The impact of the COVID-19 pandemic on the use of restraint and seclusion interventions in Ontario emergency departments: A population-based study.

While COVID-19 impacted all aspects of health care and patient treatment, particularly for patients with mental health/substance use (MH/SU) concerns, research has suggested a concerning increase in the use of restraint and seclusion (R/S) interventions, although results vary depending on facility type and patient population. Thus, the present study sought to explore COVID-related changes in the use of R/S interventions among patients presenting to Ontario emergency departments (EDs) with MH/SU complaints. To determine whether temporal and clinical factors were associated with changes in R/S use during COVID, binary logistic regression models were computed using data from the National Ambulatory Care Reporting System database. We then compared both prevalence rates and probability of an R/S event occurring during an ED visit in Ontario before and after the onset of COVID. The number of ED visits during which an R/S event occurred for patients presenting with MH/SU concerns increased by 9.5%, while their odds of an R/S event occurring during an ED visit increased by 23% in Ontario after COVID onset. Similarly, R/S event probability increased for patients presenting with MH/SU concerns after COVID onset (0.7% - 21.3% increase), particularly during the first wave, with the greatest increases observed for concerns associated with increased restraint risk pre-COVID. R/S intervention use increased substantially for patients presenting to Ontario EDs with MH/SU concerns during the first wave of COVID when the strain on healthcare system and uncertainty about the virus was arguably greatest. Patients with concerns already associated with increased R/S risk also showed the largest increases in R/S probability, suggesting increased behavioural issues during treatment among this population after COVID onset. These results have the potential to inform existing policies to mitigate risks associated with R/S intervention use during future public health emergencies and in general practice.

The relation between belief in a just world and early processing of deserved and undeserved outcomes: An ERP study.

We used event-related potentials (ERPs) to examine how quickly people in general, and certain people in particular, process deservingness-relevant information. Female university students completed individual difference measures, including individual differences in the belief in a just world (BJW), a belief that people get what they deserve. They then read stories in which an outcome was deserved, undeserved, or neither deserved nor undeserved (i.e., "neutral") while their ERPs were recorded with scalp electrodes. We found no overall differentiation between early ERP responses (<300 ms post-stimulus onset) to deserved, undeserved, and neutral outcomes. However, BJW correlated with the difference between early ERP responses to these forms of information (rs from |.44| to |.61|; ps from .018 to < .001). The early nature of our effects (e.g., 96 ms after stimulus onset) suggests individual differences in socially-relevant information processing that begins before conscious evaluation of the stimuli. Potential underlying processes include automatic attention to schema-relevant information and to unexpected (and therefore salient) information and automatic processing of belief-consistent information. Our research underscores the importance of the concept of deservingness in human information processing as well as the utility of ERP technology and robust statistical analyses in investigations of complex social stimuli.

The political (and physiological) divide: Political orientation, performance monitoring, and the anterior cingulate response.

Our goal was to test a model of sociopolitical attitudes that posits a relationship between individual differences in liberal versus conservative political orientation and differential levels of anterior cingulate cortex (ACC) responsivity. We recorded event-related potentials (ERPs) while participants who varied along a unidimensional liberal-conservative continuum engaged in a standard Go/NoGo task. We also measured component attitudes of political orientation in the form of traditionalism (degree of openness to social change) and egalitarianism (a preference for social equality). Generally, participants who reported a more liberal political orientation made fewer errors and produced larger ACC-generated ERPs (the error-related negativity, or ERN and the NoGo N2). This ACC activation, especially as indicated by a larger NoGo N2, was most strongly associated with greater preference for social equality. Performance accuracy, however, was most strongly associated with greater openness to social change. These data are consistent with a social neuroscience view that sociopolitical attitudes are related to aspects of neurophysiological responsivity. They also indicate that a bidimensional model of political orientation can enhance our interpretation of the nature of these associations.