Perinatal Care for Women from Africa with Refugee Backgrounds: Intersections with Psychological Wellbeing

This item is only available electronically.People with refugee backgrounds face poorer psychological outcomes than general populations post-resettlement. Contributing to these outcomes are post-migration challenges including experiences with healthcare services. These services include perinatal healthcare, which is essential for many refugee women living in Australia; many of whom are from Africa. Positive perinatal healthcare experiences are pivotal for ensuring women’s access to ongoing care and healthy psychological outcomes. However, disparities persist between refugee and non-refugee populations. This review will critically evaluate the evidence regarding African refugee women’s psychological wellbeing following experiences with perinatal healthcare services, and will inform an empirical study in the Australian context.Thesis (M.Psych(Clinical)) -- University of Adelaide, School of Psychology, 202

Understanding Oral Health Help-Seeking: Beliefs, Barriers and Facilitators Among Middle Eastern Refugees and Asylum Seekers

This item is only available electronically.Oral health is a significant health issue with marked inequalities for people of refugee and asylum seeking backgrounds. However, despite evidence of oral health disparities and unequal service access for this population, there is limited research exploring help-seeking behaviours among people with refugee and asylum seeking backgrounds, particularly in Australia. Andersen’s Model of Healthcare Utilisation (1968; 1995) has frequently been employed to explore use of health services, but has not been applied to oral health help-seeking behaviours among this population. To address these research gaps, the aims of this study were to improve understandings of Middle Eastern refugees’ and asylum seekers’ oral health help-seeking behaviours and the barriers and facilitators to their dental service use, and to determine the utility of Andersen’s Model in this context. Semi-structured interviews were conducted with 20 people from Syria, Iran and Afghanistan who had recently arrived as refugees or asylum seekers, and six oral health practitioners with professional experience with this population. Results were analysed using a combination of inductive and deductive thematic analysis, and provided some support for the use of Andersen’s Model in relation to oral health help-seeking for this population, but also identified some limitations with this approach. Results of this study support a revised version of Andersen’s Model, and highlight the need for a tailored approach to understanding oral health help-seeking among peoples with diverse refugee and asylum seeking backgrounds, with greater consideration of the impacts of health and resettlement policies, service experiences and migration experiences on oral health outcomes.Thesis (B.PsychSc(Hons)) -- University of Adelaide, School of Psychology, 201

The physiological changes of circulatory death with respect to organ donation

Donation of organs after circulatory death (DCD) is re-emerging as an important source of organs for transplantation worldwide, and in the United Kingdom DCD donors comprise 39% of all deceased organ donors. However, organs from DCD organ donors work less well after transplantation than those from brainstem dead organ donors. This increased prevalence of initial poor function, despite good performance in the donor prior to death, suggests that changes in donor physiology during the agonal phase, together with the subsequent period of warm ischaemia, may be responsible for the differences seen in organ function. Although donated organs and warm ischaemia have been extensively studied, the physiological changes occurring in the DCD organ donor during the dying process remain poorly understood and ill-defined mechanistically. In this thesis, the physiology of the DCD donor between withdrawal of life supporting treatment and death is examined in detail for the first time in human donors. Extensive public and patient engagement work demonstrate public support for research in the potential organ donor, and this finding is borne out by focus group work. Examination of a cohort of DCD donors demonstrated previously undocumented patterns of physiology, which have significant implications for the function of transplanted organs. A key finding is the lack of concordance between arterial oxygen saturations when measured by pulse oximetry and by arterial blood gas (ABG) analysis. This has demonstrated that saturation assessment by ABG analysis document oxygen saturation being above generally accepted minimal levels for up to 40 minutes longer in donors during the maximum accepted agonal period of 240 minutes. I also present evidence of cardiothoracic organ retrieval decisions based on saturations which have led to potentially transplantable organs being declined. An investigation of markers of anaerobic metabolism in the potential donors who do proceed to DCD revealed correlations between hypotension, oxygen delivery and oxygen extraction ratio, and elevated lactate levels. Further examination of the relationship between oxygen delivery and systolic blood pressure in this cohort demonstrate that blood pressure is conserved in many patients beyond the point at which oxygen delivery falls to critical levels. This finding suggests current organ retrieval decisions based on systolic blood pressure may not be best practice or evidence based. These physiological changes during the agonal period of circulatory death are accompanied by cognate changes in human donor biology that have not previously been documented in DCD donors. These include evidence of sympathetic stimulation (elevated catecholamine levels), activation of the hypothalamic-pituitary-adrenal axis (with cortisol levels elevated in a subgroup surviving over 30 minutes after withdrawal of life support), and immune activation (changes in IL-6 and TNF- that mirror those seen in animal models of DCD donation). In conclusion, this thesis demonstrates physiological changes not previously recorded in human subjects in a cohort of DCD organ donors undergoing circulatory death. These changes have implications for the management of potential organ donors undergoing circulatory death, and impact on the organs they donate. Modulation of these changes represent a therapeutic target, successful modulation of which could translate to improved donation rates and organ transplantation outcomes.NIH

Efektifitas penerapan standar asuhan keperawatan jiwa generalis pada pasien skizofrenia dalam menurunkan gejala halusinasi

Halusinasi merupakan persepsi yang diterima oleh panca indera tanpa adanya stimulus eksternal. Klien dengan halusinasi sering merasakan keadaan/kondisi yang hanya dapat dirasakan olehnya namun tidak dapat dirasakan oleh orang lain. Tujuan laporan kasus ini yaitu untuk menganalisis mengenai tandar asuhan keperawatan generalis pada pasien skizofrenia dalam menurunkan gejala halusinasi. Karya ilmiah akhir ini merupakan analisis terhadap pelaksanaan asuhan keperawatan pada pasien halusinasi dengan skizofrenia yang dilakukan di Ruang Srikandi Rumah Sakit dr. H. Marzoeki Mahdi Bogor. Hasil analisis menunjukkan bahwa ntervensi keperawatan secara generalis sangat efektif diberikan pada pasien dengan gangguan sensori persepsi halusinasi pendengaran. Hal ini ditandai dengan penurunan tanda gejala halusinasi pada klien setelah diberikannya tindakan keperawatan. Kata kunci: asuhan keperawatan jiwa generalis, halusinasi, skizofrenia EFFECTIVENESS OF THE IMPLEMENTATION OF STANDARDS FOR NURSING GENERALIS NURSING AT SKIZOFRENIA PATIENTS IN REDUCING HALUSINATION SYMPTOMS ABSTRACTHallucinations are perceptions received by the five senses in the absence of an external stimulus. Clients with hallucinations often feel the conditions / conditions that can only be felt by him but can not be felt by others. The purpose of this case report is to analyze the level of generalist nursing care in schizophrenic patients in reducing hallucinatory symptoms. This final scientific work is an analysis of the implementation of nursing care in hallucinatory patients with schizophrenia conducted in the Srikandi Room of Dr. dr. H. Marzoeki Mahdi Bogor. The results of the analysis showed that general nursing intervention was very effective given to patients with sensory disorders of auditory hallucinations perception. This is marked by a decrease in hallucinatory symptoms to the client after nursing is given. Keywords: generalist mental nursing care, hallucinations, schizophreni

Lessons from a national mental health arts festival

The Scottish Mental Health Arts and Film Festival has evolved over the last 10 years into one of the world’s largest mental health events, engaging more than 30,000 people each year. The model of the festival will be outlined and the evolution traced over three distinct phases: from its inception as an anti-stigma campaign, to a broad-based social movement harnessing grassroots activism, and finally, to achieving international reach and artistic recognition. The first phase details the inception and early incarnations of the festival, building upon Allport’s contact theory model that the most effective way to reduce stigma is through positive personal contact with someone in a valued social role. The learning demonstrated that the festival could achieve large-scale reach among the most marginalized communities and increase positive perceptions and intentions among audience members. As the festival evolved into its second phase, artists and activists began to develop events and grassroots partnerships throughout Scotland. A feature of the festival at this stage, as people with and without mental health diagnoses worked together, was that many events explored "mental health identities" in a broader sense, and this led many of those involved to reframe their ideas of mental health and illness. The third phase explores the impact of the festival at a broader social level

Analisis Pendapatan Masyarakat Dari Pengolahan Gula Aren (Arenga pinnata) Pada Hutan Rakyat Pola Agroforestry Di Kecamatan Cendana Kabupaten Enrekang

Penelitian ini bertujuan untuk untuk mengetahui pendapatan masyarakat dari hasil pengolahan gula aren di Kelurahan Cendana Kecamatan Cendana Kabupaten Enrekang. Metode pengumpulan data yang digunakan dalam penelitian ini adalah observasi dan wawacara. Teknik pengambilan sampel dilakukan dengan Teknik purposive sampling sebanyak 23 orang petani aren. Hasil penelitian menunjukkan bahwa Pendapatan masyarakat dari hasil pengolahan gula aren yang menyadap 3-6 pohon, rata-rata Rp  62,335,668.90/orang/tahun.  Secara keseluruhan usaha pengolahan gula aren di Desa Karrang Kecamatan Cendana Kabupaten Enrekang layak untuk dilanjutkan karena menguntungkan dengan Nilai R/C ratio rata-rata 1 yaitu 9,03

Non-monotonicity of the frictional bimaterial effect

Sliding along frictional interfaces separating dissimilar elastic materials is qualitatively different from sliding along interfaces separating identical materials due to the existence of an elastodynamic coupling between interfacial slip and normal stress perturbations in the former case. This bimaterial coupling has important implications for the dynamics of frictional interfaces, including their stability and rupture propagation along them. We show that while this bimaterial coupling is a monotonically increasing function of the bimaterial contrast, when it is coupled to interfacial shear stress perturbations through a friction law, various physical quantities exhibit a non-monotonic dependence on the bimaterial contrast. In particular, we show that for a regularized Coulomb friction, the maximal growth rate of unstable interfacial perturbations of homogeneous sliding is a non-monotonic function of the bimaterial contrast, and provide analytic insight into the origin of this non-monotonicity. We further show that for velocity-strengthening rate-and-state friction, the maximal growth rate of unstable interfacial perturbations of homogeneous sliding is also a non-monotonic function of the bimaterial contrast. Results from simulations of dynamic rupture along a bimaterial interface with slip-weakening friction provide evidence that the theoretically predicted non-monotonicity persists in non-steady, transient frictional dynamics.Comment: 14 pages, 5 figure

Thalidomide is Associated With Increased T Cell Activation and Inflammation in Antiretroviral-naive HIV-infected Individuals in a Randomised Clinical Trial of Efficacy and Safety

Trial Design: Open-label, randomised, controlled, pilot proof-of-concept clinical trial. Methods: Participants: Antiretroviral naive adult males with CD4 count >= 350 cells/mm(3). Interventions: Patients were randomised to receive thalidomide 200 mg QD for 3 weeks (Thalidomide group) or not (Control group) and followed for 48 weeks. Objective: We hypothesized that short-term Thalidomide use would reduce HIV related inflammation and HIV replication among antiretroviral naive HIV infected individuals. Outcome: Viral loads, CD4/CD8 counts, ultra-sensitive C-reactive protein (US-CRP), cell activation markers, and plasma lipopolysaccharide (LPS) were analyzed. Randomisation: Unrestricted randomisation. Blinding: No blinding was used. Results: Numbers randomised: Thirty recruited individuals were randomised to Thalidomide (16 patients) or Control (14 patients) groups. Recruitment: Patients were recruited from April 2011 to January 2013. Outcome: Viral loads remained stable in both groups. During thalidomide treatment, a decrease in CD4/CD8 ratio (p = 0.04), a decrease in CD4 count (p = 0.04), an increase in cell activation calculated by the percentage of CD38 (+)/HLA-DR+ CD8 cells (p < 0.05) and an increase in US-CRP (p < 0.01) were observed in the Thalidomide group, with all parameters returning to baseline levels after thalidomide interruption. We confirmed that thalidomide increased HIV replication in vitro of 6 of 7 samples from long-term antiretroviral suppressed individuals. Harms: No class 3/4 adverse events occurred. Conclusions: Short-termuse of thalidomide led to an intense transient increase in T cell activation and inflammation, with a decrease in the CD4(+) cell count without changes to the CD8(+) cell count. We confirmed that thalidomide acts in vitro as a latency reversal agent and speculate that the in vivo results obtained were due to an increase in HIV replication. (C) 2017 The Authors. Published by Elsevier B.V.Fundação de Amparo a Pesquisa do Estado de São Paulo (FAPESP)Univ Fed São Paulo, Lab Retrovirol, São Paulo, BrazilFiocruz MS, Inst Oswaldo Cruz, Lab Interdisciplinar Pesquisas Med, Rio De Janeiro, BrazilSecretaria Municipal Saude Antonio Ribeiro Neto, Rio De Janeiro, BrazilOncohiv, Rio De Janeiro, BrazilUniv Fed Rio de Janeiro, Rio De Janeiro, BrazilInst Fed Educ Ciencia & Tecnol Rio de Janeiro IF, Rio De Janeiro, BrazilUniv Fed São Paulo, Lab Retrovirol, São Paulo, BrazilFAPESP: 04/15856-9Web of Scienc

A computer-based application advisory system for bicycle safety at campus towards sustainable transportation

Bicycle safety is a concerning issue as it leads to accidents among cyclists who use bicycles as their mode of transportation, especially in campus areas. This research discusses the development of an advisory system for bicycle safety (AS-BS) to help cyclists gain information and make better decisions before and during cycling that will help avoid things that might cause an accident. Acquisition of knowledge from domain experts (engineers who worked in the area of road traffic safety or transportation engineering) and various sources such as books and journals are crucial for the advisory system knowledge database. The data from journals and other literature studies will be collected and then placed in the google form. The google form will then be send to domain experts to ask them to choose the best answer for each problem. After that, data gathered from domain experts will be analysed and reasoned. The relevant data was then retrieved and codified to create the knowledge base in the AS-BS. Then, the application of AS-BS is developed using the programming language Visual Basic in Microsoft Visual Studio 2019. AS-BS have been verified, validated, and evaluated at the final stage to ensure users' specifications, quality, and acceptance. The verification, validation, and evaluation were conducted using a questionnaire involving the researcher, expert evaluators, and end-users (students at UMS). Based on the result, the AS-BS passed its verification and validation. Also, the acceptance of the AS-BS by the end users is high, and it can provide an optimum strategy to advise cyclists about bicycle safety