Technology and Simulation to Improve Patient Safety.

Improving the quality and efficiency of surgical techniques, reducing technical errors in the operating suite, and ultimately improving patient safety and outcomes through education are common goals in all surgical specialties. Current surgical simulation programs represent an effort to enhance and optimize the training experience, to overcome the training limitations of a mandated 80-hour work week, and have the overall goal of providing a well-balanced resident education in a society with a decreasing level of tolerance for medical errors

“You are not alone”: A big data and qualitative analysis of men's unintended fatherhood

Background: Becoming a father is a profound change in a man's life that is not always planned or wanted. Little is known about the subjective experiences of men who become fathers unintentionally or reluctantly. The aim of this research was to explore how men who did not intend to have children discuss their feelings about becoming a father in an online, anonymous environment. We sought insights into emotional responses, appraisals of family functioning, and relationships with infants. Method: Data were collected from two Reddit forums for new and expectant fathers, r/Daddit and r/Predaddit. Approximately 2600 posts and 21,000 comments were extracted from the period between January 2019 and March 2020. We employed a two-stage methodology, blending big data techniques and qualitative analyses. Stage One included extraction and data preparation for topic modelling Stage Two was an adapted approach to thematic qualitative analysis. Results: Topic modelling revealed 49 topics of which 6 were relevant thematically to unintended fatherhood. Men's communication in these were then classified within three domains: 1) Men's Concerns included their mental health, problems bonding with baby, their relationships with family and partner, and finances; 2) Men's Affective Experiences existed on a spectrum of complex emotions including regret, resignation, ambivalence, acceptance, and excitement; and 3) the Purpose of Communication included asking for and offering advice, normalisation, and perspective. Conclusions: Online forums like Reddit provide a unique opportunity for fathers who did not intend to have children to normalize their experience by expressing concerns and emotions in a pseudonymous environment. This study highlights the supportive environment that online discussions offer to fathers, and particularly unexpected fathers who may face stigma or barriers in other settings

Ceftriaxone-induced up-regulation of cortical and striatal GLT1 in the R6/2 model of Huntington's disease

<p>Abstract</p> <p>Background</p> <p>Huntington's disease (HD) is an inherited neurodegenerative disorder characterized by cortico-striatal dysfunction and loss of glutamate uptake. At 7 weeks of age, R6/2 mice, which model an aggressive form of juvenile HD, show a glutamate-uptake deficit in striatum that can be reversed by treatment with ceftriaxone, a β-lactam antibiotic that increases GLT1 expression. Only at advanced ages (> 11 weeks), however, do R6/2 mice show an actual loss of striatal GLT1. Here, we tested whether ceftriaxone can reverse the decline in GLT1 expression that occurs in older R6/2s.</p> <p>Results</p> <p>Western blots were used to assess GLT1 expression in both striatum and cerebral cortex in R6/2 and corresponding wild-type (WT) mice at 9 and 13 weeks of age. Mice were euthanized for immunoblotting 24 hr after five consecutive days of once daily injections (ip) of ceftriaxone (200 mg/kg) or saline vehicle. Despite a significant GLT1 reduction in saline-treated R6/2 mice relative to WT at 13, but not 9, weeks of age, ceftriaxone treatment increased cortical and striatal GLT1 expression relative to saline in all tested mice.</p> <p>Conclusions</p> <p>The ability of ceftriaxone to up-regulate GLT1 in R6/2 mice at an age when GLT1 expression is significantly reduced suggests that the mechanism for increasing GLT1 expression is still functional. Thus, ceftriaxone could be effective in modulating glutamate transmission even in late-stage HD.</p

Magnetization reversal by injection and transfer of spin: experiments and theory

Reversing the magnetization of a ferromagnet by spin transfer from a current, rather than by applying a magnetic field, is the central idea of an extensive current research. After a review of our experiments of current-induced magnetization reversal in Co/Cu/Co trilayered pillars, we present the model we have worked out for the calculation of the current-induced torque and the interpretation of the experiments

Field dependence of magnetization reversal by spin transfer

We analyse the effect of the applied field (Happl) on the current-driven magnetization reversal in pillar-shaped Co/Cu/Co trilayers, where we observe two different types of transition between the parallel (P) and antiparallel (AP) magnetic configurations of the Co layers. If Happl is weaker than a rather small threshold value, the transitions between P and AP are irreversible and relatively sharp. For Happl exceding the threshold value, the same transitions are progressive and reversible. We show that the criteria for the stability of the P and AP states and the experimentally observed behavior can be precisely accounted for by introducing the current-induced torque of the spin transfer models in a Landau-Lifschitz-Gilbert equation. This approach also provides a good description for the field dependence of the critical currents

The Child and Parent Emotion Study: Protocol for a longitudinal study of parent emotion socialisation and child socioemotional development

Introduction:&nbsp;Parents shape child emotional competence and mental health via their beliefs about children&rsquo;s emotions, emotion-related parenting, the emotional climate of the family and by modelling emotion regulation skills. However, much of the research evidence to date has been based on small samples with mothers of primary school-aged children. Further research is needed to elucidate the direction and timing of associations for mothers and fathers/partners across different stages of child development. The Child and Parent Emotion Study (CAPES) aims to examine longitudinal associations between parent emotion socialisation, child emotion regulation and socioemotional adjustment at four time points from pregnancy to age 12 years. CAPES will investigate the moderating role of parent gender, child temperament and gender, and family background.Methods and analysis:&nbsp;CAPES recruited 2063 current parents from six English-speaking countries of a child 0&ndash;9 years and 273 prospective parents (ie, women/their partners pregnant with their first child) in 2018&ndash;2019. Participants will complete a 20&ndash;30 min online survey at four time points 12 months apart, to be completed in December 2022. Measures include validated parent-report tools assessing parent emotion socialisation (ie, parent beliefs, the family emotional climate, supportive parenting and parent emotion regulation) and age-sensitive measures of child outcomes (ie, emotion regulation and socioemotional adjustment). Analyses will use mixed-effects regression to simultaneously assess associations over three time-point transitions (ie, T1 to T2; T2 to T3; T3 to T4), with exposure variables lagged to estimate how past factors predict outcomes 12 months later.Ethics and dissemination:&nbsp;Ethics approval was granted by the Deakin University Human Research Ethics Committee and the Deakin University Faculty of Health Human Research Ethics Committee. We will disseminate results through conferences and open access publications. We will invite parent end users to co-develop our dissemination strategy, and discuss the interpretation of key findings prior to publication.Trial registeration:&nbsp;Protocol pre-registration: DOI 10.17605/OSF.IO/NGWUY.</jats:sec

Associations between maternal psychological distress and mother-infant bonding: a systematic review and meta-analysis

Purpose: Maternal psychological distress and mother-infant bonding problems each predict poorer offspring outcomes. They are also related to each other, yet the extensive literature reporting their association has not been meta-analysed. Methods: We searched MEDLINE, PsycINFO, CINAHL, Embase, ProQuest DTG, and OATD for English-language peer-reviewed and grey literature reporting an association between mother-infant bonding, and multiple indicators of maternal psychological distress. Results: We included 133 studies representing 118 samples; 99 samples (110,968 mothers) were eligible for meta-analysis. Results showed concurrent associations across a range of timepoints during the first year postpartum, between bonding problems and depression (r = .27 [95% CI 0.20, 0.35] to r = .47 [95% CI 0.41, 0.53]), anxiety (r = .27 [95% CI 0.24, 0.31] to r = .39 [95% CI 0.15, 0.59]), and stress (r = .46 [95% CI 0.40, 0.52]). Associations between antenatal distress and subsequent postpartum bonding problems were mostly weaker and with wider confidence intervals: depression (r = .20 [95% CI 0.14, 0.50] to r = .25 [95% CI 0.64, 0.85]), anxiety (r = .16 [95% CI 0.10, 0.22]), and stress (r = .15 [95% CI − 0.67, 0.80]). Pre-conception depression and anxiety were associated with postpartum bonding problems (r = − 0.17 [95% CI − 0.22, − 0.11]). Conclusion: Maternal psychological distress is associated with postpartum mother-infant bonding problems. Co-occurrence of psychological distress and bonding problems is common, but should not be assumed. There may be benefit in augmenting existing perinatal screening programs with well-validated mother-infant bonding measures

Deep brain stimulation for Parkinson\u27s disease changes perception in the Rubber Hand Illusion

Parkinson\u27s disease (PD) alters cortico-basal ganglia-thalamic circuitry and susceptibility to an illusion of bodily awareness, the Rubber Hand Illusion (RHI). Bodily awareness is thought to result from multisensory integration in a predominantly cortical network; the role of subcortical connections is unknown. We studied the effect of modulating cortico-subcortical circuitry on multisensory integration for bodily awareness in 24 PD patients treated with subthalamic nucleus (STN) deep brain stimulation (DBS), in comparison to 21 healthy volunteers, using the RHI experiment. Typically, synchronous visuo-tactile cues induce a false perception of touch on the rubber hand as if it were the subject\u27s hand, whereas asynchronous visuo-tactile cues do not. However, we found that in the asynchronous condition, patients in the off-stimulation state did not reject the RHI as strongly as healthy controls; patients\u27 rejection of the RHI strengthened when STN-DBS was switched on, although it remained weaker than that of controls. Patients in the off-stimulation state also misjudged the position of their hand, indicating it to be closer to the rubber hand than controls. However, STN-DBS did not affect proprioceptive judgements or subsequent arm movements altered by the perceptual effects of the illusion. Our findings support the idea that the STN and subcortical connections have a key role in multisensory integration for bodily awareness. Decision-making in multisensory bodily illusions is discussed

Heritability of overlapping impulsivity and compulsivity dimensional phenotypes

Funder: David Winston Turner Endowment FundAbstract: Impulsivity and compulsivity are traits relevant to a range of mental health problems and have traditionally been conceptualised as distinct constructs. Here, we reconceptualised impulsivity and compulsivity as partially overlapping phenotypes using a bifactor modelling approach and estimated heritability for their shared and unique phenotypic variance within a classical twin design. Adult twin pairs (N = 173) completed self-report questionnaires measuring psychological processes related to impulsivity and compulsivity. We fitted variance components models to three uncorrelated phenotypic dimensions: a general impulsive–compulsive dimension; and two narrower phenotypes related to impulsivity and obsessiveness.There was evidence of moderate heritability for impulsivity (A2 = 0.33), modest additive genetic or common environmental effects for obsessiveness (A2 = 0.25; C2 = 0.23), and moderate effects of common environment (C2 = 0.36) for the general dimension, This general impulsive–compulsive phenotype may reflect a quantitative liability to related mental health disorders that indexes exposure to potentially modifiable environmental risk factors

Study Protocol for the COVID-19 Pandemic Adjustment Survey (CPAS): A Longitudinal Study of Australian Parents of a Child 0–18 Years

Background: The COVID-19 pandemic presents significant risks to the mental health and wellbeing of Australian families. Employment and economic uncertainty, chronic stress, anxiety, and social isolation are likely to have negative impacts on parent mental health, couple and family relationships, as well as child health and development. Objective: This study aims to: (1) provide timely information on the mental health impacts of the emerging COVID-19 crisis in a close to representative sample of Australian parents and children (0–18 years), (2) identify adults and families most at risk of poor mental health outcomes, and (3) identify factors to target through clinical and public health intervention to reduce risk. Specifically, this study will investigate the extent to which the COVID-19 pandemic is associated with increased risk for parents’ mental health, lower well-being, loneliness, and alcohol use; parent-parent and parent-child relationships (both verbal and physical); and child and adolescent mental health problems. Methods: The study aims to recruit a close to representative sample of at least 2,000 adults aged 18 years and over living in Australia who are parents of a child 0–4 years (early childhood, N = 400), 5–12 years (primary school N = 800), and 13–18 years (secondary school, N = 800). The design will be a longitudinal cohort study using an online recruitment methodology. Participants will be invited to complete an online baseline self-report survey (20 min) followed by a series of shorter online surveys (10 min) scheduled every 2 weeks for the duration of the COVID-19 pandemic (i.e., estimated to be 14 surveys over 6 months). Results: The study will employ post stratification weights to address differences between the final sample and the national population in geographic communities across Australia. Associations will be analyzed using multilevel modeling with time-variant and time-invariant predictors of change in trajectory over the testing period. Conclusions: This study will provide timely information on the mental health impacts of the COVID-19 crisis on parents and children in Australia; identify communities, parents, families, and children most at risk of poor outcomes; and identify potential factors to address in clinical and public health interventions to reduce risk