Jamaican adolescents’ receptiveness to digital mental health services: a cross-sectional survey from rural and urban communities

Background: Improving access to mental health resources for young people is an urgent healthcare challenge. As the majority of youth live in low and middle-income countries (LMICs) mental ill health can exert substantial adverse impacts on societies that can least afford it. Digital mental health technologies might help close the treatment gap but we need to understand barriers to implementing these strategies, especially in resource constrained contexts such as LMICs. Methods: We surveyed adolescents (N = 107; aged 10–19 years) from Jamaican communities using questionnaires adopted from previous studies conducted in LMICs. The questions addressed mental health help-seeking preferences, expectations of help-seeking effectiveness, and practical and attitudinal barriers to using mobile-phone-based mental health resources. We present descriptive data alongside exploratory analyses of differences in attitudes and preferences expressed by subgroups of respondents. Results: Adolescents reported very few practical or infrastructure barriers to accessing digital mental health resources. >90% of the sample had access to a smartphone, 78% expected that digital solutions could benefit adolescents with symptoms of mental distress, and 56% were interested in using mental health apps to monitor their own mental health. Stigma, shame, and embarrassment were major barriers to help-seeking and formal professional help was only preferred for more severe conditions such as psychosis and substance abuse. Conclusions: Practical barriers are unlikely to impede the uptake of digital mental health resources by Jamaican adolescents. Our data suggest that mental health literacy, stigma, and embarrassment pose more serious blocks to help-seeking

ナンキョク ケンキュウ カガク イインカイ ノ レンゾク プランクトン サイシュウキ センモンカ グループ ワークショップ ホウコク

2010年11月22-26日に国立極地研究所にて「南極研究科学委員会(以下SCAR)連続プランクトン採集器(以下CPR)専門家グループワークショップ」を開催した.4カ国から12名が参加し,南大洋CPR観測実務担当者の間で,観測データの品質管理,種同定やデータ分析手法の再確認,及び今後の活動についての詳細な討議を行った.前半は文献資料及び顕微鏡観察を通して,動物プランクトンの分類群ごとに種同定の情報交換及び具体的な分類カテゴリーの統一を図った.まとめられた種同定基準を用いて新たにマニュアルを作成することとなった.後半はデータ分析手法とデータマネージメント,さらには将来的な観測計画を確認した.今後,定期的にワークショップを開催し,各国間で統一された試料処理及びデータ管理を維持していくことで合意した."Southern Ocean Continuous Plankton Recorder (SO-CPR) Standards Workshop: SCAR Expert Group on CPR Research" was held at the National Institute of Polar Research (NIPR) on 22-26 November 2011. Twelve participants from four countries attended. The purposes of the workshop were to ensure that consistent and high standards of species identification, methodology, and data quality were being maintained amongst all participants and laboratories in the SO-CPR survey, and to discuss future contributions of the SO-CPR program to a global CPR network. The first three and a half days of the workshop were focused on assessing the accuracy and consistency of species identifications. We concluded that our species identifications and procedures are accurate and uniform, and that the SO-CPR database is of the highest possible standard. Certain taxonomic criteria developed at the workshop will be described in a new laboratory procedures manual. Four major gaps in the database (spatial, temporal, taxonomic, and data analysis gaps) were identified and discussed. Participants concurred that there should be more regular workshops to ensure that the high standards of the SO-CPR program are maintained

The FIRST-Optical-VLA Survey for Lensed Radio Lobes

We present results from a survey for gravitationally lensed radio lobes. Lensed lobes are a potentially richer source of information about galaxy mass distributions than lensed point sources, which have been the exclusive focus of other recent surveys. Our approach is to identify radio lobes in the FIRST catalog and then search optical catalogs for coincident foreground galaxies, which are candidate lensing galaxies. We then obtain higher-resolution images of these targets at both optical and radio wavelengths, and obtain optical spectra for the most promising candidates. We present maps of several radio lobes that are nearly coincident with galaxies. We have not found any new and unambiguous cases of gravitational lensing. One radio lobe in particular, FOV J0743+1553, has two hot spots that could be multiple images produced by a z=0.19 spiral galaxy, but the lensing interpretation is problematic.Comment: 38 pages, 18 figures, aastex, accepted to A

Neurological and behavioral abnormalities, ventricular dilatation, altered cellular functions, inflammation, and neuronal injury in brains of mice due to common, persistent, parasitic infection.

BACKGROUND: Worldwide, approximately two billion people are chronically infected with Toxoplasma gondii with largely unknown consequences. METHODS: To better understand long-term effects and pathogenesis of this common, persistent brain infection, mice were infected at a time in human years equivalent to early to mid adulthood and studied 5-12 months later. Appearance, behavior, neurologic function and brain MRIs were studied. Additional analyses of pathogenesis included: correlation of brain weight and neurologic findings; histopathology focusing on brain regions; full genome microarrays; immunohistochemistry characterizing inflammatory cells; determination of presence of tachyzoites and bradyzoites; electron microscopy; and study of markers of inflammation in serum. Histopathology in genetically resistant mice and cytokine and NRAMP knockout mice, effects of inoculation of isolated parasites, and treatment with sulfadiazine or alphaPD1 ligand were studied. RESULTS: Twelve months after infection, a time equivalent to middle to early elderly ages, mice had behavioral and neurological deficits, and brain MRIs showed mild to moderate ventricular dilatation. Lower brain weight correlated with greater magnitude of neurologic abnormalities and inflammation. Full genome microarrays of brains reflected inflammation causing neuronal damage (Gfap), effects on host cell protein processing (ubiquitin ligase), synapse remodeling (Complement 1q), and also increased expression of PD-1L (a ligand that allows persistent LCMV brain infection) and CD 36 (a fatty acid translocase and oxidized LDL receptor that mediates innate immune response to beta amyloid which is associated with pro-inflammation in Alzheimer's disease). Immunostaining detected no inflammation around intra-neuronal cysts, practically no free tachyzoites, and only rare bradyzoites. Nonetheless, there were perivascular, leptomeningeal inflammatory cells, particularly contiguous to the aqueduct of Sylvius and hippocampus, CD4+ and CD8+ T cells, and activated microglia in perivascular areas and brain parenchyma. Genetically resistant, chronically infected mice had substantially less inflammation. CONCLUSION: In outbred mice, chronic, adult acquired T. gondii infection causes neurologic and behavioral abnormalities secondary to inflammation and loss of brain parenchyma. Perivascular inflammation is prominent particularly contiguous to the aqueduct of Sylvius and hippocampus. Even resistant mice have perivascular inflammation. This mouse model of chronic T. gondii infection raises questions of whether persistence of this parasite in brain can cause inflammation or neurodegeneration in genetically susceptible hosts

Every child mattered in England: but what matters to children?

“Every Child Matters” under New Labour provided a framework for services for young children’s care and education. It was pushed aside by the Conservative led coalition and replaced by “More Great Childcare”. The UK as a signatory to the United Nations Convention on the Rights of the Child, and therefore has obligations for legislation, policy and curriculum, specifically with regard to children’s rights and participation. On the 25th anniversary of the UNCRC, in practice there may be different levels of participation employed to engage children’s views in the development of policy about them. This project set out to ask children about what “matters” to them. Ninety finalist Early Childhood Studies students worked as co-researchers in this project. Five themes are discussed highlighting the powerful thoughts and ideas of children. A range of ‘child-friendly’ methods were used to collect data from children including role-play, interviews, drawings and artefacts, and story-telling

Decolonizing Listening: Towards an Equitable Approach to Speech Training for the Actor.

This article confirms and deepens an understanding of the negative impact of teaching culturally embedded speech standards to actors who are “othered” by a dominant “somatic norm” within the performing arts. The author analyzes evidence from a three-year longitudinal study of actors within a UK conservatory in relation to the critical frame of the somatic norm and colonized listening practices in the performing arts. The author identifies conscious and unconscious bias within traditional training methods and proposes a decolonizing approach to listening within foundational speech training. The ideological shift outlined follows the “affective turn” in the humanities and social sciences and moves away from the culturally embedded listening at the core of “effective” speech methods, which focus solely on clarity and intelligibility. The outcome of this research is a radical performance pedagogy, which values the intersectional identities and linguistic capital of students from pluralistic backgrounds. The revised curriculum offers an approach to affective speaking and listening that assumes an equality of understanding from the outset, and requires actors, actor trainers, and, ultimately, audiences to de-colonize their listening ears

Risk assessment and decision making about in-labour transfer from rural maternity care: a social judgment and signal detection analysis

Background: The importance of respecting women's wishes to give birth close to their local community is supported by policy in many developed countries. However, persistent concerns about the quality and safety of maternity care in rural communities have been expressed. Safe childbirth in rural communities depends on good risk assessment and decision making as to whether and when the transfer of a woman in labour to an obstetric led unit is required. This is a difficult decision. Wide variation in transfer rates between rural maternity units have been reported suggesting different decision making criteria may be involved; furthermore, rural midwives and family doctors report feeling isolated in making these decisions and that staff in urban centres do not understand the difficulties they face. In order to develop more evidence based decision making strategies greater understanding of the way in which maternity care providers currently make decisions is required. This study aimed to examine how midwives working in urban and rural settings and obstetricians make intrapartum transfer decisions, and describe sources of variation in decision making. Methods: The study was conducted in three stages. 1. 20 midwives and four obstetricians described factors influencing transfer decisions. 2. Vignettes depicting an intrapartum scenario were developed based on stage one data. 3. Vignettes were presented to 122 midwives and 12 obstetricians who were asked to assess the level of risk in each case and decide whether to transfer or not. Social judgment analysis was used to identify the factors and factor weights used in assessment. Signal detection analysis was used to identify participants' ability to distinguish high and low risk cases and personal decision thresholds. Results: When reviewing the same case information in vignettes midwives in different settings and obstetricians made very similar risk assessments. Despite this, a wide range of transfer decisions were still made, suggesting that the main source of variation in decision making and transfer rates is not in the assessment but the personal decision thresholds of clinicians. Conclusions: Currently health care practice focuses on supporting or improving decision making through skills training and clinical guidelines. However, these methods alone are unlikely to be effective in improving consistency of decision making

NOTCH signaling specifies arterial-type definitive hemogenic endothelium from human pluripotent stem cells

NOTCH signaling is required for the arterial specification and formation of hematopoietic stem cells (HSCs) and lympho-myeloid progenitors in the embryonic aorta-gonad-mesonephros region and extraembryonic vasculature from a distinct lineage of vascular endothelial cells with hemogenic potential. However, the role of NOTCH signaling in hemogenic endothelium (HE) specification from human pluripotent stem cell (hPSC) has not been studied. Here, using a chemically defined hPSC differentiation system combined with the use of DLL1-Fc and DAPT to manipulate NOTCH, we discover that NOTCH activation in hPSC-derived immature HE progenitors leads to formation of CD144+CD43−CD73−DLL4+Runx1 + 23-GFP+ arterial-type HE, which requires NOTCH signaling to undergo endothelial-to-hematopoietic transition and produce definitive lympho-myeloid and erythroid cells. These findings demonstrate that NOTCH-mediated arterialization of HE is an essential prerequisite for establishing definitive lympho-myeloid program and suggest that exploring molecular pathways that lead to arterial specification may aid in vitro approaches to enhance definitive hematopoiesis from hPSCs

The study protocol for a randomized controlled trial of a family-centred tobacco control program about environmental tobacco smoke (ETS) to reduce respiratory illness in Indigenous infants

Background: Acute respiratory illness (ARI) is the most common cause of acute presentations and hospitalisations of young Indigenous children in Australia and New Zealand (NZ). Environmental tobacco smoke (ETS) from household smoking is a significant and preventable contributor to childhood ARI. This paper describes the protocol for a study which aims to test the efficacy of a family-centred tobacco control program about ETS to improve the respiratory health of Indigenous infants in Australia and New Zealand. For the purpose of this paper 'Indigenous' refers to Australia's Aboriginal and Torres Strait Islander peoples when referring to Australian Indigenous populations. In New Zealand, the term 'Indigenous' refers to Maori

Knowledge, attitudes and other factors associated with assessment of tobacco smoking among pregnant Aboriginal women by health care providers: a cross-sectional survey

<p>Abstract</p> <p>Background</p> <p>As with many Indigenous peoples, smoking rates among Aboriginal Australians are considerably higher than those of the non-Indigenous population. Approximately 50% of Indigenous women smoke during pregnancy, a time when women are more motivated to quit. Antenatal care providers are potentially important change agents for reducing the harms associated with smoking, yet little is known about their knowledge, attitudes or skills, or the factors associated with providing smoking cessation advice.</p> <p>Methods</p> <p>This paper aimed to explore the knowledge and attitudes of health care providers caring for pregnant Australian Aboriginal women with regard to smoking risks and cessation; and to identify factors associated with self-reported assessment of smoking. A cross-sectional survey was undertaken with 127 staff providing antenatal care to Aboriginal women from two jurisdictions: the Northern Territory and New South Wales, Australia. Measures included respondents' estimate of the prevalence of smoking among pregnant women; optimal and actual assessment of smoking status; knowledge of risks associated with antenatal smoking; knowledge of smoking cessation; attitudes to providing cessation advice to pregnant women; and perceived barriers and motivators for cessation for pregnant women.</p> <p>Results</p> <p>The median provider estimate of the smoking prevalence was 69% (95%CI: 60,70). The majority of respondents considered assessment of smoking status to be integral to antenatal care and a professional responsibility. Most (79%) indicated that they assess smoking status in 100% of clients. Knowledge of risks was generally good, but knowledge of cessation was poor. Factors independently associated with assessing smoking status among all women were: employer service type (<it>p </it>= 0.025); cessation knowledge score (<it>p </it>= 0.011); and disagreeing with the statement that giving advice is not worth it given the low level of success (<it>p </it>= 0.011).</p> <p>Conclusions</p> <p>Addressing knowledge of smoking risks and cessation counselling is a priority and should improve both confidence and ability, and increase the frequency and effectiveness of counselling. The health system must provide supports to providers through appropriate policy and resourcing, to enable them to address this issue.</p