Assessing the role of sustainability competencies in enhancing psychological first aid effectiveness for disaster responders in Fiji.

Background: Psychological first aid (PFA) is essential for mental health and wellbeing after traumatic events. Integrating competency-based outcomes is crucial with the increasing demand for effective psychological first-aid interventions. This study examines the correlation between sustainability competencies and PFA principles within Fiji's disaster responder's context. Method: The research was guided by a theoretical framework based on a comprehensive review of sustainability competencies and PFA principles. A cross-sectional survey assessed the importance of sustainability competencies in disaster responders to deliver PFA effectively. The survey used a stratified random sampling method to get diverse PFA-trained participants (66%) and non-PFA trained (34%), aiming to understand how these competencies can impact PFA success in various disaster situations. The survey, encompassing various domains of disaster response and a diverse range of respondents age, gender, and years of experience, employed the Likert scale to assess the importance of competencies such as integrated problem-solving, strategic, systems thinking, self-awareness, normative, collaboration, anticipatory, and critical thinking. Results: The study involved 49 PFA-trained participants (55% female, 45% male) and 15 non-PFA-trained participants (53% female, 46% male), excluding 10 responses from the latter group due to ambiguous answers to critical questions. The correlation between age, experience, and the valuation of professional competencies among disaster responders indicates that disaster responders, with extensive experience and PFA training, rated competencies as "important," reflecting a perspective shaped by long-term career development and practical experiences. Equally, younger and early career responders emphasize competencies as "very important," indicating an initial recognition of their significance. The appraisal patterns across different age groups, especially among those with PFA training, suggest a tendency to moderate assessments of competency importance with increasing experience. Statistical analysis, including mean, median, standard deviation, and variance, provided a detailed understanding of the data, underscoring competencies like self-awareness in both data sets and integrated problem-solving and collaboration within PFA-trained responders as the key for effective PFA interventions. Conclusion: The study underlines the critical need to integrate sustainability competencies into the PFA curriculum in Fiji's unique sociocultural context. This interplay between age, experience, and competency assessment stresses the diverse factors influencing perceptions in the disaster response field beyond experience alone. The results show that sustainability competencies are the ultimate to the effectiveness of PFA measurement and interventions. The research lays the foundation for future studies to develop validated tools for assessing sustainable competencies in different cultural contexts, thereby improving the effectiveness of PFA in disaster management. Integrating these competencies into PFA training could significantly strengthen PFA intervention and competency-based evaluation.

Somatostatin neurons in the bed nucleus of the stria terminalis play a sex-dependent role in binge Drinking.

Alcohol use disorder (AUD) is characterized by alcohol use coupled with chronic relapse and involves brain regions including the bed nucleus of the stria terminalis (BNST). Here, we explore whether a subpopulation of BNST neurons, somatostatin (SST) expressing GABAergic neurons, play a role in an animal model of binge-like alcohol consumption, the Drinking in the Dark (DID) model. Chemogenetic activation of BNST SST neurons reduced binge alcohol consumption in female but not male SST-Cre mice, while inhibition of these neurons in the same mice had no effect. In addition, chemogenetic activation of these neurons did not cause apparent changes in models of anxiety-like behavior in either sex. Basal SST cell counts and intrinsic excitability of SST neurons were compared to attempt to understand sex differences in DREADD-induced changes in drinking, and while males had a greater number of BNST SST neurons, this effect went away when normalizing for total BNST volume. Together, these results suggest SST neurons in the BNST should be further explored as a potential neuronal subtype modulated by AUD, and for their therapeutic potential.

Somatostatin neurons control an alcohol binge drinking prelimbic microcircuit in mice.

Somatostatin (SST) neurons have been implicated in a variety of neuropsychiatric disorders such as depression and anxiety, but their role in substance use disorders, including alcohol use disorder (AUD), is not fully characterized. Here, we found that repeated cycles of alcohol binge drinking via the Drinking-in-the-Dark (DID) model led to hypoactivity of SST neurons in the prelimbic (PL) cortex by diminishing their action potential firing capacity and excitatory/inhibitory transmission dynamic. We examined their role in regulating alcohol consumption via bidirectional chemogenetic manipulation. Both hM3Dq-induced excitation and KORD-induced silencing of PL SST neurons reduced alcohol binge drinking in males and females, with no effect on sucrose consumption. Alcohol binge drinking disinhibited pyramidal neurons by augmenting SST neurons-mediated GABA release and synaptic strength onto other GABAergic populations and reducing spontaneous inhibitory transmission onto pyramidal neurons. Pyramidal neurons additionally displayed increased intrinsic excitability. Direct inhibition of PL pyramidal neurons via hM4Di was sufficient to reduce alcohol binge drinking. Together these data revealed an SST-mediated microcircuit in the PL that modulates the inhibitory dynamics of pyramidal neurons, a major source of output to subcortical targets to drive reward-seeking behaviors and emotional response.

Forced Abstinence From Alcohol Induces Sex-Specific Depression-Like Behavioral and Neural Adaptations in Somatostatin Neurons in Cortical and Amygdalar Regions.

Forced abstinence (FA) from alcohol has been shown to produce a variety of anxiety- and depression-like symptoms in animal models. Somatostatin (SST) neurons, a subtype of GABAergic neurons found throughout the brain, are a novel neural target with potential treatment implications in affective disorders, yet their role in alcohol use disorders (AUD) remains to be explored. Here, we examined the neuroadaptations of SST neurons during forced abstinence from voluntary alcohol consumption. Following 6 weeks of two-bottle choice alcohol consumption and protracted forced abstinence, male and female C57BL/6J mice exhibited a heightened, but sex-specific, depressive-like behavioral profile in the sucrose preference test (SPT) and forced swim test (FST), without changes in anxiety-like behaviors in the elevated plus maze (EPM) and open field test (OFT). FST-induced cFos expressions in the prefrontal cortex (PFC) and ventral bed nucleus of the stria terminalis (vBNST) were altered in FA-exposed female mice only, suggesting a sex-specific effect of forced abstinence on the neural response to acute stress. SST immunoreactivity in these regions was unaffected by forced abstinence, while differences were seen in SST/cFos co-expression in the vBNST. No differences in cFos or SST immunoreactivity were seen in the lateral central nucleus of the amygdala (CEA) and the basolateral amygdala (BLA). Additionally, SST neurons in female mice displayed opposing alterations in the PFC and vBNST, with heightened intrinsic excitability in the PFC and diminished intrinsic excitability in the vBNST. These findings provide an overall framework of forced abstinence-induced neuroadaptations in these key brain regions involved in emotional regulation and processing.

Effect of Lorazepam in Reducing Psychological Distress and Anticipatory Nausea and Vomiting in Patients Undergoing Chemotherapy.

OBJECTIVES: To evaluate the efficacy and safety of lorazepam in reducing psychological distress and chemotherapy-induced nausea and vomiting. METHODOLOGY: It was a prospective interventional study with seventy patients for a period of 1 year. In which, patients' anxiety, distress and status of nausea, and vomiting were assessed in the first four chemotherapy cycles before drug intervention. During the subsequent chemotherapy cycles, the outcomes of the intervention were reassessed along with patient's quality of life (QOL). RESULTS: Out of seventy patients, 62 showed improvement in their distress level after the drug intervention and patient counseling. Lorazepam along with other antiemetic drugs reduced chemotherapy-induced delayed nausea and vomiting. During the course of the study, 15 patients experienced drowsiness as an adverse reaction to lorazepam. The overall QOL of the population was also improved with lorazepam. CONCLUSION: Lorazepam along with patient counseling can improve patient's psychological distress and thus their QOL. The off-labeled use of lorazepam can be utilized for controlling chemotherapy-induced nausea vomiting.