Developing a protocol for campus health service professional nurses to manage students with mental distress

Professional nurses working at a campus health service have to cope with challenges such as staff shortages and budgetary constraints associated with working in a complex environment providing primary health care. The aim of primary health care includes promoting health, preventing disease and the early detection and treatment of illness. Mental health services form an integral part of the integrated primary health care package as implemented in the campus health service. Students attend the Campus Health Service for help related to their health. Health care is provided by professional nurses and counsellors through a comprehensive primary health care service which serves students as well as staff. Some students may state that they experience feelings of being stressed or depressed. Other students may complain of physical symptoms such as headache or upper backache. Upon further investigation emotional problems may be identified as the cause of the psychosomatic symptoms. The professional nurses working in the campus health service verbalised that it is sometimes difficult to identify a mental illness or mental distress as there is no effective assessment tool that they can use. Management of conditions is also problematic as there are no protocols indicating the therapeutic interventions that can be taken. The research question in this study was therefore: What information should be included in a protocol to assess and manage a student experiencing mental distress that can be used by professional nurses working in a Campus Health Service? The aim of this study is to develop a mental health care protocol for campus health service professional nurses to assess and manage university students who are experiencing mental distress. The research design of this study was qualitative, explorative, descriptive, explanatory and contextual. In this study the Delphi research technique was used to create an instrument to standardise mental health care in a campus health service. The Delphi technique is a series of sequential questionnaires or “rounds” interspersed with controlled feedback that seeks to gain the most reliable consensus of opinion of a group of experts. A questionnaire was developed based on an extensive literature review. The research population of this study consisted of two groups: professional nurses with knowledge of student health care needs and expert psychiatric nurses. The study was conducted at the Campus Health Service at a university in the Eastern Cape. The data collection and analysis was done utilising the Delphi technique. Trustworthiness was ensured by using the Lincoln and Guba Model utilising the criteria of credibility, applicability, dependability and conformability. In this study the ethical principles of beneficence, non-maleficence, justice and self determination were applied to ensure that participants are treated with respect and consideration and ensured high ethical standards. Informed consent was obtained from the participants in this study. The findings of this research were utilised to assist the researcher in developing a protocol for mental health care of students in campus health service settings

Inclusive Education and UDL Professional Development for Teachers in Sweden and India

In education, the factors involved in a successful inclusive education classroom are diverse and multidimensional, with a growing research base. Universal design for learning (UDL) can help educators address the varied needs of students through diversification of the design of instructional methods, materials, and assessments. Global interest in UDL has driven the need for more teacher training opportunities. This chapter contributes to the literature base on professional development in UDL cases by presenting two examples from two national contexts, Sweden and India. The authors ground the two cases in the literature on teacher training, inclusive education, and UDL, concluding with a discussion on the contextual impact and insights stemming from the cases

Household disaster preparedness and information sources: Rapid cluster survey after a storm in New South Wales, Australia

Background: A storm-related disaster in New South Wales, Australia in June 2007 caused infrastructure damage, interrupted essential services, and presented major public health risks. We investigated household disaster preparedness and information sources used before and during the disaster.\ud \ud Methods: Rapid cluster survey of 320 randomly selected households in Newcastle and Lake Macquarie, New South Wales, Australia.\ud \ud Results: 227 households (71%) responded to the survey. By the day before the storm, 48% (95%CI 40–57%) of households were aware of a storm warning, principally through television (67%; 58–75%) and radio (57%; 49–66%) announcements. Storm preparations were made by 42% (28–56%) of these households.\ud \ud Storm information sources included: radio (78%; 68–88%); family, friends, colleagues and neighbours (50%; 40–60%); and television (41%; 30–52%). Radio was considered more useful than television (62%; 51–73% vs. 29%; 18–40%), even in households where electricity supply was uninterrupted (52%; 31–73% vs. 41%; 20–63%).\ud \ud Only 23% (16–30%) of households were aware that the local government-operated radio network has a designated communication role during disasters. A battery-operated household radio and appropriate batteries were available in 42% (34–50%) of households, while only 23% (16–29%) had all of: a torch, battery-operated radio, appropriate batteries, mobile phone, emergency contact list and first aid equipment.\ud \ud Conclusion: Broadcast media are important information sources immediately before and during disasters. Health services should promote awareness of broadcast networks' disaster role, especially the role of radio, and encourage general household disaster preparedness. A rapid cluster survey conducted shortly after a natural disaster provided practical, robust information for disaster planning

Interferon γ (IFN-γ) Is Necessary for the Genesis of Acetylcholine Receptor–induced Clinical Experimental Autoimmune Myasthenia gravis in Mice

Experimental autoimmune myasthenia gravis (EAMG) is an animal model of human myasthenia gravis (MG). In mice, EAMG is induced by immunization with Torpedo californica acetylcholine receptor (AChR) in complete Freund's adjuvant (CFA). However, the role of cytokines in the pathogenesis of EAMG is not clear. Because EAMG is an antibody-mediated disease, it is of the prevailing notion that Th2 but not Th1 cytokines play a role in the pathogenesis of this disease. To test the hypothesis that the Th1 cytokine, interferon (IFN)-γ, plays a role in the development of EAMG, we immunized IFN-γ knockout (IFN-gko) (−/−) mice and wild-type (WT) (+/+) mice of H-2b haplotype with AChR in CFA. We observed that AChR-primed lymph node cells from IFN-gko mice proliferated normally to AChR and to its dominant pathogenic α146–162 sequence when compared with these cells from the WT mice. However, the IFN-gko mice had no signs of muscle weakness and remained resistant to clinical EAMG at a time when the WT mice exhibited severe muscle weakness and some died. The resistance of IFN-gko mice was associated with greatly reduced levels of circulating anti-AChR antibody levels compared with those in the WT mice. Comparatively, immune sera from IFN-gko mice showed a dramatic reduction in mouse AChR-specific IgG1 and IgG2a antibodies. However, keyhole limpet hemocyanin (KLH)–priming of IFN-gko mice readily elicited both T cell and antibody responses, suggesting that IFN-γ regulates the humoral immune response distinctly to self (AChR) versus foreign (KLH) antigens. We conclude that IFN-γ is required for the generation of a pathogenic anti-AChR humoral immune response and for conferring susceptibility of mice to clinical EAMG

Smart density: a more accurate method of measuring rural residential density for health-related research

<p>Abstract</p> <p>Background</p> <p>Studies involving the built environment have typically relied on US Census data to measure residential density. However, census geographic units are often unsuited to health-related research, especially in rural areas where development is clustered and discontinuous.</p> <p>Objective</p> <p>We evaluated the accuracy of both standard census methods and alternative GIS-based methods to measure rural density.</p> <p>Methods</p> <p>We compared residential density (units/acre) in 335 Vermont school neighborhoods using conventional census geographic units (tract, block group and block) with two GIS buffer measures: a 1-kilometer (km) circle around the school and a 1-km circle intersected with a 100-meter (m) road-network buffer. The accuracy of each method was validated against the actual residential density for each neighborhood based on the Vermont e911 database, which provides an exact geo-location for all residential structures in the state.</p> <p>Results</p> <p>Standard census measures underestimate residential density in rural areas. In addition, the degree of error is inconsistent so even the relative rank of neighborhood densities varies across census measures. Census measures explain only 61% to 66% of the variation in actual residential density. In contrast, GIS buffer measures explain approximately 90% of the variation. Combining a 1-km circle with a road-network buffer provides the closest approximation of actual residential density.</p> <p>Conclusion</p> <p>Residential density based on census units can mask clusters of development in rural areas and distort associations between residential density and health-related behaviors and outcomes. GIS-defined buffers, including a 1-km circle and a road-network buffer, can be used in conjunction with census data to obtain a more accurate measure of residential density.</p

Laser microdissection of actinomycin D segregated nucleoli

Nucleoli of tissue culture cells were segregated into their fibrillar (light) and granular (dark) components by treatment with actinomycin D. Following this segregation, the cells were treated with quinacrine hydrochloride, an agent which selectively sensitizes the nucleoli to argon laser light. The actinomycin D-segregated, quinacrine-sensitized nucleolar components (dark and light) were selectively irradiated with the laser microbeam and subsequent uridine uptake assayed. The data indicate that selective damage to the light (fibrillar) area is generally more damaging than damage to the dark (granular) area. These results support the idea that DNA is closely associated with the nucleolar fibrillar component.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/22301/1/0000745.pd

Perspectives on Proterozoic surface ocean redox from iodine contents in ancient and recent carbonate

© The Author(s), 2017. This is the author's version of the work. It is posted here under a nonexclusive, irrevocable, paid-up, worldwide license granted to WHOI. It is made available for personal use, not for redistribution. The definitive version was published in Earth and Planetary Science Letters 463 (2017): 159-170, doi:10.1016/j.epsl.2017.01.032.The Proterozoic Eon hosted the emergence and initial recorded diversification of eukaryotes. Oxygen levels in the shallow marine settings critical to these events were lower than today’s, although how much lower is debated. Here, we use concentrations of iodate (the oxidized iodine species) in shallow-marine limestones and dolostones to generate the first comprehensive record of Proterozoic near-surface marine redox conditions. The iodine proxy is sensitive to both local oxygen availability and the relative proximity to anoxic waters. To assess the validity of our approach, Neogene-Quaternary carbonates are used to demonstrate that diagenesis most often decreases and is unlikely to increase carbonate-iodine contents. Despite the potential for diagenetic loss, maximum Proterozoic carbonate iodine levels are elevated relative to those of the Archean, particularly during the Lomagundi and Shuram carbon isotope excursions of the Paleo- and Neoproterozoic, respectively. For the Shuram anomaly, comparisons to Neogene-Quaternary carbonates suggest that diagenesis is not responsible for the observed iodine trends. The baseline low iodine levels in Proterozoic carbonates, relative to the Phanerozoic, are linked to a shallow oxic-anoxic interface. Oxygen concentrations in surface waters would have at least intermittently been above the threshold required to support eukaryotes. However, the diagnostically low iodine data from mid-Proterozoic shallow-water carbonates, relative to those of the bracketing time intervals, are consistent with a dynamic chemocline and anoxic waters that would have episodically mixed upward and laterally into the shallow oceans. This redox instability may have challenged early eukaryotic diversification and expansion, creating an evolutionary landscape unfavorable for the emergence of animals.TL, ZL, and DH thank NSF EAR-1349252. ZL further thanks OCE-1232620. DH, ZL, and TL acknowledge further funding from a NASA Early Career Collaboration Award. TL, AB, NP, DH, and AK thank the NASA Astrobiology Institute. TL and NP received support from the Earth-Life Transitions Program of the NSF. AB acknowledges support from NSF grant EAR-05-45484 and an NSERC Discovery and Accelerator Grants. CW acknowledges support from NSFC grant 40972021

Health-related quality of life in people with aphasia: Implications for fluency disorders quality of life research

Abstract It is increasingly important that clinicians address the health-related quality of life (HRQOL) of adults with communication disorders in clinical practice. The overall aim of this paper is to draw conclusion about the suitability of the Short Form 36 Health Survey for the communication disorders of aphasia and stuttering. This study reports on the impact of post-stroke aphasia on 30 Australian older adults’ HRQOL. It also comments on the capacity of the SF-36 to measure HRQOL in this population, specifically whether it is sensitive to the three known determinants of post-stroke HRQOL – emotional, physical and social functioning. Comparisons with other data are made to assist interpretation of the SF-36 subscale scores: with 75 older adults with no history of neurological conditions; and with data from the 1995 National Health Survey data. The main findings are: (1) adults with post-stroke aphasia have similar HRQOL to their peers on six subscales, but significantly lower Role emotional and Mental health HRQOL; (2) a substantial number of aphasic adults reported depressive mood; and (3) aphasic adults with depressive mood have significantly worse HRQOL on six subscales than aphasic adults without depressive mood, but similar Role emotional and Body pain HRQOL. In conclusion, stroke and aphasia have minimal impact on older adults’ HRQOL as measured by the SF-36, which conflicts with an established evidence base of the negative consequences of aphasia on life. Thus, the SF-36 is not advisable for use with aphasic adults. Implications of these findings for aphasia and stuttering are discussed. Educational objectives: The reader will be able to: (a) describe the impact of aphasia and depressive mood on quality of life; (b) compare the impact of aphasia on the quality of life of adults to adults who do not have aphasia; (c) describe the similarities and differences between quality of life of adults with aphasia and adults who stutter; and (d) describe the strengths and limitations of the SF-36 as a measure of quality of life in adults who stutter versus adults with aphasia

Behavioral and Physiological Responses to Child-Directed Speech of Children with Autism Spectrum Disorders or Typical Development

Young boys with autism were compared to typically developing boys on responses to nonsocial and child-directed speech (CDS) stimuli. Behavioral (looking) and physiological (heart rate and respiratory sinus arrhythmia) measures were collected. Boys with autism looked equally as much as chronological age-matched peers at nonsocial stimuli, but less at CDS stimuli. Boys with autism and language age-matched peers differed in patterns of looking at live versus videotaped CDS stimuli. Boys with autism demonstrated faster heart rates than chronological age-matched peers, but did not differ significantly on respiratory sinus arrhythmia. Reduced attention during CDS may restrict language-learning opportunities for children with autism. The heart rate findings suggest that young children with autism have a nonspecific elevated arousal level