Digging over that old ground: an Australian perspective of women's experience of psychosocial assessment and depression screening in pregnancy and following birth

BACKGROUND: There is increasing recognition of the need to identify risk factors for poor mental health in pregnancy and following birth. In New South Wales, Australia, health policy mandates psychosocial assessment and depression screening for all women at the antenatal booking visit and at six to eight weeks after birth. Few studies have explored in-depth women’s experience of assessment and how disclosures of sensitive information are managed by midwives and nurses. This paper describes women’s experience of psychosocial assessment and depression screening examining the meaning they attribute to assessment and how this influences their response. METHODS: This qualitative ethnographic study included 34 women who were observed antenatally in the clinic with 18 midwives and 20 of the same women who were observed during their interaction with 13 child and family health nurses after birth in the home or the clinic environment. An observational tool, 4D&4R, together with field notes was used to record observations and were analysed descriptively using frequencies. Women also participated in face to face interviews. Field note and interview data was analysed thematically and similarities and differences across different time points were identified. RESULTS: Most participants reported that it was acceptable to them to be asked the psychosocial questions however they felt unprepared for the sensitive nature of the questions asked. Women with a history of trauma or loss were distressed by retelling their experiences. Five key themes emerged. Three themes; ’Unexpected: a bit out of the blue’, ‘Intrusive: very personal questions’ and ‘Uncomfortable: digging over that old ground’, describe the impact that assessment had on women. Women also emphasised that the approach taken by the midwife or nurse during assessment influenced their experience and in some cases what they reported. This is reflected in the themes titled: Approach: ’sensitivity and care’ and ’being watched’. CONCLUSIONS: The findings emphasise the need for health services to better prepare women for this assessment prior to and after birth. It is crucial that health professionals are educationally prepared for this work and receive ongoing training and support in order to always deliver care that is empathetic and sensitive to women who are disclosing personal information

The RMS Survey: Far-Infrared Photometry of Young Massive Stars

Context: The Red MSX Source (RMS) survey is a multi-wavelength campaign of follow-up observations of a colour-selected sample of candidate massive young stellar objects (MYSOs) in the galactic plane. This survey is returning the largest well-selected sample of MYSOs to date, while identifying other dust contaminant sources with similar mid-infrared colours including a large number of new ultra-compact (UC)HII regions. Aims:To measure the far-infrared (IR) flux, which lies near the peak of the spectral energy distribution (SED) of MYSOs and UCHII regions, so that, together with distance information, the luminosity of these sources can be obtained. Methods:Less than 50% of RMS sources are associated with IRAS point sources with detections at 60 micron and 100 micron, though the vast majority are visible in Spitzer MIPSGAL or IRAS Galaxy Atlas (IGA) images. However, standard aperture photometry is not appropriate for these data due to crowding of sources and strong spatially variable far-IR background emission in the galactic plane. A new technique using a 2-dimensional fit to the background in an annulus around each source is therefore used to obtain far-IR photometry for young RMS sources. Results:Far-IR fluxes are obtained for a total of 1113 RMS candidates identified as young sources. Of these 734 have flux measurements using IGA 60 micron and 100 micron images and 724 using MIPSGAL 70 micron images, with 345 having measurements in both data sets.Comment: 10 pages, 10 figures, 2 Tables, accepted to A&A. A full version of table 1 is available from the lead author or at the CDS upon publicatio

Domain mapping of periodically poled lithium niobate via terahertz wave form analysis

We demonstrate a nondestructive probing technique to investigate the inner crystal domain structure of ferroelectric crystals by analyzing the terahertz wave forms generated by optical rectification. Quantitative analysis of the domain structure has been performed for the domain width in periodically poled lithium niobate. Simulation results show that the terahertz wave form analysis reproduces root-mean-square domain width fluctuations. © 2000 American Institute of Physics.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69673/2/APPLAB-77-16-2488-1.pd

Pain severity predicts depressive symptoms over and above individual illnesses and multimorbidity in older adults.

BACKGROUND: Multi-morbidity in older adults is commonly associated with depressed mood. Similarly, subjective reports of pain are also associated with both physical illness and increased depressive symptoms. However, whether pain independently contributes to the experience of depression in older people with multi-morbidity has not been studied. METHODS: In this study, participants were 1281 consecutive older adults presenting to one of 19 primary care services in Australia (recruitment rate = 75%). Participants were asked to indicate the presence of a number of common chronic illnesses, to rate their current pain severity and to complete the Geriatric Depression Scale. RESULTS: Results confirmed that the number of medical illnesses reported was strongly associated with depressive symptoms. Twenty-six percent of participants with multi-morbidity scored in the clinical range for depressive symptoms in comparison to 15% of participants with no illnesses or a single illness. In regression analyses, the presence of chronic pain (t = 5.969, p < 0.0005), diabetes (t = 4.309, p < 0.0005), respiratory (t = 3.720, p < 0.0005) or neurological illness (t = 2.701, p = 0.007) were all independent contributors to depressive symptoms. Even when controlling for each individual illness, and the overall number of illnesses (t = 2.207, p = 0.028), pain severity remained an independent predictor of depressed mood (F change = 28.866, p < 0.0005, t = 5.373, p < 0.0005). CONCLUSIONS: Physicians should consider screening for mood problems amongst those with multi-morbidity, particularly those who experience pain

Embedded Star Formation in the Eagle Nebula with Spitzer/GLIMPSE

We present new Spitzer photometry of the Eagle Nebula (M16, containing the optical cluster NGC 6611) combined with near-infrared photometry from 2MASS. We use dust radiative transfer models, mid-infrared and near-infrared color-color analysis, and mid-infrared spectral indices to analyze point source spectral energy distributions, select candidate young stellar objects (YSOs), and constrain their mass and evolutionary state. Comparison of the different protostellar selection methods shows that mid-infrared methods are consistent, but as has been known for some time, near-infrared-only analysis misses some young objects. We reveal more than 400 protostellar candidates, including one massive young stellar object (YSO) that has not been previously highlighted. The YSO distribution supports a picture of distributed low-level star formation, with no strong evidence of triggered star formation in the ``pillars''. We confirm the youth of NGC 6611 by a large fraction of infrared-excess sources, and reveal a younger cluster of YSOs in the nearby molecular cloud. Analysis of the YSO clustering properties shows a possible imprint of the molecular cloud's Jeans length. Multiwavelength mid-IR imaging thus allows us to analyze the protostellar population, to measure the dust temperature and column density, and to relate these in a consistent picture of star formation in M16.Comment: 16p preprint - ApJ accepte

Higgs Messengers

We explore the consequences of the Higgs fields acting as messengers of supersymmetry breaking. The hidden-sector paradigm in the gauge mediation framework is relaxed by allowing two types of gauge-invariant, renormalizable operators that are typically discarded: direct coupling between the Higgses and supersymmetry breaking singlets, and Higgs-messenger mixing terms. The most important phenomenological consequence is a flavor-dependent shift in sfermion masses. This is from a one-loop contribution, which we compute for a general set of weak doublet messengers. We also study a couple of explicit models in detail, finding that precision electroweak constraints can be satisfied with a spectrum significantly different from that of gauge mediation.Comment: 20 pages, 5 figure

Methods for delivering the UK's multi-centre prison-based naloxone-on-release pilot randomised trial (N-ALIVE): Europe's largest prison-based randomised controlled trial

INTRODUCTION AND AIMS: Naloxone is an opioid antagonist used for emergency resuscitation following opioid overdose. Prisoners with a history of heroin use by injection have a high risk of drug-related death in the first weeks after prison-release. The N-ALIVE trial was planned as a large prison-based randomised controlled trial (RCT) to test the effectiveness of naloxone-on-release in the prevention of fatal opiate overdoses soon after release. The N-ALIVE pilot trial was conducted to test the main trial's assumptions on recruitment of prisons and prisoners, and the logistics for ensuring that participants received their N-ALIVE pack on release. DESIGN AND METHODS: Adult prisoners who had ever injected heroin, were incarcerated for ≥7 days and were expected to be released within 3 months were eligible. Participants were randomised to receive, on liberation, a pack containing a single 'rescue' injection of naloxone or a control pack with no naloxone syringe. The trial was double-blind prior to prison-release. RESULTS: We randomised 1685 prisoners (842 naloxone; 843 control) across 16 prisons in England. We stopped randomisation on 8 December 2014 because only one-third of administrations of naloxone-on-release were to the randomised ex-prisoner; two-thirds were to others whom we were not tracing. DISCUSSION AND CONCLUSIONS: Prevention RCTs are seldom conducted within prisons; we demonstrated the feasibility of conducting a multi-prison RCT to prevent fatality from opioid overdose in the outside community. We terminated the N-ALIVE trial due to the infeasibility of individualised randomisation to naloxone-on-release. Large RCTs are feasible within prisons