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Objective: To evaluate recent high school graduates' opinions on mandatory cardiopulmonary resuscitation (CPR) training in the high school curriculum as a solution to improving bystander CPR rates. Methods: Participants completed questionnaires assessing their CPR training history during their high school education, their willingness to learn CPR during their high school years and their opinion on making CPR training mandatory for high school curricula. Results: Of the 178 participants in this study, 60% had undertaken CPR training during their high school education. Of those who had not undertaken CPR training, 75% reported that they would have been willing to learn CPR had they been provided with the opportunity. A total of 97% of participants were in support of mandatory CPR training in high school education. Conclusion: Implementing mandatory CPR training in high school education would be embraced by students. Implications for public health: Findings of this study support our recommendation to implement mandatory CPR training in the high school curriculum. This will likely increase the number of bystanders in the community who would spontaneously administer CPR, thereby improving outcomes for patients experiencing out‐of‐hospital cardiac arrest.

Background: Mass-casualty incidents (MCIs) are catastrophic. Whether they arise from natural or man-made disasters, the nature of such incidents and the multiple casualties involved can rapidly ove...

Study Objectives This randomized, double-blind, placebo-controlled, crossover study was conducted to evaluate the safety and efficacy of 2 weeks of nightly sublingual cannabinoid extract (ZTL-101) in treating chronic insomnia (symptoms ≥3 months). Methods Co-primary study endpoints were safety of the medication based on adverse event reporting and global insomnia symptoms (Insomnia Severity Index [ISI]). Secondary endpoints included: self-reported (sleep diary), actigraphy-derived, and polysomnography measurements of sleep onset latency (SOL), wake after sleep onset (WASO), total sleep time (TST), sleep efficiency (SE); and self-reported assessments of sleep quality (sSQ) and feeling rested upon waking. Adjusted mean differences between placebo and ZTL-101 were calculated. Results Twenty-three of 24 randomized participants (n = 20 female, mean age 53 ± 9 years) completed the protocol. No serious adverse events were reported. Forty mild, nonserious, adverse events were reported (36 during ZTL-101) with all but one resolving overnight or soon after waking. Compared to placebo, ZTL-101 decreased ISI (−5.07 units [95% CI: −7.28 to −2.86]; p = 0.0001) and self-reported SOL (−8.45 min [95% CI: −16.33 to −0.57]; p = 0.04) and increased self-reported TST (64.6 min [95% CI: 41.70 to 87.46]; p < 0.0001), sSQ (0.74 units [95% CI: 0.51 to 0.97]; p < 0.0001), and feeling of being rested on waking (0.51 units [95% CI: 0.24 to 0.78]; p = 0.0007). ZTL-101 also decreased actigraphy-derived WASO (−10.2 min [95% CI: −16.2 to −4.2]; p = 0.002), and increased actigraphy-derived TST (33.4 min [95% CI: 23.07 to 43.76]; p < 0.001) and SE (2.9% [95% CI: 2.0 to 3.8]; p = 0.005). Conclusions Two weeks of nightly sublingual administration of a cannabinoid extract (ZTL-101) is well tolerated and improves insomnia symptoms and sleep quality in individuals with chronic insomnia symptoms. Clinical Trial ANZCTR; anzctr.org.au; ACTRN12618000078257.

Indexación Scopus The aim of the present study was to quantify explosive joint torque or the ability to develop joint torque rapidly, typically measured as the rate of torque development, in individuals with prodromal Huntington’s disease and healthy controls and its associations with measures of disease burden and striatal pathology. Twenty prodromal Huntington’s disease and 19 healthy control individuals volunteered for this study. Plantar flexor isometric rate of torque development values were evaluated using isokinetic dynamometry. Pathological changes in striatal shape were evaluated using magnetic resonance imaging. Disease burden was evaluated using the disease burden score and cytosine-adenine-guanine age product score. No statistical differences in the rate of torque development were observed between individuals with prodromal Huntington’s disease and healthy controls. However, significant associations were observed between the rate of torque development values and measures of disease burden (r = −0.42 to −0.69) and striatal pathology (r = 0.71–0.60) in individuals with prodromal Huntington’s disease. We found significant associations between lower rate of torque development values and greater striatal shape deflation and disease burden and striatal pathology in individuals with prodromal Huntington’s disease. While no significant differences in the rate of torque development were found between prodromal Huntington’s disease and healthy controls, the noted associations suggest that differences may emerge as the disease advances, which should be investigated longitudinally in future studies. © 2020, The Author(s). https://www-nature-com.recursosbiblioteca.unab.cl/articles/s41598-020-72042-2

Background Hypothalamic pathology is a well-documented feature of Huntington's disease (HD) and is believed to contribute to circadian rhythm and habitual sleep disturbances. Currently, no therapies exist to combat hypothalamic changes, nor circadian rhythm and habitual sleep disturbances in HD. Objective To evaluate the effects of multidisciplinary rehabilitation on hypothalamic volume, brain-derived neurotrophic factor (BDNF), circadian rhythm and habitual sleep in individuals with preclinical HD. Methods Eighteen individuals with HD (ten premanifest and eight prodromal) undertook a nine-month multidisciplinary rehabilitation intervention (intervention group), which included exercise, cognitive and dual task training and social events, and were compared to a community sample of eleven individuals with premanifest HD receiving no intervention (control group). Hypothalamic volume, serum BDNF, salivary cortisol and melatonin concentrations, subjective sleep quality, daytime somnolence, habitual sleep-wake patterns, stress and anxiety and depression symptomatology were evaluated. Results Hypothalamus grey matter volume loss was significantly attenuated in the intervention group compared to the control group after controlling for age, gender, Unified Huntington's Disease Rating Scale-Total Motor Score and number of cytosine-adenine-guanine repeats. Serum BDNF levels were maintained in the intervention group, but decreased in the control group following the study period. Both groups exhibited decreases in cortisol and melatonin concentrations. No changes were observed in sleep or mood outcomes. Conclusions This exploratory study provides evidence that multidisciplinary rehabilitation can reduce hypothalamic volume loss and maintain peripheral BDNF levels in individuals with preclinical HD but may not impact on circadian rhythm. Larger, randomised controlled trials are required to confirm these findings.

Background Despite immense scientific efforts, there are still no proven drug agents that delay or treat cognitive impairments in individuals with Huntington’s disease (HD). Recent clinical and preclinical data suggests that environmental interventions have a positive impact on many cognitive domains that are affected by HD. There are, however, no empirical studies on the effect of environmental interventions on cognition in individuals with premanifest HD. Intervening during this early stage of the disease may support and/or boost cognitive abilities in affected individuals. Aims To evaluate the effectiveness of a nine month multidisciplinary therapy intervention on cognition in individuals with premanifest HD. Methods Eighteen individuals with premanifest HD (13 women, 5 men; 43 ± 13 years) undertook a multidisciplinary therapy intervention for nine months. The intervention consisted of three times weekly supervised aerobic and resistance exercise, dual task and computerised cognitive training. Participants were assessed using validated cognitive measures before and after the intervention. Results Participants completed all mandatory training sessions throughout the study. Significant improvements in verbal learning and memory (Hopkins Verbal Learning Test), information processing speed (Symbol Digit Modalities Test), attention (Trail Making Test Part A), cognitive flexibility (Trail Making Test Part B) and problem solving (One Touch Stockings of Cambridge) were observed following the intervention. Conclusions This study provides preliminary evidence on the positive effects of multidisciplinary therapy on cognition in individuals with premanifest HD. Larger controlled trials are, however, required to confirm these promising findings.

Background Subjective and objective sleep disturbances have been reported in premanifest Huntington’s disease (pre-HD). These disturbances have the potential to induce structural and functional changes to the brain, including cognitive deficits, and may facilitate, or even contribute to, disease onset and progression. Treatment of sleep disturbances could therefore improve function in affected individuals. Here, we investigated the effects of a non-pharmaceutical, short duration multidisciplinary therapy intervention on subjective and objective sleep in pre-HD participants. Aims To evaluate the effects of multidisciplinary therapy on sleep patterns and subjective sleep quality in pre-HD participants. Methods Eleven pre-HD participants aged 40 ± 11 years (5 male) underwent a twelve week multidisciplinary therapy intervention consisting of three, two hour sessions per week encompassing supervised group exercise and cognitive training. Objective (actigraphy) and subjective (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Consensus Sleep Diary) measures of sleep were obtained at baseline, six weeks and twelve weeks. Stress, depression and anxiety were measured at each time-point using the Perceived Stress Scale and the Hospital Anxiety and Depression Scale (as potential confounders of sleep abnormalities). Results All participants completed the required number of therapy sessions (30 sessions in total) for the study. Decreases, relative to baseline, in sleep onset latency (d > 0.5) and number and duration of awakenings (d > 0.2) were observed following the 12 week intervention. Subjective sleep quality also improved following 12 weeks of physical and cognitive training (d > 0.5). Conclusion This study provides evidence that multidisciplinary therapy has the potential to improve subjective and objective sleep quality in pre-HD. It is possible that a longer intervention duration may further improve sleep quality outcomes in this population.