A Toolkit to Adequately Screen Pregnant Women for Depression and thus Increase Screening in an Outpatient Obstetrical Clinic

Background: Perinatal depression is a common health complication during pregnancy. Untreated depression among perinatal women is associated with adverse health outcomes for infants and mothers. Screening during the perinatal time period is needed to identify and treat depression and to prevent adverse health outcomes. Purpose: The purpose of this clinical project is to equip health care providers with the knowledge and tools needed to screen pregnant women for depression and thus increase the amount of screening done in an outpatient obstetrical clinic. Methods: An evidenced- based educational tool kit was developed to increase provider knowledge of perinatal depression and increase depression screening. The effectiveness of the educational toolkits was assessed using self-report pre and post questionnaires and through a review of patient health records pre- and post-education to determine screening rates during pregnancy. Results: Participant knowledge about perinatal depression increased by 20.8% after completing the education program. Perinatal depression screening increased from 3 screenings to 28 screening pre- and post- intervention, an increase of 44.6%. Conclusion: An education program on the importance of perinatal depression and screening increased the knowledge of attendees and increased the number of depression screenings completed in the outpatient obstetrical clinic

Vegetation Analysis of Urban Ethnic Markets Shows Supermarket Generalists and Chinatown Ethnic-specialist Vendors

researchThe growing cultural diversity in the United States calls attention to ethnobotanical studies of urban ethnic food markets. These venues illustrate dynamic interactions between people and plants. A market survey of the Chinatown markets in Honolulu, Hawai`i was conducted to collect empirical data on this culturally rich urban area. The objectives included: (1) To analyze the food plant richness of selected Chinatown markets in comparison to local mainstream supermarkets; and (2) To test the use of vegetation analysis to describe the structure of these markets (e.g., “ethnic markets”). Surveys and mapping of food plants at three market areas in Chinatown and three mainstream supermarkets were conducted between February and March 2006. Microsoft Excel and the Community Analysis Package programs were used to analyze and compare plant richness and the structure of vendors and markets. In all of the markets combined, 291 “fresh” food plant varieties were recorded, representing 42 plant families and a group of fungi. The mainstream supermarkets were more rich in varieties of food plants than the Chinatown market area (mean ± s, 144 ± 21 vs. 95 ± 23, p=0.05, Mann-Whitney U test). Allium cepa L. and Allium sativum L. were ubiquitous. The Mainstream market group contained significantly more sweet-fruits than the Chinatown market areas. Agglomerate cluster analyses revealed groupings of mainstream supermarkets, Chinatown market areas; further analysis of the Chinatown areas defined culturally identified “Filipino,” “Vietnamese,” and specialty fruits vendors. Mainstream supermarkets may be viewed as “generalists” while the Chinatown market areas and vendors may be viewed as “specialists” for an ethnic or cultural group or food plant commodity

Communication interventions for medically unexplained symptom conditions in general practice : a systematic review and meta-analysis of randomised controlled trials

Background Medically unexplained symptoms (MUS) account for 3–50% of all General Practitioner (GP) consultations and are difficult to diagnose due to their unknown aetiology, symptom overlap between conditions, and lack of effective treatment options. MUS patients’ and primary care clinicians frequently face challenges during consultations, with GPs reporting difficulty identifying and classifying MUS, whilst patients report stigma and feeling illegitimised by clinicians. Communication interventions have been proposed as a method to facilitate the doctor-patient relationship and aid the management of MUS. Aim This systematic review aims to evaluate the effectiveness of primary care based communication interventions at improving MUS patients’ and/or clinician outcomes. Method Four electronic databases were searched from inception to November 2021. Two researchers independently undertook screening, data extraction and quality appraisal. Given the heterogeneous nature of the studies identified, narrative syntheses were conducted, along with meta-analyses where possible to pool data. Results 9 papers from 10 Randomised Controlled Trials were included. The included studies displayed considerable risk of bias and poor reporting. Some limited evidence suggests that communication interventions tailored to MUS and not following a pre-specified model (such as reattribution) could improve pain, mental and physical functioning whilst reattribution training may improve clinician confidence treating MUS. However, methodological limitations mean that these findings should be interpreted with caution. Conclusion A range of interventions for improving communication with MUS patients in primary care have been evaluated. However, the heterogeneous nature of existing evidence and poor study quality mean we cannot conclude whether these interventions are effective. Before considering further randomised controlled trials researchers should focus on developing a new or modified communication intervention for MUS patients and their clinicians. Trail registration The systematic review was prospectively registered with PROSPERO (registration record CRD42020206437)

Barriers facing social workers undertaking direct work with children and young people with a learning disability who communicate using non-verbal methods

This is a pre-copyedited, author-produced PDF of an article accepted for publication in British Journal of Social Work following peer review. The version of record Prynallt-Jones, K. A., Carey, M., & Doherty, P. (2018). Barriers facing social workers undertaking direct work with children and young people with a learning disability who communicate using non-verbal methods. British Journal of Social Work Advanced, 48(1), 88-105. https://doi.org/10.1093/bjsw/bcx004 is available online at: https://academic.oup.com/bjsw/article/3061534/BarriersAbstract: This paper analyses data drawn from a small group of qualified social workers’ specialising in work with disabled children who communicate using non-verbal methods. While a number of studies have criticised social services for neglecting disabled children, this paper re-evaluates evidence from the standpoint of a small group of experienced practitioners. Three substantive themes are explored which include: problems faced by practitioner’s communicating with children and young people; barriers to direct work; and positive engagement or use of creative methods. Among other findings, the paper highlights the complexity of communication techniques when seeking to accommodate diverse service user and carer needs, as well as creative responses used by practitioners despite significant barriers that include limited available training, technology and financial resources. Despite policy initiatives and legal requirements emphasising the importance of direct work and participation with disabled children, the conclusion reiterates the narrow focus of current risk-averse social work around disability, as well a need for additional resources and training to improve relationships, communication and meaningful support for children and young people that meet basic legal requirements

Økologiske fødevarer og menneskets sundhed

Økologiske fødevarer er genstand for stigende forbrugerinteresse og politisk opmærksomhed i hele den vestlige verden i disse år. Det er i den forbindelse blevet et stadig væsentligere tema hvorvidt økologiske fødevarer kan anses for at have særlige sundhedsfremmende og sygdomsforebyggende egenskaber. På anbefaling af Det Økologiske Fødevareråd bevilgede Strukturdirektoratet i efteråret 1999 derfor midler til at få samlet den faktuelle viden om økologiske fødevarers sundhedsmæssige betydning. Det Økologiske Fødevareråd anbefalede at denne sammenstilling af viden skulle benyttes som fundament for iværksættelse af ny forskning til yderligere belysning af emnet

Meals and snacks from the child’s perspective: the contribution of qualitative methods to the development of dietary interventions

Abstrac

Use it or lose it: Establishment and persistence of T cell memory

Pre-existing T cell memory provides substantial protection against viral, bacterial, and parasitic infections.The generation of protective T cell memory constitutes a primary goal for cell-mediatedvaccines, thus understanding the mechanistic basis of memory development and maintenance are of major importance. The widely accepted idea that T cell memory pools are directly descended from the effector populations has been challenged by recent reports that provide evidence for the early establishment of T cell memory and suggest that the putative memory precursorT cells do not undergo full expansion to effector status. Moreover, it appears that once the memory T cells are established early in life, they can persist for the lifetime of an individual.This is in contrast to the reported waning of naïveT cell immunity with age.Thus, in the elderly, immune memory that was induced at an early age may be more robust than recently induced memory, despite the necessity for long persistence.The present review discusses the mechanisms underlying the early establishment of immunological memory and the subsequent persistence of memoryT cell pools in animal models and humans. © 2012 Kedzierska, Valkenburg, Doherty.Link_to_subscribed_fulltex

Seasonal kinetic energy variability of near-inertial motions

Author Posting. © American Meteorological Society, 2009. This article is posted here by permission of American Meteorological Society for personal use, not for redistribution. The definitive version was published in Journal of Physical Oceanography 39 (2009): 1035-1049, doi:10.1175/2008JPO3920.1.Seasonal variability of near-inertial horizontal kinetic energy is examined using observations from a series of McLane Moored Profiler moorings located at 39°N, 69°W in the western North Atlantic Ocean in combination with a one-dimensional, depth-integrated kinetic energy model. The time-mean kinetic energy and shear vertical wavenumber spectra of the high-frequency motions at the mooring site are in reasonable agreement with the Garrett–Munk internal wave description. Time series of depth-dependent and depth-integrated near-inertial kinetic energy are calculated from available mooring data after filtering to isolate near-inertial-frequency motions. These data document a pronounced seasonal cycle featuring a wintertime maximum in the depth-integrated near-inertial kinetic energy deriving chiefly from the variability in the upper 500 m of the water column. The seasonal signal in the near-inertial kinetic energy is most prominent for motions with vertical wavelengths greater than 100 m but observable wintertime enhancement is seen down to wavelengths of the order of 10 m. Rotary vertical wavenumber spectra exhibit a dominance of clockwise-with-depth energy, indicative of downward energy propagation and implying a surface energy source. A simple depth-integrated near-inertial kinetic energy model consisting of a wind forcing term and a dissipation term captures the order of magnitude of the observed near-inertial kinetic energy as well as its seasonal cycle.Funding to initiate the McLane Moored Profiler observations at Line W were provided by grants from the G. Unger Vetlesen Foundation and the Comer Charitable Fund to the Woods Hole Oceanographic Institution’s Ocean and Climate Change Institute. Ongoing moored observations at Line W are supported by the National Science Foundation (NSF Grant OCE-0241354)