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Article ; Online: Mental Health and COVID-19 in Pediatric Emergency Departments: Perspectives From Directors.

Bowden, Cadence F / Worsley, Diana / Doupnik, Stephanie K

The Journal of adolescent health : official publication of the Society for Adolescent Medicine

2022 Volume 71, Issue 3, Page(s) 360–363

Abstract: Purpose: The aim of this study is to understand pediatric emergency department (PED) directors' perspectives on the COVID-19 pandemic's effect on PED visits for mental health concerns.: Methods: Semi-structured phone interviews were conducted with a ... ...

Abstract	Purpose: The aim of this study is to understand pediatric emergency department (PED) directors' perspectives on the COVID-19 pandemic's effect on PED visits for mental health concerns. Methods: Semi-structured phone interviews were conducted with a national convenience sample of PED directors. Interviews were recorded, transcribed verbatim, and analyzed using rapid content analysis. Results: Twenty-one PED directors from 18 states were interviewed. Directors perceived an increased volume of mental health visits and higher patient acuity. Some PEDs innovatively adapted services but were also met with new barriers in providing care due to increased use of personal protective equipment and required COVID-19 testing. Transfer to inpatient psychiatric units was more complicated due to reduced overall bed capacity and the need for a negative COVID test. Discussion: The COVID-19 pandemic strained an already fragile pediatric emergency mental health system. Building infrastructure for adaptations and mental health service reserve capacity could help ensure proper care for pediatric patients with mental health crises during future public health emergencies.
MeSH term(s)	COVID-19 ; COVID-19 Testing ; Child ; Emergency Service, Hospital ; Humans ; Mental Health ; Pandemics
Language	English
Publishing date	2022-04-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1063374-1
ISSN	1879-1972 ; 1054-139X
ISSN (online)	1879-1972
ISSN	1054-139X
DOI	10.1016/j.jadohealth.2022.03.019
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Article: Evaluating the effects of sedentary behaviour on plantar skin health in people with diabetes.

Henshaw, F R / Bostan, L E / Worsley, P R / Bader, D L

Journal of tissue viability

2020 Volume 29, Issue 4, Page(s) 277–283

Abstract: Background: Diabetes-Related Foot Ulcers (DRFUs) are a common and devastating consequence of Diabetes Mellitus and are associated with high morbidity, mortality, social and economic costs. Whilst peak plantar pressures during gait are implicated cited ... ...

Abstract	Background: Diabetes-Related Foot Ulcers (DRFUs) are a common and devastating consequence of Diabetes Mellitus and are associated with high morbidity, mortality, social and economic costs. Whilst peak plantar pressures during gait are implicated cited as a major contributory factor, DRFU occurrence has also been associated with increased periods of sedentary behaviour. The present study was designed aimed to assess the effects of sitting postures on plantar tissue health. Methods: After a period of acclimatisation, transcutaneous oxygen tensions (T Results: During weight-bearing, participants with diabetes showed increases in tissue ischaemia which were linearly correlated proportional to plantar pressures (Pearson's r = 0.81; p < 0.05). Within the healthy group, no such correlation was evident (p > 0.05). There were also significant increases in post seated weight-bearing values for ratio for IL-1α and IL-1RA, normalised to total protein, post seated weight-bearing in participants with diabetes compared to healthy controls. Conclusion: This study shows that prolonged sitting may be detrimental to plantar skin health. It highlights the need to further examine the effects of prolonged sitting in individuals, who may have a reduced tolerance to loading in the plantar skin and soft tissues.
MeSH term(s)	Adult ; Body Mass Index ; Diabetes Complications/physiopathology ; Diabetes Mellitus/physiopathology ; Diabetic Foot/classification ; Diabetic Foot/diagnosis ; Female ; Healthy Volunteers/statistics & numerical data ; Humans ; Interleukin 1 Receptor Antagonist Protein/analysis ; Interleukin 1 Receptor Antagonist Protein/blood ; Interleukin-1alpha/analysis ; Interleukin-1alpha/blood ; Male ; Middle Aged ; Pressure/adverse effects ; Sedentary Behavior ; Skin/physiopathology
Chemical Substances	Interleukin 1 Receptor Antagonist Protein ; Interleukin-1alpha
Language	English
Publishing date	2020-09-08
Publishing country	England
Document type	Journal Article
ZDB-ID	1282604-2
ISSN	0965-206X
ISSN	0965-206X
DOI	10.1016/j.jtv.2020.09.001
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Article ; Online: Caregiver experiences during their child's acute medical hospitalization for a mental health crisis.

Bowden, Cadence F / Worsley, Diana / Pettit, Amy R / Doupnik, Stephanie K

Journal of child health care : for professionals working with children in the hospital and community

2021 Volume 26, Issue 1, Page(s) 123–138

Abstract: Adolescents in the United States are increasingly seeking treatment for mental health crises in emergency departments and general medical hospitals. Medical needs are often addressed quickly, yet youth remain hospitalized because further psychiatric ... ...

Abstract	Adolescents in the United States are increasingly seeking treatment for mental health crises in emergency departments and general medical hospitals. Medical needs are often addressed quickly, yet youth remain hospitalized because further psychiatric treatment is not immediately available. We sought to better understand the experiences of caregivers whose children are "boarding" in a medical hospital while awaiting inpatient psychiatric treatment. We conducted semi-structured interviews with caregivers who were recruited, enrolled, and interviewed during their child's hospital stay. Interviews were audio-recorded, transcribed verbatim, and thematic analysis was facilitated by NVivo 12. Fourteen caregivers enrolled in the study. Themes that emerged included positive hospital and provider experiences; frustration with the medical and mental health care systems; information needs; fears about inpatient psychiatric units; practical challenges and emotional needs; difficulties with caregiver-child communication; difficulties with clinician-caregiver communication; and need for self-care and support. While many caregivers felt positively about the overall experience at the hospital, they also wished for more information about their child's treatment plan and future, as well as social support, emotional comfort for themselves, and self-care skills and resources. Their experiences illuminate ways in which clinical practice can ameliorate concerns and alleviate stress of caregivers related to their child's mental health crisis.
MeSH term(s)	Adolescent ; Caregivers/psychology ; Family ; Hospitalization ; Humans ; Mental Health ; Social Support
Language	English
Publishing date	2021-03-31
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2299167-0
ISSN	1741-2889 ; 1367-4935
ISSN (online)	1741-2889
ISSN	1367-4935
DOI	10.1177/13674935211001222
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Article ; Online: Pediatric emergency departments' readiness for change toward improving suicide prevention: A mixed-methods study with US leaders.

Bowden, Cadence F / Worsley, Diana / Esposito, Jeremy M / Cutler, Gretchen J / Doupnik, Stephanie K

Journal of the American College of Emergency Physicians open

2022 Volume 3, Issue 5, Page(s) e12839

Abstract: Objective: To assess pediatric emergency departments' (PEDs) current suicide prevention practices and climate for change to improve suicide prevention for youth.: Methods: We conducted an explanatory, sequential mixed-methods study. First, we ... ...

Abstract	Objective: To assess pediatric emergency departments' (PEDs) current suicide prevention practices and climate for change to improve suicide prevention for youth. Methods: We conducted an explanatory, sequential mixed-methods study. First, we deployed a national, cross-sectional survey of PED leaders identified through publicly available data in Fall 2020, and then we conducted follow-up interviews with those who expressed interest. The survey queried each PED's suicide prevention practices and measured readiness for change to improve suicide prevention practices using questions scored on a 5-point Likert scale. Interviews gathered further, in-depth descriptions of PEDs' practices and culture. Interviews were audio-recorded, transcribed verbatim, and analyzed using a rapid analysis approach. Results: Of 135 PED directors eligible to complete the survey, 64 responded (response rate 47%). A total of 64% of PEDs had a mental health specialist available 24 hours/day, 7 days/week; 80% reported practicing mental health disposition planning, and 41% reported practicing psychiatric medication management. Altogether 91% of directors agreed or strongly agreed that their PED had a positive culture and 92% agreed/strongly agreed that their PED was ready for change. However, 31% disagreed/strongly disagreed that their PED had tools for evaluation and quality measurement. Resources needed for change (including budget, staffing, training, and facilities) varied across institutions. Interviews with our convenience sample of 21 directors revealed varying suicide prevention practices and confirmed that standardization, evaluation, and quality improvement initiatives were needed at most institutions. Leaders reported a high interest in improving care. Conclusions: PED leaders reported high motivation to improve suicide prevention services for young people, and reported needing quality improvement infrastructure to monitor and guide improvement.
Language	English
Publishing date	2022-10-25
Publishing country	United States
Document type	Journal Article
ISSN	2688-1152
ISSN (online)	2688-1152
DOI	10.1002/emp2.12839
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Article ; Online: Streptomyces

Worsley, Sarah F / Newitt, Jake / Rassbach, Johannes / Batey, Sibyl F D / Holmes, Neil A / Murrell, J Colin / Wilkinson, Barrie / Hutchings, Matthew I

Applied and environmental microbiology

2020 Volume 86, Issue 16

Abstract: ... ...

Abstract	Streptomyces
MeSH term(s)	Arabidopsis/growth & development ; Arabidopsis/microbiology ; Arabidopsis/physiology ; Endophytes/physiology ; Host Microbial Interactions ; Seedlings/growth & development ; Seedlings/microbiology ; Soil Microbiology ; Streptomyces/physiology ; Triticum/growth & development ; Triticum/microbiology ; Triticum/physiology
Language	English
Publishing date	2020-08-03
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	223011-2
ISSN	1098-5336 ; 0099-2240
ISSN (online)	1098-5336
ISSN	0099-2240
DOI	10.1128/AEM.01053-20
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Article: Investigating the influence of intermittent and continuous mechanical loading on skin through non-invasive sampling of IL-1α.

Soetens, J F J / Worsley, P R / Bader, D L / Oomens, C W J

Journal of tissue viability

2019 Volume 28, Issue 1, Page(s) 1–6

Abstract: Pressure ulcers (PUs) are a major burden to both patients, carers and the healthcare system. It is therefore important to identify patients at risk and detect pressure ulcers at an early stage of their development. The pro-inflammatory cytokine IL-1α is ... ...

Abstract	Pressure ulcers (PUs) are a major burden to both patients, carers and the healthcare system. It is therefore important to identify patients at risk and detect pressure ulcers at an early stage of their development. The pro-inflammatory cytokine IL-1α is a promising indicator of tissue damage. The aim of this study was to compare the temporal skin response, by means of IL-1α expression, to different loading regimens and to investigate the presence of individual variability. The sacrum of eleven healthy volunteers was subjected to two different loading protocols. After a baseline measurement, the left and right side of the sacrum were subjected to continuous and intermittent loading regimen, respectively, at a pressure of 100 mmHg. Data was collected every 20 min, allowing for a total experimental time of 140 min. Sebum, collected at ambient conditions using Sebutape, was analyzed for the pro-inflammatory cytokine IL-1α. Most robust results were obtained using a baseline normalization approach on individual data. The IL-1α level significantly changed upon load application and removal (p<0.05) for both loading regimens. Highest IL-1α ratio increase, 3.7-fold, was observed for 1 h continuous loading. During the refractory periods for both loading regimen the IL-1α levels were still found to be up-regulated compared to baseline (p<0.05). The IL-1α level increased significantly for the two initial loading periods (p<0.05), but stabilized during the final loading period for both loading regimens. Large individual variability in IL-1α ratio was observed in the responses, with median values of 1.91 (range 1.49-3.08), and 2.52 (range 1.96-4.29), for intermittent and continuous loading, respectively, although the differences were not statistically significant. Cluster analysis revealed the presence of two distinct sub-populations, with either a low or high response to the applied loading regimen. The measurement after the first loading period proved to be representative for the subsequent measurements on each site. This study revealed that trends in normalized IL-1α provided an early indicator for tissue status following periods of mechanical loading and refractory unloaded conditions. Additionally, the observed individual variability in the response potentially identifies patients at risk of developing PUs.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Interleukin-1alpha/analysis ; Interleukin-1alpha/blood ; Male ; Middle Aged ; Pressure Ulcer/etiology ; Skin/injuries ; Stress, Mechanical
Chemical Substances	IL1A protein, human ; Interleukin-1alpha
Language	English
Publishing date	2019-01-04
Publishing country	England
Document type	Journal Article
ZDB-ID	1282604-2
ISSN	0965-206X
ISSN	0965-206X
DOI	10.1016/j.jtv.2018.12.003
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Article ; Online: Personal protective equipment related skin reactions in healthcare professionals during COVID-19.

Abiakam, Nkemjika / Worsley, Peter / Jayabal, Hemalatha / Mitchell, Kay / Jones, Michaela / Fletcher, Jacqui / Spratt, Fran / Bader, Dan

International wound journal

2021 Volume 18, Issue 3, Page(s) 312–322

Abstract: Since the outbreak of COVID-19 pandemic, clinicians have had to use personal protective equipment (PPE) for prolonged periods. This has been associated with detrimental effects, especially in relation to the skin health. The present study describes a ... ...

Abstract	Since the outbreak of COVID-19 pandemic, clinicians have had to use personal protective equipment (PPE) for prolonged periods. This has been associated with detrimental effects, especially in relation to the skin health. The present study describes a comprehensive survey of healthcare workers (HCWs) to describe their experiences using PPE in managing COVID-19 patients, with a particular focus on adverse skin reactions. A 24-hour prevalence study and multi-centre prospective survey were designed to capture the impact of PPE on skin health of hospital staff. Questionnaires incorporated demographics of participants, PPE type, usage time, and removal frequency. Participants reported the nature and location of any corresponding adverse skin reactions. The prevalence study included all staff in intensive care from a single centre, while the prospective study used a convenience sample of staff from three acute care providers in the United Kingdom. A total of 108 staff were recruited into the prevalence study, while 307 HCWs from a variety of professional backgrounds and demographics participated in the prospective study. Various skin adverse reactions were reported for the prevalence study, with the bridge of the nose (69%) and ears (30%) being the most affected. Of the six adverse skin reactions recorded for the prospective study, the most common were redness blanching (33%), itchiness (22%), and pressure damage (12%). These occurred predominantly at the bridge of the nose and the ears. There were significant associations (P < .05) between the adverse skin reactions with both the average daily time of PPE usage and the frequency of PPE relief. The comprehensive study revealed that the use of PPE leads to an array of skin reactions at various facial locations of HCWs. Improvements in guidelines are required for PPE usage to protect skin health. In addition, modifications to PPE designs are required to accommodate a range of face shapes and appropriate materials to improve device safety.
MeSH term(s)	COVID-19/epidemiology ; Disease Transmission, Infectious/prevention & control ; Female ; Health Personnel ; Humans ; Hypersensitivity/epidemiology ; Hypersensitivity/etiology ; Male ; Pandemics ; Personal Protective Equipment/adverse effects ; Prevalence ; Prospective Studies ; SARS-CoV-2 ; Skin ; Surveys and Questionnaires ; United Kingdom/epidemiology
Language	English
Publishing date	2021-01-28
Publishing country	England
Document type	Journal Article ; Multicenter Study
ZDB-ID	2170920-8
ISSN	1742-481X ; 1742-4801
ISSN (online)	1742-481X
ISSN	1742-4801
DOI	10.1111/iwj.13534
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Article: The expression of anaerobic metabolites in sweat and sebum from human skin subjected to intermittent and continuous mechanical loading.

Soetens, J F J / Worsley, P R / Herniman, J M / Langley, G J / Bader, D L / Oomens, C W J

Journal of tissue viability

2019 Volume 28, Issue 4, Page(s) 186–193

Abstract: Pressure ulcers (PUs) represent a substantial burden to both patients and healthcare providers. Accordingly, effective prevention strategies should follow early detection of PUs. Anaerobic metabolites, such as lactate and pyruvate, are promising ... ...

Abstract	Pressure ulcers (PUs) represent a substantial burden to both patients and healthcare providers. Accordingly, effective prevention strategies should follow early detection of PUs. Anaerobic metabolites, such as lactate and pyruvate, are promising noninvasive biomarkers indicative of tissue ischaemia, one of the major mechanisms leading to PU development. The aim of this study was to investigate if the temporal release profile of these metabolites in sweat and sebum is sensitive to detect local tissue changes resulting from prolonged mechanical loads. The sacrum of healthy volunteers was subjected to two different loading protocols. After a baseline measurement, the left and right side of the sacrum were subjected to continuous and intermittent loading regimen, respectively, at a pressure of 100 mmHg. Biomarker samples were collected every 20 min, with a total experimental time of 140 min. Sweat was collected at 37
MeSH term(s)	Adult ; Aged ; Anaerobiosis/physiology ; Biomarkers/analysis ; Biomarkers/metabolism ; Female ; Healthy Volunteers ; Humans ; Male ; Middle Aged ; Pressure Ulcer/metabolism ; Pressure Ulcer/physiopathology ; Sebum/metabolism ; Skin/metabolism ; Skin/physiopathology ; Sweat/metabolism ; United Kingdom ; Weight-Bearing/physiology
Chemical Substances	Biomarkers
Language	English
Publishing date	2019-10-21
Publishing country	England
Document type	Journal Article
ZDB-ID	1282604-2
ISSN	0965-206X
ISSN	0965-206X
DOI	10.1016/j.jtv.2019.10.001
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Article ; Online: An exploration of young people's, parent/carers', and professionals' experiences of a voluntary sector organisation operating a Youth Information, Advice, and Counselling (YIAC) model in a disadvantaged area.

Hassan, Shaima M / Worsley, Joanne / Nolan, Lisa / Fearon, Nicky / Ring, Adele / Shelton, Jane / McEgan, David / Yameen, Farheen / Khedmati, Esmaeil Morasae / Kullu, Cecil

BMC health services research

2022 Volume 22, Issue 1, Page(s) 383

Abstract: Background: The present evaluation explored young people's, parents/carers, and healthcare professionals' perceptions of the Youth Information, Advice and Counselling (YIAC) model operated by a voluntary sector organisation in North West England. With ... ...

Abstract	Background: The present evaluation explored young people's, parents/carers, and healthcare professionals' perceptions of the Youth Information, Advice and Counselling (YIAC) model operated by a voluntary sector organisation in North West England. With an aim to understand the key components that contribute to enhancing the success of the YIAC model. Method: Semi-structured interviews and focus groups with young people, parents/carers, and healthcare professionals were conducted. Data were analysed using thematic analysis. Results: Five main themes were identified from the data: 1) Accessibility and flexibility; 2) Non-clinical model and environment; 3) Staff; 4) Partnership working; and 5) Promotion of positive mental health and wellbeing. Conclusion: Findings highlight the importance of non-clinical, community-based, 'one-stop-shop' hubs for young people in disadvantaged areas. The key components highlighted as facilitating access and engagement include: opportunity to self-refer, choice of location, timely provision of support, non-clinical environment, age appropriate services, a non-hierarchical workforce, inclusive support for family and carers, a focus on wider, often social, issues, and collaboration with partner organisations. These findings suggest that early support hubs for young people's mental health should have consistent, long-term funding and should exist in every local area.
MeSH term(s)	Adolescent ; Caregivers/psychology ; Counseling ; Humans ; Organizations ; Parents/psychology ; Vulnerable Populations
Language	English
Publishing date	2022-03-23
Publishing country	England
Document type	Journal Article
ZDB-ID	2050434-2
ISSN	1472-6963 ; 1472-6963
ISSN (online)	1472-6963
ISSN	1472-6963
DOI	10.1186/s12913-022-07800-1
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Article ; Online: Anthropometric Status among 6⁻9-Year-Old School Children in Rural Areas in Hai Phong City, Vietnam.

Hoang, Ngan T D / Orellana, Liliana / Le, Tuyen D / Gibson, Rosalind S / Worsley, Anthony F / Sinclair, Andrew J / Szymlek-Gay, Ewa A

Nutrients

2018 Volume 10, Issue 10

Abstract: A double burden of malnutrition in Vietnamese children has emerged as a key challenge: childhood undernutrition remains a public health concern while childhood overweight/obesity has gradually increased. This study aimed to (1) estimate the prevalence of ...

Abstract	A double burden of malnutrition in Vietnamese children has emerged as a key challenge: childhood undernutrition remains a public health concern while childhood overweight/obesity has gradually increased. This study aimed to (1) estimate the prevalence of undernutrition and overnutrition among 6⁻9-year-old primary school children in rural areas of Vietnam, and (2) identify sociodemographic factors associated with undernutrition and overnutrition in this population. A cross-sectional survey was conducted in October 2016 in 2334 children from eight primary schools in rural areas in Hai Phong City, Vietnam. Anthropometric and demographic data were collected. The prevalence of underweight, stunting, wasting, and anthropometric failure was 8.0%, 5.1%, 5.3%, and 11.9%, respectively. Up to 22.1% of children were affected by overweight/obesity, and 31.0% by abdominal overweight/obesity. Low maternal education was associated with higher odds of underweight and anthropometric failure, whereas overweight/obesity or abdominal overweight/obesity were more likely in boys and children of mothers with a high education level. This study provides evidence for a double burden of diseases among primary school children in rural areas in Hai Phong City. Future interventions for the prevention and control of childhood undernutrition and overweight/obesity should take into account child sex and maternal education level.
MeSH term(s)	Anthropometry ; Child ; Cross-Sectional Studies ; Educational Status ; Female ; Growth Disorders/epidemiology ; Humans ; Male ; Malnutrition/complications ; Mothers ; Nutritional Status ; Obesity, Abdominal/epidemiology ; Overweight/epidemiology ; Pediatric Obesity/epidemiology ; Prevalence ; Rural Population ; Schools ; Sex Factors ; Socioeconomic Factors ; Thinness/epidemiology ; Vietnam/epidemiology ; Wasting Syndrome/epidemiology
Language	English
Publishing date	2018-10-04
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu10101431
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