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Children fed via a gastrostomy are provided with commercial produced formula feeds. They are not offered blended diet (BD) as an alternative, and it is not formally supported in the UK due to concerns regarding nutritional content, contamination and tube blockages. Despite this increasing numbers of families are opting to use BD.To discover why parents opt to use of BD with their children and young people who are fed via gastrostomy.This mixed methods study comprised a qualitative phase of 18 in-depth interviews with parents who were using BD with their child. The quantitative phase comprised a survey of 208 parents, 140 of whom used BD and 68 did not use BD.The in-depth interviews identified four overarching themes that influenced parents' decision to use BD; loss, conflict, empowerment and quality of life. Responses from the survey revealed differences between those who did and did not use BD in levels of self-efficacy, views about formula feeds, rating of their child's health and stools.Concerns about formula feeds and less perceived need for it are key determiners in parents' decision to use BD. These views are influenced by social constructs and individual beliefs and circumstances. Those using BD were more likely to rate their child's stools as being normal and rated their child's health more highly than those not using BD.

International multi-professional expert consensus was sought to develop best practice recommendations for clinical management of patients following cervical spinal cord injury with oropharyngeal dysphagia and associated complications. Additionally, risk factors for dysphagia were identified to support the development of a screening tool. A two-round Delphi study was undertaken with a 27-member panel of expert professionals in cervical spinal cord injury and complex dysphagia. They rated 85 statements across seven topic areas in round one, using a five-point Likert scale with a consensus set at 70%. Statements not achieving consensus were revised for the second round. Comparative group and individual feedback were provided at the end of each round. Consensus was achieved for 50 (59%) statements in round one and a further 12 (48%) statements in round two. Recommendations for best practice were agreed for management of swallowing, respiratory function, communication, nutrition and oral care. Twelve risk factors for dysphagia were identified for components of a screening tool. Best practice recommendations support wider clinical management to prevent complications and direct specialist care. Screening for risk factors allows early dysphagia identification with the potential to improve clinical outcomes. Further evaluation of the impact of these recommendations is needed.Implications for RehabilitationDysphagia is an added complication following cervical spinal cord injury (cSCI) affecting morbidity, mortality and quality of life.Early identification of dysphagia risk allows focused interventions that reduce associated nutritional and respiratory impairments.Best practice recommendations based on expert consensus provide a baseline of appropriate interventions, in the absence of empirical evidence.A multi-professional approach to rehabilitation encourages a consistent and coordinated approach to care across acute and rehabilitation settings. Dysphagia is an added complication following cervical spinal cord injury (cSCI) affecting morbidity, mortality and quality of life. Early identification of dysphagia risk allows focused interventions that reduce associated nutritional and respiratory impairments. Best practice recommendations based on expert consensus provide a baseline of appropriate interventions, in the absence of empirical evidence. A multi-professional approach to rehabilitation encourages a consistent and coordinated approach to care across acute and rehabilitation settings.

For this special edition of Scene, award-winning Australian set and costume designer Christina Smith was invited to reflect on her experience of resuming work on Melbourne Theatre Company’s Berlin after a year hiatus due to COVID-19 lockdowns. In the form of a reflective note from the field, Christina examines the unexpected discoveries and unlooked-for liberation that came from being forcibly untethered from her creative process. Raw and personal, this note offers one designer’s journey out of isolation and back to the stage.

Most existing research assumes “phone use during face-to-face interactions” to be psychosocially detrimental. Drawing on the digital social multitasking framework, this study explored not only the negative but also positive implications of the behavior. A sample of 517 adolescents (Mage = 14.83, S.D. = 1.93; 50% female) recruited through the Qualtrics panel completed an online survey. Results showed that adolescents’ and their friend’s digital social multitasking were both associated with (1) greater perceived efficiency, which, in turn, was associated with competence need satisfaction, and (2) greater perceived connection, which, in turn, was associated with better friendship quality, autonomy need satisfaction, and relatedness need satisfaction. Adolescents’ own multitasking also had an indirect, negative relationship with friendship quality through perceived distraction, but friend’s multitasking did not compromise friendship quality. The study provides a more balanced picture, showing that despite the potential harm of digital social multitasking, adolescents’ phone use during face-to-face peer interactions also involves potential benefits for teens’ psychosocial well-being.

ImportanceThere is some evidence that men may be at higher risk of depression directly following the birth of their child and that approximately 1 in 10 men will experience depression in the year after birth, but less is known about men’s antidepressant treatment during this time. Likewise, few direct comparisons have been made with antidepressant treatment in men who have not recently become fathers.ObjectivesTo determine whether recently having a child was associated with increased odds of antidepressant treatment in men.Design, Setting, and ParticipantsThis cohort study used UK primary care electronic health records from the IQVIA Medical Research Database. Participants included men aged 15 to 55 years who had had a child in the previous year, from January 2007 to December 2016, and compared with up to 5 men who did not have a child in the same calendar year. Data were analyzed from January 2022 to March 2023.ExposureA record of having a child in the previous year was identified through linked primary care records using a family identification number.Main Outcomes and MeasuresThe main outcome was antidepressant initiation in the year after childbirth or in the year after this index date for men who did not have a child. Random-effects Poisson regression was used to determine associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after index date using prevalence risk rates (PPRs).ResultsAnalysis included 90 736 men who had had a child in the previous year and 453 632 men in the comparison cohort. Most men in the study (463 879 men [85.2%]) were aged between 25 and 44 years, and there were more men living in the least deprived areas (130 277 men [23.9%]) than the most deprived areas (72 268 men [13.3%]). Overall, 4439 men (4.9%) had at least 1 antidepressant prescription in the year after they had a child, compared with 26 646 men (5.9%) who did not have a child in the same year. However, after adjustment there was no difference in antidepressant treatment between groups (adjusted PRR [aPRR], 1.01; 95% CI, 0.98-1.04). In fathers, those who had recently received antidepressant treatment were much more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment (aPRR, 32.31; 95% CI, 30.37-34.38). Fathers living in the most deprived areas were 18% more likely to have an antidepressant prescription compared with fathers living in the least deprived areas (aPRR, 1.18; 95% CI, 1.07-1.30).Conclusions and RelevanceThese findings suggest that recently having a child was not associated with an increase in antidepressant treatment among men, but previous antidepressant treatment in fathers was strongly associated with treatment after childbirth. Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment.

Purpose: Tracheostomy is a common surgical procedure in ICU. Whilst often life-saving, it can have important impacts on patients. Much of the literature on tracheostomy focuses on timing and technique of insertion, risk factors and complications. More knowledge of patient experience of tracheostomy in ICU is needed to support person-centred care. Materials and Methods: Qualitative systematic review and metasynthesis of the literature on adult experience of tracheostomy in ICU. Comprehensive search of four bibliographic databases and grey literature. Title and abstract screening and full text eligibility was completed independently by two reviewers. Metasynthesis was achieved using thematic synthesis, supported by a conceptual framework of humanised care. Results: 2971 search returns were screened on title and abstract and 127 full texts assessed for eligibility. Thirteen articles were included for analysis. Five descriptive and three analytical themes were revealed. The over-arching theme was ‘To be seen and heard as a whole person’. Patients wanted to be treated as a human, and having a voice made this easier. Conclusions: Voice restoration should be given high priority in the management of adults with a tracheostomy in ICU. Staff training should focus on both technical skills and compassionate care to improve person-centred outcomes.

Eating and drinking difficulties are common in dementia, but little is known about the experiences of ethnic minority groups managing these difficulties at home. We undertook qualitative semi-structured interviews, exploring the meaning of food, the impact of dementia on eating and drinking and carers’ experiences of support. Interviews were audio-recorded and transcribed verbatim. We interviewed 17 carers and people with dementia from ethnic minority backgrounds, using reflexive thematic analysis to analyse data. Food/drink had strong links to identity, culture and emotions. Providing culturally familiar foods, celebrating traditional festivals and supporting previous food-related roles promoted reminiscence, which encouraged people with dementia to eat and drink, as did social interactions. However, these strategies sometimes led to distress in those with more advanced dementia. Food choices were also influenced by carer strain, generational differences and the impact of health conditions. Despite a strong sense of duty to care for relatives at home, there was low awareness of community support services. Carers expressed a need for culturally tailored support for managing dementia-related eating and drinking difficulties at home. Healthcare professionals must provide contextually relevant advice to carers, being mindful of how cultural backgrounds can affect dietary choices.

The licensed rotavirus vaccines are live attenuated and are a component of the routine U.S. childhood immunization schedule. Live vaccines administered to infants of mothers who received biologic response modifiers (BRM) during pregnancy can potentially cause serious vaccine-associated disease. The Advisory Committee on Immunization Practices (ACIP) recommends infants born to women who received BRM during pregnancy avoid live viral vaccines during the first year of life. There is a paucity of information regarding adverse events following inadvertent administration of live viral vaccines in these infants. We report three infants, born to mothers receiving infliximab during pregnancy, who tolerated multiple doses of rotavirus vaccine. Live viral vaccines may be safe in infants who were exposed to BRM in utero. Further studies are needed to support this observation, as this could affect current ACIP recommendations.

This research investigated 20 middle and high school teachers’ use of project-based learning curriculum after engaging in a 115-hour professional development program that was developed collaborativ...

The altitudes of Martian water-ice clouds above Gale crater are being calculated through the Cloud Altitude Observation (CAO) taken by the Mars Science Laboratory (MSL, Curiosity). Typically, a mission needs a lidar onboard to calculate altitude, but this observation utilizes local topography – Aeolis Mons – to follow shadows and determine an absolute wind velocity. Comparing this velocity to the angular wind velocity found in a paired vertical movie determines the cloud’s altitude. This method is useful for the community when a mission doesn’t have a lidar but nearby terrain to observe shadows. During Mars Year (MY) 35, 28 observations were collected and will be compared to Campbell et al. [1] results from MY 34 to determine any changes. Introduction The Aphelion Cloud Belt (ACB) season is a yearly equatorial cloud belt caused by cooler atmospheric temperatures. Occurring between solar longitude (Ls) 45°-150°, water-ice clouds are typically visible during two times of each sol, early morning and late afternoon [2,11]. Since 2012, MSL has been observing the ACB season in Gale crater (4.5°S, 137.4°E) with a variety of cloud observations to study seasonal and diurnal changes of different parameters such as seasonal and diurnal changes [1,8,9], cloud altitude [1], opacity [8,9,10] and ice crystal geometry [3]. One parameter, altitude, is of interest to the atmospheric science community to determine the cloud’s relation to the Planetary Boundary Layer (PBL). Orbiters are able to constrain cloud altitudes through limb measurements but observations within 10 km of the surface are hampered by dust opacity [7]. This is difficult for studying the PBL in Gale crater from orbit as the PBL is very shallow during the ACB season, ranging between 2-3 km [5,12]. From the surface, cloud altitudes could be measured with a lidar [4, 13], but only a single Mars mission has carried this instrument and therefore we must employ other methods to find altitude. As described in Campbell et al. [1], a new atmospheric observation was implemented on MSL during the MY 34 ACB season. Typically used for dust-devil searching, the Navigation Camera (Navcam) took a movie pointed at Aeolis Mons observed shadows moving along the mountain cast by clouds above. These shadows were georeferenced with a digital terrain model and the distance travelled was used to determine an absolute wind velocity. Angular wind velocity is already determined using a vertically pointed movie that follows how clouds move with respect to the camera’s field of view [1]. When these two movies are paired together, the comparison between velocities is used to calculate altitude via trigonometry. Therefore, this paired movie combination facilitates a way to directly calculate cloud altitudes at Gale crater for the first time. For the remainder of MY 34 season, these observations were paired whenever possible and resulted in 9 detections of clouds and their shadows, with the results reported in [1]. Following this success, a new MSL observation was designed, optimized, and implemented to observe water-ice cloud shadows and deduce the water-ice cloud altitudes for the MY 35 ACB season and named the Cloud Altitude Observation (CAO). Cloud Altitude Observation The CAO is performed in the ACB season on a weekly cadence. It consists of two movies – Cloud Shadow Movie (CSM) and Zenith Movie (ZM) – taken one after the other by the Navcam. Both are made up of eight 1022x1022 pixeled images and span 240 seconds each. The CSM (Figure 1, top) points directly at Aeolis Mons to capture shadow motion which is used to determine an absolute wind velocity. The ZM (Figure 1, bottom) points directly above the rover and is used to determine an angular velocity based on the camera’s field of view. Comparing these two velocities allows the altitude of the clouds to be calculated. Results and Discussion A total of 28 observations were collected between Ls 47°-163° and will be compared to MY 34 results [1] to determine any seasonal changes. Processing and analysis of these observations are ongoing, but the entire MY 35 ACB season's data will be processed and analyzed by the time of the conference. The MY 35 ACB season is unique in that it followed a Global Dust Storm (GDS) that occurred from Ls 188°-250° [6]. These storms are large enough to envelope the entire planet and affect the local and global environment. MSL has the unique ability to continue operations during a GDS and detected dust optical depths of up to an order of magnitude larger than normally observed [6]. Studying how the cloud altitudes change before/after the GDS will help determine if there are any long-term effects to the water-ice clouds. Once the MY 36 ACB season concludes, it will be added to the current data set to further determine any seasonal changes. References [1] Campbell et al., Planet. Space Sci. 182. 104785. 2020. [2] Clancy et al., Icarus. 122, 36-62. 1996. [3] Cooper et al., P&SS. 168, 62-72. 2019. [4] Dickinson et al., Geophys. Res. Lett. 37, L18203. 2010. [5] Guzewich et al., JGR-Planets, 122, 2779–2792. 2017. [6] Guzewich et al., Geophys. Res. Lett., 46, 71-79. 2019. [7] Kleinbohl et al., JGR-Planets, 114, E10006. 2009. [8] Kloos et al., Adv Sp Res. 58, 1223-1240. 2016. [9] Kloos et al., JGR-Planets. 123, 233–245. 2018. [10] Moores, et al., Adv. Space Res. 55, 2217–2238. 2015b. [11] Tamppari et al., JGR-Planets. 108, 5073. 2003. [12] Tyler, Barnes, Int. J. Mars Sci. Explor. 8, 58–77. 2013. [13] Whiteway et al., Science. 325. 68. 2009.

Small-molecule modulators of TLR8 have drawn much interests as it plays pivotal roles in the innate immune response to single-stranded RNAs (ssRNAs) derived from viruses. However, their clinical uses are limited because they can invoke an uncontrolled, global inflammatory response. The efforts described herein culminate in the fortuitous discovery of a tetrasubstituted imidazole CU-CPD107 which inhibits R848-induced TLR8 signaling. In stark contrast, CU-CPD107 shows unexpected synergistic agonist activities in the presence of ssRNA, while CU-CPD107 alone is unable to influence TLR8 signaling. CU-CPD107’s unique, dichotomous behavior sheds light on a way to approach TLR agonists. CU-CPD107 offers the opportunity to avoid the undesired, global inflammation side effects that have rendered imidazoquinolines clinically irrelevant, providing an insight for the development of antiviral drugs., Toll-like receptor 8 (TLR8) plays essential roles in the innate immune response to viral single-stranded RNA (ssRNA), so small molecule modulators of TLR8 are of interest, however adverse effects limit their use. Here, the authors report a tetrasubstituted imidazole CU-CPD107 with dichotomous behaviour, which inhibits R848-induced TLR8 signaling, but shows synergistic activity in the presence of ssRNA, making it a potential antiviral agent.

Introduction Pseudomonas aeruginosa is the most commonly isolated organism in children with ventilator-associated tracheobronchitis (VAT). Enteral treatment with ciprofloxacin or levofloxacin is sometimes employed, but supportive data are limited. The purpose of this study was to evaluate the effectiveness and safety of enteral ciprofloxacin and levofloxacin administration for VAT in children. Methods This was a retrospective review of electronic medical records for children less than 18 years of age who received enteral ciprofloxacin or levofloxacin for the treatment of VAT from January 2013 through January 2020 at an academic children’s hospital. Results Seventy-six children (median age 9.5, IQR 3.6-13.1 years), received ciprofloxacin or levofloxacin for VAT treatment during the study period. Median treatment duration was 8 (range 7-10) days. Most tracheostomy cultures (n=70/82, 85%) were polymicrobial, with P. aeruginosa most commonly isolated (n=67/224 organisms, 30%). Sixty-five children (86%) were successfully treated with an enteral fluoroquinolone. Antibiotics were changed or extended for two (3%) children. Ten (13%) children were prescribed antibiotics and eight (11%) required hospitalization for a lower respiratory tract infection within 30 days of completion of their fluoroquinolone course. Six (8%) patients received a seizure rescue medication, seven (9%) experienced emesis, and one (1%) had elevated transaminases. Tendonitis, tendon rupture and QTc prolongation were not observed. Conclusions The results of this study suggest enteral fluoroquinolones may be effective for the treatment of VAT in children. Further study is warranted to clarify the role of these agents in pediatric VAT.

3-Nitrobenzanthrone (3-NBA) is a byproduct of diesel exhaust and is highly present in industrial and populated areas. Inhalation of 3-NBA results in formation of N-(2′-deoxyguanosin-8-yl)-3-aminobenzanthrone (dG(C8-N-ABA)), a bulky DNA lesion that is of concern due to its mutagenic and carcinogenic potential. If dG(C8-N-ABA) is not bypassed during genomic replication, the lesion can stall cellular DNA replication machinery, leading to senescence or apoptosis. We have previously used running start assays to demonstrate that human DNA polymerases eta (hPolκ) and kappa (hPolκ) are able to catalyze translesion DNA synthesis (TLS) across a site-specifically placed dG(C8-N-ABA) in a DNA template. Consistently, gene knockdown of hPolη and hPolκ in HEK293T cells reduces the efficiency of TLS across dG(C8-N-ABA) by ~25 and ~30%, respectively. Here, we kinetically investigated why hPolκ paused when bypassing and extending from dG(C8-N-ABA). Our kinetic data show that correct dCTP incorporation efficiency of hPolκ dropped by 116-fold when opposite dG(C8-N-ABA) relative to undamaged dG, leading to hPolκ pausing at the lesion site observed in the running start assays. The already low nucleotide incorporation fidelity of hPolκ was further decreased by 10-fold during lesion bypass and thus, incorrect nucleotides, especially dATP, were incorporated opposite dG(C8-N-ABA) with comparable efficiencies as correct dCTP. With regard to the dG(C8-N-ABA) bypass product extension step, hPolκ incorporated correct dGTP onto the damaged DNA substrate with a 786-fold lower efficiency than onto the corresponding undamaged DNA substrate, resulting in hPolκ pausing at the site in the running start assays. Furthermore, hPolκ extended the primer-terminal matched base pair dC:dG(C8-N-ABA) with a 100-1,000 fold lower fidelity than it extended the undamaged dC:dG base pair. Together, our kinetic results strongly indicate that hPolκ was error-prone during TLS of dG(C8-N-ABA).

Disasters have many deleterious effects and are becoming more frequent. From a health-care perspective, disasters may cause periods of stress for hospitals and health-care systems. Telemedicine is a rapidly growing technology that has been used to improve access to health-care during disasters. Telemedicine applied in disasters is referred to as disaster telemedicine. Our objective was to conduct a scoping literature review on current use of disaster telemedicine to develop recommendations addressing the most common barriers to implementation of a telemedicine system for regional disaster health response in the United States. Publications on telemedicine in disasters were collected from online databases. This included both publications in English and those translated into English. Predesigned inclusion/exclusion criteria and a PRISMA flow diagram were applied. The PRISMA flow diagram was used on the basis that it would help streamline the available literature. Literature that met the criteria was scored by 2 reviewers who rated relevance to commonly identified disaster telemedicine implementation barriers, as well as how disaster telemedicine systems were implemented. We also identified other frequently mentioned themes and briefly summarized recommendations for those topics. Literature scoring resulted in the following topics: telemedicine usage (42 publications), system design and operating models (43 publications), as well as difficulties with credentialing (5 publications), licensure (6 publications), liability (4 publications), reimbursement (5 publications), and technology (24 publications). Recommendations from each category were qualitatively summarized.

Patients with hereditary angioedema (HAE) can experience attacks at any age; however, the onset of swelling is typically in childhood. Unlike adults, this population is uniquely vulnerable; attacks in young children may be subtle, resemble other diseases, and often lead to a delay in diagnosis. Misdiagnosis contributes to significant delays in treatment, painful attacks, increased emotional stress, unnecessary procedures, and a potential risk of death. Older children may hide their symptoms due to anxiety or fear of social isolation. Attacks typically become more severe and more frequent during and after puberty. The impact of HAE attacks on school attendance and school performance may prevent future career or education opportunities. Living with HAE poses significant psychosocial stress on children and their families. In the United States, medical treatments for acute attacks in children approved for self-administration are limited to intravenous therapies, which complicates early treatment. To provide optimal care, we suggest that physicians screen all children with a family history of HAE, appreciate the dynamic nature of the disease during adolescence, proactively assess the psychosocial impact of disease, and continually reassess the treatment plan.

BACKGROUND In light of the scarcity of culturally tailored mobile health (mHealth) lifestyle interventions for African Americans, we designed and pilot tested the Fostering African-American Improvement in Total Health (FAITH!) App in a community-based participatory research partnership with African American churches to promote cardiovascular health and wellness in this population. OBJECTIVE This report presents the results of a formative evaluation of the FAITH! App from participants in an intervention pilot study. METHODS We included 2 semistructured focus groups (n=4 and n=5) to explore participants’ views on app functionality, utility, and satisfaction as well as its impact on healthy lifestyle change. Sessions were audio-recorded and transcribed verbatim, and qualitative data were analyzed by using general inductive analysis to generate themes. RESULTS In total, 6 overarching themes emerged among the 9 participants: overall impression, content usefulness, formatting, implementation, impact, and suggestions for improvement. Underpinning the themes was a high level of agreement that the intervention facilitated healthy behavioral change through cultural tailoring, multimedia education modules, and social networking. Suggestions for improvement were streamlining the app self-monitoring features, prompts to encourage app use, and personalization based on individuals’ cardiovascular risk. CONCLUSIONS This formative evaluation found that the FAITH! App had high reported satisfaction and impact on the health-promoting behaviors of African Americans, thereby improving their overall cardiovascular health. Further development and testing of the app among African Americans is warranted. CLINICALTRIAL ClinicalTrials.gov NCT03084822; https://clinicaltrials.gov/ct2/show/NCT03084822.

Detection of 3′ PMS2 copy-number mutations that cause Lynch syndrome is difficult because of highly homologous pseudogenes. To improve the accuracy and efficiency of clinical screening for these mutations, we developed a new method to analyze standard capture-based, next-generation sequencing data to identify deletions and duplications in PMS2 exons 9 to 15. The approach captures sequences using PMS2 targets, maps sequences randomly among regions with equal mapping quality, counts reads aligned to homologous exons and introns, and flags read count ratios outside of empirically derived reference ranges. The method was trained on 1352 samples, including 8 known positives, and tested on 719 samples, including 17 known positives. Clinical implementation of the first version of this method detected new mutations in the training (N = 7) and test (N = 2) sets that had not been identified by our initial clinical testing pipeline. The described final method showed complete sensitivity in both sample sets and false-positive rates of 5% (training) and 7% (test), dramatically decreasing the number of cases needing additional mutation evaluation. This approach leveraged the differences between gene and pseudogene to distinguish between PMS2 and PMS2CL copy-number mutations. These methods enable efficient and sensitive Lynch syndrome screening for 3′ PMS2 copy-number mutations and may be applied similarly to other genomic regions with highly homologous pseudogenes.

Introduction: Sudden cardiac arrest is a leading cause of mortality in the United States, with over 475,000 people dying annually. Bystander CPR significantly improves the odds of neurologically intact survival, yet nationally is performed in only 46% of out of hospital cardiac arrests. Significant regional variation exists in the performance of bystander CPR, with our community performing lower than national norms (26%). We sought to assess our community’s awareness of current American Heart Association (AHA) recommendations and the perceived barriers to performing bystander CPR. Methods: Adult study volunteers were recruited within the community (Norfolk, VA; pop. 244,703) and completed a 15-question anonymous survey that assessed knowledge of AHA recommendations, willingness to perform, and perceived barriers to performing CPR. Results: A total of 1,017 respondents completed all or part of the survey (40% male; 60% female). Knowledge of the importance of CPR was high. Of the respondents, 78% (n=708) indicated they would know if CPR was required, 84% (n=756) recognized the importance of performing CPR on a person who is unconscious and not breathing, and 89% (n=733) agreed CPR should not be delayed until the arrival of an ambulance. Though 70% (n=597) of respondents indicated they had been previously trained to perform CPR, only 44% (n=397) had been trained to perform “hands-only” CPR. Several barriers to performing CPR were identified. Forty-nine percent of respondents (n=402) believed they must perform “mouth to mouth” during CPR while 32% (n=284) were concerned they could catch a disease. Fear of doing something wrong while performing CPR was a concern for 28% (n=257). Twenty-six percent (n=237) reported concerns about the legal consequences of performing CPR. Conclusions: Though the importance of bystander CPR is well recognized in our community, misunderstandings regarding requirements and risks continue to exist. Education efforts should focus on increasing community awareness of current AHA recommendations.