Trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder, and psychiatric comorbidity among people with anaphylactic shock experience

Objectives: This study investigated the interrelationship between trauma exposure characteristics, past traumatic life events, coping strategies, posttraumatic stress disorder (PTSD) symptoms, and psychiatric comorbidity among people after anaphylactic shock experience. Method: The design was cross-sectional in that 94 people with anaphylactic shock experience responded to a postal survey. They completed the Posttraumatic Stress Disorder Checklist, the General Health Questionnaire 28, and the COPE Scale. They also answered questions on trauma exposure characteristics. The control group comprised 83 people without anaphylaxis. Results: Twelve percent of people with anaphylactic shock experience fulfilled the diagnostic criteria for full PTSD. As a group, people with anaphylaxis reported significantly more past traumatic life events and psychiatric comorbidity than did the control. Partial least squares analysis showed that trauma exposure characteristics influenced postanaphylactic shock PTSD symptoms and psychiatric comorbidity, which, in turn, influenced coping strategies. Conclusions: People could develop PTSD and psychiatric comorbidity symptoms after their experience of anaphylactic shock. The way they coped with anaphylactic shock was affected by the severity of these symptoms. Past traumatic life events had a limited role to play in influencing outcomes. © 2011 Elsevier Inc. All rights reserved

Origins, Destinations and Catchments: Mapping travel to work in Ireland in 2002

Over recent years there has emerged an increased awareness of the importance of strategic spatial planning and of the extent to which concepts such as place and space really matter. An enhanced understanding of the geography of living and of the economy requires not only a knowledge of where people and objects are but also of how those places relate to one another. This requires fundamentally sound data on movement patterns, of which the most important is probably the daily journey to work (Horner, 1999). In this paper we explore for the first time several aspects of the journey to work using data from the CSO 2002 Census of Population (CSO 2003a, CSO 2003b. CSO 2004a). While the approach at this stage is mainly descriptive supported by detailed mapping it is timely and it will hopefully contribute to discussion in a number of areas of public policy. These include the estimation of regional per capita levels of output (per capita GVA), the extent of the catchment areas of the National Spatial Strategy Gateways and hubs, the environmental sustainability of new trip patterns, and the impact of longer and more stressful journey times on quality of life

Origins, Destinations and Catchments: Mapping travel to work in Ireland in 2002

Over recent years there has emerged an increased awareness of the importance of strategic spatial planning and of the extent to which concepts such as place and space really matter. An enhanced understanding of the geography of living and of the economy requires not only a knowledge of where people and objects are but also of how those places relate to one another. This requires fundamentally sound data on movement patterns, of which the most important is probably the daily journey to work (Horner, 1999). In this paper we explore for the first time several aspects of the journey to work using data from the CSO 2002 Census of Population (CSO 2003a, CSO 2003b. CSO 2004a). While the approach at this stage is mainly descriptive supported by detailed mapping it is timely and it will hopefully contribute to discussion in a number of areas of public policy. These include the estimation of regional per capita levels of output (per capita GVA), the extent of the catchment areas of the National Spatial Strategy Gateways and hubs, the environmental sustainability of new trip patterns, and the impact of longer and more stressful journey times on quality of life

What are the mechanisms and contexts by which care groups achieve social and behavioural change in low- and middle-income countries? Group motivation findings from a realist synthesis

Infant and under-five mortality rates in low- and middle-income countries (LMIC) can be reduced by encouraging behaviours such as sleeping under insecticide-treated bed nets, exclusive breast-feeding for the first 6 months, regular handwashing, etc. Community-based volunteer or peer-to-peer mechanisms are cost-effective ways of promoting these lifesaving practices. However, the sustainability and reach of community-based behaviour change promotion remains a challenge. Our inquiry focuses on the utilisation, by non-governmental organisations (NGO), of Care Groups, a peer-to-peer behaviour change intervention. We asked: What are the mechanisms and contexts by which Care Groups achieve social and behavioural change in nutrition, health and other sectors? Design: Realist synthesis reviewing forty-two texts that contained empirical evidence about Care Group interventions. Setting: LMIC. Participants: We held consultations with a research reference group, which included Care Group and nutrition experts, and Care Group – implementing NGO staff in Malawi. Results: Different types of motivation drive the establishment and the sustainability of peer group interventions. A certain amount of motivation was derived from the resources provided by the NGO establishing the Care Groups. Subsequently, both volunteers and neighbourhood group members were motivated by the group dynamics and mutual support, as well as support from the wider community. Finally, volunteers and group members alike became self-motivated by their experience of being involved in group activities. Conclusions: When designing and implementing community-based behaviour change interventions, awareness of the multi-directional nature of the motivating drivers that are experienced by peer- or community group members is important, to optimise these groups’ reach and sustainability

Exploring how and why care groups work to improve infant feeding practices in low and middle-income countries: a realist review protocol

Background: Within our inquiry into the implementation of breastfeeding policy in Malawi, Care Groups have been mentioned as a means to improve maternal and child health and nutrition outcomes. The ‘Care Group model’ is an approach primarily used in international development settings, whereby social and behaviour changes are promoted through supported peer-to-peer (mostly mother-to-mother) knowledge sharing. The aim of most Care Groups is to promote improved infant nutrition, improve hygiene and increase the number of children who are fully vaccinated and exclusively breastfed for the first 6 months. The behavioural changes promoted by Care Groups (such as safe infant feeding, frequent hand washing, consistent mosquito net usage, providing suitable complementary foods from 6 months old) have the potential of averting preventable deaths particularly among children under five. While a variety of approaches are used to promote improved health and nutrition for children under five, the Care Groups model was best known and frequently referenced during our discussions with key stakeholders regarding the delivery at community level of Malawi’s National Multi-Sector Nutrition Policy 2018-2022. A better understanding of how Care Groups achieve their social and behaviour change results and how community-based efforts are sustained can potentially help to ensure more effective planning and budgeting for Care Group interventions and enable greater sustainability and increased coverage of infant feeding support countrywide. This realist review is designed to improve our understanding of how, why, to what extent and under what circumstances Care Groups improve infant feeding practices in low- and middle-income countries (LMICs). Methods and analysis: A realist review is a theory-driven approach to evidence synthesis. To undertake this realist review, we will gather evidence by conducting peer-reviewed and grey literature database searches in order to find peer reviewed articles, programme guidelines and evaluation reports, among other texts, associated with the implementation of Care Groups in low- and middle-income countries. Our review process has five key steps: (1) locating existing theories; (2) searching for evidence in literature; (3) selecting articles and other suitable evidence; (4) extracting data, identifying configurations of context-mechanism-outcomes; and (5) synthesising the evidence, drawing conclusions Discussion: The results of this realist review will be written up according to RAMESES guidelines and disseminated through a stakeholder workshop in Malawi, through conference presentations and peer-reviewed publications. It is intended to improve the understanding of the potential and limits of working through Care Groups globally and among relevant Malawi Ministry of Health staff and the donor and NGO community, both internationally and within Malawi. This systematic review protocol has been submitted for registration on the PROSPERO database (receipt number: 170261)

Findings from the first phase of developing a receptive vocabulary test for the Irish language

Aims and objectives: The aim of this study was to develop and pilot a test of receptive vocabulary for bilingual Irish-English-speaking children, based on a model from Welsh. Design/Methodology/Approach: 310 typically developing children aged five, six and seven years took part. The children were all attending Irish-medium education in Irish-dominant Gaeltacht regions and in immersion education schools outside of these regions. Data and Analysis: Participants were identified as being from either bilingual Irish- and English-speaking homes or English-dominant homes. A mixed-factorial analysis of variance found a significant main effect of age and language background, but no interaction. Post hoc comparisons revealed that those from Bilingual-speaking homes had significantly higher Irish receptive vocabulary scores than those from English-dominant homes. Linear regression models showed that the receptive vocabulary scores of children in immersion schools grew by an average of 21 words per year between the ages of five and seven, compared to almost 12 words per year in Gaeltacht schools. Findings/Conclusions: The findings demonstrate the advantages of immersion education and the need for vocabulary enrichment of children in the Gaeltacht. However, the complexities of developing assessments for first language speakers of a minority language that is in conflict with a second language variety of that language and the majority English language are also highlighted. Significance/Implications: The implications of this study are that immersion schooling is advantageous to the Irish vocabulary of children, but that children from Gaeltacht schools may require vocabulary enrichment that is sufficiently complex to address their needs. Limitations: Limitations to this study include the uneven number of children from each language background/school location and incomplete background details from the children, such as socio-economic status and language use amongst peers

Expression of endogenous Mkp1 in 6-OHDA rat models of Parkinson's disease.

We have previously demonstrated that mitogen-activated protein kinase phosphatase 1, Mkp1, is expressed in the developing and rat adult substantia nigra and striatum, where it promotes the growth of nigral dopaminergic neurons. Mkp1 may therefore have therapeutic potential for Parkinson's disease. In the present study, we have assessed the expression of Mkp1 and TH in the substantia nigra and striatum of parkinsonian rat models. Expression was measured at 4 and 10 days post-lesion in the 6-hydroxydopamine (6-OHDA) medial forebrain bundle lesion model and after 4, 10 and 28 days in the 6-OHDA striatal lesion model. Our results show that Mkp1 expression was transiently up-regulated in the substantia nigra at 4 days post-6-OHDA administration in the two models while TH expression was decreased at the later time-points examined. These data suggest that Mkp1 may play a role in counteracting the neurotoxic effects of 6-OHDA in nigral dopaminergic neurons

Exploring community-based participatory research for household and ambient air pollution projects: insights from key informants

Background: Despite the extensive use of community-based participatory research (CBPR) in health-related projects, there is limited work on how CBPR processes result in outcomes, especially in household and ambient air pollution (HAAP) research. This study explores the reflections of key informants on factors that shape the implementation and outcomes of CBPR in HAAP projects. Methods: We conducted semi-structured interviews with 13 key stakeholders, including academic researchers, non-governmental organisation administrators, a policymaker, and community members. All interviewees have experience in CBPR projects. Interviews were analysed using framework analysis, and findings were mapped to Wallerstein et al.’s CBPR conceptual model, which consists of four constructs: context, partnership processes, intervention and research, and outcomes. Results: The findings are described under two main categories: ‘barriers to participation’ and ‘good practices for effective CBPR design and implementation’. Relevant sub-categories were barriers at the structural, research, community, and individual levels. Suggestions for good practices included respect, cultural humility, trust, effective communication, suitable and affordable interventions such as improved cookstoves, appropriate participatory research tools, and gratuity for the community’s time. Conclusion: Key informants’ perspectives identified factors supported by the CBPR model to inform the design and implementation of the CBPR approach. The add-ons to some of the model’s factors, such as intra-community dynamics, give value to the informants’ knowledge to support community-research partnerships and improve outcomes in HAAP intervention projects. Addressing these factors at the design stage and reporting CBPR evaluation could deepen the understanding of community-research partnerships

Using mixed methods and community participation to explore household and ambient air pollution practices in a rural community in Malawi

Aim: Globally, household and ambient air pollution (HAAP) accounts for almost 7 million premature deaths each year. Over half of these are from incomplete biomass fuel combustion in open fires and inefficient cookstoves. Solutions to the problem remain challenging due to cost, people’s perception of pollution, and unsuitability tomeet user needs.Subjects and Methods: We used mixed methods and participatory approaches to measure and understand practices and beliefs relating to HAAP in a low-resource community in Malawi. Eighty-six households were randomly sampled for the survey, fine particulate matter (PM2·5) levels were measured in 46 kitchens and four ambient locations, and 38 households were engaged during participatory transect walks. We analysed the data using descriptive and thematic analysis.Results: Kitchen PM2·5 levels far exceeded the World Health Organization’s recommended safe levels. Open-burning practices further contributed to ambient air pollution in the community. While there was high awareness of smoke in cooking areas, participants did not associate it with adverse health outcomes. Availability and affordability of cleaner alternatives influenced household energy choices. Integrating participatory methods alongside quantitative data allowed an in-depth understanding of the community’s practices and relationship with HAAP.Conclusion: The findings demonstrate that energy poverty is a key factor in access to clean energy sources and highlight the importance of engaging communities to design HAAP interventions that meet their physical, socioeconomic, and cultural needs