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Wearing them takes me back there: The wearing of face coverings following an experience of trauma and the use of grounding techniques to alleviate distress during the COVID-19 pandemic

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Designed for users of services and professionals alike, this article is relevant within health and care settings across all sectors where it is only just beginning to be acknowledged that for many, particularly those with experiences of interpersonal trauma, difficulties can arise due to the use of face coverings. Through the introduction of the window of tolerance, this co-produced article from four authors spanning service user involvement, third sector provision, secondary mental health and research provides a practical means of alleviating the trauma reaction through the sharing of skills in the form of grounding techniques, all carefully developed and practiced by the author’s themselves.
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Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19 and is spread person-to-person through close contact. We aimed to investigate the effects of physical distance, face masks, and eye protection on virus transmission in health-care and non-health-care (eg, community) settings. Methods We did a systematic review and meta-analysis to investigate the optimum distance for avoiding person-to-person virus transmission and to assess the use of face masks and eye protection to prevent transmission of viruses. We obtained data for SARS-CoV-2 and the betacoronaviruses that cause severe acute respiratory syndrome, and Middle East respiratory syndrome from 21 standard WHO-specific and COVID-19-specific sources. We searched these data sources from database inception to May 3, 2020, with no restriction by language, for comparative studies and for contextual factors of acceptability, feasibility, resource use, and equity. We screened records, extracted data, and assessed risk of bias in duplicate. We did frequentist and Bayesian meta-analyses and random-effects meta-regressions. We rated the certainty of evidence according to Cochrane methods and the GRADE approach. This study is registered with PROSPERO, CRD42020177047. Findings Our search identified 172 observational studies across 16 countries and six continents, with no randomised controlled trials and 44 relevant comparative studies in health-care and non-health-care settings (n=25 697 patients). Transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m (n=10 736, pooled adjusted odds ratio [aOR] 0·18, 95% CI 0·09 to 0·38; risk difference [RD] −10·2%, 95% CI −11·5 to −7·5; moderate certainty); protection was increased as distance was lengthened (change in relative risk [RR] 2·02 per m; pinteraction=0·041; moderate certainty). Face mask use could result in a large reduction in risk of infection (n=2647; aOR 0·15, 95% CI 0·07 to 0·34, RD −14·3%, −15·9 to −10·7; low certainty), with stronger associations with N95 or similar respirators compared with disposable surgical masks or similar (eg, reusable 12–16-layer cotton masks; pinteraction=0·090; posterior probability >95%, low certainty). Eye protection also was associated with less infection (n=3713; aOR 0·22, 95% CI 0·12 to 0·39, RD −10·6%, 95% CI −12·5 to −7·7; low certainty). Unadjusted studies and subgroup and sensitivity analyses showed similar findings. Interpretation The findings of this systematic review and meta-analysis support physical distancing of 1 m or more and provide quantitative estimates for models and contact tracing to inform policy. Optimum use of face masks, respirators, and eye protection in public and health-care settings should be informed by these findings and contextual factors. Robust randomised trials are needed to better inform the evidence for these interventions, but this systematic appraisal of currently best available evidence might inform interim guidance. Funding World Health Organization.
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In this article, we attempt to bridge the gap between practice (service delivery) and philosophy (trauma theory, empowerment, and relational theory). Specifically, we identify 10 principles that define trauma-informed service, discuss the need for this type of service, and give some characteristics of trauma-informed services in eight different human service areas. The areas include outreach and engagement, screening and assessment, resource coordination and advocacy, crisis intervention, mental health and substance abuse services, trauma-specific services, parenting support, and healthcare. We draw upon the experiences of the nine sites involved in the Substance Abuse and Mental Health Service Administration's (SAMHSA) 5-year grant project, Women, Co-occurring Disorders and Violence Study (WCDVS), and include the recommendation that consumers be integrated into the design and evaluation of services. © 2005 Wiley Periodicals, Inc. J Comm Psychol 33: 461–477, 2005.
Presents an integrative framework for understanding the interface of the brain and the social environment through childhood, adolescence, and adulthood. The author addresses fundamental questions about mental health and dysfunction as he explores the ways that interpersonal relationships influence the genetically programmed unfolding of the human mind. The volume synthesizes current knowledge from independent, usually isolated areas of research, including attachment, memory, emotion, neuroscience, genetics, and psychopathology. The chapters focus on how specific mental processes and cognitive abilities are fueled by emotional relationships throughout life. When attachment to caregivers is hindered or disrupted specific problems with memory, self-organization, and emotional regulation may result. Implications for adult states of mind, emotional competence, and relationship skills are considered, as well as links to such clinical problems as dissociation and depression. The book is intended to serve as a text for courses in psychiatry, clinical and developmental psychology, neuropsychology, and cognitive science. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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