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As bloodstream infections and associated septic shock are common causes of mortality in hospitals, rapid antibiotic susceptibility testing (AST) performed directly on positive blood cultures is needed to implement an efficient therapy in clinical settings. We evaluated the Reveal® rapid AST system on a collection of 197 fully characterized carbapenem-resistant Enterobacterales, including 177 carbapenemase producers (CPE) spiked in blood culture bottles. The clinical categorization based on the Minimal Inhibitory Concentration (MIC) determination of eighteen antimicrobial molecules was compared to the clinical categorization based on the disk diffusion assay as a reference. The Reveal AST system provided results within a mean time to result of 5 h. Overall, the categorical agreement (CA) between the two techniques was 94.1%. The rates of very major errors (VMEs), major errors (MEs) and minor errors (mEs) were 3.8%, 3.7% and 5.6%, respectively. Imipenem was the antimicrobial with the lowest CA rate (78.7%), with rates of 15% VMEs and 10.7% MEs, but the performances were better when considering only the non-CPE category (CA of 89%). On this resistant collection of Enterobacterales with numerous acquired β-lactamases, the Specific Reveal assay proved to be useful for a rapid determination of AST compatible with a quick adaptation of the patient's antimicrobial treatment. [ABSTRACT FROM AUTHOR]

A majority of people from a refugee background endure cumulative traumatic experiences that are compounded by acculturative distress, which disrupts their systems of safety, support, sense of justice, and identity. Literature highlighting the impacts of consistently bearing witness to traumatic experiences and addressing the multiple needs of refugee survivors of trauma is limited. This integrative review is based on a systematic database and citation search in Scopus, PsycINFO, PTSDpubs and PubMed and identified four interrelated themes, as a sequel to refugee trauma work: Being challenged by refugee narratives, Altered beliefs and attitudes, Benefits or rewards, and Coping strategies. The review highlights that extant literature in the field of refugee trauma does not sufficiently capture unique, experiential complexities in the sector. It identifies the need for additional research with methodological rigor and a comprehensive theoretical framework to capture the varied vicarious impacts of working with refugee survivors of trauma. [ABSTRACT FROM AUTHOR]

This meta-study systematically appraises and synthesizes research into athletes' experiences of mental illness. Our critical review of 37 studies conformed to the meta-study structure of meta-theory, meta-method, and meta-data analysis. We also produced a meta-synthesis of findings to deliver new insights into athlete mental illness. Athlete accounts of mental illness pertained to experience of the following: depression, eating disorders, gambling addiction and substance-related disorders (alcohol and drugs). Following a critical interrogation of original articles' theory, method, and findings, we noted a general lack of methodological coherence (congruence between philosophical stance, theoretical position, and methodology). Through the process of a thematic synthesis, we developed 4 new themes: origins of certainty and ambiguity, a gradual sense of decline, mental illness as a threat to identity, and constructing recovery stories. Athletes drew upon dominant illness discourses to construct mental illness and recovery experiences. Our results provide us with an understanding of how mental illness and recovery were experienced within an elite sport involvement. We recommend future research embraces more diverse methodologies and authors ensure a strong alignment between guiding philosophies and methodological approach. [ABSTRACT FROM AUTHOR]

This study investigated whether higher maternal psychological distress, lower provision of psychosocial stimulation and a negative appraisal of parenting experience were associated with lower cognitive, motor, social-emotional and adaptive behaviour development in children under 3 years of age in Kenya. A cross-sectional design was used, with 81 caregiver-child dyads recruited through convenience sampling. The mean age of these infants was 8.5 months (SD = 5.6 months, range 23 days to 25.5 months). Higher maternal psychological distress was associated with lower social-emotional development, but not cognitive, motor and adaptive development of a child. Psychosocial stimulation provided by mothers was not related to any developmental outcomes. Maternal psychological distress and appraisal of parenting experience were significant, unique predictors of child social-emotional development. Findings suggest that interventions designed to promote social-emotional development of young children in Kenya should target maternal mental health and enhance confidence and experience of parenting.

Consistent exposure to refugee narratives of trauma and torture can profoundly impact trauma therapists. This secondary analysis reanalyzed data from a narrative inquiry investigating the lived experiences of refugee trauma therapists. We aimed to explore emergent concerns through an existential lens to enrich understanding and provide additional insights into the lived experiences of these individuals. Participants in this purposive sample (N = 19) were therapists who had provided interventions to refugees for 2–34 years. Narrative construction, theory‐guided data analysis, and memo writing were used to reanalyze data generated by semistructured interviews augmented by photo elicitation. The findings indicate that being forced to reevaluate familiar beliefs consequent to one's professional roles induced intense existential moments, described as "a dark night of the soul," "the paradox of life and death," "uncanny feelings of not being at home," and "a falling." Acknowledging the complexities of the field, an existential framework to assist refugee trauma therapists in metabolizing and living with the professional challenges they encounter instead of focusing on alleviating decontextualized symptoms of distress is recommended. Research to inform requirements of the space to enable refugee trauma therapists to share their concerns and facilitate transitions toward more authentic, nonevasive sense of "being‐in‐the‐world" is suggested. [ABSTRACT FROM AUTHOR]

Refugee narratives of torture and trauma can have profound impacts on refugee trauma workers. This narrative inquiry aimed to explore the lived experiences of the impacts of providing therapeutic interventions to refugees. The purposive sample consisted of 19 therapists who had provided interventions to refugees for at least 1 year. Data generated by semistructured interviews augmented by photo elicitation were analysed utilizing a three phased narrative analysis including narrative construction, analysis of narratives, and narrative configuration. When participants told their unique stories as they interpreted their journeys assisting refugee survivors, two distinct narratives emerged: A narrative of surviving and thriving, and a narrative of striving and yielding. Upon closer examination these narratives generated five interconnected plotlines: Self-transcending, being optimistic, championing, being valiant, and being vanquished. The findings give voice to therapists who have been forced to quit the field despite their commitment and strong desire to continue highlight possible organizational issues and query the dominant binary of trauma versus adversarial growth. To mitigate adverse impacts that acknowledge the need for trauma organizations to accept responsibility to sustain their staff, we recommend the introduction of proactive strategies at a systemic level. Public Significance Statement: This narrative inquiry describes the impacts of working with refugee survivors as a fluid, intersecting continuum between satisfaction of ongoing clinical engagement and incapacity in the clinical field. The study suggests that current strategies to support refugee trauma workers place disproportionate responsibility of managing these impacts on the individual and recommends the need for additional research to inform alternative perspectives at a systemic level. [ABSTRACT FROM AUTHOR]