Practices Which Promote Harmonious Relationships with Adolescent Boys as Reported by a Group of Parents

Family Relations and Child Developmen

The Feasibility of a Telehealth Exercise Program Aimed at Increasing Cardiorespiratory Fitness for People After Stroke

Background: Accessing suitable fitness programs post-stroke is difficult for many. The feasibility of telehealth delivery has not been previously reported.Objectives: To assess the feasibility of, and level of satisfaction with home-based telehealth-supervised aerobic exercise training post-stroke.Methods: Twenty-one ambulant participants (?3 months post-stroke) participated in a home-based telehealth-supervised aerobic exercise program (3 d/week, moderate-vigorous intensity, 8-weeks) and provided feedback via questionnaire postintervention. Session details, technical issues, and adverse events were also recorded.Results: Feasibility was high (83% of volunteers met telehealth eligibility criteria, 85% of sessions were conducted by telehealth, and 95% of participants rated usability favourably). Ninety-five percent enjoyed telehealth exercise sessions and would recommend them to others. The preferred telehealth exercise program parameters were: frequency 3 d/week, duration 20-30 min/session, program length 6-12 weeks.Conclusion: The telehealth delivery of exercise sessions to people after stroke appear

Mental health mobile app use: Considerations for serving underserved patients in integrated primary care settings

Depression, the most commonly experienced mental illness, affects more than 264 million people and is one of the leading causes of disability worldwide [1]. Depression, or major depressive disorder, is characterized by depressed mood and often accompanies other symptoms such as lack of interest, fatigue, feelings of worthlessness, impaired thinking, psychomotor agitation or slowing, thoughts of being better off dead and/or of suicide [2]. According to the 2018 National Survey of Drug Use and Health (NSDUH), 17.7 million or 7.7% of U.S. adults met the criteria for having a major depressive episode in the past year [3]. The prevalence of depression is closely related to socioeconomic factors and prevalence increases as family income level decreases. For example, 19.8% of women aged 20 years and older living below the federal poverty level (FPL) experience depression compared to only 4.8% of those living at or above 400% of the FPL [4]. Despite the availability of safe and effective treatments, many adults diagnosed with depressive disorders do not receive treatment [5]. Of the 17.7 million adults (≥ 18 years) meeting criteria for a major depressive disorder in the past year, only 64.8% reported having received treatment for depression [3]. There are disparities in receipt of treatment for mental health care, particularly among racial and ethnic minority groups. Only about 30% of African American and Hispanic adults (≤18 years) with any mental illness receive treatment, compared to 43.3% of the overall U.S. population [3]. Further, for those with lower education, the odds of receiving treatment declined (women) or remained stable (men) between 2005 and 2014 [6]

A qualitative exploration of the feasibility of incorporating depression apps into integrated primary care clinics

Background: The use of mobile applications or “apps” is beginning to be identified as a potential cost-effective tool for treating depression. While the use of mobile apps for health management appears promising, little is known on how to incorporate these tools into integrated primary care settings – especially from the viewpoints of patients and the clinic personnel. Purpose: The purpose of this study was to explore patient- and clinic-level perceptions of the use of depression self-management apps within an integrated primary care setting. Methods: Patients (n=17), healthcare providers, and staff (n=15) completed focus groups or semi-structured interviews in-person or via Zoom between January and July 2020. Participants were asked about barriers and facilitators to app use, how to best integrate it into care, and reviewed pre-selected mental health apps. Data were analyzed using a directed content analysis approach. Results: From a patient perspective, features within the app such as notifications, the provision of information, easy navigation, and a chat/support function as well as an ability to share data with their doctor were desirable. Providers and staff identified integration of app data into electronic health records to be able to share data with patients and the healthcare team as well as clear evidence of effectiveness as factors that could facilitate implementation. All participants who reviewed apps identified at least one of them they would be interested in continuing to use. Conclusions: Overall, patients, healthcare providers, and staff believed depression apps could be beneficial for both patients and the clinic

High harmonic interferometry of the Lorentz force in strong mid-infrared laser fields

The interaction of intense mid-infrared laser fields with atoms and molecules leads to a range of new opportunities, from the production of bright, coherent radiation in the soft x-ray range, to imaging molecular structures and dynamics with attosecond temporal and sub-angstrom spatial resolution. However, all these effects, which rely on laser-driven recollision of an electron removed by the strong laser field and its parent ion, suffer from the rapidly increasing role of the magnetic field component of the driving pulse: the associated Lorentz force pushes the electrons off course in their excursion and suppresses all recollision-based processes, including high harmonic generation as well as elastic and inelastic scattering. Here we show how the use of two non-collinear beams with opposite circular polarizations produces a forwards ellipticity which can be used to monitor, control, and cancel the effect of the Lorentz force. This arrangement can thus be used to re-enable recollision-based phenomena in regimes beyond the long-wavelength breakdown of the dipole approximation, and it can be used to observe this breakdown in high harmonic generation using currently available light sources

Addressing and Evaluating Health Literacy in mHealth: A Scoping Review

BACKGROUND: Recent surveys have revealed many adults have basic or below basic health literacy, which is linked to medical errors, increased illness, and compromised public health. Health literacy as a concept is multi-faceted extending beyond the individual to include social structures and the context in which health information is being accessed. Delivering health information via mobile devices (mHealth) expands the amount of information available while presenting challenges to ensuring these materials are suitable for a variety of literacy needs. The aims of this study are to discover how health literacy is addressed and evaluated in mHealth app development. METHODS: A scoping review of 5 peer-reviewed databases was conducted. Eligible articles were written in English, addressed general literacy or mHealth/digital/eHealth literacy, and collected literacy information in order to incorporate literacy into the design and/or modification of an app or collected literacy information to describe the population being studied. The Health Literacy Online (HLO) United States (U.S.) government guide was used as a framework. RESULTS: Thirty-two articles were reviewed. Articles included health literacy recommendations for all HLO categories and some recommendations not aligned with these categories. Most articles addressed health literacy using specific HLO categories though none incorporated every HLO category. The most common categories addressed engagement and testing of mHealth content. Though several studies addressed health literacy through a formal assessment tool, most did not. Evaluation of health literacy in mHealth was end-user focused and did not extensively evaluate content for fit to a variety of individuals with limited health literacy. CONCLUSIONS: The recommendations seen consistently in our results in conjunction with formal HLO categories can act as beginning steps towards development of a health literacy evaluation tool for mHealth apps themselves. It is clear efforts are being made to reduce barriers to using mHealth for those with literacy deficits, however, it was also clear that this space has room to be more pragmatic in evaluation of mHealth tools for literacy. End user engagement in design and testing is necessary in future mHealth literacy tool development

Comprehensive Analysis of HLA-A, HLA-B, HLA-C, HLA-DRB1, and HLA-DQB1 Loci and Squamous Cell Cervical Cancer Risk

Variation in human major histocompatibility genes may influence the risk of squamous cell cervical cancer (SCC) by altering the efficiency of the T-cell–mediated immune response to human papillomavirus (HPV) antigens. We used high-resolution methods to genotype human leukocyte antigen (HLA) class I (A, B, and Cw) and class II (DRB1 and DQB1) loci in 544 women with SCC and 542 controls. Recognizing that HLA molecules are codominantly expressed, we focused on co-occurring alleles. Among 137 allele combinations present at >5% in the case or control groups, 36 were significantly associated with SCC risk. All but one of the 30 combinations that increased risk included DQB1*0301, and 23 included subsets of A*0201-B*4402-Cw*0501-DRB1*0401-DQB1*0301. Another combination, B*4402-DRB1*1101-DQB1*0301, conferred a strong risk of SCC (odds ratio, 10.0; 95% confidence interval, 3.0–33.3). Among the six combinations that conferred a decreased risk of SCC, four included Cw*0701 or DQB1*02. Most multilocus results were similar for SCC that contained HPV16; a notable exception was A*0101-B*0801-Cw*0701-DRB1*0301-DQB1*0201 and its subsets, which were associated with HPV16-positive SCC (odds ratio, 0.5; 95% confidence interval, 0.3–0.9). The main multilocus associations were replicated in studies of cervical adenocarcinoma and vulvar cancer. These data confirm that T helper and cytotoxic T-cell responses are both important cofactors with HPV in cervical cancer etiology and indicate that co-occurring HLA alleles across loci seem to be more important than individual alleles. Thus, certain co-occurring alleles may be markers of disease risk that have clinical value as biomarkers for targeted screening or development of new therapies

London and beyond: essays in honour of Derek Keene

This volume contains selected papers from a major conference held in October 2008 to celebrate the 20th anniversary of the setting up of the Centre for Metropolitan History at the IHR, and the contribution of Professor Derek Keene to the Centre, the IHR and the wider world of scholarship. 'One of the pioneer volumes in the handsomely produced new Institute of Historical Research Conference series, this book serves as a fitting tribute to one of the most influential urban historians of our time.' - Ian Archer, Urban History, May 2013