correlated significantly with depressive mood into a multiple regression analysis, and the variables in the final model explained 64% of the variance in depressive mood. Gross motor impairment (beta = .45), blaming self (beta = .41), avoidance (beta = .33), symptom severity (beta = .21), and recreational intimacy (beta = -.14) were strong predictors of depressive mood. The authors discuss the findings in terms of interventions aimed at reducing the use of emotion-focused strategies, encouraging recreational intimacy among people with PD and their partners, and educational programs that provide information on PD symptoms, to promote positive mood and adjustment among people with PD.

A review of prevalence studies of Autism Spectrum Disorder by latitude and solar irradiance impact.

Autism Spectrum Disorder (ASD) is a lifelong disability with no known cause or cure. Among the suggested etiologies, is Cannell's hypothesis of a deficiency in Vitamin D the main natural source of which is Solar Ultraviolet-B (UVB) radiation. The aim in this paper is to build on this hypothesis and explore the relationship of solar irradiance of which UVB is a component, by latitude with the prevalence rates of ASD. Twenty-five reports published between 2011 and 2016 using comparable diagnostic criteria were reviewed. The results suggest a tendency for the prevalence rates of ASD to be lowest in countries near the equator and for this rate to increase as the latitude increases. These findings provide some support not just for the Vitamin D hypothesis, but also for a new proposition that along with UVB radiation, the entire solar radiation spectrum which reaches the earth, may play a role in ASD. While these results are both novel and encouraging in terms of the potential efficacy of exposure to natural sunlight, further research is warranted before results can be considered definitive, and before the implications of the findings can be implemented clinically.

Yes: The Symptoms of OCD and Depression Are Discrete and Not Exclusively Negative Affectivity.

Although Obsessive-Compulsive Disorder (OCD) and Depression are classified as separate disorders, the high incidence of co-morbidity and the strong correlations between measures of each has led to debate about the nature of their relationship. Some authors have proposed that OCD is in fact a mood disorder while others have suggested that the two disorders are grounded in negative affectivity. A third proposition is that depression is an essential part of OCD but that OCD is a separate disorder from depression. The aim in this study was to investigate these diverse propositions in a non-clinical sample and also to determine whether factors implicated in each, that is anxious and depressive cognitions, hopelessness, and self-criticism, would demonstrate commonality as predictors of the symptoms of OCD and of depression. Two hundred participants (59% female) (M age = 34 years, SD = 16) completed the Padua Inventory, Carroll Rating Scale, Cognitions Checklist, Self-Criticism Scale, Beck Hopelessness Scale, Buss-Durkee Hostility Inventory-Revised and a Negative Affectivity Schedule. Results indicated a strong correlation between OCD and depression, depression, and negative affectivity but a weaker relationship between OCD and negative affectivity. Path analyses revealed that both anxious and depressive cognitions, as well as hostility predicted both disorders but the Beta-weights were stronger on OCD. Self-criticism predicted only depression while hopelessness failed to predict either disorder but was itself predicted by depressive cognitions. Depression was a stronger indicator of negative affect than OCD and while OCD positively predicted depression, depression was a negative indicator of OCD. These results support the hypothesis that OCD and depression are discrete disorders and indicate that while depression is implicated in OCD, the reverse does not hold. While both disorders are related to negative affectivity, this relationship is much stronger for depression thus failing to confirm that both are subsumed by a common factor, in this case, negative affectivity. The proposition that depression is part of OCD but that OCD is not necessarily implicated in depression and is, in fact, a separate disorder, is supported by the current model. Further research is required to support the utility of the model in clinical samples.

Help from home for depression: A randomised controlled trial comparing internet-delivered cognitive behaviour therapy with bibliotherapy for depression.

Major Depressive Disorder (MDD) is a leading cause of the Global Burden of Disease. Cognitive Behavioural Therapy (CBT) is an effective treatment for MDD, but access can be impaired due to numerous barriers. Internet-delivered CBT (iCBT) can be utilised to overcome treatment barriers and is an effective treatment for depression, but has never been compared to bibliotherapy. This Randomised Controlled Trial (RCT) included participants meeting diagnostic criteria for MDD (n = 270) being randomised to either: iCBT (n = 61), a CBT self-help book (bCBT) (n = 77), a meditation self-help book (bMED) (n = 64) or wait-list control (WLC) (n = 68). The primary outcome was the Patient Health Questionnaire 9-item scale (PHQ-9) at 12-weeks (post-treatment). All three active interventions were significantly more effective than WLC in reducing depression at post-treatment, but there were no significant differences between the groups. All three interventions led to large within-group reductions in PHQ-9 scores at post-treatment (g = 0.88-1.69), which were maintained at 3-month follow-up, although there was some evidence of relapse in the bMED group (within-group g [post to follow-up] = 0.09-1.04). Self-help based interventions could be beneficial in treating depression, however vigilance needs to be applied when selecting from the range of materials available. Replication of this study with a larger sample is required.

Does profound hypothermic circulatory arrest improve survival in patients with acute type a aortic dissection?

OBJECTIVE: No evidence exists that profound hypothermic circulatory arrest (PHCA) improves survival or reduces the likelihood of distal aortic reoperation in patients with acute type A aortic dissection. METHODS: Records of 307 patients with acute type A aortic dissection from 1967 to 1999 were retrospectively reviewed. The influence of repair using PHCA (n=121) versus without PHCA (n=186) on death and freedom from distal aortic reoperation was analyzed using multivariable Cox regression models. Propensity score analysis identified a subset of 152 comparable patients in 3 quintiles (QIII-V) in which the effects of PHCA (n=113) versus no PHCA (n=39) were further compared. RESULTS: For all patients, 30-day, 1-year, and 5-year survival estimates were 81+/-2%, 74+/-3%, and 63+/-3% (+/-1 SE). Survival rates and actual freedom from distal aortic reoperation was not significantly different between treatment methods in the entire patient cohort nor in the matched patients in quintiles III-V. Treatment method was not associated with differences in early major complications, late survival, or distal aortic reoperation rates in the entire patient sample or in quintiles III-V. CONCLUSIONS: Aortic repair with or without circulatory arrest was associated with comparable early complications, survival, and distal aortic reoperation rates in patients with acute type A aortic dissection. Despite the lack of concrete evidence favoring the use of PHCA, it does no harm, and most of our group uses PHCA regularly because of its practical technical advantages and theoretical potential merit.

The role of general and specific stressors in the health and well-being of call centre operators.

BACKGROUND: The call centre industry has developed a reputation for generating a highly stressful work environment with high absenteeism and turnover rates. Research has identified role ambiguity, role conflict, role overload, and work-family conflict as common stressors in other settings. Call centre research has additionally identified performance monitoring, job design and job opportunities as call centre specific stressors. OBJECTIVE AND METHODS: This study investigated the impact of the identified stressors on burnout, somatic symptomology, and turnover intent among 126 call centre representatives (CCRs) from 11 call centres in metropolitan Melbourne, Australia. RESULTS: Hierarchical multiple regression analyses found that the common organizational stressors significantly explained between 10% and 53% of the variance in somatic symptomology, burnout (all 3 dimensions) and turnover intent. An additional amount of variance, between 6% and 22% in each of these dependent measures was significantly accounted for by the grouped call centre specific stressors. CONCLUSIONS: Overall, common organizational stressors and call centre specific stressors both significantly and independently contributed to burnout, somatic symptomology and turnover intent. These findings are discussed in relation to previous research, and suggestions for improved practice within call centres to safeguard the well-being of workers and for future research are provided.