The relationship between agitation and impairments of orientation and memory during the PTA period after traumatic brain injury.

Agitation is common during the post-traumatic amnesia (PTA) period after traumatic brain injury (TBI), although our knowledge of what causes or predicts agitation is limited. The current study aimed to examine the association of agitation in PTA with the concurrent impairments in orientation and memory while controlling for covariates of agitation. Participants were 125 patients in PTA following moderate to extremely severe TBI recruited from an inpatient brain injury rehabilitation service who were assessed throughout PTA on the Agitated Behavior Scale (ABS) and the Westmead PTA Scale (WPTAS). Agitation was observed in 42.4% of participants (ABS score > 21), with disinhibited behaviours (e.g., distractibility and impulsivity) most common. Multilevel modelling found daily ABS scores to be associated with daily scores on the WPTAS but in a non-linear pattern. Analysis of covariates found that shorter time post-admission, younger age, presence of infection and higher antipsychotic doses were associated with higher ABS scores. These results support a relationship between agitation and the concurrent cognitive impairment during PTA. While a causal link cannot yet be inferred, management strategies that can potentially interfere with cognition (e.g., sedating medications, environmental changes) should be used cautiously in case they exacerbate agitation.

Effects of the COVID-19 pandemic on stress, coping, and well-being among adults with histories of child maltreatment.

A number of studies now confirm that the COVID-19 pandemic has increased and exacerbated mental health problems in the general population. Previous quantitative studies have found similar effects on mental health symptoms among adults with histories of childhood adversity; however, qualitative research is needed to provide a more in-depth understanding of pandemic-related experiences among this vulnerable population. Using semistructured qualitative interviews, we explored perceptions of adults with histories of child maltreatment and neglect to better understand the overall impact of the pandemic on their mental health, reported changes in stress and alcohol use, and reported coping strategies during the first year of the pandemic (N = 40). Approximately half of participants reported that the pandemic had greatly (negatively) impacted their life, relationships, and well-being. Contributing stressors included being fearful of getting sick, navigating work changes, and experiencing economic and housing hardships, grief and loss, and social isolation. Fewer than half of the sample reported more stress (46%), whereas a third (33%) indicated no changes to stress, and 10% had reduced stress. The majority (80%) indicated no changes in their alcohol use. Most participants reported they used positive coping strategies during the pandemic. Three primary themes emerged related to participants' perceptions of getting through difficult times: seeking outside support, engaging in positive reframing, and drawing on internal strength and resources. Findings can guide prevention strategies that strengthen social support and foster resilience among vulnerable populations of adults with histories of childhood maltreatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Using EMA and Physiological Data to Explore the Relationship between Day-to-Day Occupational Stress, Musculoskeletal Pain and Mental Health among University Staff: A Study Protocol.

Exposure to work-related stressors is associated with poor physical and mental health outcomes for workers. The role of chronic stressors on health outcomes has been explored, but less is known about the potential role of exposure to day-to-day stressors on health. This paper describes the protocol for a study that aims to collect and analyze day-to-day data on work-related stressors and health outcomes. Participants will be workers engaged in predominantly sedentary work at a university. Self-report data on work-related stressors, musculoskeletal pain, and mental health will be collected three times per day for 10 work days through ecological momentary assessment via online questionnaires. These data will be combined with physiological data collected continuously via a wristband throughout the working day. The feasibility and acceptability of the protocol will be assessed via semi-structured interviews with participants and adherence to the study protocol. These data will inform the feasibility of using the protocol in a larger study to investigate the relationship between exposure to work-related stressors and health outcomes.

Current state of inclusion and diversity in pediatric urology fellowship programs.

BACKGROUND: Increased racial/ethnic diversity of the physician workforce can improve health outcomes for marginalized populations. Currently, the pediatric urology workforce is less racially/ethnically diverse than the pediatric population it serves. OBJECTIVE: We aimed to assess current recruitment efforts and barriers to recruitment of underrepresented in medicine (URM) fellows in pediatric urology fellowship programs. METHODS: A 20-question REDCap survey was created and distributed to 27 pediatric urology fellowship program directors (PDs). The survey consisted of 4 sections of questions focused on PD demographics, program characteristics, recruitment efforts, and perceptions of barriers to recruitment. RESULTS: A total of 20 PDs responded to the survey (74 %), including 3 incomplete responses. A majority of participants identified as Caucasian/white (79 %), male (68 %), over 40 years of age (89 %), and had served as PD for 5 years or more (68 %). Most PDs (70 %) identified their program having 5-10 full-time pediatric urologists. Many PDs (75 %, 15/20) identified their program as less diverse than the patient population served, and 53 % (9/17) reported having no methods in place for diversity recruitment. Of those who reported a recruitment method, mentorship was the most common (35 %, 6/17). When asked about recruitment barriers, 59 % (10/17) reported that no barriers existed, while those who identified a barrier most commonly cited an overall limited applicant pool (18 %, 3/17). DISCUSSION: Pediatric urology fellowship programs are less diverse than the patient populations served; while PDs value program diversity, most PDs report that there are no mechanisms in place to recruit racially/ethnically diverse trainees. To address this, we recommend active and intentional efforts to increase URM recruitment in pediatric urology. By taking an active role in existing recruitment efforts, pediatric urologists can increase their visibility, broadcast their commitment to diversity, form relationships with trainees earlier in training and increase opportunities for mentorship and early exposure to the field. CONCLUSION: Intentional recruitment efforts are needed to recruit URM trainees to pediatric urology fellowship programs and ensure the diversity of the pediatric urology workforce can better reflect patients served.

How the mental health of working parents in Australia changed during COVID-19: A pre- to during pandemic longitudinal comparison.

BACKGROUND: Cross-sectional studies indicate that mental health has deteriorated in Australia during the COVID-19 pandemic, including for parents. However, robust longitudinal studies interrogating change from before to during the pandemic remain rare. The current study analysed data from Australian parents surveyed in 2016 and August 2020. We investigate whether distress was higher in the COVID-19 period compared to pre-pandemic levels, and whether any increases in distress were greatest for parents living in Victoria (who had entered their second prolonged lockdown). METHODS: A community cohort of Australian working parents (n = 5197) was recruited online in 2016. In August 2020, 25.9 % (n = 1348) completed a follow-up survey. Analyses were restricted to those employed at both time-points (n = 1311). Random effects longitudinal models examined the association between time (i.e. pre vs. during-pandemic) and distress (K6 scale). Fixed effects models specifically tested change between time periods in association with change in distress. LIMITATIONS: The initial sample were recruited online with highly educate parents over-represented. Attrition between survey time-points may also limit generalisability. RESULTS: All models consistently showed that the pandemic period was associated with greater distress. Overall, serious mental illness (i.e. K6 score ≥ 18) increased by 5.3 percentage points (from 8.0 to 13.3). This increase was greater (by 4.7 percentage points) for those parents in Victoria. CONCLUSIONS: This study is one of few to longitudinally assess mental health pre- to during the pandemic. Psychological distress and serious mental illness increased for Australian working parents, and this effect was greatest for those experiencing a prolonged lockdown in Victoria.

A Prospective Study on Child Abuse and Elder Mistreatment: Assessing Direct Effects and Associations With Depression and Substance Use Problems During Adolescence and Middle Adulthood.

BACKGROUND AND OBJECTIVES: We examined the prospective association between 2 measures of child abuse, one based on official child welfare records and the other based on parent self-reports, and the perpetration of elder mistreatment by an adult child. We also examined measures of adolescent and adult depression and substance use problems as predictors of elder mistreatment. RESEARCH DESIGN AND METHODS: Data are from a prospective study that began in the 1970s with a sample of children aged 18 months to 6 years of age. Analyses draw on data collected when child participants were in preschool and elementary school, when they were adolescents, and as adults at midlife (at ages 36 and 46, on average). Results are from bivariate correlations and multivariable path models in which variables from different life stages were entered in steps to assess their prediction of elder mistreatment. RESULTS: All variables were significantly correlated with elder mistreatment. In a final path model, parent self-reports of physical child abuse remained a significant, unique predictor of elder mistreatment. Adolescent and adult substance use problems were also statistically significant. DISCUSSION AND IMPLICATIONS: Few longitudinal studies have tracked patterns of abuse over time and relationships. Findings suggest that child abuse is a risk factor for the perpetration of elder mistreatment by an adult child. Substance use problems may also increase the risk for the perpetration of elder mistreatment. Further longitudinal research is needed to replicate and extend these findings in order to advance prevention and intervention programs and policies.

Protocol for the Adaptation of a Direct Observational Measure of Parent-Child Interaction for Use With 7-8-Year-Old Children.

OBJECTIVE: Parenting sensitivity and mutual parent-child attunement are key features of environments that support children's learning and development. To-date, observational measures of these constructs have focused on children aged 2-6 years and are less relevant to the more sophisticated developmental skills of children aged 7-8 years, despite parenting being equally important at these ages. We undertook a rigorous process to adapt an existing observational measure for 7-8-year-old children and their parents. This paper aimed to: (i) describe a protocol for adapting an existing framework for rating parent-child interactions, (ii) determine variations in parents' sensitive responding and parent-child mutual attunement ('positive mutuality') by family demographics, and (iii) evaluate the psychometric properties of the newly developed measure (i.e., inter-rater reliability, construct validity). METHOD: Parent-child dyads completed one home visit, including a free-play observation and parent questionnaire. Dyads were provided with three toy sets: LEGO® Classic Box, Classic Jenga®, and animal cards. The Coding of Attachment-Related Parenting (CARP) was adapted for use with 7-8-year-old children, and rating procedures were streamlined for reliable use by non-clinician/student raters, producing the SCARP:7-8 Years. Trained staff rated video-recorded observations on 11 behaviors across two domains (five for parents' sensitive responding, six for parent-child positive mutuality). RESULTS: Data were available for 596 dyads. Consistently strong inter-rater agreement on the 11 observed behaviors was achieved across the 10-week rating period (average: 87.6%, range: 71.7% to 96.7%). Average ICCs were 0.77 for sensitive responding and 0.84 for positive mutuality. These domains were found to be related but distinct constructs (r = 0.49, p < 0.001). For both domains, average ratings were strongly associated with the main toy used during the observation (p < 0.001, highest: cards, lowest: LEGO®). Adjusted multivariate linear regression models (accounting for toy choice) revealed that less sensitive responding was associated with younger parent (p = 0.04), male parent (p = 0.03), non-English speaking background (p = 0.04), and greater neighborhood disadvantage (p = 0.02). Construct validity was demonstrated using six parent-reported psychosocial and parenting measures. CONCLUSION: The SCARP: 7-8 Years shows promise as a reliable and valid measure of parent-child interaction in the early school years. Toy selection for direct observation should be considered carefully in research and practice settings.

Tablet-based adaptation and administration of the Castles and Coltheart Reading Test 2 for a large longitudinal study.

Tablet-adapted measures provide an efficient, accurate method of data collection for large-scale studies. The Castles and Coltheart Reading Test 2 (CC2) is a standardized paper-and-pencil measure of children's reading ability. In the current study, the CC2 was administered to 603 children aged 7-8 years via iPad using electronic data capture software. Results indicate the tablet-adapted measure could be reliably administered by non-clinical staff and showed quantitative equivalence, i.e., comparable score distributions, to CC2 normative data. Internal consistency was good for regular and non-word lists. Findings suggest that the tablet-adapted CC2 is a viable tool for large research studies.