Optical Distress Beacon for Use in Space Environments

A beacon system includes emitter devices, driver circuitry configured for controlling the emitter devices, and at least one processor programmed to receive and process one or more inputs and control the driver circuitry to actuate the emitter devices. In an example embodiment, the emitter devices include visible light sources that are oriented to provide omnidirectional visibility for the beacon system. In an example embodiment, components of the beacon system including the emitter devices, driver circuitry and at least one processor are configured such that in a space environment heat generated by the beacon system is dissipated sufficiently well to prevent the beacon system from overheating

Serving highly vulnerable families in home-visitation programs

Home-visitation programs for families with young children are growing in popularity in the US. These programs typically seek to prevent child abuse and neglect and/or promote optimal development for infants, toddlers, and/or preschool-age children. This paper focuses on improving the capacity of home-visitation programs to meet the complex needs of highly vulnerable families with young children. Poverty, maternal depression and substance abuse, and domestic violence are noted as factors that place young children at risk for poor outcomes. The challenges of providing home-visitation services to families in which these risk factors are present are discussed. Family engagement, matching services to families’ needs, and staff capabilities are highlighted as areas in which improvements can be made to enhance home-visitation programs’ capacity to serve highly vulnerable families. Recommendations are given for improving the effectiveness of home-visitation programs in serving these families, as well for addressing policy and research issues related to the further development and evaluation of these programs.First author draf

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

Cross-cutting principles for planetary health education

Since the 2015 launch of the Rockefeller Foundation Lancet Commission on planetary health,1 an enormous groundswell of interest in planetary health education has emerged across many disciplines, institutions, and geographical regions. Advancing these global efforts in planetary health education will equip the next generation of scholars to address crucial questions in this emerging field and support the development of a community of practice. To provide a foundation for the growing interest and efforts in this field, the Planetary Health Alliance has facilitated the first attempt to create a set of principles for planetary health education that intersect education at all levels, across all scales, and in all regions of the world—ie, a set of cross-cutting principles

Longer-Term Mental and Behavioral Health Effects of the Deepwater Horizon Gulf Oil Spill

Mental health issues are a significant concern after technological disasters such as the 2010 Gulf Oil Spill; however, there is limited knowledge about the long-term effects of oil spills. The study was part of a larger research effort to improve understanding of the mental and behavioral health effects of the Deepwater Horizon Gulf Oil Spill. Data were collected immediately following the spill and the same individuals were resampled again after the second anniversary (n = 314). The results show that mental health symptoms of depression, serious mental illness and posttraumatic stress have not statistically decreased, and anxiety symptoms were statistically equivalent to immediate symptoms. Results also showed that the greatest effect on anxiety is related to the extent of disruption to participants’ lives, work, family, and social engagement. This study supports lessons learned following the Exxon Valdez spill suggesting that mental health effects are long term and recovery is slow. Elevated symptoms indicate the continued need for mental health services, especially for individuals with high levels of disruption resulting in increased anxiety. Findings also suggest that the longer-term recovery trajectories following the Deepwater Horizon Gulf Oil Spill do not fall within traditional disaster recovery timelines

Four States, Four Projects, One Mission: Collectively Enhancing Mental and Behavioral Health Capacity Throughout the Gulf Coast

Context: The 2010 Deepwater Horizon oil spill triggered numerous concerns regarding the health and well-being of citizens within the already vulnerable Gulf Coast region. Four Mental and Behavioral Health Capacity Projects (MBHCPs) united to form the Quad-State MBHCP component of the Gulf Region Health Outreach Program (GRHOP). Their shared mission was to increase mental and behavioral health (MBH) capacity within coastal counties of Louisiana, Mississippi, Alabama, and the Florida Panhandle. Objective: To describe strategies used to collectively enhance the impact of the 4 state-specific MBHCPs and to share lessons learned from a multistate collaborative flexibly designed to meet a shared mission. Materials and Procedures: Archival materials were assessed. They included attendance sheets/notes from regularly scheduled group meetings, GRHOP quarterly and annual reports, and state-specific MBHCP logic models. Nationally available data on MBH services provided in project-relevant primary care sites were also examined. Results: Three strategies were found to be effective facilitators of collective success: (i) reciprocal participation in the backbone organization (GRHOP); (ii) creation and comparison of state-specific MBHCP logic models and activities; and (iii) cross-fertilization among the MBHCP state-specific logic models, a unified Quad-State, and the GRHOP-wide logic model to generate additional synergistic endeavors and measureable outcomes. Examples of region-wide MBHCP success, such as uptake in integrated health services in health care clinics across the jurisdiction of investment, are presented. Conclusions: Isolated approaches to complex issues are, at times, ineffective. The Collective Impact (CI) model, with an emphasis on coordination among existing organizations, stakeholders, and the public, can serve as a guidepost to facilitate sustainable change even when used in a modified form. Strategies discussed herein for maximizing the 5 prescribed CI conditions provide an important roadmap for how to interface among multidisciplinary projects seeking to address the same, large-scale public health problem