Using Virtual Reality to Bring Restorative Environments to Employees: An Online Pilot Study.

Employees face many demands throughout the workday. Participating in activities can help employees recover from the pressures of work, and physical activity and time spent in nature are among the most beneficial. Simulations of nature offer some of the benefits of actual contact with nature and can address some of the barriers to exercising outdoors that some employees may face. In this pilot study, we examine the influence of physical activity and virtual or actual nature contact on affect, boredom, and satisfaction when experienced during a break from a demanding work task. Twenty-five employed adults participated in an online study in which they completed a problem-solving task, completed a twenty-minute break, and then completed another session of the problem-solving task. During the break, participants were randomized to either a control condition, a physical activity and low-fidelity virtual nature contact condition, a physical activity and high-fidelity virtual nature contact condition, or a physical activity and actual nature contact condition. An examination of the means of affect, boredom, and satisfaction before, during, and after the break revealed that those in high-fidelity virtual nature and actual nature contact conditions seemed to report more positive well-being during the break. The results highlight that to help employees recover from work demands, it could be important to take breaks, be physically active, and have contact with nature, which should be simulated in high fidelity if actual nature contact cannot be achieved.

Assessing the concordance and accuracy between hospital discharge data, electronic health records, and register books for diagnosis of inpatient admissions of miscarriage: A retrospective linked data study.

BACKGROUND: Despite the high prevalence of miscarriage, there are few studies which assess the concordance of a diagnosis of miscarriage in routinely collected health databases. OBJECTIVES: To determine agreement and accuracy for the diagnosis of miscarriage between electronic health records (EHR), the Hospital Inpatient-Enquiry (HIPE) system, and hospital register books in Ireland. METHODS: This is a retrospective study comparing agreement of diagnosis of miscarriage between three hospital data sources from January to June 2017. All inpatient admissions for miscarriage were reviewed from a single, tertiary maternity hospital in Ireland. Kappa, sensitivity, specificity, positive and negative predictive value were calculated. RESULTS: In this retrospective concordance study, EHR records confirmed 96.2% diagnosis of miscarriage of HIPE records, and 95.1% of register books records. A total of 95 records were not recorded in the register books but were recorded in HIPE and EHR. This study found a considerable variability when comparing definitions of type of miscarriage (i.e., missed miscarriage, incomplete, and complete) between the three data sources. CONCLUSION: Although this study found a high concordance in inpatient admissions for miscarriage between EHR, HIPE, and register books, a considerable discrepancy was found when classifying miscarriage between the three data sources.

Assessment of commercially sexually exploited girls upon entry to treatment: Confirmed vs. at risk victims.

BACKGROUND: Research has documented many risk factors for commercial sexual exploitation of children as well as serious emotional and behavioral consequences for such victims. OBJECTIVE: This study aims to provide an understanding of risk factors and symptom presentation of girls who are victims or at risk for commercial sexual exploitation. PARTICIPANTS AND SETTING: Ninety-six girls (12-18 years) who were referred to a child advocacy center's specialized treatment program for commercially sexually abused girls served as participants (56 confirmed victims, 40 at risk of commercial sexual exploitation). METHODS: At intake participants were administered the Youth Self-Report, the Trauma Symptom Checklist for Children, and the UCLA Post-Traumatic Stress (PTSD) Reaction Index for DSM -5. Parents or guardians were asked to complete the Child Behavior Checklist and the UCLA PTSD Reaction Index for DSM - 5(Parent/Caregiver). RESULTS: Intake information revealed significant differences between groups with confirmed victims reporting higher levels of sex work, kidnapping, physical abuse, physical assault and sexual abuse by a non-family member (p < .05) than at risk victims. All participants were exposed to traumas, were racially and ethnically diverse and lived primarily with their families. At risk girls were significantly more likely to be in school than the confirmed victims. The UCLA PTSD Index revealed that the confirmed victims had experienced significantly more physical abuse than the at-risk group and 26.7% of confirmed victims and 7.7% of the at risk victims met the DSM criteria for PTSD. Twenty percent of the confirmed victims met criteria for Dissociative subtype, while only 7.7% of at risk victims did. On the CBCL, victims from both groups scored in the clinical range on Externalizing Problems and Total Problems and the at risk group scored significantly higher on the School subscale than the confirmed victims group. CONCLUSION: Commercially sexually exploited girls have experienced multiple traumas in their lives and display emotional and behavioral difficulties. Early detection of girls who may be at risk for sexual exploitation may allow for prevention and intervention as these girls also have traumatic backgrounds and display similar symptoms.

Increasing Child Serving Professionals' Awareness and Understanding of the Commercial Sexual Exploitation of Children.

Child serving professionals need increased understanding of the identification and therapeutic needs of child victims of commercial sexual exploitation. This study evaluated the effectiveness of a training program aimed to increase awareness of commercial sexual exploitation of children (CSEC) among professionals likely to encounter victims in their work. Professionals' (N = 227) knowledge level was examined prior to the training, immediately thereafter, and in a 6-12 month follow-up. Despite professional position or years of experience, participants had similar levels of CSEC knowledge before the training and all showed a significant improvement in their knowledge after the training. However, follow-up testing on a smaller subsample demonstrated that knowledge gains were not maintained. The analysis of the participants' responses to how their behavior would change subsequent to the training revealed important themes including: (1) greater ability to identify/assess or recognize CSEC victims, (2) greater understanding and knowledge of CSEC, (3) increased ability to communicate, interact, and engage with CSEC victims, and (4) heightened desire to educate others and raise awareness about CSEC. Results also indicated that participants were very satisfied with the training and found it highly relevant to their work.

Patterns of antipsychotic and anticholinergic prescribing for hospital inpatients.

The development of atypical antipsychotics has not only given the prescriber more options, but also increased the complexity of decision making. We examined current prescribing practice for antipsychotic and anticholinergic drugs, which involved a 1-day census of all antipsychotic and anticholinergic drugs prescribed for 4191 inpatients in 49 UK mental health services. Eighty-five percent of inpatients were prescribed antipsychotics, 48% of whom were prescribed more than one. Atypical antipsychotics were widely prescribed and combined with typicals in over 60% of cases. Large doses of antipsychotics were frequently prescribed 'as required'. The dose administered was always much less than the dose prescribed and nothing at all was administered against 79% of prescriptions. Antipsychotic prescribing often deviates from recommended practice. Nursing staff have considerable discretion to administer large doses of antipsychotics on an 'as required' basis.