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The present study investigated the effects of animal-assisted interventions (AAIs) with therapy dogs on the school wellbeing of kindergarten to year 12 students, and important considerations and challenges for implementing therapy dog AAIs in school settings. Participants were 118 school leaders, teachers, school mental health professionals, and researchers with experience with therapy dog AAIs for school-aged students. Participants completed a survey with 16 open-ended items about the positive and negative effects of therapy dogs on students' school wellbeing and important factors for implementing therapy dog AAIs in their school settings. Participants perceived that therapy dogs facilitate improvements in students' social and learning engagement, and their emotional and behavioral wellbeing. However, participants raised concerns about potential safety risks for students and therapy dogs during their interactions. To address these challenges, participants perceived the importance of establishing expectations and rules for how students interact with therapy dogs and standardized regulations to ensure that therapy dog AAIs are implemented safely in kindergarten to year 12 school settings. • Therapy dogs facilitate students' engagement in social interactions and learning tasks. • Therapy dogs assist students to regulate their emotions and behaviors. • There are important safety risks associated with therapy dogs in schools. • Standardized regulations can ensure therapy dogs are safe in schools. [ABSTRACT FROM AUTHOR]

• COVID-19 has impacted many individuals and workplaces, but it is unclear how early childhood educators have been affected. • Educators reported symptoms of post-traumatic distress on the Impact of Events Scale-Revised. • Educators reported that the pandemic increased stress, anxiety, anger, frustration, sleeping problems and somatic complaints. There is growing awareness of the impacts of COVID-19 on children, families, and more recently, early childhood educators. This study aimed to add to this research and explore Australian early childhood educators' psychological distress and wellbeing in relation to COVID-19. Accordingly, 205 educators (117 early childhood educators, 86 leaders and 2 others) completed the Impact of Event Scale-Revised, measuring levels of post-traumatic distress, and an open-ended question on wellbeing, both in relation to COVID-19. Educators' responses to the open-ended question were matched to those who scored high, medium, and low on the Impact of Events Scale-Revised. Results demonstrated 66.8% of educators scored in the low range for post-traumatic distress, 11.7% scored in the moderate range, and 21.5% scored in the high range for post-traumatic distress on the Impact of Events Scale-Revised. Participants scoring in the low range on the Impact of Events Scale-Revised provided fewer comments regarding the emotional impacts of COVID-19. There were no differences between the groups in terms of fear of COVID-19 infection, challenges related to increased workload during the pandemic, and frustration with the Australian government response to COVID-19. Educators and early childhood leaders reported comparable wellbeing challenges during the pandemic. This research has implications for the types of support provided to educators during future pandemics. [ABSTRACT FROM AUTHOR]

• Implementation of trauma-informed practice in residential care is dependent on several factors. • Factors that influence trauma-informed implementation include organisational support and continued training. • Barriers to trauma-informed implementation include lack of training regarding positive behaviour support and developing children's adaptive skills. Young people in residential out-of-home care are one of the most traumatised, vulnerable, and disadvantaged groups in the Australian community. Residential care workers are trained in trauma-informed practice, to provide quality care to young people in residential care through a trauma-informed lens. However, limited research exists on perceptions of residential care workers on the implementation of trauma-informed practice in the Australian context, and whether it is sufficient to support young people in residential care. This qualitative study used interpretative phenomenological analysis to better understand worker perceptions and experiences when implementing trauma-informed practice in residential care, and explore any perceived barriers or recommendations to implementation in this context. Seven participants were recruited and interviewed. The results demonstrated that workers apply some elements of trauma-informed practice into everyday practice, such as self-awareness, providing a safe environment, and giving the young person choice and control. However, participants perceived that they lacked the training to support positive behaviour changes and engaging young people with trauma to develop adaptive skills to become more independent. It was also found that participants rarely referenced or identified their own trauma-informed actions and aligned these principles to practical aspects of their role, even when incidental trauma-informed approaches were being used. Understanding the experiences of residential care workers provides insight into the functional day-to-day delivery of trauma-informed practice, demonstrating which aspects are translatable, and which areas workers may benefit from further training to improve practical and contextualised application. [ABSTRACT FROM AUTHOR]

Although school staff are in a prime position to intervene with students who self-injure, how they respond to these students and their training needs regarding self-injury have not been examined. The aims of this study were to explore the responses and training needs of school staff towards youth self-injury. Pre- and in-service teachers and other school staff ( N = 768) completed open-ended questions. Results suggested that school staff require training to respond effectively and confidently to students who self-injure. Self-injury education programs may enhance the knowledge and confidence of staff to detect and respond to students who self-injure. [ABSTRACT FROM AUTHOR]

Background: There is a paucity of investigation on which to base the treatment of chronic urticaria after a patient fails maximum therapy with antihistamines. One prospective, open-label, uncontrolled study suggested that mycophenolate mofetil may be a successful second-line therapy. Objective: We sought to evaluate the efficacy and safety of mycophenolate mofetil in 19 patients with autoimmune and chronic idiopathic urticaria. Methods: In a retrospective chart review, records of patients with autoimmune and chronic idiopathic urticaria who were evaluated between 2001 and 2009 were analyzed. Results: Improvement in urticaria was observed in 89% of patients, specifically 91% of patients with autoimmune urticaria and 88% with chronic idiopathic urticaria. Time to initial improvement ranged from 1 to 9 weeks. In 59% of these patients, complete control of urticaria was achieved, which included 70% of patients with autoimmune urticaria and 43% with chronic idiopathic urticaria. Mean time to complete control was 14 weeks, with a range of less than 1 to 31 weeks. The dose of mycophenolate mofetil at complete control ranged from 1000 to 6000 mg divided twice daily. Mycophenolate mofetil was tapered in 7 of these 10 patients after an average of 7 weeks. Six of the 7 patients tapered then discontinued mycophenolate mofetil with remissions lasting between 2 and 16 weeks up to when the chart review ended. Mycophenolate mofetil was well tolerated with no serious infections or laboratory abnormalities. Gastrointestinal symptoms were most common. Limitations: This was a retrospective chart analysis. The number of patients was relatively small. Conclusions: Mycophenolate mofetil is a useful and well-tolerated second-line therapy for patients with autoimmune and chronic idiopathic urticaria in whom antihistamines and other therapeutic agents have failed. [ABSTRACT FROM AUTHOR]

A cross-sectional survey of 3090 Morwell adults, including 446 young adults (18–34) was administered approximately 2.5 years following the 2014 Hazelwood smoke event in Morwell, Victoria. Young adults with higher smoke exposure tended to experience greater psychological distress than other ages. For every 10 (μg/m3) increase in exposure there was a 2.08 point increase in event related psychological distress for young adults (95% CI: 0.11 to 4.10) compared to no increase for adults aged 65 and over (−0.04; 95% CI: -0.75 to 0.67). A similar non-significant trend was identified for general psychological distress. Prior mental health conditions and prior traumatic event exposures also tended to place young adults at higher risk of general psychological distress. These findings have critical implications for intervening with young adults following prolonged smoke events. [ABSTRACT FROM AUTHOR]

Psoriasis is an inflammatory skin condition that can be accompanied by joint disease. Pre-biological and biological systemic therapies are effective. Dermatologists have used systemic immunomodulators including methotrexate to treat moderate-to-severe disease for over 30 years. Pre-biological agents have toxicities and side effects that can be difficult to tolerate and require frequent monitoring. Beginning with alefacept in 2003, several biologics including cell-adhesion-molecule antagonists and cytokine antagonists such as tumor necrosis factor-blockers gained approval for psoriasis. They greatly advanced our understanding of psoriasis pathogenesis. Because they are so new, their safety is not established. Tumor necrosis factor-blockers have controversial associations with certain cancers and infections. Biologics require clinical monitoring and have specific contraindications. Scientists are exploring several new therapeutic targets. [Copyright &y& Elsevier]

Young adulthood (18 to 34) is a time of transitional change where individuals can be highly susceptible to mental health concerns. Despite similar vulnerabilities to their adolescent counterparts, the psychological outcomes for young adults following disasters are not well understood. This scoping review aimed to explore the literature on the psychological outcomes for young adults after disaster events. A systematic search of the literature was conducted in seven electronic databases, including PsycINFO, Medline, CINAHL, PILOTS, EMBASE, Scopus, and ProQuest dissertations and theses global. In total, 91 reports from 15 countries were included. Findings suggested that young adults experience a range of psychological consequences after disasters, including posttraumatic stress symptoms, depression, anxiety, and other psychological outcomes, such as general/non-specific psychological distress. Pre-disaster, peri-disaster, and post-disaster factors were also found to influence the degree of psychological outcomes experienced by young adults, including prior psychological functioning and disaster exposure, among a host of other factors. Future research is recommended to better understand young adults' psychological outcomes, experiences, and service needs following disasters. [ABSTRACT FROM AUTHOR]

In February 2014, the coalmine adjacent to the Hazelwood Power Station in the Latrobe Valley of Victoria, Australia, caught fire, with residents from the nearby town of Morwell and the wider area exposed to smoke for six weeks. Although there was evidence linking the mine-fire event with psychological distress, no studies have evaluated the degree of distress in relation to the level of smoke exposure. We aimed to investigate the exposure-response relationship between particulate matter 2.5 μm or less in diameter (PM 2.5) released during the Hazelwood mine fire event and long-term symptoms of posttraumatic distress in the affected community, including the consideration of other key factors. A total of 3096 Morwell residents, and 960 residents from the largely unexposed comparison community of Sale, were assessed for symptoms of posttraumatic distress 2.5 years after the Hazelwood incident using the Impact of Events Scale-Revised (IES-R). Individual-level PM 2.5 exposure was estimated by mapping participants' self-reported location data on modelled PM 2.5 concentrations related to the mine fire. Multivariate linear regression was used to evaluate the exposure-response relationship. Both mean and peak exposure to mine fire-related PM 2.5 were found to be associated with participant IES-R scores with an interaction effect between age and mean PM 2.5 exposure also identified. Each 10 μg/m3 increase in mean PM 2.5 exposure corresponded to a 0.98 increase in IES-R score (95% CI: 0.36 to 1.61), and each 100 μg/m3 increase in peak PM 2.5 exposure corresponded to a 0.36 increase (95% CI: 0.06 to 0.67). An age-effect was observed, with the exposure-response association found to be stronger for younger adults. The results suggest that increased exposure to PM 2.5 emissions from the Hazelwood mine fire event was associated with higher levels of psychological distress associated with the mine fire and the most pronounced effect was on younger adults living in the affected community. Image 1 • PM 2.5 exposure was objectively estimated at an individual level. • An exposure-response relationship was observed between PM 2.5 and distress. • Younger adults reported higher distress in response to increased exposure. • Other factors such as prior traumatic experiences were related to distress. • This work provides a nuanced understanding of distress following a pollution event. [ABSTRACT FROM AUTHOR]

• Importance of safe and stable school environments and positive relationships for children in care. • Impact of frequent school changes on children in care, their mental health, behaviour and learning. • Children in care wanted teachers to understand their circumstances and individual learning needs. • Impact of teachers' low expectations, negative attitudes and perceptions on children in care. Children in care frequently experience poor educational outcomes, which in turn have been linked to a number of adverse circumstances later in life. Accordingly, it is important to identify the educational experiences of children in care and what they consider to be their needs in this space. This systematic review of qualitative research aimed to identify and synthesise the findings of relevant studies that documented the experiences of children in care in regard to their school experiences. Inclusion criteria included English language, peer-reviewed, qualitative, or mixed-methods studies that examined the educational experiences of children currently in care or youth/adults who had previously been in care. Five online databases were systematically searched, along with manual hand searching of a relevant journal and reference lists to identify relevant studies. Eleven studies were identified. Thematic analysis was employed to identify five primary themes: the importance of school being a 'safe haven'; the importance of relationships with teachers and peers; children's mental health, behaviour and educational experiences; children in care taking control; and what children in care say they need to improve their educational experiences. Results illustrate the important role of teachers and the need for children in care to have their opinions acknowledged in the decision-making process. The review provides future direction and recommendations for research, school policy, and practice. [ABSTRACT FROM AUTHOR]

Clinical trials for systemic psoriasis therapy typically enroll healthy patients and exclude patients with cardiovascular disease, latent tuberculosis, liver disease, histories of malignancies, viral infections, children, and pregnant or breast-feeding women. Physicians often require guidance for optimum management of severe psoriasis in patients that have a combination of underlying disease states. To provide treatment recommendations for complex psoriasis scenarios, a consensus panel comprising 15 experts in psoriatic disease convened to review and discuss available evidence-based data and to arrive at a consensus for treatment options of difficult cases. An application of the Delphi Method was used to select case scenarios, provide medical treatment options, present the case study with existing medical evidence, and anonymously vote on treatment options. The top 10 treatment options were ranked and statistically analyzed to compare the differences between treatments. The final rankings and analysis provide guidance for practical, safe, and efficacious treatment options in a number of complex psoriasis scenarios. [Copyright &y& Elsevier]

Educators' wellbeing is inextricably linked to their capacity to teach and care for children. In this context, many factors may support or hinder educator wellbeing. This study identified educators' perspectives regarding their wellbeing experiences and needs. Thirteen focus groups (n = 49) were facilitated, with a range of cohorts. Analysis identified five themes; (i) thriving, how educator wellbeing is manifested, (ii) struggling, when educator wellbeing is compromised, (iii) factors that impede educator wellbeing, (iv) marginalization and exclusion experiences, and (v) strategies for promoting wellbeing. A multi-layered systemic approach is required to improve workplace culture and policies and enhance educator wellbeing. • Educator wellbeing is associated with children's wellbeing and learning outcomes. • Poor leadership and high workloads were amongst the factors that impeded wellbeing. • Discrimination was tolerated and reproduced within unhealthy workplace cultures. • Individualized wellbeing initiatives minimize the role of environmental factors. • A multilayered, systems approach is required to promote educator wellbeing. [ABSTRACT FROM AUTHOR]

Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM2.5) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM2.5 exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM2.5 from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults. [ABSTRACT FROM AUTHOR]