Using new and innovative technologies to assess clinical stage in early intervention youth mental health services: Evaluation study

Background: Globally there is increasing recognition that new strategies are required to reduce disability due to common mental health problems. As 75% of mental health and substance use disorders emerge during the teenage or early adulthood years, these strategies need to be readily accessible to young people. When considering how to provide such services at scale, new and innovative technologies show promise in augmenting traditional clinic-based services. Objective: The aim of this study was to test new and innovative technologies to assess clinical stage in early intervention youth mental health services using a prototypic online system known as the Mental Health eClinic (MHeC). Methods: The online assessment within the MHeC was compared directly against traditional clinician assessment within 2 Sydney-based youth-specific mental health services (headspace Camperdown and headspace Campbelltown). A total of 204 young people were recruited to the study. Eligible participants completed both face-to-face and online assessments, which were randomly allocated and counterbalanced at a 1-to-3 ratio. These assessments were (1) a traditional 45- to 60-minute headspace face-to-face assessment performed by a Youth Access Clinician and (2) an approximate 60-minute online assessment (including a self-report Web-based survey, immediate dashboard of results, and a video visit with a clinician). All assessments were completed within a 2-week timeframe from initial presentation. Results: Of the 72 participants who completed the study, 71% (51/72) were female and the mean age was 20.4 years (aged 16 to 25 years); 68% (49/72) of participants were recruited from headspace Camperdown and the remaining 32% (23/72) from headspace Campbelltown. Interrater agreement of participants’ stage, as determined after face-to-face assessment or online assessment, demonstrated fair agreement (kappa=.39, P\u3c.001) with concordance in 68% of cases (49/72). Among the discordant cases, those who were allocated to a higher stage by online raters were more likely to report a past history of mental health disorders (P=.001), previous suicide planning (P=.002), and current cannabis misuse (P=.03) compared to those allocated to a lower stage. Conclusions: The MHeC presents a new and innovative method for determining key clinical service parameters. It has the potential to be adapted to varied settings in which young people are connected with traditional clinical services and assist in providing the right care at the right tim

Light-based therapies in prostate cancer treatment

Photodynamic Therapy (PDT) and Photochemical Internalisation (PCI) are both light-based therapies which can be used for the focal treatment of cancer. Both PDT and PCI require the combination of photosensitisers, light and molecular oxygen to induce photooxidative reactions that damage biomolecules. However, while PDT employs a photosensitiser as the sole therapeutic agent, PCI combines low-dose PDT with another therapeutic agent to enable the improved delivery of this agent to its intended subcellular targets. The overall aim of this study was to investigate PDT and PCI for prostate cancer in both in vitro and in vivo tumour models. In the PCI procedures, the ribosome inactivating protein type 1 saporin was used as a model chemotherapy agent. We have concluded an enhancement in cell killing in prostate carcinoma cells after PCI compared to PDT in 2-dimensional models, i.e. 80% cell death, compared to 32% killing after PDT. Similar observations resulted from qualitative observations in the 3-dimensional model. Moreover, conjugation of a photosensitiser to cell penetrating peptides (TAT or Antp), resulted in a similar difference in cytotoxicity after PCI and PDT using lower concentrations of the conjugates - 76% and 14% respectively. These data confirm the synergistic effect of drug and photosensitiser in PCI. Three different clinically relevant photosensitisers were used in vivo in a subcutaneous rat model. Vascular-targeted PDT resulted in the most efficient treatment, and photosensitisers targeting a cellular effect, showed a better outcome with shorter drug-light intervals. The analysis of tumour samples through immunohistochemistry and molecular analysis revealed an innate inflammatory response that led to an adaptive immune response. A highly suppressive tumour microenvironment was suggested by the infiltration of regulatory T cells (FoxP3+), up-regulation of PD-L1 and down-regulation of cytolytic proteins (i.e. Perforin). Moreover, the beneficial effect of using immunoadjuvants (cyclophosphamide) was investigated. Light based therapies could play an important role in prostate cancer treatment both eradicating tumours and generating long-term immune protection against secondary tumour deposits

Análisis del rendimiento en salto vertical, agilidad,

Objetivo Analizar la influencia de la categoría de edad en la capacidad de salto, sprint, agilidad y velocidad de golpeo en futbolistas jóvenes. Método Estudio transversal en el que participaron 36 jugadores de nivel subélite provenientes de las categorías inferiores (cadete y juvenil) de equipos de fútbol andaluces (edad: 15,87 ± 1,43 años; masa corporal: 65,38 ± 10,84 kg; altura: 1,71 ± 0,06 m). Se evaluó la composición corporal, el rendimiento en salto vertical (CMJ), la agilidad mediante el test de Balsom, velocidad de sprint en 5, 10, 20 y 30 m y la velocidad de golpeo con ambas piernas. Resultados Los análisis mostraron que los jugadores juveniles tienen mayor rendimiento en los test de CMJ, agilidad y velocidad de golpeo con ambas piernas que los cadetes. No se aprecian diferencias significativas (p ≥ 0,05) en la prueba de velocidad, aunque se evidencia una clara tendencia a favor de los juveniles. Conclusión Existe efecto de la edad durante la etapa de la adolescencia sobre la capacidad de salto, la agilidad, la velocidad de golpeo y, en menor medida, sobre la velocidad de jóvenes jugadores de fútbol, además de asociación entre las capacidades condicionales más influyentes en el rendimiento del futbolista

Anàlisi del rendiment en el salt vertical, agilitat i velocitat

Objectiu Analitzar la influència de la categoria d’edat en la capacitat de salt, esprint, agilitat i velocitat de xut de futbolistes joves. Mètode Estudi transversal en què participaren 36 jugadors de nivell subelit provinents de les categories inferiors (cadet i juvenil) d’equips de futbol andalusos (edat: 15,87 ± 1,43 anys; massa corporal: 65,38 ± 10,84 kg; alçada: 1,71 ± 0,06 m). S’avaluà la composició corporal, el rendiment en el salt vertical (CMJ), l’agilitat mitjançant el test de Balsom, la velocitat d’esprints en 5, 10, 20 i 30 m i la velocitat del xut amb ambdues cames. Resultats Les anàlisis mostraren que els jugadors juvenils tenien un rendiment major en els tests del CMJ, agilitat i velocitat de xut amb ambdues cames que els cadets. No s’aprecien diferències significatives (p ≥ 0,05) en la prova de velocitat, tot i que s’evidencia una tendència clara a favor dels juvenils. Conclusió Existeix l’efecte de l’edat durant l’etapa de l’adolescència sobre la capacitat de salt, l’agilitat, la velocitat de xut i, en menor mesura, sobre la velocitat dels jugadors de futbol joves, a més d’associació entre les capacitats condicionals, més influents en el rendiment del futbolista

Efficacy of photochemical internalisation using disulfonated chlorin and porphyrin photosensitisers: An in vitro study in 2D and 3D prostate cancer models

This study shows the therapeutic outcome of Photochemical Internalisation (PCI) in prostate cancer in vitro surpasses that of Photodynamic Therapy (PDT) and could improve prostate PDT in the clinic, whilst avoiding chemotherapeutics side effects. In addition, the study assesses the potential of PCI with two different photosensitisers (TPCS2a and TPPS2a) in prostate cancer cells (human PC3 and rat MatLyLu) using standard 2D monolayer culture and 3D biomimetic model. Photosensitisers were used alone for photodynamic therapy (PDT) or with the cytotoxin saporin (PCI). TPPS2a and TPCS2a were shown to be located in discrete cytoplasmic vesicles before light treatment and redistribute into the cytosol upon light excitation. PC3 cells exhibit a higher uptake than MatLyLu cells for both photosensitisers. In the 2D model, PCI resulted in greater cell death than PDT alone in both cell lines. In 3D model, morphological changes were also observed. Saporin-based toxicity was negligible in PC3 cells, but pronounced in MatLyLu cells (IC50 = 18 nM). In conclusion, the study showed that tumour features such as tumour cell growth rate or interaction with drugs determine therapeutic conditions for optimal photochemical treatment in metastatic prostate cancer

Pattern revivals from fractional Gouy phases in structured light

We investigate pattern revivals in specially designed optical structures that combine different transverse modes. In general, the resulting pattern is not preserved under free propagation and gets transformed due to non synchronized Gouy phases. However, it is possible to build structures in which the Gouy phases synchronize at specific fractional values, thus recovering the initial pattern at the corresponding longitudinal positions. This effect is illustrated with a radially structured light spot in which the beam energy can be addressed to different positions without the need of intermediate optical components, what can be useful for optical communications and optical tweezing with structured beams

Vertical Jumping as a Monitoring Tool in Endurance Runners: A Brief Review

Jumping performance (e.g., countermovement jump [CMJ]), as a measure of neuromuscular performance, has been suggested as an easy-to-use tool which simultaneously provides neuromuscular and metabolic information and, thereby, allows coaches to confidently monitor the status of their athletes during a workout. This hypothesis has been satisfactorily tested with sprint athletes. However, the rationale for the use of CMJ height loss as an index to monitor the workload during an endurance running session is not sufficiently evidence-based. First, it is assumed that a CMJ height loss occurs during typical interval training for endurance runners. Second, it is also assumed that a significant relationship between metabolic stress and the neuromuscular strain induced during these endurance workouts exists. These two assumptions will be questioned in this review by critically analyzing the kinetics of CMJ performance during and after running workouts, and the relationship between neuromuscular and physiological stress induced during different protocols in endurance runners. The current evidence shows that fatigue induced by common running workouts for endurance runners does not counterbalance the potentiation effect in the CMJ height. Additionally, the findings reported among different studies are consistent regarding the lack of association between CMJ height loss and physiological stress during interval sessions in endurance runners. In practical terms, the authors suggest that this marker of neuromuscular fatigue may not be used to regulate the external training load during running workouts in endurance runners. Nevertheless, the analysis of CMJ height during running workouts may serve to monitor chronic adaptations to training in endurance runners

Cultural dynamism and business vitality in medium-sized cities—evidence and proposals for sustainable development

This work uses tools recently designed to conduct analyses and proposals around the cultural development of medium-sized cities. The Cultural and Creative Cities Monitor model, or CCCM, is first applied to the 81 cities in Spain with between 50, 000 and 100, 000 inhabitants. We also refer to the UNESCO Culture/2030 Indicators, specifically indicator 8 (Cultural companies), to in-vestigate whether cultural dynamism is related to business vitality in those cities. Our observation of the 29 CCCM indicators and the C3 index, which synthesizes cultural performance, is explained, and these data are complemented with cultural business data (on assets, benefits, and jobs) from a sample of 13, 204 firms. The C3 index values reveal significant differences in the cultural and creative performance of the selected cities according to their location (metropolitan or non-metropolitan) and their administrative rank. Moreover, when comparing the C3 index with the indicators on business activity, evidence indicates a clear positive relationship between cultural dynamism and firm vitality. These results support the contribution of culture to the sustainable development of me-dium-sized Spanish cities and further establish the suitability of the tools used to assist cities in designing appropriate cultural policies

Developing a mental health eClinic to improve access to and quality of mental health care for young people: Using participatory design as research methodologies

Background: Each year, many young Australians aged between 16 and 25 years experience a mental health disorder, yet only a small proportion access services and even fewer receive timely and evidence-based treatments. Today, with ever-increasing access to the Internet and use of technology, the potential to provide all young people with access (24 hours a day, 7 days a week) to the support they require to improve their mental health and well-being is promising. Objective: The aim of this study was to use participatory design (PD) as research methodologies with end users (young people aged between 16 and 25 years and youth health professionals) and our research team to develop the Mental Health eClinic (a Web-based mental health clinic) to improve timely access to, and better quality, mental health care for young people across Australia. Methods: A research and development (R&D) cycle for the codesign and build of the Mental Health eClinic included several iterative PD phases: PD workshops; translation of knowledge and ideas generated during workshops to produce mockups of webpages either as hand-drawn sketches or as wireframes (simple layout of a webpage before visual design and content is added); rapid prototyping; and one-on-one consultations with end users to assess the usability of the alpha build of the Mental Health eClinic. Results: Four PD workshops were held with 28 end users (young people n=18, youth health professionals n=10) and our research team (n=8). Each PD workshop was followed by a knowledge translation session. At the conclusion of this cycle, the alpha prototype was built, and one round of one-on-one end user consultation sessions was conducted (n=6; all new participants, young people n=4, youth health professionals n=2). The R&D cycle revealed the importance of five key components for the Mental Health eClinic: a home page with a visible triage system for those requiring urgent help; a comprehensive online physical and mental health assessment; a detailed dashboard of results; a booking and videoconferencing system to enable video visits; and the generation of a personalized well-being plan that includes links to evidence-based, and health professional–recommended, apps and etools. Conclusions: The Mental Health eClinic provides health promotion, triage protocols, screening, assessment, a video visit system, the development of personalized well-being plans, and self-directed mental health support for young people. It presents a technologically advanced and clinically efficient system that can be adapted to suit a variety of settings in which there is an opportunity to connect with young people. This will enable all young people, and especially those currently not able or willing to connect with face-to-face services, to receive best practice clinical services by breaking down traditional barriers to care and making health care more personalized, accessible, affordable, and available