In response to the increase in anned robberies to banks and building societies during the 1980s and 1990s, a training programme was developed within one building society to buttress employees against the potentially hannful psychological consequences of being involved in an anned raid. The 'Coping With Robberies' training programme consisted of a package of practical, procedural and psychological coping techniques based on Meichenbaum's (1985) 'Stress Inoculation Training' principles utilising video, workbook and discussion formats. It was delivered over four months to 4,000 employees of the Society via monthly, branch-based training sessions. The programme was evaluated using a mixed qualitative and quantitative methodology to determine whether the training would improve employees' predicted confidence that they would cope in a raid and reduce their symptoms of post -traumatic stress should they be raided. In addition, aspects of both the individual and the training were assessed to investigate which of these aspects were related to confidence and post-traumatic stress symptoms. The training improved confidence, employees felt empowered by the training and viewed it almost entirely positively. However, for those employees subsequently raided, there was no evidence that the training reduced symptoms of psychological distress in either the immediate or longer term. Other personal and environmental factors were related to confidence and post-traumatic stress symptoms, most notably degree of involvement in the raid, job position/role in the Society, social support and coping style. Although levels of initial distress post-raid were high, the majority of those involved recovered quickly.The implications for training employees exposed to the potential for criminal assault are that the majority will appreciate and benefit from both procedural and simple psychological techniques for use during a raid but will be less appreciative of attempts to be taught anxiety management techniques for post-raid stress. Although the majority of those involved in raids will recover from their initial distress, a small minority of employees are very vulnerable to psychological ill health as a consequence of being involved in a raid. This group should be given the opportunity for specialised one-to-one training and therapy to enable them to cope should they be raided.

Objectives: This study was designed to address whether or not the level (high or low) of Streptococcus mutans in the saliva of preschool children can be used as an indicator of caries risk. Material and Methods: Levels of Streptococcus mutans was assessed in saliva of 100 preschool children, before and approximately 6-months after receiving a health promotion intervention known as anticipatory guidance. The S. mutans bacterial level was assessed using an immunoassay system (Saliva-Check MUTANS) based on monoclonal antibody technology. Bacterial counts were determined at baseline as well as at a six month recall examination. Obtained data was analyzed using SPSS 20.0 for Windows to report frequencies and to look for trends and associations between the dependent and independent variables. Bivariate analysis (ANOVA, Chi Square/Fishers/McNemar exact test) was used to identify associations between variables. Results: The main finding of this study was that higher levels of Streptococcus mutans were associated with higher caries prevalence at baseline, and caries incidence at follow-up. Furthermore following anticipatory guidance, the levels of Streptococcus mutans were reduced at the subsequent follow-up examination, approaching but not reaching statistical significance, and caries incidence was significantly lower in subjects demonstrating low Streptococcus mutans levels. Conclusions: Results from this study have shown that anticipatory guidance, offered to caregivers and children at an initial examination, led to a statistically non-significant reduction in the proportion of children with high Streptococcus mutans levels upon recall six mothers later. Children with low Streptococcus mutans levels were also less likely to develop new dental caries. These findings suggest that Streptococcus Mutans counts could be used to assess caries risk and encourages clinicians to provide anticipatory guidance to their patients to help avoid the development of new caries.

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Background: Professional guidelines recommend that all adolescents receive annual preventive visits including psychosocial and behavioral screening, and anticipatory guidance and counseling for health risk behaviors. Youth with special health care needs (YSHCN) experience many health-related disparities yet little is known about receipt of such counseling this population. Objective: We characterized adolescents’ receipt of recommended healthcare provider-delivered counseling and assessed differences between youth with and without special health care needs. Design/Methods: We used data from a 2016 school-based survey of adolescents ages 16-18 in rural South Central Appalachia Tennessee (n=403). About one-quarter (23%) were categorized as YSHCN. A greater proportion of YSHCN were female (68% vs. 49%), non-Hispanic white (96% vs. 83%), or had seen a doctor or other healthcare provider in the past year (97% vs. 83%) (all p<.05). Adolescents reported on their discussions with a healthcare provider about ten different recommended topics across four areas: weight/physical activity; mental health; substance use; and protective factors (i.e., friends, school). We assessed differences in individual topics discussed by YSHCN status using chi-square analyses and multivariable logistic regression. Results: Overall, only half (50%) of adolescents reported talking with their healthcare provider about any of the assessed topics. As shown in Figure 1, receipt of counseling varied by YSHCN status with a greater proportion of YSHCN reporting having discussed most of the assessed topics with a healthcare provider compared to other youth. In multivariable models controlling for adolescents’ sex, age, race/ethnicity, SES, use of health services, and quality of a relationship with their healthcare provider, YSHCN had greater odds than other youth of discussing topics related to weight/physical activity (OR=4.08, 95% CI: 2.35-7.07); mental health (OR=2.50, 95%CI: 1.46-4.31); protective factors (OR=2.32, 95% CI: 1.29-4.18); but not substance use (p>.05). Conclusion(s): This study provides novel data on receipt of healthcare provider-delivered counseling about important health risk and promotion topics. Findings suggest that YSHCN are more likely than other youth to receive counseling about most topics, even when controlling for their increased receipt of preventive care. However, findings also highlight suboptimal provision of anticipatory guidance to all youth, and point to the need to increase delivery of adolescent preventive servcies.

Adolescents are individuals who are gradually approaching adulthood and begin to experience some changes in their lives owing to their exposure to environmental influences. These individuals also indulge in behaviors that may be harmful to them and will require the guidance of health providers to stay healthy. However, many adolescents have reported unmet health care needs or guidance from health care providers. The purpose of this study was to determine the prevalence of provider anticipatory guidance reported by adolescents in rural Appalachia. The study participants were aged 16 to 19 years and a total of 762 participants in rural Appalachia were recruited from the 2016 Adolescent Community Health Survey. Participants were asked to indicate whether a provider asked them about a series of health behaviors in a 12-month period. Health behaviors included healthy eating/diet, physical activity, school performance/grades, friends, emotions, feeling sad, suicide, chewing tobacco, drug use, use of steroids, risks of drinking, smoking, and the importance of wearing seatbelts whilst driving. Descriptive statistics were conducted using SAS 9.4. Of the 762 study participants, 53.4% were females. Less than 30% of the study participants reported a doctor had talked to them about their weight/ healthy eating in the last 12 months. In the last 12 months,18.3% reported a doctor had talked to them about suicide, 26.4% reported a doctor had talked to them about their moods and emotions. Less than 25% reported a doctor had talked to them about drug use and 22.31% reported a doctor had talked to them about wearing a seat belt while driving in the last 12 months. Adolescents are in need of anticipatory guidance from health care providers. Our studies reveal more than 70% of adolescents report not receiving anticipatory guidance in several areas including drug use, chewing tobacco, use of steroid pills or shots without a doctor’s prescription, weight, school performance, healthy eating/diet, suicide, their emotions and the importance of wearing a seatbelt whilst driving. The prevalence of anticipatory guidance as reported by these adolescents in Appalachia is low. Therefore, there is a need to create awareness amongst healthcare providers such as physicians, nurses, psychologists, etc. to ensure that whilst they treat medical illnesses, they also talk to young adolescents about risky behaviors. This awareness will go a long way in mitigating adolescent risky behaviors. This study also has implications that drive policy decision-making.

No description available.