The Link Between Intimate Partner Violence, Substance Abuse and Mental Health in California

Presents findings about how Californians who have been victims of intimate partner violence as adults are more likely to report serious psychological distress, violence-related substance abuse, and need for mental health and/or substance abuse services

Child research in South Africa: How do the new regulations help?

Child research is governed by legal norms in the National Health Act (2003) and the Regulations. There is increasing harmony between the two on many issues, including the conditions under which children should be enrolled in research. The most striking disjuncture in the ethical-legal framework remains the allowable consent strategy for child research, where the law requires mandatory parental or legal guardian consent for all child research, while ethical guidelines afford research stakeholders the discretion to implement exceptions to this approach in specific justifiable circumstances

Nearly Four Million California Adults Are Victims of Intimate Partner Violence

Based on 2007 California Health Interview Survey data, analyzes the incidence and nature of physical and/or sexual intimate partner violence by gender, race/ethnicity, nativity, marital status, and sexual orientation

An inservice programme in developmental reading for ninth-grade content area teachers

This internship project was primarily concerned with the implementation of an inservice programme in developmental reading for ninth-grade content area teachers. The major purpose of the programme was to help these teachers understand and apply teaching techniques and procedures to help their students improve their reading-study skills and to achieve subject matter objectives more completely. -- Prior to implementing the inservice programme the intern assessed the present school situation regarding content area reading instruction to identify the teachers' specific inservice needs. Various sources of information were used to familiarize the intern with existing procedures, including a checklist pertaining to teachers' current practices regarding content area reading instruction and an attitude inventory designed to assess teachers' attitudes toward such instruction. -- The information obtained from these sources revealed that no organized programme of reading instruction existed in the school. It was apparent from the teachers' responses that they recognized the need for content area reading instruction and were willing to provide it. However, they felt that the teaching of reading required specialized training and therefore they questioned their competence to provide such instruction. -- The results also indicated that teacher support for a reading programme in the content areas was already present. Therefore, the inservice programme was mainly concerned with developing teachers' knowledge about reading instruction and helping them achieve some degree of competence in this area. This programme was implemented through such means as formal and informal meetings, classroom demonstrations of reading skill activities and written resource materials. These inservice activities were concerned with: (1) identifying the reading-study skills which should be emphasized in each content area, (2) constructing, administering and interpreting informal reading inventories to ascertain students reading needs, (3) helping teachers formulate procedures for teaching reading-study skills in content area classes, and (4) supplying teachers with multi-level reading lists to enable them to provide materials suited to the reading levels of their students. -- Teachers' responses to a questionnaire which was designed to assess their opinions regarding the value of the inservice programme indicated that the programme was worthwhile in helping them to develop an understanding of reading-study skills and also in helping them to apply techniques for teaching these skills in regular subject matter classes

Summarised, verified and accessible:Improving clinical information management for potential haematopoietic stem cell transplantation patients

The Welsh Transplantation and Immunogenetics Laboratory (WTAIL) is responsible for managing patient work-up for haematopoietic stem cell transplantation (HSCT), the only potentially curative option for many haematological and non-haematological conditions. Work-up requires regular communication between WTAIL and the transplanting clinicians, facilitated by weekly multidisciplinary team (MDT) meetings, to agree decisions and proceed through each work-up stage. Effective communication and minimising error are critical, as transplanting cells from a suboptimal donor could have severe or fatal consequences for the patient. We reviewed our HSCT patient management and identified issues including staff dissatisfaction with the inefficiency of the current (paper-based) system and concern about the potential for incidents caused by errors in manual transcription of patient information and tracking clinical decisions. Another driver for change was the COVID-19 pandemic, which prevented the usual face-to-face MDT meetings in which staff would show clinicians the paper records and reports; the shift to online MDT required new ways of sharing data. In this project we developed a new central reference point for our patient management data along with electronic patient summary sheets, designed with an eye to improving safety and efficiency. Over several improvement cycles we tested and refined the summary sheets with staff and clinicians and experimented with videoconferencing to facilitate data sharing. We conducted interviews with staff from which we concluded that the new process successfully reduced transcription and duplication and improved communication with the clinicians during the pandemic. Despite an increase in workload due to build-up of active patient work-up cases during the pandemic, staff reported that the new summaries enabled them to cope well. A key initiative was creation of a Task and Finish group that helped establish continual improvement culture and identified additional areas for improvement which have been followed up in further improvement projects

Improving the normalization of complex interventions: part 1 - development of the NoMAD instrument for assessing implementation work based on normalization process theory (NPT)

Background Understanding and measuring implementation processes is a key challenge for implementation researchers. This study draws on Normalization Process Theory (NPT) to develop an instrument that can be applied to assess, monitor or measure factors likely to affect normalization from the perspective of implementation participants. Methods An iterative process of instrument development was undertaken using the following methods: theoretical elaboration, item generation and item reduction (team workshops); item appraisal (QAS-99); cognitive testing with complex intervention teams; theory re-validation with NPT experts; and pilot testing of instrument. Results We initially generated 112 potential questionnaire items; these were then reduced to 47 through team workshops and item appraisal. No concerns about item wording and construction were raised through the item appraisal process. We undertook three rounds of cognitive interviews with professionals (n = 30) involved in the development, evaluation, delivery or reception of complex interventions. We identified minor issues around wording of some items; universal issues around how to engage with people at different time points in an intervention; and conceptual issues around the types of people for whom the instrument should be designed. We managed these by adding extra items (n = 6) and including a new set of option responses: ‘not relevant at this stage’, ‘not relevant to my role’ and ‘not relevant to this intervention’ and decided to design an instrument explicitly for those people either delivering or receiving an intervention. This version of the instrument had 53 items. Twenty-three people with a good working knowledge of NPT reviewed the items for theoretical drift. Items that displayed a poor alignment with NPT sub-constructs were removed (n = 8) and others revised or combined (n = 6). The final instrument, with 43 items, was successfully piloted with five people, with a 100% completion rate of items. Conclusion The process of moving through cycles of theoretical translation, item generation, cognitive testing, and theoretical (re)validation was essential for maintaining a balance between the theoretical integrity of the NPT concepts and the ease with which intended respondents could answer the questions. The final instrument could be easily understood and completed, while retaining theoretical validity. NoMAD represents a measure that can be used to understand implementation participants’ experiences. It is intended as a measure that can be used alongside instruments that measure other dimensions of implementation activity, such as implementation fidelity, adoption, and readiness

Improving the normalization of complex interventions: measure development based on normalization process theory (NoMAD): study protocol

<b>Background</b> Understanding implementation processes is key to ensuring that complex interventions in healthcare are taken up in practice and thus maximize intended benefits for service provision and (ultimately) care to patients. Normalization Process Theory (NPT) provides a framework for understanding how a new intervention becomes part of normal practice. This study aims to develop and validate simple generic tools derived from NPT, to be used to improve the implementation of complex healthcare interventions.<p></p> <b>Objectives</b> The objectives of this study are to: develop a set of NPT-based measures and formatively evaluate their use for identifying implementation problems and monitoring progress; conduct preliminary evaluation of these measures across a range of interventions and contexts, and identify factors that affect this process; explore the utility of these measures for predicting outcomes; and develop an online users’ manual for the measures.<p></p> <b>Methods</b> A combination of qualitative (workshops, item development, user feedback, cognitive interviews) and quantitative (survey) methods will be used to develop NPT measures, and test the utility of the measures in six healthcare intervention settings.<p></p> <b>Discussion</b> The measures developed in the study will be available for use by those involved in planning, implementing, and evaluating complex interventions in healthcare and have the potential to enhance the chances of their implementation, leading to sustained changes in working practices

Transcriptional Heterogeneity of Cryptococcus gattii VGII Compared with Non-VGII Lineages Underpins Key Pathogenicity Pathways

We thank Jose Munoz for his input on the analysis of the mouse RNA-seq enrichment. R.A.F. was supported by a Wellcome Trust-Massachusetts Institute of Technology (MIT) Postdoctoral Fellowship. M.C.F. and J.R. were supported by Medical Research Council grant MR/K000373/1. R.C.M. is supported by a Wolfson Royal Society Research Merit Award and by funding from the European Research Council under the European Union’s Seventh Framework Program (FP/2007-2013)/ERC (grant agreement no. 614562). This work was funded in part by NIAID grant U19AI110818 to the Broad Institute.Peer reviewedPublisher PD

Salivary glands regenerate after radiation injury through SOX2-mediated secretory cell replacement

Salivary gland acinar cells are routinely destroyed during radiation treatment for head and neck cancer that results in a lifetime of hyposalivation and co-morbidities. A potential regenerative strategy for replacing injured tissue is the reactivation of endogenous stem cells by targeted therapeutics. However, the identity of these cells, whether they are capable of regenerating the tissue, and the mechanisms by which they are regulated are unknown. Using in vivo and ex vivo models, in combination with genetic lineage tracing and human tissue, we discover a SOX2+ stem cell population essential to acinar cell maintenance that is capable of replenishing acini after radiation. Furthermore, we show that acinar cell replacement is nerve dependent and that addition of a muscarinic mimetic is sufficient to drive regeneration. Moreover, we show that SOX2 is diminished in irradiated human salivary gland, along with parasympathetic nerves, suggesting that tissue degeneration is due to loss of progenitors and their regulators. Thus, we establish a new paradigm that salivary glands can regenerate after genotoxic shock and do so through a SOX2 nerve-dependent mechanism