Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries

© 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group. Background: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective: To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method: Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t-tests and multiple regression. Results: Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions: There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries

Evolution and networks in ancient and widespread symbioses between Mucoromycotina and liverworts

Like the majority of land plants, liverworts regularly form intimate symbioses with arbuscular mycorrhizal fungi (Glomeromycotina). Recent phylogenetic and physiological studies report that they also form intimate symbioses with Mucoromycotina fungi and that some of these, like those involving Glomeromycotina, represent nutritional mutualisms. To compare these symbioses, we carried out a global analysis of Mucoromycotina fungi in liverworts and other plants using species delimitation, ancestral reconstruction, and network analyses. We found that Mucoromycotina are more common and diverse symbionts of liverworts than previously thought, globally distributed, ancestral, and often co-occur with Glomeromycotina within plants. However, our results also suggest that the associations formed by Mucoromycotina fungi are fundamentally different because, unlike Glomeromycotina, they may have evolved multiple times and their symbiotic networks are un-nested (i.e., not forming nested subsets of species). We infer that the global Mucoromycotina symbiosis is evolutionarily and ecologically distinctive

Anodal transcranial direct current stimulation over the ventromedial prefrontal cortex enhances fear extinction in healthy humans: A single blind sham-controlled study

Anxiety disorders are among the most common mental disorders[1,2]. Fear extinction is considered essential to promote successfultreatment of several anxiety disorders. Neuroscienceresearch has provided evidence for the contribution of the ventromedialprefrontal cortex (vmPFC) in extinction learning and recall[3,4]. Its role in fear extinction has been investigated via transcranialdirect current stimulation (tDCS) in a recent sham-controlledstudy involving healthy participants. In that study [5], 5 minutesof 2 mA anodal stimulation over the left vmPFC during fear extinctionreduced the physiological expression of fear (reduction of Skinconductance response - SCR) induced via Pavlovian conditioning.However, no effects were reported for the recall session

Anodal transcranial direct current stimulation over the ventromedial prefrontal cortex enhances fear extinction in healthy humans: A single blind sham-controlled study

Anxiety disorders are among the most common mental disorders [1,2]. Fear extinction is considered essential to promote successful treatment of several anxiety disorders. Neuroscience research has provided evidence for the contribution of the ventromedial prefrontal cortex (vmPFC) in extinction learning and recall [3,4]. Its role in fear extinction has been investigated via transcranial direct current stimulation (tDCS) in a recent sham-controlled study involving healthy participants. In that study [5], 5 minutes of 2 mA anodal stimulation over the left vmPFC during fear extinction reduced the physiological expression of fear (reduction of Skin conductance response - SCR) induced via Pavlovian conditioning. However, no effects were reported for the recall session. We extended this study by applying tDCS for 10 minutes over the vmPFC during fear extinction, and hypothesized that this intensified stimulation enhances tDCS efficacy. Thirty-two participants with an age mean of 24.15 years were recruited. They were randomly assigned to one of two sub-groups: anodal (n = 16, 5 males) or sham (n = 16, 5 males) stimulation. Overall, tDCS over the left vmPFC appears to reduce the sympathetic component of fear reactions in extinction in participants that acquired fear responses during fear acquisition. Therefore, tDCS had a facilitatory effect on consolidation of extinction, as compared to initial extinction learning. In conclusion, our results corroborate and also extend those provided by van \u2018t Wout et al. [5], as we showed that prolonged tDCS, as compared to the former protocol, facilitates fear extinction consolidation