Early Hypnotic Intervention After Traumatic Events in Children.

Post-traumatic stress disorder is a debilitating condition that can develop after exposure to any potentially traumatic event (natural disaster, physical assault, and car accident). This study focused on four pediatric patients presenting with an early stress response after a motor vehicle accident who were offered early therapeutic and a preventive management by hypnotherapy shortly after exposure to the traumatic event. All patients improved after one or several sessions of hypnosis. The results indicate that hypnotherapy can immediately help patients during the early period following a traumatic event.

Psychological Care Augmented by Telemedicine after a Polar Bear Encounter at an Arctic Research Station: A Case Report.

Background: Psychologically stressful events can be particularly challenging in the wilderness or extreme environments due to a lack of immediate medical or psychological support. Telemedicine consultations may provide a means to supply medical providers in austere environments with expertise when confronted with these situations. Methods: In this study, we detail a case of psychological care imparted to residents at a remote, arctic research station after they encountered a polar bear. The health care provider at the camp was not a dedicated mental health professional but was able to deliver psychological care with assistance from a trained provider through use of telemedicine. We provide a brief overview of the evidence behind psychological first aid and incident support sessions for the treatment of stress injuries. We also review the evidence for telemedicine for psychological care in wilderness situations and describe its use in this scenario. Results: All station residents were able to resume regular arctic activities. Resident feedback was that the sessions were advantageous. Conclusions: We anticipate the need for psychological care in austere situations to increase in the future, and further training in this field and the advancement of telemedicine consultation will be of benefit to wilderness providers.

Direct and indirect psychological impacts of shark-bite events.

OBJECTIVE: Shark bites are rare, with intense media exposure. There are no known studies of the psychological impacts of this specific type of traumatic event. This is the first study that describes those directly and indirectly affected, and evaluates the prevalence of post-traumatic stress disorder (PTSD) and related risk factors. METHODS: In total, 124 members of an Australian shark-bite peer-support group were invited to complete an online survey assessing demographic, event, media and psychological factors. Response rate was 48% ( n = 60, 63% male, 44 ± 14 years). Retrospective and current measures of PTSD (PTSD Checklist for DSM-5 [PCL-5]) and suicidality (Suicidal Ideation Attributes Scale [SIDAS-5]) were used. RESULTS: Post-event PTSD was prevalent in this sample ( n = 16/59, 27.1%, 95% confidence interval [CI] = [15.4, 38.8]), but less so currently ( n = 2/55, 3.6%, 95% CI = [0.0, 8.7]). In addition, nine ( n = 9/59, 15.3%, 95% CI = [5.8, 24.7]) had subthreshold, but highly symptomatic, syndromes post event. There was no association of PTSD with direct/indirect bite involvement, gender, or prior trauma. Two respondents were at risk of suicidal behaviour. PTSD was commonly reported by those without a partner (odds ratio [OR] = 5.91, 95% CI = [1.52, 22.99], p = 0.01) or with two friends or fewer to rely on (OR = 5.83, 95% CI = [1.62, 21.01], p = 0.01). PTSD was more likely in those with a negative media experience ( n = 34/52, 65.4%, OR = 11.90, 95% CI = [1.42, 100.04], p = 0.02) and 61.5% ( n = 32/52) of respondents reported media coverage lasting months or years. In multivariate modelling, negative media impact, relationship status and friendships were independently associated with PTSD and explained much of the variance in PTSD ( F4,41 = 10.94, p < 0.0001, r2 = 0.52). CONCLUSION: Nearly one-third of members of an Australian shark-bite peer-support group report post-event PTSD, and one-quarter of these were not present at the time of the event. Findings support interventions targeting negative media impact, similar to media reporting guidelines for suicide, and enhancing social support.

Scoping decades of dog evidence: a scoping review of dog bite-related sequelae.

OBJECTIVES: There has been considerable literature published focusing on various sequelae to dog bites over the last three decades. Much of the literature has focused on rabies, particularly canine rabies variant, which accounts for the majority of rabies deaths worldwide. This paper describes the complications, the pathogens, and other sequelae resulting from dog bites documented in the literature. METHODS: This paper used evidence found through a scoping review which charted the published peer-reviewed and non-peer-reviewed gray literature and online information relating to dog bite incidents. Each complication or sequela was additionally assessed from the viewpoint of Canadian Indigenous, rural, and geographically remote communities, which experience a high number of dog bite incidents annually. SYNTHESIS: Peer-reviewed literature (N = 693; case report, original research, and review articles) provided detailed information on specific pathogens, infections, and diseases of interest, especially rabies. However, in addition to these, the sequelae from dog bites may include moderate to severe injuries that further result in anxiety around dogs or post-traumatic stress disorder (PTSD). CONCLUSIONS: While a lot of focus in the literature is on rabies as a sequela to dog bites, the impacts of anxiety and PTSD are not as well articulated. Treatment of dog bite injuries may be standardized; however, improved collaborations between diverse health professionals (physicians, veterinarians, counseling services, animal behaviourists, and others) could be of considerable benefit in decreasing the effects of dog bites.

Rabies vaccine initiation and adherence among animal-bite patients in Haiti, 2015.

BACKGROUND: Approximately 59,000 people die from rabies worldwide annually. Haiti is one of the last remaining countries in the Western Hemisphere with endemic canine rabies. Canine-mediated rabies deaths are preventable with post-exposure prophylaxis (PEP): wound treatment, immunoglobulin, and vaccination. In countries where PEP is available, variability in healthcare seeking behaviors and lack of adherence to recommended treatment guidelines could also contribute to these deaths. Yet, few studies have addressed these issues. METHODS: We examined animal-bite reporting and assessed adherence to treatment guidelines at nine healthcare facilities in Haiti. We analyzed individual-level, de-identified patient data (demographic characteristics, geographic location, healthcare facility type, vaccine administration, and bite injury information) using descriptive analyses and logistic regression to examine factors associated with receiving PEP. FINDINGS: During the 6 month study period, we found 2.5 times more animal-bite case-patients than reported by the national surveillance system (690 versus 274). Of the 690 animal-bite patients identified, 498 (72%) sought care at six PEP providing facilities. Of the case-patients that sought care, 110 (22%) received at least one rabies vaccine. Of the 110 patients, 60 (55%) received all five doses. Delays were observed for three events: when patients presented to a facility after an animal-bite (3.0 days, range: 0-34 days), when patients received their fourth dose (16.1 days, range: 13-52 days), and when patients received their fifth dose (29 days, range: 26-52). When comparing vaccination status and patient characteristics, we found a significant association for bite location (p < .001), severity rank score (p < .001), geographic location (p < .001), and healthcare facility type (p = .002) with vaccination. CONCLUSION: High levels of underreporting identified here are of concern since vaccine distribution may, in part, be based on the number of animal-bite cases reported. Given that the Haitian government provides PEP to the population for free and we found animal-bite victims are seeking care in a timely manner─ reducing rabies deaths is an achievable goal.

Mental health effects caused by red imported fire ant attacks (Solenopsis invicta).

Susceptible individuals who have suffered painful stings caused by red imported fire ants, Solenopsis invicta, usually experience physical health effects such as fever, dizziness, generalized urticaria, or other systemic reactions such as anaphylactic shock. Whether S. invicta stings also have negative effects on mental health is not clear. In the present study, the psychological impact of S. invicta stings was evaluated using a questionnaire that included a previously published posttraumatic stress disorder (PTSD) checklist, the Patient Health Questionnaire 9-item (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7) scale, the Beck Anxiety Inventory (BAI), and the Pittsburgh Sleep Quality Index, 5th scale (PSQI(5)). A total of 96 valid questionnaires were obtained; 37 participants were placed in the stung group, and 59 participants were placed in the unstung group. Our results showed that symptoms of anxiety, depression and sleep disturbances were not associated with S. invicta stings (for GAD-7 scale, Pearson Chi-Square test, χ2 = 0.152, df = 1, P = 0.697; for the BAI, χ2 = 2.252, df = 1, P = 0.133; for the PHQ-9, χ2 = 0.098, df = 1, P = 0.754; for the PSQI(5), χ2 = 0.536, df = 1, P = 0.453). In total, 2 of 83 individuals stung by S. invicta met the criteria (>50) for PTSD. However, there was no significant difference on PTSD between those stung by S. invicta in the 30-day group and the over 30-day group (χ2 = 0.318, df = 1, P = 0.573). Overall, our data do not show an effect of S. invicta stings on mental health as measured using a range of indicators.

Defaming Rover: Error-Based Latent Rhetoric in the Medical Literature on Dog Bites.

This article examines the accuracy and rhetoric of reports by human health care professionals concerning dog bite injuries published in the peer-reviewed medical literature, with respect to nonclinical issues, such as dog behavior. A qualitative content analysis examined 156 publications between 1966 and 2015 identified by terms such as "dog bite" or "dangerous dogs." The analysis revealed misinformation about human-canine interactions, the significance of breed and breed characteristics, and the frequency of dog bite-related injuries. Misinformation included clear-cut factual errors, misinterpretations, omissions, emotionally loaded language, and exaggerations based on misunderstood or inaccurate statistics or reliance on the interpretation by third parties of other authors' meaning. These errors clustered within one or more rhetorical devices including generalization, catastrophization, demonization, and negative differentiation. By constructing the issue as a social problem, these distortions and errors, and the rhetorical devices supporting them, mischaracterize dogs and overstate the actual risk of dog bites.

The use of genetic markers to estimate relationships between dogs in the course of criminal investigations.

OBJECTIVE: Attacks on humans by dogs in a pack, though uncommon, do happen, and result in severe, sometimes fatal, injuries. We describe the role that canine genetic markers played during the investigation of a fatal dog-pack attack involving a 50-year-old male truck driver in a parking lot in Tuscany (Italy). Using canine specific STR genetic markers, the local authorities, in the course of their investigations, reconstructed the genetic relationships between the dogs that caused the deadly aggression and other dogs belonging to the owner of the parking who, at the moment of the aggression, was located in another region of Italy. RESULTS: From a Bayesian clustering algorithm, the most likely number of clusters was two. The average relatedness among the dogs responsible for the aggression was higher than the average relatedness among the other dogs or between the two groups. Taken together, all these results indicate that the two groups of dogs are clearly distinct. Genetic relationships showed that the two groups of dogs were not related. It was therefore unlikely that the murderous dogs belonged to the owner of the parking lot who, on grounds of this and additional evidence, was eventually acquitted.

Incidence and impact of dog attacks on guide dogs in the UK: an update.

Data on dog attacks on Guide Dogs' stock were reviewed to investigate the characteristics of the attacks. An average of 11.2 attacks occurred each month. Nearly all of the attacks occurred in public areas, 68.4 per cent of victim dogs were qualified guide dogs and 55.5 per cent of victim dogs were working in harness when they were attacked. Guide Dogs' stock were injured in 43.2 per cent of attacks and veterinary costs for attacks were estimated at £34,514.30. Over 40 per cent of qualified guide dogs' working ability was affected and >20 per cent of qualified guide dogs required some time off from working after a dog attack. Twenty dogs were permanently withdrawn from the Guide Dogs' programme as a result of dog attacks, 13 of which were qualified and working with guide dog owners at the time of the withdrawal; this resulted in a financial cost of >£600,000 to the charity. More importantly perhaps, temporary and permanent withdrawals have a significant impact upon the mobility and independence of guide dog owners and in many cases significantly impacted their emotional well-being.

Dog Demography, Animal Bite Management and Rabies Knowledge-Attitude and Practices in the Awash Basin, Eastern Ethiopia.

BACKGROUND: Rabies is a viral zoonosis that has been described in limited numbers of studies in Ethiopia at large and among pastoralists in particular. This study assessed dog demography, bite wound prevalence and management, potential risk factors of disease transmission and knowledge attitude practice towards rabies among urban dwellers, pastoralists and health workers in Awash, Eastern Ethiopia. METHODOLOGY: Information was collected by means of structured questionnaires and interviews and through medical and official records from the Agricultural and Health bureaus. PRINCIPAL FINDINGS: Respondents totaled 539 (471 urban, 49 pastoralists, 19 medical). Dog(s) were owned in 33% urban and 75.5% pastoralist households respectively. Mean dog number per dog owning household was 1.50 (95%CI: 1.40-1.60) in urban and 2.05 (95%CI: 1.51-2.60) in pastoralists sites. Human Dog Ratio in Metahara was 4.7:1. No bite wounds records were kept in medical facilities, where staff recalled around 100 bites per year, 2/3 being in adults. Over 90% of the respondents claimed knowing rabies but up to 79.2% pastoralist did not know how dogs acquire the disease; 37.3% urban and 23% pastoralist did not know the symptoms of rabies in dogs; 36% urban and 44% pastoralists did not know rabies symptoms in people. Eighty percent of pastoralists did not know that the disease was fatal in people if untreated. Over half (58.7%) of pastoralist respondents go to traditional healers if bitten, despite a health extension worker program in place in the study area. Knowledge gaps were also shown amidst medical staff. CONCLUSIONS: The study highlighted overall poor disease knowledge, severe under-reporting of human rabies cases, lack of record keeping and poor collaboration between the public and animal health sectors and communities in rabies control.

Reconhecimento materno na Unidade de Cuidado Intensivo Neonatal / Reconocimiento materno en la Unidad de Cuidado Intensivo Neonatal / Mother recognition in the Neonatal Intensive Care Unit

RESUMO Objetivo: analisar experiências maternas em Unidade de Cuidado Intensivo Neonatal, com foco nas relações de reconhecimento. Método: estudo qualitativo, desenvolvido na perspectiva da hermenêutica gadameriana, fundamentado no conceito honnethiano de reconhecimento. Foram entrevistadas, em profundidade, dez mães de crianças internadas em Unidade de Cuidado Intensivo Neonatal. Resultados: há comprometimentos no processo de reconhecimento materno na unidade e, como desdobramento, surgem sentimentos de obrigação e insegurança para o cuidado do filho e fragilidades na autoestima. Conclusão: as interações com os profissionais de saúde e as normas e protocolos ali existentes promovem vulnerabilidades e comprometem o reconhecimento e a autonomia materna. .

RESUMEN Objetivo: analizar la experiencia derivada de la maternidad en la Unidad de Cuidados Intensivos Neonatales, centrándose en las relaciones de reconocimiento. Método: estudio cualitativo, desarrollado desde la perspectiva de la hermenéutica de Gadamer, basado en el concepto honnethiano de reconocimiento. Fueron entrevistados en profundidad diez madres de niños ingresados en una Unidad de Cuidados Intensivos Neonatales. Resultados: existen deficiencias en el proceso de reconocimiento materno en la UCIN y, por consiguiente, surgen sentimientos de inseguridad y obligación de cuidar de su hijo resultando en debilidades en su autoestima. Conclusión: las interacciones con profesionales de la salud en la unidad y las normas y protocolos allí existentes llevan a vulnerabilidades y comprometen el reconocimiento y autonomía materna. .

ABSTRACT Objective: analyze the maternal experience in a neonatal intensive care unit, focusing on relations of recognition. Method: a qualitative study, built on the perspective of Gadamer’s hermeneutics, based on Honneth’s concept of recognition. In-depth interviews were conducted with 10 mothers of children admitted to a neonatal intensive care unit. Results: failures were reported in the process of mother recognition in the unit, with consequent feelings of insecurity and obligation to child care, resulting in fragility of self-esteem. Conclusion: interactions with health professionals in the NICU and its standards and protocols cause vulnerabilities and affect maternal recognition and autonomy. .

Change in excitability of a putative decision-making neuron in Aplysia serves as a mechanism in the decision not to feed following food satiation.

Although decision making is a ubiquitous function, the understanding of its underlying mechanisms remains limited, particularly at the single-cell level. In this study, we used the decision not to feed that follows satiation in the marine mollusk Aplysia to examine the role of putative decision-making neuron B51 in this process. B51 is a neuron in the feeding neural circuit that exhibits decision-making characteristics in vitro, which bias the circuit toward producing the motor programs responsible for biting behavior. Once satiated, Aplysia decided not to bite for a prolonged period of time (≥24h) when presented with a food stimulus that normally elicits feeding in non-satiated animals. Twenty-four hours after satiation, suppressed feeding was accompanied by a significant decrease of B51 excitability compared to the control group of unfed animals. No differences were measured in B51 resting membrane properties or synaptic input to B51 between the satiated and control groups. When B51 properties were measured at a time point in which feeding had recovered from the suppressive effects of satiation (i.e., 96 h after satiation), no difference in B51 excitability was observed between satiated and control groups. These findings indicate that B51 excitability changes in a manner that is coherent with the modifications in biting resulting from food satiation, thus implicating this neuron as a site of plasticity underlying the decision not to bite following food satiation in Aplysia.

Tail biting in pigs: blood serotonin and fearfulness as pieces of the puzzle?

Tail biting in pigs is a widespread problem in intensive pig farming. The tendency to develop this damaging behaviour has been suggested to relate to serotonergic functioning and personality characteristics of pigs. We investigated whether tail biting in pigs can be associated with blood serotonin and with their behavioural and physiological responses to novelty. Pigs (n = 480) were born in conventional farrowing pens and after weaning at four weeks of age they were either housed barren (B) or in straw-enriched (E) pens. Individual pigs were exposed to a back test and novel environment test before weaning, and after weaning to a novel object (i.e. bucket) test in an unfamiliar arena. A Principal Component Analysis on behaviours during the tests and salivary cortisol (novel object test only) revealed five factors for both housing systems, labeled 'Early life exploration', 'Near bucket', 'Cortisol', 'Vocalizations & standing alert', and 'Back test activity'. Blood samples were taken at 8, 9 and 22 weeks of age to determine blood platelet serotonin. In different phases of life, pigs were classified as tail biter/non-tail biter based on tail biting behaviour, and as victim/non-victim based on tail wounds. A combination of both classifications resulted in four pig types: biters, victims, biter/victims, and neutrals. Generally, only in phases of life during which pigs were classified as tail biters, they seemed to have lower blood platelet serotonin storage and higher blood platelet uptake velocities. Victims also seemed to have lower blood serotonin storage. Additionally, in B housing, tail biters seemed to consistently have lower scores of the factor 'Near bucket', possibly indicating a higher fearfulness in tail biters. Further research is needed to elucidate the nature of the relationship between peripheral 5-HT, fearfulness and tail biting, and to develop successful strategies and interventions to prevent and reduce tail biting.

A quick assessment tool for human-directed aggression in pet dogs.

Many test series have been developed to assess dog temperament and aggressive behavior, but most of them have been criticized for their relatively low predictive validity or being too long, stressful, and/or problematic to carry out. We aimed to develop a short and effective series of tests that corresponds with (a) the dog's bite history, and (b) owner evaluation of the dog's aggressive tendencies. Seventy-three pet dogs were divided into three groups by their biting history; non-biter, bit once, and multiple biter. All dogs were exposed to a short test series modeling five real-life situations: friendly greeting, take away bone, threatening approach, tug-of-war, and roll over. We found strong correlations between the in-test behavior and owner reports of dogs' aggressive tendencies towards strangers; however, the test results did not mirror the reported owner-directed aggressive tendencies. Three test situations (friendly greeting, take-away bone, threatening approach) proved to be effective in evoking specific behavioral differences according to dog biting history. Non-biters differed from biters, and there were also specific differences related to aggression and fear between the two biter groups. When a subsample of dogs was retested, the test revealed consistent results over time. We suggest that our test is adequate for a quick, general assessment of human-directed aggression in dogs, particularly to evaluate their tendency for aggressive behaviors towards strangers. Identifying important behavioral indicators of aggressive tendencies, this test can serve as a useful tool to study the genetic or neural correlates of human-directed aggression in dogs.

Antecedents and consequences of pediatric dog-bite injuries and their developmental trends: 101 cases in rural China.

OBJECTIVE: Study the contextual antecedents and consequences of pediatric dog bites in rural China. METHODS: A total of 101 caregivers from rural Anhui Province, China, whose children had suffered dog-bite injuries in the past year, participated in a structured interview about the circumstances, antecedents and consequences of their child's injury. RESULTS: Contextual circumstances identified frequently included outside-home environment and presence of peers but not adult supervisors. Frequent antecedents were dogs' initiation of the encounter, children walking to/from school, and dogs unleashed. Consequences to children identified frequently were rabies vaccines, restricted activity, and fear of dogs. Developmental trends emerged, with bite circumstances differing by children's ages. CONCLUSIONS: These results offer data on common antecedents and consequences of pediatric dog bites in rural China, a necessary prerequisite for development of empirically supported prevention programs in a vulnerable population.

The neurocognitive effects of simulated use-of-force scenarios.

While the physiologic effects of modern conducted electrical weapons (CEW) have been the subject of numerous studies, their effects on neurocognitive functioning, both short-term and long-term, are less well understood. It is also unclear how these effects compare to other use-of-force options or other arrest-related stressors. We compared the neurocognitive effects of an exposure to a TASER(®) (TASER International, Inc, Scottsdale, AZ) X26™ CEW to four other use-of-force scenarios during a training exercise using a well-established neurocognitive metric administered repeatedly over 1 h. Overall, we found that there was a decline in neurocognitive performance immediately post-scenario in all groups, but this effect was transient, of questionable clinical significance, and returned to baseline by 1 h post-scenario.

Identifying youth at risk for difficulties following a traumatic event: pre-event factors are associated with acute symptomatology.

This study examined factors related to children's acute symptoms following a potentially traumatic event (PTE) to more clearly identify domains that should be included in screenings of youth exposed to a PTE. In particular, the authors examined whether trauma category (i.e., sexual abuse/disclosure of abuse, intentionally perpetrated traumas other than sexual abuse, and unintentional traumas) was related to symptoms after controlling for other relevant factors. Participants were 112 youth presenting for clinical evaluation within a month of a PTE and their nonoffending caregivers. Using data from baseline assessments collected as part of a randomized controlled trial of a secondary prevention program, the following factors were tested in 3 hierarchical regression models: index PTE category, history of traumatic exposure, preindex event functioning, and parenting behaviors. Prior trauma exposure, preindex event functioning, and hostile parenting were uniquely related to children's symptoms in the acute posttraumatic period after controlling for time since the event and child age, but trauma category was not. Implications for identifying and referring children at high risk for poor outcomes in the early aftermath of a PTE are discussed. An exclusive focus on the event is insufficient and more comprehensive understanding of the child and family is required.

Indirect genetic effects and housing conditions in relation to aggressive behaviour in pigs.

Indirect Genetic Effects (IGEs), also known as associative effects, are the heritable effects that an individual has on the phenotype of its social partners. Selection for IGEs has been proposed as a method to reduce harmful behaviours, in particular aggression, in livestock and aquaculture. The mechanisms behind IGEs, however, have rarely been studied. The objective was therefore to assess aggression in pigs which were divergently selected for IGEs on growth (IGEg). In a one generation selection experiment, we studied 480 offspring of pigs (Sus scrofa) that were selected for relatively high or low IGEg and housed in homogeneous IGEg groups in either barren or enriched environments. Skin lesion scores, a proxy measure of aggression, and aggressive behaviours were recorded. The two distinct IGEg groups did not differ in number of skin lesions, or in amount of reciprocal fighting, both under stable social conditions and in confrontation with unfamiliar pigs in a 24 h regrouping test. Pigs selected for a positive effect on the growth of their group members, however, performed less non-reciprocal biting and showed considerably less aggression at reunion with familiar group members after they had been separated during a 24 h regrouping test. The enriched environment was associated with more skin lesions but less non-reciprocal biting under stable social conditions. Changes in aggression between pigs selected for IGEg were not influenced by G×E interactions with regard to the level of environmental enrichment. It is likely that selection on IGEg targets a behavioural strategy, rather than a single behavioural trait such as aggressiveness.