Experiences of Adults who Disclose Self-harm to Non-professionals

Background: Research suggests that self-harm is often a private behaviour and many individuals do not disclose their self-harm. People who feel unable to disclose their self-harm have less opportunity to seek support. There is a paucity of research on adult self-harm disclosure experiences, with most existing studies recruiting adolescents. Aims: This study aimed to understand the expectations and experiences of adults who self-harm when they disclose to non-professionals. Methods: Ten participants (aged 26-51) were recruited through the NHS and a third sector organisation. Semi-structured interviews were conducted and data was analysed using thematic analysis. Results: Four themes were identified; ‘The insular nature of self-harm’, ‘Imagined versus reality’, ‘Self-preservation’ and ‘New ways of relating’. Participants described self-harm as an insular behaviour, which created an inherent tension when considering disclosure; a social process. There were risks associated with self-harm disclosure, including stigma and losing control. Participants carefully considered the decision to disclose, experiencing high levels of ambivalence about disclosing and spending extended periods rehearsing potential disclosures. In reality, disclosure experiences were sometimes very different, with participants describing a range of positive and negative responses. Making such risky personal disclosures meant self-preservation was key, both during and after a disclosure. Participants found new ways of relating to their disclosure recipients and evaluated future potential disclosures depending on the response received. Most participants had experienced negative responses, which caused distress and curtailed future disclosures, highlighting a need for improved public awareness of supportive responses to disclosures of self-harm. Discussion: This study highlighted the personal risks and highly variable responses people experience when disclosing self-harm to a family member, friend or colleague. Helpful ways of responding to self-harm disclosures were highlighted by participants in this study and guidance could be published so that non-professionals can be informed and prepared for having conversations about self-harm

Hypoxia promotes production of neural crest cells in the embryonic head

ABSTRACT Hypoxia is encountered in either pathological or physiological conditions, the latter of which is seen in amniote embryos prior to the commencement of a functional blood circulation. During the hypoxic stage, a large number of neural crest cells arise from the head neural tube by epithelial-to-mesenchymal transition (EMT). As EMT-like cancer dissemination can be promoted by hypoxia, we investigated whether hypoxia contributes to embryonic EMT. Using chick embryos, we show that the hypoxic cellular response, mediated by hypoxia-inducible factor (HIF)-1α, is required to produce a sufficient number of neural crest cells. Among the genes that are involved in neural crest cell development, some genes are more sensitive to hypoxia than others, demonstrating that the effect of hypoxia is gene specific. Once blood circulation becomes fully functional, the embryonic head no longer produces neural crest cells in vivo, despite the capability to do so in a hypoxia-mimicking condition in vitro, suggesting that the oxygen supply helps to stop emigration of neural crest cells in the head. These results highlight the importance of hypoxia in normal embryonic development.</jats:p

Preliminary Analysis of in Utero Low-Level Arsenic Exposure and Fetal Growth Using Biometric Measurements Extracted from Fetal Ultrasound Reports

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. Results: In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value \u3c 0.05). Although, associations were attenuated in adjusted analyses — among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: −0.151, 0.007) decrease in biparietal head diameter Z-score. Conclusions: Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation

Preliminary Analysis of in Utero Low-Level Arsenic Exposure and Fetal Growth Using Biometric Measurements Extracted from Fetal Ultrasound Reports

Background: Early life exposure to arsenic is associated with decreased birth weight in highly exposed populations but little is known about effects of low-level arsenic exposure on growth in utero. Methods: Using a sample of 272 pregnancies from New Hampshire we obtained biometric measurements directly from fetal ultrasound reports commonly found in electronic medical records. We used information extraction methods to develop and validate an automated approach for mining biometric measurements from the text of clinical reports. As a preliminary analysis, we examined associations between in utero low-level arsenic exposure (as measured by maternal urinary arsenic concentration) and fetal growth measures (converted to Z-scores based on reference populations for estimated fetal weight, head, and other body measures) at approximately 18 weeks of gestation. Results: In a preliminary cross-sectional analysis of 223 out of 272 pregnancies, maternal urinary arsenic concentration (excluding arsenobetaine) was associated with a reduction in head circumference Z-score (Spearman correlation coefficient, rs = -0.08, p-value = 0.21) and a stronger association was observed among female fetuses at approximately 18 weeks of gestation (rs = - 0.21, p-value \u3c 0.05). Although, associations were attenuated in adjusted analyses — among female fetuses a 1 μg/L increase in maternal urinary arsenic concentration was associated with a decrease of 0.047 (95% CI: -0.115, 0.021) in head circumference and 0.072 (95% CI: −0.151, 0.007) decrease in biparietal head diameter Z-score. Conclusions: Our study demonstrates that useful data can be extracted directly from electronic medical records for epidemiologic research. We also found evidence that exposure to low-level arsenic may be associated with reduced head circumference in a sex dependent manner that warrants further investigation

Partnering in a Pandemic: a Case Study on Designing Teaching and Learning Tools by Undergraduate and Graduate Medical Students with Academic Support

This case study reflects on the concept of student\u27s-as-partners in a project that took place during the Summer 2020, during the COVID-19 pandemic, involving nine students from two medical schools in Ireland (University College Dublin (UCD) and the Royal College of Surgeons in Ireland (RCSI) and makes a pedagogical case for partnership in learning and teaching in medical education. This virtual partnership project lasted three weeks under the supervision of practitioners from the National Maternity Hospital (NMH). The focus of this paper on one output from the project: designing and developing Multiple Choice Questions (MCQ) bank. This bank of MCQ questions were written by the students, based on national and international guidelines, then peer reviewed by the students before final review by academic staff and then integrated into the online teaching for the next iteration of the Obstetrics and Gynaecology module in September 2020. The reflections on this MCQ development work provides valuable insights on challenges and opportunities for medical students at both undergraduate and graduate level who are planning for collaborative partnerships as a component of their medical education, as well as academic-practitioners in medical education who are initiating student-staff partnership

Bearings House: Community Reintegration Project

Research poster documenting the following project: Long Creek Youth Development Center offers a variety of activities, an education, mentorship, and structure for Bearings House residents. In addition to those programs, we hoped through building a relationship with residents we could identify their occupational interests and assist in their transition to life in the community. We strived to support residents through their transition to Bearings House and give them an opportunity to further explore their interests as well as expose them to new occupations they may have not previously participated in order to help as they reintegrate into the community.https://dune.une.edu/cecespring2020/1010/thumbnail.jp

Two novel missense mutations in ABCA1 result in altered trafficking and cause severe autosomal recessive HDL deficiency

AbstractExtremely low concentrations of high density lipoprotein (HDL)-cholesterol and apolipoprotein (apo) AI are features of Tangier disease caused by autosomal recessive mutations in ATP-binding cassette transporter A1 (ABCA1). Less deleterious, but dominantly inherited mutations cause HDL deficiency. We investigated causes of severe HDL deficiency in a 42-year-old female with progressive coronary disease.ApoAI-mediated efflux of cholesterol from the proband's fibroblasts was less than 10% of normal and nucleotide sequencing revealed inheritance of two novel mutations in ABCAI, V1704D and L1379F. ABCA1 mRNA was approximately 3-fold higher in the proband's cells than in control cells; preincubation with cholesterol increased it 5-fold in control and 8-fold in the proband's cells, but similar amounts of ABCA1 protein were present in control and mutant cells. When transiently transfected into HEK293 cells, confocal microscopy revealed that both mutant proteins were retained in the endoplasmic reticulum, while wild-type ABCA1 was located at the plasma membrane.Severe HDL deficiency in the proband was caused by two novel autosomal recessive mutations in ABCA1, one (V1704D) predicted to lie in a transmembrane segment and the other (L1379F) in a large extracellular loop. Both mutations prevent normal trafficking of ABCA1, thereby explaining their inability to mediate apoA1-dependent lipid efflux

SARS-CoV-2 Infection and the Risk of Suicidal and Self-Harm Thoughts and Behaviour:A Systematic Review

OBJECTIVE: The COVID-19 pandemic has had a complex impact on risks of suicide and non-fatal self-harm worldwide with some evidence of increased risk in specific populations including women, young people, and people from ethnic minority backgrounds. This review aims to systematically address whether SARS-CoV-2 infection and/or COVID-19 disease confer elevated risk directly. METHOD: As part of a larger Living Systematic Review examining self-harm and suicide during the pandemic, automated daily searches using a broad list of keywords were performed on a comprehensive set of databases with data from relevant articles published between January 1, 2020 and July 18, 2021. Eligibility criteria for our present review included studies investigating suicide and/or self-harm in people infected with SARS-CoV-2 with or without manifestations of COVID-19 disease with a comparator group who did not have infection or disease. Suicidal and self-harm thoughts and behaviour (STBs) were outcomes of interest. Studies were excluded if they reported data for people who only had potential infection/disease without a confirmed exposure, clinical/molecular diagnosis or self-report of a positive SARS-CoV-2 test result. Studies of news reports, treatment studies, and ecological studies examining rates of both SARS-CoV-2 infections and suicide/self-harm rates across a region were also excluded. RESULTS: We identified 12 studies examining STBs in nine distinct samples of people with SARS-CoV-2. These studies, which investigated STBs in the general population and in subpopulations, including healthcare workers, generally found positive associations between SARS-CoV-2 infection and/or COVID-19 disease and subsequent suicidal/self-harm thoughts and suicidal/self-harm behaviour. CONCLUSIONS: This review identified some evidence that infection with SARS-CoV-2 and/or COVID-19 disease may be associated with increased risks for suicidal and self-harm thoughts and behaviours but a causal link cannot be inferred. Further research with longer follow-up periods is required to confirm these findings and to establish whether these associations are causal

Toward a containerized pipeline for longitudinal analysis of open-source software projects

Trust in open-source software is a cornerstone of scientific progress and a foundation of high-quality public services. Just as standards are integral when judging the efficacy of a novel pharmaceutical compound or determining the spread of a new disease, the software used to make those determinations should be useful, error-free, reliable, performant, and secure. A small bug in an application, library, or framework can lead to economic loss and even loss of life. We rely on software developers to be dynamic and responsive to user review and bug-reporting. Our team developed an open-source modular pipeline to perform empirical investigations of software quality. A key innovation of our approach is to look at projects “from a distance” similar to methods used in climate, e.g. satellite images being used to observe environmental impacts in air quality/rain forests. Instead of looking at language-specific source code features, our pipeline uses a language-agnostic high-level approach to track software quality by focusing on the development process itself, which yields great insight into the processes programmers use to write and maintain their software. Our distributed modular approach to analytics allows the pipeline to be easily extended to support additional metrics in future work. We store extracted data in an embedded SQLite database, which means that analysis can proceed without complex server setup, let alone hosting the software on dedicated servers. Our analytical modules are designed for efficiency, and future runs of our software only collect missing data, supporting the incremental analysis of known, important open-source projects