Safety Learning Research Articles

BDNF haploinsufficiency induces behavioral endophenotypes of schizophrenia in male mice that are rescued by enriched environment

Brain-derived neurotrophic factor (BDNF) is implicated in a number of processes that are crucial for healthy functioning of the brain. Schizophrenia is associated with low BDNF levels in the brain and blood, however, not much is known about BDNF’s role in the different symptoms of schizophrenia. Here, we used BDNF-haploinsufficient (BDNF+/−) mice to investigate the role of BDNF in different mouse behavioral endophenotypes of schizophrenia. Furthermore, we assessed if an enriched environment can prevent the observed changes. In this study, male mature adult wild-type and BDNF+/− mice were tested in mouse paradigms for cognitive flexibility (attentional set shifting), sensorimotor gating (prepulse inhibition), and associative emotional learning (safety and fear conditioning). Before these tests, half of the mice had a 2-month exposure to an enriched environment, including running wheels. After the tests, BDNF brain levels were quantified. BDNF+/− mice had general deficits in the attentional set-shifting task, increased startle magnitudes, and prepulse inhibition deficits. Contextual fear learning was not affected but safety learning was absent. Enriched environment housing completely prevented the observed behavioral deficits in BDNF+/− mice. Notably, the behavioral performance of the mice was negatively correlated with BDNF protein levels. These novel findings strongly suggest that decreased BDNF levels are associated with several behavioral endophenotypes of schizophrenia. Furthermore, an enriched environment increases BDNF protein to wild-type levels and is thereby able to rescue these behavioral endophenotypes.

Pursuing Excellence: Integrating Clinical Learning Environment Staff and Learners Into the Pursuit of Quality, Safety, Equity, and Value

<i>Pursuing Excellence</i>: Integrating Clinical Learning Environment Staff and Learners Into the Pursuit of Quality, Safety, Equity, and Value

The importance of safety learning to increase student awareness when working in laboratories in vocational education institutions

Laboratory is the most important instrument in vocational education. That is a place where student working in vocational education institution. Therefore, big attention for safety aspect becomes the priority. Students practiced under the risk. Thus, they needs safety and healthy in working environment, especially in laboratory. The identification of potential hazards and risks must be done in Laboratory. This study have assessed 5 of potential hazards and risks in Politeknik Negeri Medan laboratory by Likert Scale. This object was divided into 2 assessment, namely likelihood of hazards and severity of consequences. The data are collected based on questionnaire results that involving 100 students with random academic level. The result shows that the highest state is chemical hazards, which accounted for 73.2% in likelihood of hazards, meanwhile electrical hazards contributed of 85% in severity of consequences. These condition are classified as “high” state. The specific attention must be given to “high” state. The action plan table giving an information literacy to help us for determining mitigate action.

Prototyping and Usability Evaluation of Road Safety Education Courseware for Primary Schools in Malaysia

&lt;p&gt;The increasing number of road accidents and deaths among children in Malaysia is a concern. One of the main causes stems from lack of knowledge and skills in dealing with the complexity and condition of the road system. Recognizing the significance of road safety among students, road safety education has been introduced to primary schoolsby the Ministry of Education in 2008. Initially it was blended into the Malay language subject with the goal to equip the children withthe knowledge and skills about road safety.However, road safety teaching and learning still uses the conventional methods without the use of specialized tools. This paper introduces ROSE courseware, a specialized learning tool developed to meet the needs of the Malaysian primary school curriculum for road safety education. Its learning environment is a blend of virtual reality, augmented reality and interactive multimedia, which enables children to understand and acquire skills related to road safety through interactive, real-time and immersive learning tool. In order to receive the children’s feedbacks pertaining to their experience in interacting with the ROSE courseware, a usability evaluation was conducted. The results show that the children strongly agreed on the usefulness, information quality and interface quality of the ROSE courseware.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

Manipulation of rapid eye movement sleep via orexin and GABAA receptor modulators differentially affects fear extinction in mice: effect of stable versus disrupted circadian rhythm.

Sleep disruption, and especially rapid eye movement (REM) sleep disruption, is associated with fear inhibition impairment in animals and humans. The REM sleep-fear inhibition relationship raises concern for individuals with posttraumatic stress disorder (PTSD), whose sleep disturbance is commonly treated with hypnotics that disrupt and/or decrease REM sleep, such as benzodiazepines or "Z-drugs." Here, we examined the effects of the Z-drug zolpidem, a gamma-aminobutyric acidA (GABAA) receptor positive allosteric modulator, as well as suvorexant, an orexin receptor antagonist (hypnotics which decrease and increase REM sleep, respectively) in the context of circadian disruption in murine models of fear inhibition-related processes (i.e. fear extinction and safety learning). Adult male C57Bl/6J mice completed fear and safety conditioning before undergoing shifts in the light-dark (LD) cycle or maintaining a consistent LD schedule. Fear extinction and recall of conditioned safety were thereafter tested daily. Immediately prior to the onset of the light phase between testing sessions, mice were treated with zolpidem, suvorexant, or vehicle (methylcellulose). Polysomnographic analyses showed the temporal distribution of REM sleep was misaligned during LD cycle-shifts, while REM sleep duration was preserved. Suvorexant increased REM sleep and improved fear extinction rate, relative to zolpidem, which decreased REM sleep. Survival analysis demonstrated LD shifted mice treated with suvorexant were faster to achieve complete extinction than vehicle and zolpidem-treated mice in the LD shifted condition. By contrast, retention of conditioned safety memory was not influenced by either treatment. This study thus provides preclinical evidence for the potential clinical utility of hypnotics which increase REM sleep for fear extinction after PTSD-relevant sleep disturbance.

Intranasal oxytocin compensates for estrus cycle-specific reduction of conditioned safety memory in rats: Implications for psychiatric disorders

Stress and anxiety disorder patients frequently fail to benefit from psychotherapies which often consist of inhibitory fear learning paradigms. One option to improve the therapy outcome is medication-enhanced psychotherapy. Research in humans and laboratory rodents has demonstrated that oxytocin (OT) reduces fear and facilitates fear extinction. However, the role of OT in conditioned safety learning, an understudied but highly suitable type of inhibitory fear learning, remains to be investigated. The present study aimed at investigating the effect of intranasal OT on conditioned safety. To test this, Sprague Dawley rats (♂n = 57; ♀n = 72) were safety conditioned. The effects of pre-training or pre-testing intranasal OT on conditioned safety and contextual fear, both measured by the acoustic startle response, and on corticosterone plasma levels were assessed. Furthermore, the involvement of the estrous cycle was analyzed. The present data show that intranasal OT administration before the acquisition or recall sessions enhanced conditioned safety memory in female rats while OT had no effects in male rats. Further analysis of the estrus cycle revealed that vehicle-treated female rats in the metestrus showed reduced safety memory which was compensated by OT-treatment. Moreover, all vehicle-treated rats, regardless of sex, expressed robust contextual fear following conditioning. Intranasal OT-treated rats showed a decrease in contextual fear, along with reduced plasma corticosterone levels. The present data demonstrate that intranasal OT has the capacity to compensate deficits in safety learning, along with a reduction in contextual fear and corticosterone levels. Therefore, add-on treatment with intranasal OT could optimize the therapy of anxiety disorders.

The Correlation Between Safety Climate With Unsafe Act In Apartment Building Construction Workers Pt. Multikon 2020

Construction is one of the highest industries in contributing to work accident rates. Unsafe act is the cause of 73% of work accidents. One way to prevent unsafe act is through safe behavior implemented by management and workers themselves. This study aims to determine the correlation between the safety climate with unsafe act. This research uses quantitative analytic methods with cross sectional design study. Data was analyzed using chi-square with a sample of 88 people selected by purposive sampling method. The results showed that the proportion of respondents who frequently perform unsafe acts was 33%. In bivariate analysis showed there were a relevant relationship between the dimensions of management safety empowerment (OR 2.455; 95% CI 1.06-5.87), worker’s safety priority and risk non-acceptance (OR 2.679; 95% CI 1.05- 6,83) and the dimensions of safety communication, learning and trust in co-worker’s safety competence (OR 2,500; 95% CI 1.05-5.91) with unsafe act. Workers who have a good perception of a safety climate rarely take unsafe actions.

The Use of Augmented Reality to Build Occupational Health and Safety (OHS) Learning Media

Occupation Health and Safety (OHS) has a purpose to ensure a safe and healthy work environment. Occupation health and safety must be apllied by an industry that have potential hazards arising from the production process carried out. The potential hazards include work accident such as explosion, fire, pollution, and disease. The technological development brought us to the next level of invention. One of the invention that found in 21st century is Augmented Reality. Augmented Reality is an revolutionaty invention which combines virtual object into reality environment. Augmented Reality widely used as a learning media, promotional tools, and for some special purpose. Augmented Reality can be use in desktop, mobile device, and wearable technology. The purpose of this research is to build Occupational Health and Safety learning media based on Augmented Reality. The learning media will be made mobile based with android devices. The method of software development using the waterfall method. The output of this research is marker card that can display objects in the form of images about Occupation Health and Safety. Images will reveal if card scanned using android mobile device that has the Augmented Reality application installed.

Lateral Habenula Mediates Defensive Responses Only When Threat and Safety Memories Are in Conflict.

Survival depends on the ability to adaptively react or execute actions based on previous aversive salient experiences. Although lateral habenula (LHb) activity has been broadly implicated in the regulation of aversively motivated responses, it is not clear under which conditions this brain structure is necessary to regulate defensive responses to a threat. To address this issue, we combined pharmacological inactivations with behavioral tasks that involve aversive and appetitive events and evaluated defensive responses in rats. We found that LHb pharmacological inactivation did not affect cued threat conditioning (fear) and extinction (safety) learning and memory, anxiety-like or reward-seeking behaviors. Surprisingly, we found that LHb inactivation abolished reactive defensive responses (tone-elicited freezing) only when threat (conditioning) and safety memories (extinction and latent inhibition) compete during retrieval. Consistently, we found that LHb inactivation impaired active defensive responses [platform-mediated avoidance (PMA)], thereby biasing choice behavior (between avoiding a threat or approaching food) toward reward-seeking responses. Together, our findings suggest that LHb activity mediates defensive responses only when guided by competing threat and safety memories, consequently revealing a previously uncharacterized role for LHb in experience-dependent emotional conflict.

Learning the lessons from patient safety incidents.

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some key reports and sources of information that can help inform patient safety teaching and learning.

Reappraising fear: is up-regulation more efficient than down-regulation?

Catastrophizing thoughts may contribute to the development of anxiety, but functional emotion regulation may help to improve treatment. No study so far directly compared up- and down-regulation of fear by cognitive reappraisal. Here, healthy individuals took part in a cued fear experiment, in which multiple pictures of faces were paired twice with an unpleasant scream or presented as safety stimuli. Participants (N = 47) were asked (within-subjects) to down-regulate, to up-regulate and to maintain their natural emotional response. Valence and arousal ratings indicated successful up- and down-regulation of the emotional experience, while heart rate and pupil dilation increased during up-regulation, but showed no reduction in down-regulation. State and trait anxiety correlated with evaluations of safety but not threat stimuli, which supports the role of deficient safety learning in anxiety. Reappraisal did not modulate this effect. In conclusion, this study reveals evidence for up-regulation effects in fear, which might be even more efficient than down-regulation on a physiological level and highlights the importance of catastrophizing thoughts for the maintenance of fear and anxiety.

Student perceptions of school safety and student learning outcomes in a context of protracted conflict

In this study, we analyze quantitative survey and assessment data on 712 students in northeast Nigeria to examine, first, which students feel safe in school in a region experiencing protracted conflict, and second, how perceived safety was associated with literacy. Students with vision and hearing disabilities were less likely than other children to perceive themselves as safe at school. Children with these disabilities who felt unsafe performed nearly 0.8 standard deviations below other students, while students with disabilities who felt safe performed only slightly below others. We found no association between length of conflict-related school closures and literacy outcomes.

Subsequent memory effects on event-related potentials in associative fear learning.

Studies of human fear learning suggest that a reliable discrimination between safe and threatening stimuli is important for survival and mental health. In the current study, we applied the subsequent memory paradigm in order to identify neurophysiological correlates of successful threat and safety learning. We recorded event-related potentials, while participants incidentally learned associations between multiple neutral faces and an aversive outcome [unconditioned stimulus (US)/conditioned stimulus (CS)+] or no outcome (noUS/CS−). We found that an enhanced late positive potential (LPP) to both CS+ and CS− during learning predicted subsequent memory. A quadratic relationship between LPP and confidence in memory indicates a possible role in both correct and false fear memory. Importantly, the P300 to the omission of the US (following CS−) was enhanced for remembered CS−, while there was a positive correlation between P300 amplitude to both US occurrence and omission and individual memory performance. A following re-exposure phase indicated that memory was indeed related to subjective fear of the CS+/CS−. These results highlight the importance of cognitive resource allocation to both threat and safety for the acquisition of fear and suggest a potential role of the P300 to US omission as an electrophysiological marker of successful safety learning.

737 Risk factors for acute care utilization in the 90 days following childbirth

One third of maternal deaths in the United States occur more than 7 days after delivery; improving the continuum of maternal care is therefore essential. As part of our institution's Postnatal Patient Safety Learning Lab, we sought to identify characteristics of birthing parents who utilized acute care, defined as emergency department, obstetric triage or readmission to inpatient care, following maternity discharge. We conducted a retrospective cohort study among individuals who gave birth at a gestational age > 23 weeks between January 1, 2018 and June 30, 2019 at a southeastern quaternary care hospital. We retrieved health utilization data from our institution’s electronic health record system through 90 days postpartum. Comorbidities were identified using billed diagnosis codes. We used chi-square tests and multivariable logistic regression to identify characteristics associated with acute care utilization (ACU). P values <0.05 were considered statistically significant. During the study period, there were 5845 eligible birthing parents and 983 ACU encounters, half of which occurred in the first 14 days after birth. A total of 696 (11.9%) women had at least one ACU event: 340 (5.8%) were seen in the emergency department but not admitted, 168 (2.9%) were readmitted, and 290 (5.0%) were seen in OB triage. Maternal factors associated with ACU in bivariate analyses included younger age, public insurance, race/ethnicity, pregravid body mass index > 30 kg/m2, cesarean birth, preterm birth, and pre-gestational diabetes or hypertension. In multivariable logistic regression, associations were similar (Table). Mothers classified as Asian, Hispanic and other Race/Ethnicity had lower odds of ACU compared with non-Hispanic White or Black mothers. Postpartum ACU is concentrated in the first 14 days after birth and clinical characteristics identify those at risk. Targeted, multi-level strategies have the potential to reduce the need for acute care and promote maternal safety and wellbeing through the 4th Trimester and beyond.

Identifying the \u201cActive Ingredients\u201d of a School-Based, Workplace Safety and Health Training Intervention

Young workers in many industrialized countries experience a higher rate of largely preventable occupation-related injuries compared with adults. Safety education and training are considered critical to the prevention of these incidents. This can be promoted by the dissemination and scale-out of an evidence-based, safety training programs in vocational education. The aim of this study was to identify the intervention core components that comprise the “active ingredients” of a safety training intervention for young workers and assess the impact on student outcomes of interest. Fidelity of implementation was operationalized using measures of adherence and quality of intervention delivery. For this study, data were collected through a school-based, cluster randomized trial conducted in 2015 in eight Finnish upper secondary-level vocational schools (n = 229 students in 22 groups, each with one teacher). Results indicate that the intervention core components (safety skills training, safety inoculation training, a positive atmosphere for safety learning, and active learning techniques) had differing associations with student outcomes. Adherence related to the acquisition of safety skills training was the strongest active ingredient in terms of positive effects. Furthermore, quality of delivery in terms of fostering positive learning atmosphere and utilizing active learning methods was associated especially with motivational outcomes. These findings indicate that different active ingredients complemented each other. Contrary to expectations, we found no statistically significant relationship between any of the core components and risk-taking attitudes. The current study advances prevention science by identifying the active ingredients of an evidence-based intervention, implemented in Finnish vocational school settings, that helps protect young workers from work-related morbidity and mortality.

Latent class growth analyses reveal overrepresentation of dysfunctional fear conditioning trajectories in patients with anxiety-related disorders compared to controls

Recent meta-analyses indicated differences in fear acquisition and extinction between patients with anxiety-related disorders and comparison subjects. However, these effects are small and may hold for only a subsample of patients. To investigate individual trajectories in fear acquisition and extinction across patients with anxiety-related disorders (N = 104; before treatment) and comparison subjects (N = 93), data from a previous study (Duits et al., 2017) were re-analyzed using data-driven latent class growth analyses. In this explorative study, subjective fear ratings, shock expectancy ratings and startle responses were used as outcome measures. Fear and expectancy ratings, but not startle data, yielded distinct fear conditioning trajectories across participants. Patients were, compared to controls, overrepresented in two distinct dysfunctional fear conditioning trajectories: impaired safety learning and poor fear extinction to danger cues. The profiling of individual patterns allowed to determine that whereas a subset of patients showed trajectories of dysfunctional fear conditioning, a significant proportion of patients (≥50 %) did not. The strength of trajectory analyses as opposed to group analyses is that it allows the identification of individuals with dysfunctional fear conditioning. Results suggested that dysfunctional fear learning may also be associated with poor treatment outcome, but further research in larger samples is needed to address this question.

The role of p21-activated kinase in maintaining the fear learning-induced modulation of excitation/inhibition ratio in lateral amygdala

We study the relations between different learning paradigms and enduring changes in excitatory synaptic transmission. Here we show that auditory fear conditioning (AFC), but not olfactory fear conditioning (OFC) training, led to enduring enhancement in AMPA-mediated miniature EPSCs (mEPSCs). Moreover, olfactory unpaired training led to a stable significant reduction in excitatory synaptic transmission. However, olfactory discrimination learning (OD) did not modulate postsynaptic AMPA-mediated mEPSCs in LA. The p21-activated kinase (PAK) activity, previously shown to have a key role in maintaining persistent long-lasting enhancement in synaptic inhibition after OFC, has an opposing effect on excitatory synaptic transmission. PAK maintained the level of excitatory synaptic transmission in the amygdala in all experimental groups, except in neurons in the OFC trained rats. PAK also maintained excitatory synaptic transmission in all neurons of auditory fear conditioning and naïve training groups except in neurons of the auditory safety learning. Safety learning was previously shown in our study to enhance synaptic inhibition. We thus suggest that PAK maintains inhibitory synaptic transmission in a learning-dependent manner and on the other hand affects excitatory synaptic transmission only in groups where learning has not affected inhibitory transmission. Thus, PAK controls learning-induced changes in the excitation/inhibition balance.

Effect of Tryptophan Depletion on Conditioned Threat Memory Expression: Role of Intolerance of Uncertainty

BackgroundResponding emotionally to danger is critical for survival. Normal functioning also requires flexible alteration of emotional responses when a threat becomes safe. Aberrant threat and safety learning occur in many psychiatric disorders, including posttraumatic stress disorder, obsessive-compulsive disorder, and schizophrenia, in which emotional responses can persist pathologically. While there is evidence that threat and safety learning can be modulated by the serotonin systems, there have been few studies in humans. We addressed a critical clinically relevant question: How does lowering serotonin affect memory retention of conditioned threat and safety memory? MethodsForty-seven healthy participants underwent conditioning to two stimuli predictive of threat on day 1. One stimulus but not the other was subsequently presented in an extinction session. Emotional responding was assessed by the skin conductance response. On day 2, we employed acute dietary tryptophan depletion to lower serotonin temporarily, in a double-blind, placebo-controlled, randomized between-groups design. We then tested for the retention of conditioned threat and extinction memory. We also measured self-reported intolerance of uncertainty, known to modulate threat memory expression. ResultsThe expression of emotional memory was attenuated in participants who had undergone tryptophan depletion. Individuals who were more intolerant of uncertainty showed even greater attenuation of emotion following depletion. ConclusionsThese results support the view that serotonin is involved in predicting aversive outcomes and refine our understanding of the role of serotonin in the persistence of emotional responsivity, with implications for individual differences in vulnerability to psychopathology.

Avoidance learning as predictor of posttraumatic stress in firefighters

BackgroundAvoidance is a well-established maintenance factor in anxiety-related psychopathology. Individuals prone to anxiety show more maladaptive avoidance responses in conditioning paradigms aimed at avoidance learning, which indicates impairments in safety learning. To what extent avoidance learning is associated with posttraumatic stress disorder (PTSD) is still unclear, despite the logical relevance to the symptomatology. In this prospective study, we investigate avoidance learning responses in first responders, a population at high risk for traumatic exposure and thus PTSD development, and studied whether avoidance learning was associated with concurrent and future PTSD symptoms. MethodFirefighters (N = 502) performed an avoidance learning task at baseline assessment in which they first learned that two conditioned stimuli (CS+) were followed by an aversive stimulus (US) and one conditioned stimulus (CS-) was not. After that, they could learn to which CS avoidance of the US was effective, ineffective or unnecessary. Self-reported PTSD symptoms were assessed at baseline, and at 6, 12, 18 and 24 months. ResultsParticipants exhibited comparable avoidance patterns to low anxiety individuals from previous studies. Avoidance learning responses were not associated with PTSD symptoms at baseline nor at follow-up. DiscussionOur study found no evidence that avoidance learning was related to PTSD symptom severity in a high-risk, yet low symptomatic population, nor did it predict the development of PTSD symptoms at a later point in time. Future research should focus on studying avoidance learning in a clinical or high symptomatic sample to further clarify the role of avoidance learning in PTSD development.

Absence Makes the Mind Grow Fonder: Reconceptualizing Studies of Safety Learning in Translational Research on Anxiety.

Overgeneralized fear (OGF), or indiscriminate fear responses to signals of threat and nonthreat, is a well-studied cognitive mechanism in human anxiety. Anxiety-related OGF has been studied primarily through fear-learning paradigms and conceptualized as overly exaggerated learning of cues signaling imminent threat. However, the role of safety learning in OGF has not only received much less empirical attention but has been fundamentally conceptualized as learning about the absence of threat rather than the presence of safety. As a result, the relative contributions of exaggerated fear learning and weakened safety learning to anxiety-related OGF remain poorly understood, as do the potentially unique biological and behavioral underpinnings of safety learning. The present review outlines these gaps by, first, summarizing animal and human research on safety learning related to anxiety and OGF. Second, we outline innovations in methods to tease apart unique biological and behavioral contributions of safety learning to OGF. Lastly, we describe clinical and treatment implications of this framework for translational research relevant to human anxiety.