653 research outputs found

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

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    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 A118.16perparticipant.Theanalysisshowednostatisticallysignificantdifferencebetweentheinterventionandcontrolgroupsincostsoroutcomes.TheincrementalcosteffectivenessratioswereA118.16 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 A152perpercentagepointreductionin30dayprevalenceofdepression,anxietyandadjustmentdisorders.TheestimateliesundertheunofficialcosteffectivenessthresholdofA152 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

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    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

    MBE Emerging Classics 2023

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    Molecular Biology and Evolution provides yearly recognition of recently published manuscripts that have made strong impressions on our research community since their publication. In recent years, this list has evolved to focus on recent contributions that have had a proportionally strong impact since publication. Below, we highlight ten discoveries, five methods, and five resources as “Emerging Classics” based on citations accrued per fractional year since print publication. Within categories, articles are listed alphabetically by the first author’s family name. Total citation counts were obtained from Web of Science on November 30, 2022. We congratulate these authors on the significance of their contributions and look forward to celebrating articles that make a difference to our community in the years to come.Temple University. College of Science and Technolog

    MBE Emerging Classics 2022

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    Since 2013, Molecular Biology and Evolution has celebrated papers with powerful impact on our community as reflected by accumulated citations. Below, we highlight ten discoveries, five methods, and five resource publications as “Emerging Classics” based on citations accrued per fractional years since publication. Articles within categories are listed in alphabetical order based on the family name of the first author. Total citation counts were obtained from Web of Science on November 30, 2021. We congratulate these authors on the significance of their contributions and look forward to publishing many high-impact articles in the years to come.Temple University. College of Science and Technolog

    Epstein-Barr virus transcription factor Zta acts through distal regulatory elements to directly control cellular gene expression

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    Lytic replication of the human gamma herpes virus Epstein-Barr virus (EBV) is an essential prerequisite for the spread of the virus. Differential regulation of a limited number of cellular genes has been reported in B-cells during the viral lytic replication cycle. We asked whether a viral bZIP transcription factor, Zta (BZLF1, ZEBRA, EB1), drives some of these changes. Using genome-wide chromatin immunoprecipitation coupled to next-generation DNA sequencing (ChIP-seq) we established a map of Zta interactions across the human genome. Using sensitive transcriptome analyses we identified 2263 cellular genes whose expression is significantly changed during the EBV lytic replication cycle. Zta binds 278 of the regulated genes and the distribution of binding sites shows that Zta binds mostly to sites that are distal to transcription start sites. This differs from the prevailing view that Zta activates viral genes by binding exclusively at promoter elements. We show that a synthetic Zta binding element confers Zta regulation at a distance and that distal Zta binding sites from cellular genes can confer Zta-mediated regulation on a heterologous promoter. This leads us to propose that Zta directly reprograms the expression of cellular genes through distal elements

    A Spectroscopic Survey of a Sample of Active M Dwarfs

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    A moderate resolution spectroscopic survey of Fleming's sample of 54 X-ray selected M dwarfs with photometric distances less than 25 pc is presented. Radial and rotation velocities have been measured by fits to the H-alpha profiles. Radial velocities have been measured by cross correlation. Artificial broadening of an observed spectrum has produced a relationship between H-alpha FWHM and rotation speed, which we use to infer rotation speeds for the entire sample by measurement of the H-alpha emission line. We find 3 ultra-fast rotators (UFRs, vsini > 100km/s), and 8 stars with 30 < vsini < 100 km/s. The UFRs have variable emission. Cross-correlation velocities measured for ultra-fast rotators (UFRs) are shown to depend on rotation speed and the filtering used. The radial velocity dispersion of the sample is 17 km/s. A new double emission line spectroscopic binary with a period of 3.55 days has been discovered, and another known one is in the sample. Three other objects are suspected spectroscopic binaries, and at least six are visual doubles. The only star in the sample observed to have significant lithium is a known TW Hya Association member, TWA 8A. These results show that there are a number of young (< 10^8 yr) and very young (< 10^7 yr) low mass stars in the immediate solar neighbourhood. The H-alpha activity strength does not depend on rotation speed. Our fast rotators are less luminous than similarly fast rotators in the Pleiades. They are either younger than the Pleiades, or gained angular momentum in a different way.Comment: 38 pages incl. 14 figures and 4 tables, plus 12 pages of table for electronic journal only; LaTeX, aastex.cls. Accepted 07/18/02 for publication in The Astronomical Journa

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

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    <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

    Modelling and mapping of exceedance of critical loads and critical levels for acidification and eutrophication in the UK 2013-2016. Final report

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    This report covers the work of the original contract (2013-15) and the following one-year extension (2015-16). The overall purpose of this project was to maintain, and where appropriate update, the UK critical loads database, and to provide estimates of critical load and critical level exceedance based on current pollutant deposition or concentrations, and scenarios for the future. The exceedance results were used to inform policy makers on the areas of sensitive habitats and designated sites potentially at risk from air pollution and were updated annually to provide a UK indicator of the impacts of air pollution on ecosystems. The project also supported the UK National Focal Centre (NFC) for critical loads modelling and mapping. The 1-year extension to this contract additionally included the biodiversity modelling required to enable the UK NFC to begin work in preparation for responding to the 2015-17 “Call for Data” under the UNECE Convention on Long-Range Transboundary Air Pollution (CLRTAP)
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