Rural primary care workforce views on trauma‐informed care for parents experiencing complex trauma: A descriptive study

Background An important service system for rural parents experiencing complex trauma is primary health care. Aim To investigate workforce knowledge, attitudes and practices, and barriers and enablers to trauma-informed care in rural primary health care. Material & Methods This study used a descriptive, cross-sectional design. It involved an on-line survey conducted in 2021 in rural Victoria, Australia. Participants were the primary health care workforce. The main outcome measures were study-developed and included, a 21-item Knowledge, Attitudes and Practices tool, a 16-item Barriers and Enablers to Trauma-Informed Care Implementation tool, and three open-ended questions. Results The 63 respondents were from community health (n = 40, 63%) and child and family services (n = 23, 37%). Many (n = 43, 78%) reported undertaking trauma-informed care training at some point in their career; with 32% (n = 20) during higher education. Respondents self-rated their knowledge, attitudes and practices positively. Perceived enablers were mainly positioned within the service (e.g. workforce motivation and organisational supports) and perceived barriers were largely external structural factors (e.g. availability of universal referral pathways, therapeutic-specific services). Open-ended comments were grouped into four themes: (1) Recognition and understanding; (2) Access factors; (3) Multidisciplinary and collaborative approaches; and (4) Strengths-based and outcome-focused approaches. Discussion & Conclusion Primary health care is an important driver of population health and well-being and critical in rural contexts. Our findings suggest this sector needs a rural trauma-informed care implementation strategy to address structural barriers. This also requires policy and system development. Long-term investment in the rural workforce and primary care service settings is essential to integrate trauma-informed care

Travel‐time tomography in the northern Coachella Valley using aftershocks of the 1986 ML 5.9 North Palm Springs Earthquake

Tomographic inversion is applied to delay times from aftershocks of the 1986 ML 5.9 North Palm Springs (NPS) earthquake to image 3‐D velocity variations within the northern Coachella Valley. P‐wave arrival times from 1074 earthquakes, with depths ranging from 3 to 20 km, were used as sources recorded by 12 portable and 4 permanent stations. Preliminary results show well‐defined high‐ and low‐velocity anomalies (2–7%) that correlate with the rupture distribution of the 1986 mainshock. At depths less than 8 km, a low‐velocity anomaly predominates between the two NE‐dipping Banning and Mission Creek faults. From 8 to 12 km in depth, where the NPS mainshock and most of the aftershocks occur, a high‐velocity anomaly is observed. This high‐velocity feature is interpreted as imaging the asperity responsible for the 1986 rupture; and suggests that velocity information may help to define important elements, such as asperities, that control fault rupture, and thus, may help to predict the location and size of future events

Parent and child mental health during COVID-19 in Australia: The role of pet attachment

Restrictions, social isolation, and uncertainty related to the global COVID-19 pandemic have disrupted the ways that parents and children maintain family routines, health, and wellbeing. Companion animals (pets) can be a critical source of comfort during traumatic experiences, although changes to family routines, such as those caused by COVID-19, can also bring about challenges like managing undesirable pet behaviours or pet-human interactions. We aimed to examine the relationship between pet attachment and mental health for both parents and their children during the COVID-19 pandemic in Australia. A total of 1,034 parents living with a child under 18 years and a cat or dog completed an online cross-sectional survey between July and October 2020. Path analysis using multivariate linear regression was conducted to examine associations between objective COVID-19 impacts, subjective worry about COVID-19, human-pet attachment, and mental health. After adjusting for core demographic factors, stronger pet-child attachment was associated with greater child anxiety (parent-reported, p < .001). Parent-pet attachment was not associated with self-reported psychological distress (p = .42), however, parents who reported a strong emotional closeness with their pet reported greater psychological distress (p = .002). Findings highlight the role of pets during times of change and uncertainty. It is possible that families are turning to animals as a source of comfort, during a time when traditional social supports are less accessible. Alternatively, strong pet attachment is likely to reflect high levels of empathy, which might increase vulnerability to psychological distress. Longitudinal evidence is required to delineate the mechanisms underpinning pet attachment and mental health

Non-Gaussianity from violation of slow-roll in multiple inflation

Multiple inflation is a model based on N=1 supergravity wherein there are sudden changes in the mass of the inflaton because it couples to 'flat direction' scalar fields which undergo symmetry breaking phase transitions as the universe cools. The resulting brief violations of slow-roll evolution generate a non-gaussian signal which we find to be oscillatory and yielding f_NL ~ 5-20. This is potentially detectable by e.g. Planck but would require new bispectrum estimators to do so. We also derive a model-independent result relating the period of oscillations of a phase transition during inflation to the period of oscillations in the primordial curvature perturbation generated by the inflaton.Comment: 21 pages, 6 figures; Clarifying comments and references added; Accepted for publication in JCA

Community perspectives of complex trauma assessment for Aboriginal parents: 'Its important, but how these discussions are held is critical'

Background and Purpose: Becoming a parent can be an exciting and also challenging transition, particularly for parents who have experienced significant hurt in their own childhoods, and may be experiencing ‘complex trauma.’ Aboriginal and Torres Strait Islander (Aboriginal) people also experience historical trauma. While the parenting transition is an important time to offer support for parents, it is essential to ensure that the benefits of identifying parents experiencing complex trauma outweigh any risks (e.g., stigmatization). This paper describes views of predominantly Aboriginal stakeholders regarding (1) the relative importance of domains proposed for complex trauma assessment, and (2) how to conduct these sensitive discussions with Aboriginal parents. Setting and Methods: A co-design workshop was held in Alice Springs (Central Australia) as part of an Aboriginal-led community-based participatory action research project. Workshop participants were 57 predominantly Aboriginal stakeholders with expertise in community, clinical, policy and academic settings. Twelve domains of complex trauma-related distress had been identified in existing assessment tools and through community consultation. Using story-telling and strategies to create safety for discussing complex and sensitive issues, and delphi-style methods, stakeholders rated the level of importance of the 12 domains; and discussed why, by whom, where and how experiences of complex trauma should be explored. Main Findings: The majority of stakeholders supported the importance of assessing each of the proposed complex trauma domains with Aboriginal parents. However, strong concerns were expressed regarding where, by whom and how this should occur. There was greater emphasis and consistency regarding ‘qualities’ (e.g., caring), rather than specific ‘attributes’ (e.g., clinician). Six critical overarching themes emerged: ensuring emotional and cultural safety; establishing relationships and trust; having capacity to respond appropriately and access support; incorporating less direct cultural communication methods (e.g., yarning, dadirri); using strengths-based approaches and offering choices to empower parents; and showing respect, caring and compassion. Conclusion: Assessments to identify Aboriginal parents experiencing complex trauma should only be considered when the prerequisites of safety, trusting relationships, respect, compassion, adequate care, and capacity to respond are assured. Offering choices and cultural and strengths-based approaches are also critical. Without this assurance, there are serious concerns that harms may outweigh any benefits for Aboriginal parents