Adolescents' and parents' views of Child and Adolescent Mental Health Services (CAMHS) in Ireland

Aim: To explore adolescents’ and parents’ experiences of CAMHS in relation to accessibility, approachability, and appropriateness. Methods: Using a descriptive qualitative design, a combination of focus group and single interviews were conducted with adolescents (n=15) and parents (n=32) from three mental health clinics. Data were transcribed verbatim and analysed using thematic analysis. Results: Accessing mental health services was a challenging experience due to knowledge deficit, lack of information and limited availability of specialist services. Participants desired more information, involvement in decision-making, single and shared consultations, flexible scheduling of appointments, continuity with clinicians, school support and parent support groups. Participants seem to be generally satisfied, however adolescents felt less involved in decision making than they would have liked. Frequent staff changes was problematic as it disrupted continuity of care and hindered the formation of a trusting relationship. Implications for practice: Parents and adolescents expressed similar views of the positive and negative aspects of mental health services. Their need for more information-sharing and involvement in decision-making underline the importance of collaborative practice. Clinician continuity contributed to trusting therapeutic relationships and was valued. These are key principles that with attention, could lead to quality service provision for adolescents and families

Defect Characterization by Spatial Distribution of Ultrasonic Scattered Energy

The ultrasonic pulse echo technique is a highly sensitive nondestructive method for detecting small defects within the bulk of a structure. The technique is capable of reliably finding small volumetric defects when the defect size is approximately 0.030 inches in diameter and the specimen thicknesses are not too great. If the distance between the transducer and the defect is large, greater than 2 near field distances, the minimum value of volumetric flaw sizes that can be reliably detected rises considerably. For 6-8 inch thick plates, it is not too surprising to occasionally miss volumetric defects such as slag inclusions of considerable length

Health professionals' perceptions of cultural influences on stroke experiences and rehabilitation in Kuwait

This is the author's accepted manuscript. The final published article is available from the link below. Copyright @ 2012 Informa UK Ltd.Purpose: The aim of this study was to investigate the perceptions of health professionals who treat stroke patients in Kuwait regarding cultural influences on the experience of stroke and rehabilitation in Kuwait. Health professionals interviewed were from a variety of cultural backgrounds thus providing an opportunity to investigate how they perceived the influence of culture on stroke recovery and rehabilitation in Kuwait. Method: Semi-structured interviews were carried out with 12 health professionals with current/recent stroke rehabilitation experience in Kuwait, followed by thematic analysis of the verbatim transcripts. Results: The health professionals identified several features of the Kuwaiti culture that they believed affected the experiences of stroke patients. These were religious beliefs, family involvement, limited education and public information about stroke, prevailing negative attitudes toward stroke, access to finances for private treatment, social stigma and the public invisibility of disabled people, difficulties identifying meaningful goals for rehabilitation, and an acceptance of dependency linked with the widespread presence of maids and other paid assistants in most Kuwaiti homes. Conclusion: To offer culturally sensitive care, these issues should be taken into account during the rehabilitation of Kuwaiti stroke patients in their home country and elsewhere

Who is in the transition gap? Transition from CAMHS to AMHS in the Republic of Ireland

Objective: The ITRACK study explored the process and predictors of transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) in the Republic of Ireland. Method: Following ethical approval, clinicians in each of Ireland's four Health Service Executive (HSE) areas were contacted, informed about the study and invited to participate. Clinicians identified all cases who had reached the transition boundary (i.e. upper age limit for that CAMHS team ) between January and December 2010. Data were collected on clinical and socio-demographic details and factors that informed the decision to refer or not refer to AMHS and case notes were scrutinised to ascertain the extent of information exchanged between services during transition

Review:Mitigating the risks posed by intensification in livestock production: the examples of antimicrobial resistance and zoonoses

Major shifts in how animals are bred, raised and slaughtered are involved in the intensification of livestock systems. Globally, these changes have produced major increases in access to protein-rich foods with high levels of micronutrients. Yet the intensification of livestock systems generates numerous externalities including environmental degradation, zoonotic disease transmission and the emergence of antimicrobial resistance (AMR) genes. Where the process of intensification is most advanced, the expertise, institutions and regulations required to manage these externalities have developed over time, often in response to hard lessons, crises and challenges to public health. By exploring the drivers of intensification, the foci of future intensification can be identified. Low- and middle-income (LMICs) countries are likely to experience significant intensification in livestock production in the near future; however, the lessons learned elsewhere are not being transferred rapidly enough to develop risk mitigation capacity in these settings. At present, fragmentary approaches to address these problems present an incomplete picture of livestock populations, antimicrobial use, and disease risks in LMIC settings. A worldwide improvement in evidence-based zoonotic disease and AMR management within intensifying livestock production systems demands better information on the burden of livestock-associated disease, antimicrobial use and resistance and resources allocated to mitigation.</p

An Electrophysiological and Pharmacological Study of the Properties of Human iPSC-Derived Neurons for Drug Discovery

Human stem cell-derived neurons are increasingly considered powerful models in drug discovery and disease modeling, despite limited characterization of their molecular properties. Here, we have conducted a detailed study of the properties of a commercial human induced Pluripotent Stem Cell (iPSC)-derived neuron line, iCell [GABA] neurons, maintained for up to 3 months in vitro. We confirmed that iCell neurons display neurite outgrowth within 24 h of plating and label for the pan-neuronal marker, βIII tubulin within the first week. Our multi-electrode array (MEA) recordings clearly showed neurons generated spontaneous, spike-like activity within 2 days of plating, which peaked at one week, and rapidly decreased over the second week to remain at low levels up to one month. Extracellularly recorded spikes were reversibly inhibited by tetrodotoxin. Patch-clamp experiments showed that iCell neurons generated spontaneous action potentials and expressed voltage-gated Na and K channels with membrane capacitances, resistances and membrane potentials that are consistent with native neurons. Our single neuron recordings revealed that reduced spiking observed in the MEA after the first week results from development of a dominant inhibitory tone from GABAergic neuron circuit maturation. GABA evoked concentration-dependent currents that were inhibited by the convulsants, bicuculline and picrotoxin, and potentiated by the positive allosteric modulators, diazepam, chlordiazepoxide, phenobarbital, allopregnanolone and mefenamic acid, consistent with native neuronal GABAA receptors. We also show that glycine evoked robust concentration-dependent currents that were inhibited by the neurotoxin, strychnine. Glutamate, AMPA, Kainate and NMDA each evoked concentration-dependent currents in iCell neurons that were blocked by their selective antagonists, consistent with the expression of ionotropic glutamate receptors. The NMDA currents required the presence of the co-agonist glycine and were blocked in a highly voltage-dependent manner by Mg2+ consistent with the properties of native neuronal NMDA receptors. Together, our data suggest that such human iPSC-derived neurons may have significant value in drug discovery and development and may eventually largely replace the need for animal tissues in human biomedical research

Notes on Recent Cases

Notes on recent cases by William J. Coyne, Henry Hasley, Albert T. Franz, E. F. McClarnon, Marc Wonderlin, Thomas V. Happer, Edward P. McGuire, John P. Berscheid, and T. J. Jones, Jr

Seismic isolation of Advanced LIGO: Review of strategy, instrumentation and performance

The new generation of gravitational waves detectors require unprecedented levels of isolation from seismic noise. This article reviews the seismic isolation strategy and instrumentation developed for the Advanced LIGO observatories. It summarizes over a decade of research on active inertial isolation and shows the performance recently achieved at the Advanced LIGO observatories. The paper emphasizes the scientific and technical challenges of this endeavor and how they have been addressed. An overview of the isolation strategy is given. It combines multiple layers of passive and active inertial isolation to provide suitable rejection of seismic noise at all frequencies. A detailed presentation of the three active platforms that have been developed is given. They are the hydraulic pre-isolator, the single-stage internal isolator and the two-stage internal isolator. The architecture, instrumentation, control scheme and isolation results are presented for each of the three systems. Results show that the seismic isolation sub-system meets Advanced LIGO's stringent requirements and robustly supports the operation of the two detectors

Hydrologic Properties of Pervious Concrete

Pervious concrete is concrete made by eliminating most or all of the fine aggregate (sand) in the concrete mix, which allows interconnected void spaces to be formed in the hardened product. These interconnected void spaces allow the concrete to transmit water at relatively high rates. The main objective of this project was to conduct research on the potential application of pervious concrete in agricultural settings, specifically for use in animal feed lots, manure storage pads, animal manure and bedding compost facilities, or floor systems in animal buildings. Laboratory tests were conducted on replicated samples of pervious concrete formed from two rock sources (river gravel and limestone) for coarse aggregates and different size fractions to determine hydrologic relationships. Linear relationships were found between density and porosity, density and permeability, porosity and permeability, and porosity and specific yield. The results suggest that properties such as permeability, porosity, and specific yield are not significantly affected by different aggregate types. However, density and porosity can be effective methods for predicting porosity, specific yield, and permeability. In addition, t-tests were conducted to determine the effect of aggregate types on the solid/liquid separation properties of the pervious concrete after adding composted beef cattle manure and bedding to the surface of the specimens. The amount of composted beef cattle manure and bedding retained within the specimens was significantly less (p = 0.012) when samples constructed of #8 river gravel were used rather than the other aggregates. The #8 river gravel also had significantly less reduction in permeability compared to other aggregates. Although the #8 river gravel had a different effect on the compost retained and the reduction in permeability for the specimens, all four aggregates exhibited a significant reduction in the permeability after the compost was applied