The Cool Kids as a School-Based Universal Prevention and Early Intervention Program for Anxiety: Results of a Pilot Study

The efficacy of the Cool Kids program has been consistently demonstrated both within Australia and internationally, but limited data are available on the use of Cool Kids as a universal program. The purpose of the study is to evaluate Cool Kids as a universal program for preventing childhood anxiety in the school context. There were 73 Italian children (35 boys and 36 girls, ages 10–13 years) attending the last year of primary school and the first year of middle school who participated in an active intervention based on a school adaptation of the Cool Kids protocol. Results of t-test analyses highlighted a downward trend of anxiety symptoms, especially in total anxiety, somatic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia at post-treatment assessed by children. Even the score of depression symptoms, measured as a second outcome measure, decreased after the treatment. This study contributes to the evidence base for the Cool Kids program as a universal program for preventing childhood anxiety in the school context. Although these preliminary results show some promise, their replication in future research is necessary given current study limitations.

Randomized, Placebo-Controlled Prospective Clinical Trial Evaluating the Efficacy of the Assisi Anti-anxiety Device (Calmer Canine) for the Treatment of Canine Separation Anxiety

Introduction: Separation anxiety (SA) is among the most common canine behavior disorders and affects quality-of-life for dogs and their owners. Dogs with SA show signs of anxiety during absence or perceived absence of their owners. While psychoactive medications are often helpful for treating SA, dog and human factors may limit their utility. This study explored the efficacy of a pulsed electromagnetic field (PEMF) device for treatment of canine SA.Materials and Methods: In this double-blind randomized placebo-controlled study, a screening questionnaire and baseline video confirmed the diagnosis of SA. Owners treated their dog with the device twice daily for 6 weeks, completed weekly questionnaires, and noted adverse events. Videos were taken of the dog while alone at weeks 4 and 6. Behaviors were coded and categorized as negative and positive. Questionnaire and video data at weeks 4 and 6 were compared to baseline.Results: Forty client-owned dogs with moderate to severe SA completed the study. There were no differences between groups for age, weight, or sex. In owner questionnaires, no difference in behavior or overall score was found between the active and sham groups (p > 0.05). Videos of the active group compared to the sham group showed significant reduction in negative behaviors by week 6 (p = 0.036) and higher percentage of success at week 4 (Z = 2.83, p = 0.005), at week 6 (Z = 1.65, p = 0.098), and across the full study (Z = 1.99, p = 0.047). Adverse events were reported in eight dogs (6 active, 2 sham); all resolved and were unlikely to be related to treatment.Discussion: This study supports the efficacy and safety of this PEMF device for treatment of SA in dogs. Questionnaire results may not be sensitive enough to detect subtle negative behavioral states compared to video, and may not capture other owner observed behavioral changes. A caregiver placebo effect may account for some improvement seen in both groups. Video data appear better for diagnosis and monitoring dog's behavior when left alone. Future studies should assess PEMF's impact on other anxieties or combination of anxiety disorders in dogs.

Comparison of the Effects of Oral Midazolam and Intranasal Dexmedetomidine on Preoperative Sedation and Anesthesia Induction in Children Undergoing Surgeries

Background and Purpose: Premedication with either oral midazolam or intranasal dexmedetomidine prior to surgery remains less than ideal. The aim of this study was to investigate whether the combination of those two drug regimens would have any beneficial effects on the preoperative sedation and the children’s compliance during anesthesia inhalation induction.Experimental Approach: One hundred thirty-eight children aged 2–6 years were randomly allocated into three groups: Group M with oral midazolam 0.5 mg kg−1, Group D with intranasal dexmedetomidine 2 μg kg−1, and Group M + D with intranasal dexmedetomidine 1 μg kg−1 plus oral midazolam 0.5 mg kg−1. The primary outcome was the children’s compliance during inhalation induction with sevoflurane. The secondary outcomes included the preoperative sedative effects, behavior scores, parental separation anxiety scores, and the postoperative incidence of emergence agitation and recovery time.Results: Subjects in Group M + D showed higher satisfaction scores of compliance (p = 0.0049) and mask acceptance (MAS) (p = 0.0049) during anesthesia inhalation induction. Subjects in Group M + D had a significantly shorter time than those in Groups M and D to achieve the desired sedation level (p < 0.001) and remained at a higher sedation score in the holding area and up to the anesthesia induction after drug administration (p < 0.001).Conclusion and Implications: We conclude that pediatric patients premedicated with intranasal dexmedetomidine 1 μg kg−1 plus oral midazolam 0.5 mg kg−1 had significantly improved anesthesia induction compliance, and quicker onset to achieve and maintain a satisfactory level of sedation than those premedicated separately with two drugs. Therefore, the combined premed regimen is a greater choice when we are expecting a higher quality of sedation and a smoother anesthesia induction in children undergoing the surgeries.

Development of the Dog Attachment Insecurity Screening Inventory (D-AISI): A Pilot Study on a Sample of Female Owners

To date, the Strange Situation Procedure is the only tool available to investigate the quality of the dog’s attachment bond towards the owner. This study aimed to adapt a parent-report scale, named the Attachment Insecurity Screening Inventory (AISI) 6–12, originally designed to assess 6- to 12-year-old children’s attachment insecurity, to dog–owner dyads and assess measures of consistency and validity. The online questionnaire was completed by 524 female dog owners. Principal component analysis (PCA) revealed five components named, respectively, “physical contact”, “control”, “separation anxiety”, “owner as emotional support”, and “owner as a source of positive emotion”. Because of the three-factor structure of the original AISI, a PCA with a pre-fixed set of three factors was also performed. The resulting subscales mirrored the ones found for the original scale (i.e., ambivalent, avoidant, and disorganized), although four items did not fit the model. Internal reliability appeared to be satisfying for the ambivalent and the disorganized subscales, and good for the avoidant subscale. The theoretical background and the results of this study suggest that the three-dimensional model represents a better solution for the interpretation of the Dog Attachment Insecurity Screening Inventory (D-AISI). Although promising, this scale requires refinement and assessment of additional validity measures.

Health Pandemic and Experience of COVID-19 Infected Health Workers: A Qualitative Study

ABSTRACT Due to the rapid spread of the COVID-19 disease, the world communities were faced extreme stress to deal with the pandemic. The World Health Organisation (WHO) was decided to declare COVID-19 as a pandemic on March 11, 2020. COVID-19 pandemic was brought extreme challenges on health workers including nurses and ward attendants’ work in the healthcare service. The objective of this study was to explored the impact on health workers of India. This study was conducted among nurses and ward attendants and they were known for their service through the COVID-19 pandemic. This study was included 20 respondents where 10 of them were nurses and the other 10 were ward attendants at the hospital. The interview method was used to collect the data, and the interviews were conducted between November 2020 and February 2021. The interviews were conducted over the phone. Data was analysed with the help of Graneheim’s qualitative content analytical approaches. This study found that health workers were faced anxiety, fear of death, social isolation, loss of hope about future, separation anxiety from family members, etc. They were faced with uncertainty of their own life and even family members due to higher death rate among health workers and also patients.

Psychometric Properties of SCARED-C Scale in a Romanian Community Sample and its Future Utility for Dental Practice

SCARED-C instrument (the child version, 41 items) is used for screening anxiety in children between 8 to 18 years old and has been first introduced by Birmaher & collab. in 1995, with good psychometric data - internal consistency from α =.74 to .93 - and good discriminative validity indices in the original versions (1997, 1999). Since then, many countries have adopted the scale, for its utility in identifying five subsets of anxiety disorders (subscales): somatic/panic disorder, generalized anxiety, separation anxiety, social phobia, and school avoidance. The present study contains the first Romanian translated and adapted version of the SCARED-C instrument on a community sample of 477 children (8-18 years old) from Mureș county schools. The instrument showed moderate to good internal consistency (α Cronbach from to .63 to .91 for the total scale) and good test-retest reliability (.70) on a subset of 85 children sample. A confirmatory factorial analysis (CFA) was conducted to test the factor structure of the Romanian version of SCARED-C; results showed that SCARED-C has good psychometric properties to be used for screening anxiety in Romanian children and adolescents. The implications for using SCARED-C in dental practice are discussed. Future studies need to be conducted for exploring convergent and discriminative validity of the instrument and the sensitivity to current DSM-V criteria. Application on a dental pediatric sample is also required.

A Review on Pediatric Social Phobia and Selective Mutism

Selective mutism (SM) is a psychological disease that affects children and is defined by a complete lack of speech in certain social contexts while speech production appears normal in others. Separation anxiety disorder, social anxiety disorder (previously known as social phobia), agoraphobia, and panic disorder, as well as shyness and anxiety, can all be associated with selective mutism. SM is a rather uncommon condition. Estimates of its point prevalence have been found in clinic or school samples in a variety of countries, and typically range between 0.03 percent and 1.9 percent depending on the setting. To properly establish the disorder's diagnosis, clinicians can use the SM module of the Anxiety Disorders Interview Schedule for Children and Parents (ADIS-C/P) or the Schedule for Affective Disorders and Schizophrenia for Children (Kiddie- or K-SADS). Nonmedication and medication-based therapies are the two basic types of treatment for selective mutism. Psychodynamic therapy, behavioural therapy, and family therapy are among the most common nonmedication-based or psychotherapy treatments. Selective seratonin reuptake inhibitors (SSRIs) (fluoxetine in particular) have been demonstrated to improve mutism and anxiety when used as a treatment option. The study aims to evaluate and treat selective silence and social phobia in children.