Outcomes of Parent-Child Interaction Therapy (PCIT) for families presenting with child maltreatment: A systematic review.

BACKGROUND: The developmental consequences of childhood trauma for young children are extensive and impact a diverse range of areas. Young children require treatments that consider their developmental stage and are inclusive of caregiver involvement. Parent-Child Interaction Therapy (PCIT), with its dyadic focus and developmental sensitivity, is uniquely positioned to offer therapeutic support to young children and their families. AIM: The current study aimed to conduct a systematic review of the current literature on PCIT and trauma and determine treatment outcomes for children and caregivers. METHOD: A systematic review of five electronic databases was undertaken. Studies that utilized PCIT to treat a population who had experienced trauma were included in the review regardless of study design. RESULTS: PCIT was used to treat a population who had experienced trauma in 40 studies. PCIT was an effective treatment in improving a variety of child and parent outcomes in this population including reduced parenting stress, child behavior problems, child trauma symptoms, parental mental health concerns, negative parenting strategies, and reducing potential risk of recidivism of abuse and neglect. These findings should be taken with caution given attrition rates and potential for bias in the study samples. DISCUSSION: Clinicians should consider PCIT as a potential treatment for children who have experienced trauma and their families. Future research should incorporate corroborative sources of information, assessment of caregiver and child trauma symptoms, examination of permanency outcomes, and consider standardization of PCIT modifications for child trauma to determine treatment in this population of children.

An immersive orientation programme to improve medical student integration and well-being.

BACKGROUND: Multiple common challenges exist for medical students transitioning to regional clinical placements, including a relative paucity of well-being skills required for the promotion of work-life integration. Beginning Education at Central Coast Hospitals (BEACCHES) is an immersive orientation programme aimed at negotiating this transition and promoting student well-being through improved social connectedness. The programme was evaluated with the objectives of understanding the most highly valued and effective components. METHOD: BEACCHES is offered to medical students commencing regional clinical placement at the Central Coast Medical School, Australia. The programme emphasises teamwork and self care, and promotes multidirectional interaction among peers, staff and the local community. A specific well-being forum is an essential component of the programme. An evaluation of the inaugural programme was performed using semi-structured surveys with a mixed-method analysis of quantitative data (pre- and post-programme knowledge and confidence scores) and qualitative data (emergent themes). RESULTS: Knowledge acquisition significantly improved across all domains. Importantly, this included items that could positively impact on well-being, including: knowledge of psychological first aid (p = 0.01), student support services (p < 0.01), connectedness with fellow students and staff (p < 0.01), and self-management of health and workload (p = 0.01). Qualitative analysis also revealed substantial support for the importance of interaction with peers and staff outside of the formal education setting. According to the Australian Medical Association, medical schools' responsibilities include incorporating curricula designed to improve stress management CONCLUSION: Our survey results indicated that BEACCHES has the potential to foster student well-being through targeted orientation and engagement to enhance connectedness. We highlight the value of embedding an interactive experiential programme for students beginning a new regional clinical placement.

Environmental Tobacco Smoke Alters Metabolic Systems in Adult Rats.

Human exposure to environmental tobacco smoke (ETS) is associated with an increased incidence of pulmonary and cardiovascular disease and possibly lung cancer. Metabolomics can reveal changes in metabolic networks in organisms under different physio-pathological conditions. Our objective was to identify spatial and temporal metabolic alterations with acute and repeated subchronic ETS exposure to understand mechanisms by which ETS exposure may cause adverse physiological and structural changes in the pulmonary and cardiovascular systems. Established and validated metabolomics assays of the lungs, hearts. and blood of young adult male rats following 1, 3, 8, and 21 days of exposure to ETS along with day-matched sham control rats (n = 8) were performed using gas chromatography time-of-flight mass spectrometry, BinBase database processing, multivariate statistical modeling, and MetaMapp biochemical mapping. A total of 489 metabolites were measured in the lung, heart, and blood, of which 142 metabolites were identified using a standardized metabolite annotation pipeline. Acute and repeated subchronic exposure to ETS was associated with significant metabolic changes in the lung related to energy metabolism, defense against reactive oxygen species, substrate uptake and transport, nucleotide metabolism, and substrates for structural components of collagen and membrane lipids. Metabolic changes were least prevalent in heart tissues but abundant in blood under repeated subchronic ETS exposure. Our analyses revealed that ETS causes alterations in metabolic networks, especially those associated with lung structure and function and found as systemic signals in the blood. The metabolic changes suggest that ETS exposure may adversely affects the mitochondrial respiratory chain, lung elasticity, membrane integrity, redox states, cell cycle, and normal metabolic and physiological functions of the lungs, even after subchronic ETS exposure.

The effects of allergens and tobacco smoke on the laryngeal mucosa of guinea pigs.

OBJECTIVE: The purpose of this study was to investigate the effects of environmental tobacco smoke (ETS) and house dust mite allergen (HDMA) on the laryngeal mucosa of guinea pigs. STUDY DESIGN: Prospective, controlled animal study. SUBJECTS AND METHODS: Sixteen juvenile guinea pigs were randomly assigned to one of four treatment groups: (1) filtered air, (2) HDMA, (3) ETS, and (4) ETS and HDMA. The mucosal response of retrieved larynges was measured by eosinophil grade and stored mucin index. RESULTS: HDMA exposure increased eosinophil grade in the supraglottis. The mean eosinophil grade in the supraglottis was 1.25 (+/-1.26) in the filtered air group. The grade increased to 3.60 (+/-0.89) in the HDMA group (P = 0.021) and 3.00 (+/-1.16) in the ETS/HDMA group (P = 0.078). HDMA and ETS exposure was associated with increased mucin index in the subglottis. The grade increased from 1.50 (+/-1.73) in the control group to 3.25 (+/-0.50) in the ETS, 2.80 (+/-1.64) in the HDMA, and 3.25 (+/-0.50) in the ETS/HDMA group (P < 0.05). CONCLUSION: Exposure to HDMA was associated with eosinophilia in the supraglottis. Exposure to HDMA and ETS was associated with elevated mucin in the subglottis. These results provide further evidence that ETS and inhaled allergens may play a role in the development of chronic laryngitis.