(Am J Obstet Gynecol. 2020;222:415–426)
As Coronavirus Disease 2019 (COVID-19) spreads across the globe, infecting more than the reported cases for Middle East Respiratory Syndrome Coronavirus (MERS) and Severe Acute Respiratory Syndrome Coronavirus (SARS) combined, this paper reviews relevant information on COVID-19 for practicing obstetricians. As little is known at this time about COVID-19, information on SARS and MERS and their effects on pregnancy is also reviewed.
Objectives. Development of a vaccine against COVID-19 will be key to controlling the pandemic. We need to understand the barriers and facilitators to receiving a future COVID-19 vaccine so that we can provide recommendations for the design of interventions aimed at maximizing public acceptance. Design. Cross-sectional UK survey with older adults and patients with chronic respiratory disease. Methods. During the UK's early April 2020 'lockdown' period, 527 participants (311 older adults, mean age = 70.4 years; 216 chronic respiratory participants, mean age = 43.8 years) completed an online questionnaire assessing willingness to receive a COVID-19 vaccine, perceptions of COVID-19, and intention to receive influenza and pneumococcal vaccinations. A free text response (n = 502) examined barriers and facilitators to uptake. The Behaviour Change Wheel informed the analysis of these responses, which were coded to the Theoretical Domains Framework (TDF). Behaviour change techniques (BCTs) were identified. Results. Eighty-six per cent of respondents want to receive a COVID-19 vaccine. This was positively correlated with the perception that COVID-19 will persist over time, and negatively associated with perceiving the media to have over-exaggerated the risk. The majority of barriers and facilitators were mapped onto the 'beliefs about consequences' TDF domain, with themes relating to personal health, health consequences to others, concerns of vaccine safety, and severity of COVID-19. Conclusions. Willingness to receive a COVID-19 vaccination is currently high among high-risk individuals. Mass media interventions aimed at maximizing vaccine uptake should utilize the BCTs of information about health, emotional, social and environmental consequences, and salience of consequences. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Despite markedly different national suicide rates, the prevalence of self-harm in Scotland is similar to that in England with girls at least three times more likely to report self-harm than boys. The findings suggest a role for emotional literacy programmes in schools and highlight the importance of promoting positive mental health among adolescents.
BackgroundAdolescent self-harm is a major public health concern, yet little is known about the factors that distinguish adolescents who think about self-harm but do not act on these thoughts from those who act on such thoughts.AimsWithin a new theoretical model, the integrated motivational–volitional model, we investigated factors associated with adolescents having thoughts of self-harm (ideators)v.those associated with self-harm enaction (enactors).MethodObservational study of school pupils employing an anonymous self-report survey to compare three groups of adolescents: self-harm enactors (n= 628)v.self-harm ideators (n= 675)v.those without any self-harm history (n= 4219).ResultsEnactors differed from ideators on all of the volitional factors. Relative to ideators, enactors were more likely to have a family member/close friend who had self-harmed, more likely to think that their peers engaged in self-harm and they were more impulsive than the ideators. Enactors also reported more life stress than ideators. Conversely, the two self-harm groups did not differ on any of the variables associated with the development of self-harm thoughts.ConclusionsAs more adolescents think about self-harm than engage in it, a better understanding of the factors that govern behavioural enaction is crucial in the effective assessment of the risk of self-harm.
Objectives. Few studies have specifically tested the Cry of Pain model (Williams, 2001). This model conceptualises suicidal behaviour as a behavioural response to a stressful situation which has three components: defeat, no escape potential, and no rescue. In addition, the model specifies a mediating role for entrapment on the defeatsuicidal ideation relationship, and a moderating role for rescue factors on the entrapment-suicidal ideation relationship. This is the first study to investigate the utility of this psychological model in a sample of first-time and repeat self-harm (SH) patients.
Method. One hundred and thirteen patients who had been admitted to hospitalfollowing an episode of SH (36 first-time, 67 repeat) and 37 hospital controls completed measures of defeat, entrapment/escape potential, rescue (social support and positive future thinking), as well as depression, anxiety and suicidal ideation.
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