The contribution of Australian residential early parenting centres to comprehensive mental health care for mothers of infants: evidence from a prospective study

<p>Abstract</p> <p>Background</p> <p>Australia's public access residential early parenting services provide programs to assist parents who self-refer, to care for their infants and young children. Treatment programs target infant feeding and sleeping difficulties and maternal mental health. There is limited systematic evidence of maternal and infant mental health, psychosocial circumstances or presenting problems, or the effectiveness of the programs. The aim of this study was to contribute to the evidence base about residential early parenting services.</p> <p>Methods</p> <p>A prospective cohort design was used. A consecutive sample of mothers with infants under one year old recruited during admission to a public access residential early parenting service for a 4 or 5 night stay in Melbourne, Australia was recruited. They completed structured self-report questionnaires, incorporating standardised measures of infant behaviour and maternal mood, during admission and at one and six months after discharge. Changes in infant behaviour and maternal psychological functioning after discharge were observed.</p> <p>Results</p> <p>79 women completed the first questionnaire during admission, and 58 provided complete data. Women admitted to the residential program have poor physical and mental health, limited family support, and infants with substantial behaviour difficulties. One month after discharge significant improvements in infant behaviour and maternal psychological functioning were observed (mean (SD) daily crying and fussing during admission = 101.02 (100.8) minutes reduced to 37.7 (55.2) at one month post discharge, p < 0.001; mean (SD) Edinburgh Postnatal Depression Scale at admission = 11.3 (5.7) reduced to 6.78 (4.44), at one month, p < 0.001) which were sustained at six months. Participant satisfaction with the program was high; 58 (88%) found the support of the nurses and 50 (75%) the social support of other mothers very helpful.</p> <p>Conclusions</p> <p>This psycho-educational approach is an effective and acceptable early intervention for parenting difficulties and maternal mood disturbance, and contributes to a system of comprehensive mental health care for mothers of infants.</p

Combining genome-wide association mapping and transcriptional networks to identify novel genes controlling glucosinolates in Arabidopsis thaliana.

BackgroundGenome-wide association (GWA) is gaining popularity as a means to study the architecture of complex quantitative traits, partially due to the improvement of high-throughput low-cost genotyping and phenotyping technologies. Glucosinolate (GSL) secondary metabolites within Arabidopsis spp. can serve as a model system to understand the genomic architecture of adaptive quantitative traits. GSL are key anti-herbivory defenses that impart adaptive advantages within field trials. While little is known about how variation in the external or internal environment of an organism may influence the efficiency of GWA, GSL variation is known to be highly dependent upon the external stresses and developmental processes of the plant lending it to be an excellent model for studying conditional GWA.Methodology/principal findingsTo understand how development and environment can influence GWA, we conducted a study using 96 Arabidopsis thaliana accessions, &gt;40 GSL phenotypes across three conditions (one developmental comparison and one environmental comparison) and ∼230,000 SNPs. Developmental stage had dramatic effects on the outcome of GWA, with each stage identifying different loci associated with GSL traits. Further, while the molecular bases of numerous quantitative trait loci (QTL) controlling GSL traits have been identified, there is currently no estimate of how many additional genes may control natural variation in these traits. We developed a novel co-expression network approach to prioritize the thousands of GWA candidates and successfully validated a large number of these genes as influencing GSL accumulation within A. thaliana using single gene isogenic lines.Conclusions/significanceTogether, these results suggest that complex traits imparting environmentally contingent adaptive advantages are likely influenced by up to thousands of loci that are sensitive to fluctuations in the environment or developmental state of the organism. Additionally, while GWA is highly conditional upon genetics, the use of additional genomic information can rapidly identify causal loci en masse

Earthquake slip surfaces identified by biomarker thermal maturity within the 2011 Tohoku-Oki earthquake fault zone.

Extreme slip at shallow depths on subduction zone faults is a primary contributor to tsunami generation by earthquakes. Improving earthquake and tsunami risk assessment requires understanding the material and structural conditions that favor earthquake propagation to the trench. We use new biomarker thermal maturity indicators to identify seismic faults in drill core recovered from the Japan Trench subduction zone, which hosted 50 m of shallow slip during the Mw9.1 2011 Tohoku-Oki earthquake. Our results show that multiple faults have hosted earthquakes with displacement ≥ 10 m, and each could have hosted many great earthquakes, illustrating an extensive history of great earthquake seismicity that caused large shallow slip. We find that lithologic contrasts in frictional properties do not necessarily determine the likelihood of large shallow slip or seismic hazard

Preventing postnatal maternal mental health problems using a psychoeducational intervention : the cost-effectiveness of What Were We Thinking

OBJECTIVES: Postnatal maternal mental health problems, including depression and anxiety, entail a significant burden globally, and finding cost-effective preventive solutions is a public policy priority. This paper presents a cost-effectiveness analysis of the intervention, What Were We Thinking (WWWT), for the prevention of postnatal maternal mental health problems. DESIGN: The economic evaluation, including cost-effectiveness and cost-utility analyses, was conducted alongside a cluster-randomised trial. SETTING: 48 Maternal and Child Health Centres in Victoria, Australia. PARTICIPANTS: Participants were English-speaking first-time mothers attending participating Maternal and Child Health Centres. Full data were collected for 175 participants in the control arm and 184 in the intervention arm. INTERVENTION: WWWT is a psychoeducational intervention targeted at the partner relationship, management of infant behaviour and parental fatigue. OUTCOME MEASURES: The evaluation considered public sector plus participant out-of-pocket costs, while outcomes were expressed in the 30-day prevalence of depression, anxiety and adjustment disorders, and quality-adjusted life years (QALYs). Incremental costs and outcomes were estimated using regression analyses to account for relevant sociodemographic, prognostic and clinical characteristics. RESULTS: The intervention was estimated to cost $A118.16 per participant. The analysis showed no statistically significant difference between the intervention and control groups in costs or outcomes. The incremental cost-effectiveness ratios were$A36 451 per QALY gained and $A152 per percentage-point reduction in 30-day prevalence of depression, anxiety and adjustment disorders. The estimate lies under the unofficial cost-effectiveness threshold of$A55 000 per QALY; however, there was considerable uncertainty surrounding the results, with a 55% probability that WWWT would be considered cost-effective at that threshold. CONCLUSIONS: The results suggest that, although WWWT shows promise as a preventive intervention for postnatal maternal mental health problems, further research is required to reduce the uncertainty over its cost-effectiveness as there were no statistically significant differences in costs or outcomes. TRIAL REGISTRATION NUMBER: ACTRN12613000506796; results

Editorial: From Pedagogic Research to Embedded E-Learning

This Special Issue of Reflecting Education arises from the work of the PREEL project (From Pedagogic Research to Embedded e-Learning) at the Institute of Education from 2006-2008. This project was one of nine HEA/JISC (Higher Education Academy and Joint Information Systems Committee) Pilot Pathfinder Projects and followed on from our involvement in the Pilot Benchmarking of e-Learning Programme. In the benchmarking exercise we identified a lack of coordination between research and practice in e-learning at the IoE as one of our crucial weaknesses, and so our Pilot Pathfinder project concentrated on this theme of building links between e-learning research and practice

VeRSE: Vertical Reading Strategy Efficacy for Homonymous Hemianopia after Stroke: A Feasibility Study.

AimTo conduct a feasibility study using vertical reading for stroke survivors with homonymous hemianopia. Feasibility objectives included assessing the appropriateness of testing methods, outcomes and amount of recruitment possible. Vertical reading has yet no empirical evidence for its use in homonymous hemianopia.MethodA cross-over design was used involving stroke survivors with homonymous hemianopia. Three reading directions (horizontal; 90° clockwise rotation; 90° anti-clockwise rotation) were assessed in a randomised order whilst measuring reading speed.ResultsSeven participants with stroke-induced homonymous hemianopia were recruited (25.9% recruitment rate). The mean horizontal reading speed was 120.3 (SD 33.9) words per minute. When reading vertically (downwards) at 90° clockwise rotation the mean reading speed was 62.7 (SD 43.4) words per minute. When reading vertically (upwards) at 90° anti-clockwise rotation the mean reading speed was 74.6 (SD 53.5) words per minute.ConclusionsThis feasibility study has informed and provided vital information for planning and developing future studies for vertical reading. The primary outcome measure for future studies should be reading acuity, taking account of both speed and errors. Further preliminary studies are required which incorporate a practice element to assess for any improvement over time

Psychological Implications of Informed Decisions in Prenatal Genetic Screening

Prenatal genetic screening for Down Syndrome through second trimester maternal serum screening is becoming part of routine care in Australia. Public heath policy emphasises the need for decisions to participate in screening programs to be informed. There is little evidence regarding the influence of emotional factors such as anxiety on women’s capacity to comprehend complex information required to exercise informed choice. This may be especially pertinent for younger women who may have no reason to regard themselves as at risk of having a baby with Down Syndrome. Furthermore such decision making occurs in the context of growing attachment to the unborn baby, but systematic investigation of the potential that prenatal screening has to disrupt this relationship is lacking

Evaluating for Impact: Professional Development Educational Content Delivery Through Learning Communities

The National 4-H Council Learning Priorities team developed educational content for professional development to increase evaluation capacity and evaluation skills for 4-H educators. Extension specialists in Oregon, Vermont, and Virginia piloted Evaluating for Impact curriculum through learning communities. Lessons learned from the pilot project include the overall success of content in increasing individual participant evaluation skills, reflection on the comprehensive and academically rigorous nature of the curriculum, a need for an experienced evaluator to lead the circles, and an ability to customize the curriculum to the evaluation levels of participants

Epstein-Barr Virus Evades CD4 T Cell Responses in Lytic Cycle through BZLF1-mediated Downregulation of CD74 and the Cooperation of vBcl-2.

Evasion of immune T cell responses is crucial for viruses to establish persistence in the infected host. Immune evasion mechanisms of Epstein-Barr virus (EBV) in the context of MHC-I antigen presentation have been well studied. In contrast, viral interference with MHC-II antigen presentation is less well understood, not only for EBV but also for other persistent viruses. Here we show that the EBV encoded BZLF1 can interfere with recognition by immune CD4(+) effector T cells. This impaired T cell recognition occurred in the absence of a reduction in the expression of surface MHC-II, but correlated with a marked downregulation of surface CD74 on the target cells. Furthermore, impaired CD4(+) T cell recognition was also observed with target cells where CD74 expression was downregulated by shRNA-mediated inhibition. BZLF1 downregulated surface CD74 via a post-transcriptional mechanism distinct from its previously reported effect on the CIITA promoter. In addition to being a chaperone for MHC-II αβ dimers, CD74 also functions as a surface receptor for macrophage Migration Inhibitory Factor and enhances cell survival through transcriptional upregulation of Bcl-2 family members. The immune-evasion function of BZLF1 therefore comes at a cost of induced toxicity. However, during EBV lytic cycle induced by BZLF1 expression, this toxicity can be overcome by expression of the vBcl-2, BHRF1, at an early stage of lytic infection. We conclude that by inhibiting apoptosis, the vBcl-2 not only maintains cell viability to allow sufficient time for synthesis and accumulation of infectious virus progeny, but also enables BZLF1 to effect its immune evasion function