Up Outstanding Paper presented at the 18 th Annual Association for International Agricultural and Extension Education Conference

Abstract The continuing efforts to stimulate economic growth in Africa through agricultural development reflect the rise and fall of the different 'fads and fashions ' Recently, interest has begun to coalesce around the potentials offered by the Farmer Field School (FFS) approach. Drawing upon field data collected from the two oldest FFS programs in Africa, this paper takes a brief look at the main elements in the FFS approach and its transfer to Africa. The results and conclusions center around six key issues: the responsiveness of the FFS approach to local conditions; FFS achievements in facilitating 'systems learning' on the part of farmers and supporting their increased involvement in knowledge generatio

Adolescents leaving mental health or social care services: predictors of mental health and psychosocial outcomes one year later.

BACKGROUND: UK service structure necessitates a transition out of youth services at a time of increased risk for the development and onset of mental disorders. Little is currently known about the mental health and psychosocial outcomes of leaving services at this time. The aim of this study was to determine predictors of mental health and social adjustment in adolescents leaving mental health or social care services. METHODS: A cohort (n = 53) of 17 year olds were interviewed and assessed when preparing to leave adolescent services and again 12 months later. Their mental health and psychosocial characteristics were compared to a same-age community sample group (n = 1074). RESULTS: At discharge 34 (64%) met DSM IV criteria for a current psychiatric diagnosis and only 3 (6%) participants met operational criteria for successful outcomes at follow-up. Impairments in mental health, lack of employment, education or training and low preparedness were associated with poor outcomes. CONCLUSIONS: The findings suggest the current organisation of mental health and care services may not be fit for purpose and even unwittingly contribute to persistent mental illness and poor psychosocial outcomes. A redesign of services should consider a model where the timing of transition does not fall at the most hazardous time for young people, but is sufficiently flexible to allow young people to move on when they are personally, socially and psychologically most able to succeed. Assessment of a young person's readiness to transition might also be useful. A youth focused service across the adolescent and early adult years may be better placed to avoid young people falling through the service gap created by poor transitional management.This work was completed within the NIHR Collaborations for Leadership in Applied Health Research and Care (CLAHRC) for Cambridgeshire and Peterborough (now CLAHRC East of England). The CLAHRC is hosted by the University of Cambridge and the Cambridge and Peterborough NHS Foundation Trust. This work was partially supported by a Wellcome Trust programme grant (grant no. 74296) for the ROOTS data collection awarded to Ian Goodyer.This is the final version of the article. It first appeared from BioMed Central via http://dx.doi.org/10.1186/s12913-015-0853-

Friendships and Family Support Reduce Subsequent Depressive Symptoms in At-Risk Adolescents.

BACKGROUND: Early life stress (ELS) consists of child family adversities (CFA: negative experiences that happened within the family environment) and/or peer bullying. ELS plays an important role in the development of adolescent depressive symptoms and clinical disorders. Identifying factors that may reduce depressive symptoms in adolescents with ELS may have important public mental health implications. METHODS: We used structural equation modelling and examined the impact of adolescent friendships and/or family support at age 14 on depressive symptoms at age 17 in adolescents exposed to ELS before age 11. To this end, we used structural equation modelling in a community sample of 771 adolescents (322 boys and 477 girls) from a 3 year longitudinal study. Significant paths in the model were followed-up to test whether social support mediated or moderated the association between ELS and depressive symptoms at age 17. RESULTS: We found that adolescent social support in adolescence is negatively associated with subsequent depressive symptoms in boys and girls exposed to ELS. Specifically, we found evidence for two mediational pathways: In the first pathway family support mediated the link between CFA and depressive symptoms at age 17. Specifically, CFA was negatively associated with adolescent family support at age 14, which in turn was negatively associated with depressive symptoms at age 17. In the second pathway we found that adolescent friendships mediated the path between peer bullying and depressive symptoms. Specifically, relational bullying was negatively associated with adolescent friendships at age 14, which in turn were negatively associated with depressive symptoms at age 17. In contrast, we did not find a moderating effect of friendships and family support on the association between CFA and depressive symptoms. CONCLUSIONS: Friendships and/or family support in adolescence mediate the relationship between ELS and late adolescent depressive symptoms in boys and girls. Therefore, enhancing affiliate relationships and positive family environments may benefit the mental health of vulnerable youth that have experienced CFA and/or primary school bullying.AlvH was supported by a Rubicon Fellowship from the Netherlands Organization for Scientific Research. IMG was supported by a Wellcome Trust programme grant, and grants from the NIHR Collaboration for Leadership in Applied Health Research, and Care (CLAHRC) for Cambridgeshire and Peterborough; IMG, AlvH, and JLG were supported through a grant from Kidscompany UK; PBJ was supported by Wellcome Trust grants, and National Institute for Health Research grant; RAK is supported by a Wellcome grant; JLG reports grants from ESRC, grants from MRC, grants, and personal fees from Royal College of Speech, and Language therapists.This is the final version of the article. It first appeared from PLOS via http://dx.doi.org/10.1371/journal.pone.015371

Adjunctive Azithromycin Prophylaxis for Cesarean Delivery

The addition of azithromycin to standard regimens for antibiotic prophylaxis before cesarean delivery may further reduce the rate of postoperative infection. We evaluated the benefits and safety of azithromycin-based extended-spectrum prophylaxis in women undergoing nonelective cesarean section

Risk Factors for Postcesarean Maternal Infection in a Trial of Extended-Spectrum Antibiotic Prophylaxis

To identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis