Indigenous adolescent mental health: what is the role of primary health care?

This RESEARCH ROUNDup examines the current state-of-play of Indigenous adolescent primary mental health care in Australia. The differences between Indigenous and non-Indigenous concepts of mental health are presented. Indigenous Australians are more likely to be hospitalised for mental health disorders than the general Australian population, and reasons for this disparity are explored. Indigenous primary mental health care programs should be designed and delivered in a manner that is culturally sensitive and appropriate

Telehealth in primary health care settings within Australia and internationally

Access to appropriate health care services is often limited for people living in rural or remote areas, or for those with restricted mobility. One approach to minimising the inequality in access for those located at a distance from health care services is through telehealth service delivery. This review examined the evidence on telehealth models in Australia and elsewhere, with a specific focus on synchronous, real-time video consultations, where patients and health care providers were present simultaneously

Video-based telehealth in Australian primary health care: Current use and future potential

Many Australians have limited access to health-care services due to a range of barriers, including geographic distance and restricted mobility, which telehealth can potentially address. This paper reviews the current and potential use of video consultation in primary health care in Australia, drawing on international literature. There is substantial evidence of high patient satisfaction, but many studies have methodological limitations. Overall, evidence of effectiveness and cost-effectiveness is weak. There is reasonable evidence for diagnosis, home care and specialist consultations by GPs with patients present. Two telehealth initiatives using video consultation are briefly presented. Both provide evidence that video consultation has a valuable role to play, but does not obviate the need for face-to-face consultations. Video consultation challenges traditional professional roles, particularly those of nurses, and can improve health workers’ skills and job satisfaction. More fundamentally, telehealth challenges the traditional distinction between primary and secondary care. This can be a source of resistance but may ultimately be one of its strengths. Appropriately targeted video consultation has much potential to improve the delivery of primary health care in Australia, particularly in rural and remote regions

Potentially avoidable hospitalisations in Australia: causes for hospitalisations and primary health care interventions

The Australian Institute of Health and Welfare (AIHW) described potentially avoidable hospitalisations (PAHs) as “admissions to hospital that could have potentially been prevented through the provision of appropriate non-hospital health services”. The AIHW classify PAHs into three main types: vaccine-preventable, chronic, and acute conditions. In 2009-10, PAHs related to chronic conditions were the most common, due mainly to the high rates of hospitalisations for diabetes complications (24% of all PAHs). Moderately high rates of PAHs were also reported for chronic obstructive pulmonary disease (COPD), dehydration and gastroenteritis, and dental conditions (9-10% of all PAHs)

Potentially Avoidable Hospitalisations: Causes, Initiatives and Challenges from a Primary Health Care Perspective

The presentation will- • highlight some of the risk factors for potentially avoidable hospitalisations in Australia (e.g., sociodemographic characteristics, chronic conditions) based on a literature review • explore common characteristics of successful initiatives addressing potentially avoidable hospitalisations generally (e.g., integrated services, multidisciplinary teams, access, disease management) • illustrate promising interventions to specifically reduce avoidable hospital readmissions (e.g., identifying high-risk patients, education, discharge planning, follow-ups) • discuss challenges in addressing avoidable hospitalisations

Congenital Heart Disease–Causing Gata4 Mutation Displays Functional Deficits In Vivo

Defects of atrial and ventricular septation are the most frequent form of congenital heart disease, accounting for almost 50% of all cases. We previously reported that a heterozygous G296S missense mutation of GATA4 caused atrial and ventricular septal defects and pulmonary valve stenosis in humans. GATA4 encodes a cardiac transcription factor, and when deleted in mice it results in cardiac bifida and lethality by embryonic day (E)9.5. In vitro, the mutant GATA4 protein has a reduced DNA binding affinity and transcriptional activity and abolishes a physical interaction with TBX5, a transcription factor critical for normal heart formation. To characterize the mutation in vivo, we generated mice harboring the same mutation, Gata4 G295S. Mice homozygous for the Gata4 G295S mutant allele have normal ventral body patterning and heart looping, but have a thin ventricular myocardium, single ventricular chamber, and lethality by E11.5. While heterozygous Gata4 G295S mutant mice are viable, a subset of these mice have semilunar valve stenosis and small defects of the atrial septum. Gene expression studies of homozygous mutant mice suggest the G295S protein can sufficiently activate downstream targets of Gata4 in the endoderm but not in the developing heart. Cardiomyocyte proliferation deficits and decreased cardiac expression of CCND2, a member of the cyclin family and a direct target of Gata4, were found in embryos both homozygous and heterozygous for the Gata4 G295S allele. To further define functions of the Gata4 G295S mutation in vivo, compound mutant mice were generated in which specific cell lineages harbored both the Gata4 G295S mutant and Gata4 null alleles. Examination of these mice demonstrated that the Gata4 G295S protein has functional deficits in early myocardial development. In summary, the Gata4 G295S mutation functions as a hypomorph in vivo and leads to defects in cardiomyocyte proliferation during embryogenesis, which may contribute to the development of congenital heart defects in humans

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Characterizing Arginyl-tRNA from Prevotella intermedia for Drug Design

Antibiotic resistance is becoming more prevalent; thus, the need to find other inhibition pathways. A possibility is the aminoacyl-tRNA synthetases which catalyze the attachment of the amino acid to its respective tRNA. These enzymes are an excellent target for drug development. Prevotella intermedia (Pi) is an orphan organism which causes Noma, an oral cavity flesh-eating disease. We selected the Pi arginyl-tRNA synthetase (ArgRS) because of its unusual features and dissimilarity to human homologs. More so, we are characterizing the ArgRS’s ability to bind tRNA and arginine as a prelude to drug design. Gel shift assays and aminoacylation assays will be used to characterize the interaction of the enzyme with tRNA and arginine. Once the enzymatic characterization is complete, we will pursue potential drugs, which include modified arginines. This work will lead to a better understanding of the interaction of the tRNA and arginine with the synthetase and will help computational work to determine a suitable inhibitor. By designing drugs against the tRNA synthetases, we can expand a powerful new class of antibiotics

Translating Research to Support Practitioners in Addressing Disparities in Child and Adolescent Mental Health and Services in the United States.

Despite increased recognition of disparities in youth mental health, racial/ethnic disparities in mental health burden and in mental health service use persist. This phenomenon suggests that research documenting disparities alone has not led to extensive action in practice settings in order to significantly reduce disparities. In this commentary, we present a framework to actively target this research-to-practice gap by describing the development of a resource titled, \u27Addressing the Mental Health Needs of Racial and Ethnic Minority Youth—A Guide for Practitioners.\u27 We begin by presenting social justice as the impetus for eliminating disparities and then reviewing current knowledge and efforts aimed at reducing disparities. Subsequently, we describe knowledge transfer frameworks and goals guiding our work. Finally, we detail the steps taken in our approach to translation and implications for subsequent dissemination of this guide. Translation focused on evidence-based information on (a) mechanisms that contribute to disparities, and (b) strategies for providers to address disparities in their work. We reflect on the framework guiding our translation to offer future directions for others interested in bridging research and action