Online mental health forums and rural resilience: mixed methods study and logic model

Background: Rural mental health is a growing area of concern internationally, and online mental health forums offer a potential response to addressing service gaps in rural communities. Objective: The objective of this study was to explore and identify pathways by which online peer support mental health forums help to build resilience for rural residents experiencing mental ill-health by contributing to overcoming their specific contextual challenges. Methods: We developed a Theoretical Resilience Framework and applied it to 3000 qualitative posts from 3 Australian online mental health forums and to data from 30 interviews with rural forum users. Results: Drawing on the findings and an abductive approach, a logic model was developed to illustrate links between the resilience resources built and enabling features of forums that make them spaces that facilitate resilience. Conclusions: The study demonstrated that online forums make valuable contributions to social well-being and access to a range of timely support services for rural people experiencing mental ill-health, and, while doing so, involve users in the processes of resilience building. The study provides a new way for practitioners to frame the work of and value produced by forums. It gives a logic model that can be used in evaluation and audit as it facilitates a causal framing of how forums, as an intervention, link with resilience outcomes. Ultimately, the study contributes to developing new knowledge about how rural resilience building can be conceptualized and measured while showing how forums are part of contemporary health service provision in rural places

Using micro-geography to understand the realisation of wellbeing: a qualitative GIS study of three social enterprises

Social enterprises are promoted as a method of welfare reform, to transition people out of disadvantage by addressing poverty, unfulfilled capabilities and social exclusion. This study explores how three Work Integration Social Enterprises (WISEs) in Australia help to realise wellbeing for their employees by mapping their micro-geographical experience of wellbeing. By mapping the sites within a social enterprise where wellbeing is realised, we provide a practical, empirical and replicable methodology that is useful for gaining insights into where and how wellbeing realisation occurs. This situates wellbeing as an upstream place-based resource likely to influence downstream health outcomes

Inhibition of methyltransferase activity of enhancer of zeste 2 leads to enhanced lipid accumulation and altered chromatin status in zebrafish

BACKGROUND: Recent studies indicate that exposure to environmental chemicals may increase susceptibility to developing metabolic diseases. This susceptibility may in part be caused by changes to the epigenetic landscape which consequently affect gene expression and lead to changes in lipid metabolism. The epigenetic modifier enhancer of zeste 2 (Ezh2) is a histone H3K27 methyltransferase implicated to play a role in lipid metabolism and adipogenesis. In this study, we used the zebrafish (Danio rerio) to investigate the role of Ezh2 on lipid metabolism and chromatin status following developmental exposure to the Ezh1/2 inhibitor PF-06726304 acetate. We used the environmental chemical tributyltin (TBT) as a positive control, as this chemical is known to act on lipid metabolism via EZH-mediated pathways in mammals. RESULTS: Zebrafish embryos (0-5 days post-fertilization, dpf) exposed to non-toxic concentrations of PF-06726304 acetate (5 μM) and TBT (1 nM) exhibited increased lipid accumulation. Changes in chromatin were analyzed by the assay for transposase-accessible chromatin sequencing (ATAC-seq) at 50% epiboly (5.5 hpf). We observed 349 altered chromatin regions, predominantly located at H3K27me3 loci and mostly more open chromatin in the exposed samples. Genes associated to these loci were linked to metabolic pathways. In addition, a selection of genes involved in lipid homeostasis, adipogenesis and genes specifically targeted by PF-06726304 acetate via altered chromatin accessibility were differentially expressed after TBT and PF-06726304 acetate exposure at 5 dpf, but not at 50% epiboly stage. One gene, cebpa, did not show a change in chromatin, but did show a change in gene expression at 5 dpf. Interestingly, underlying H3K27me3 marks were significantly decreased at this locus at 50% epiboly. CONCLUSIONS: Here, we show for the first time the applicability of ATAC-seq as a tool to investigate toxicological responses in zebrafish. Our analysis indicates that Ezh2 inhibition leads to a partial primed state of chromatin linked to metabolic pathways which results in gene expression changes later in development, leading to enhanced lipid accumulation. Although ATAC-seq seems promising, our in-depth assessment of the cebpa locus indicates that we need to consider underlying epigenetic marks as well.</p

Deaths from acute abdominal conditions and geographical access to surgical care in India: a nationally representative spatial analysis

Background Few population-based studies quantify mortality from surgical conditions and relate mortality to access to surgical care in low-income and middle-income countries. Methods We linked deaths from acute abdominal conditions within a nationally representative, population-based mortality survey of 1·1 million households in India to nationally representative facility data. We calculated total and age-standardised death rates for acute abdominal conditions. Using 4064 postal codes, we undertook a spatial clustering analysis to compare geographical access to well-resourced government district hospitals (24 h surgical and anaesthesia services, blood bank, critical care beds, basic laboratory, and radiology) in high-mortality or low-mortality clusters from acute abdominal conditions. Findings 923 (1·1%) of 86 806 study deaths at ages 0–69 years were identifi ed as deaths from acute abdominal conditions, corresponding to 72 000 deaths nationally in 2010 in India. Most deaths occurred at home (71%) and in rural areas (87%). Compared with 567 low-mortality geographical clusters, the 393 high-mortality clusters had a nine times higher age-standardised acute abdominal mortality rate and signifi cantly greater distance to a well-resourced hospital. The odds ratio (OR) of being a high-mortality cluster was 4·4 (99% CI 3·2–6·0) for living 50 km or more from well-resourced district hospitals (rising to an OR of 16·1 [95% CI 7·9–32·8] for >100 km). No such relation was seen for deaths from non-acute surgical conditions (ie, oral, breast, and uterine cancer). Interpretation Improvements in human and physical resources at existing government hospitals are needed to reduce deaths from acute abdominal conditions in India. Full access to well-resourced hospitals within 50 km by all of India’s population could have avoided about 50 000 deaths from acute abdominal conditions, and probably more from other emergency surgical conditions

Altered non-coding RNA expression profile in F1 progeny 1 year after parental irradiation is linked to adverse effects in zebrafish

Gamma radiation produces DNA instability and impaired phenotype. Previously, we observed negative effects on phenotype, DNA methylation, and gene expression profiles, in offspring of zebrafish exposed to gamma radiation during gametogenesis. We hypothesize that previously observed effects are accompanied with changes in the expression profile of non-coding RNAs, inherited by next generations. Non-coding RNA expression profile was analysed in F1 offspring (5.5 h post-fertilization) by high-throughput sequencing 1 year after parental irradiation (8.7 mGy/h, 5.2 Gy total dose). Using our previous F1-γ genome-wide gene expression data (GSE98539), hundreds of mRNAs were predicted as targets of differentially expressed (DE) miRNAs, involved in pathways such as insulin receptor, NFkB and PTEN signalling, linking to apoptosis and cancer. snRNAs belonging to the five major spliceosomal snRNAs were down-regulated in the F1-γ group, Indicating transcriptional and post-transcriptional alterations. In addition, DEpiRNA clusters were associated to 9 transposable elements (TEs) (LTR, LINE, and TIR) (p = 0.0024), probable as a response to the activation of these TEs. Moreover, the expression of the lincRNAs malat-1, and several others was altered in the offspring F1, in concordance with previously observed phenotypical alterations. In conclusion, our results demonstrate diverse gamma radiation-induced alterations in the ncRNA profiles of F1 offspring observable 1 year after parental irradiation.publishedVersio

Intercomparison and Validation of SAR-Based Ice Velocity Measurement Techniques within the Greenland Ice Sheet CCI Project

Ice velocity is one of the products associated with the Ice Sheets Essential Climate Variable. This paper describes the intercomparison and validation of ice-velocity measurements carried out by several international research groups within the European Space Agency Greenland Ice Sheet Climate Change Initiative project, based on space-borne Synthetic Aperture Radar (SAR) data. The goal of this activity was to survey the best SAR-based measurement and error characterization approaches currently in practice. To this end, four experiments were carried out, related to different processing techniques and scenarios, namely differential SAR interferometry, multi aperture SAR interferometry and offset-tracking of incoherent as well as of partially-coherent data. For each task, participants were provided with common datasets covering areas located on the Greenland ice-sheet margin and asked to provide mean velocity maps, quality characterization and a description of processing algorithms and parameters. The results were then intercompared and validated against GPS data, revealing in several cases significant differences in terms of coverage and accuracy. The algorithmic steps and parameters influencing the coverage, accuracy and spatial resolution of the measurements are discussed in detail for each technique, as well as the consistency between quality parameters and validation results. This allows several recommendations to be formulated, in particular concerning procedures which can reduce the impact of analyst decisions, and which are often found to be the cause of sub-optimal algorithm performance

Elective surgery cancellations due to the COVID-19 pandemic: global predictive modelling to inform surgical recovery plans.

BACKGROUND: The COVID-19 pandemic has disrupted routine hospital services globally. This study estimated the total number of adult elective operations that would be cancelled worldwide during the 12 weeks of peak disruption due to COVID-19. METHODS: A global expert response study was conducted to elicit projections for the proportion of elective surgery that would be cancelled or postponed during the 12 weeks of peak disruption. A Bayesian β-regression model was used to estimate 12-week cancellation rates for 190 countries. Elective surgical case-mix data, stratified by specialty and indication (surgery for cancer versus benign disease), were determined. This case mix was applied to country-level surgical volumes. The 12-week cancellation rates were then applied to these figures to calculate the total number of cancelled operations. RESULTS: The best estimate was that 28 404 603 operations would be cancelled or postponed during the peak 12 weeks of disruption due to COVID-19 (2 367 050 operations per week). Most would be operations for benign disease (90·2 per cent, 25 638 922 of 28 404 603). The overall 12-week cancellation rate would be 72·3 per cent. Globally, 81·7 per cent of operations for benign conditions (25 638 922 of 31 378 062), 37·7 per cent of cancer operations (2 324 070 of 6 162 311) and 25·4 per cent of elective caesarean sections (441 611 of 1 735 483) would be cancelled or postponed. If countries increased their normal surgical volume by 20 per cent after the pandemic, it would take a median of 45 weeks to clear the backlog of operations resulting from COVID-19 disruption. CONCLUSION: A very large number of operations will be cancelled or postponed owing to disruption caused by COVID-19. Governments should mitigate against this major burden on patients by developing recovery plans and implementing strategies to restore surgical activity safely

Global wealth disparities drive adherence to COVID-safe pathways in head and neck cancer surgery

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