The MATRIx Models – Conceptual frameworks of barriers and facilitators to perinatal mental health care

Background: Perinatal Mental Health (PMH) problems are a leading cause of maternal death and increase the risk of poor outcomes for women and their families. It is therefore important to identify the barriers and facilitators to implementing and accessing PMH care. Aim: To develop a conceptual framework of barriers and facilitators to PMH care to inform PMH services. Methods: Relevant literature was systematically identified then categorised and mapped onto the framework. The framework was then validated through evaluating confidence with the evidence base, and feedback from stakeholders (women and families; health professionals; commissioners and policy makers). Results: Barriers and facilitators to PMH care were identified at seven levels: Individual (e.g., beliefs about mental illness); Health professional (e.g., confidence addressing perinatal mental illness); Interpersonal (e.g., relationship between women and health professionals); Organisational (e.g., continuity of carer); Commissioner (e.g., referral pathways); Political (e.g., women’s economic status); and Societal (e.g., stigma). The MATRIx conceptual frameworks provide pictorial representations of 66 barriers and 39 facilitators to PMH care. Conclusions: The MATRIx frameworks highlight the complex interplay of individual and system level factors across different stages of the care pathway that influence women accessing PMH care and effective implementation of PMH services. Recommendations are made for health policy and practice. These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to PMH care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services; and quality training for health professionals with protected time to complete it

HEP Outreach, Inreach, and Web 2.0

I report on current usage of multimedia and social networking "Web 2.0" tools for Education and Outreach in high-energy physics, and discuss their potential for internal communication within large worldwide collaborations, such as those of the LHC. Following a brief description of the history of Web 2.0 development, I present a survey of the most popular sites and describe their usage in HEP to disseminate information to students and the general public. I then discuss the potential of certain specific tools, such as document and multimedia sharing sites, for boosting the speed and effectiveness of information exchange within the collaborations. I conclude with a brief discussion of the successes and failures of these tools, and make suggestions for improved usage in the future.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90828/1/1742-6596_331_8_082003.pd

Conceptual frameworks of barriers and facilitators to perinatal mental healthcare: the MATRIx models

BACKGROUND: Perinatal mental health (PMH) problems are a leading cause of maternal death and increase the risk of poor outcomes for women and their families. It is therefore important to identify the barriers and facilitators to implementing and accessing PMH care. AIMS: To develop a conceptual framework of barriers and facilitators to PMH care to inform PMH services. METHOD: Relevant literature was systematically identified, categorised and mapped onto the framework. The framework was then validated through evaluating confidence with the evidence base and feedback from stakeholders (women and families, health professionals, commissioners and policy makers). RESULTS: Barriers and facilitators to PMH care were identified at seven levels: individual (e.g. beliefs about mental illness), health professional (e.g. confidence addressing perinatal mental illness), interpersonal (e.g. relationship between women and health professionals), organisational (e.g. continuity of carer), commissioner (e.g. referral pathways), political (e.g. women's economic status) and societal (e.g. stigma). The MATRIx conceptual frameworks provide pictorial representations of 66 barriers and 39 facilitators to PMH care. CONCLUSIONS: The MATRIx frameworks highlight the complex interplay of individual and system-level factors across different stages of the care pathway that influence women accessing PMH care and effective implementation of PMH services. Recommendations are made for health policy and practice. These include using the conceptual frameworks to inform comprehensive, strategic and evidence-based approaches to PMH care; ensuring care is easy to access and flexible; providing culturally sensitive care; adequate funding of services and quality training for health professionals, with protected time to complete it

Exact boundary S-matrices of the supersymmetric sine-Gordon theory on a half line

Using the boundary Yang-Baxter equations and exact results on the bulk $S$-matrices, we compute exact boundary scattering amplitudes of the supersymmetric sine-Gordon model with integrable boundary potentials.Comment: 15 pages, requires phyzzx.tex. Serious typo-errors are correcte

Barriers and facilitators to implementing perinatal mental health care in health and social care settings: A systematic review

The improvement of perinatal mental health forms part of the World Health Organization’s Millennium Development goals. However, research suggests implementation of perinatal mental healthcare is variable. To ensure successful implementation, barriers and facilitators to implementing perinatal mental health services need to be identified. The objectives of this review were to determine the barriers and facilitators to implementing perinatal mental health assessment, care, referral and treatment into health and social care services. A systematic review was carried out by conducting literature searches in CINAHL (1982- present); Embase (1974 – present); Medline (1946- present); and PsycINFO (1806 – present). The date of the last search was 11th December 2019 and forward and backward were completed by the 31st March 2020. Studies were included if they made statements about factors that either facilitated or impeded implementation of perinatal mental health assessment, care, or treatment. Partial (10%) dual screening and data extraction was carried out. Data were analysed using thematic synthesis. A total of 46 studies were included in the review. Implementation occurred in a wide range of settings. Implementation was affected by individual (e.g. inability to attend), healthcare professional (e.g. training), interpersonal (e.g. trusting relationships), organisational (e.g. clear referral pathways), political (e.g. funding) and societal factors (stigma and culture). There are a complex range of barriers and facilitators that can support the implementation of perinatal mental health policy and practice. Perinatal mental health services should be flexible, woman-centred and delivered by well-trained healthcare professionals working within a structure that facilitates continuity of carer. Strategies that can be used to improve implementation include, but are not limited to, co-production of services, implementation team meetings, funding and coalition building. Future research should focus on implementation barriers and facilitators dependent on illness severity, healthcare setting and inpatient care

Influence of Stress Ratio on the Elevated-Temperature Fatigue of a Silicon Carbide Fiber-Reinforced Silicon Nitride Composite

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65470/1/j.1151-2916.1991.tb07152.x.pd

Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial.

Summary Background It is unclear whether radial compared with femoral access improves outcomes in unselected patients with acute coronary syndromes undergoing invasive management. Methods We did a randomised, multicentre, superiority trial comparing transradial against transfemoral access in patients with acute coronary syndrome with or without ST-segment elevation myocardial infarction who were about to undergo coronary angiography and percutaneous coronary intervention. Patients were randomly allocated (1:1) to radial or femoral access with a web-based system. The randomisation sequence was computer generated, blocked, and stratified by use of ticagrelor or prasugrel, type of acute coronary syndrome (ST-segment elevation myocardial infarction, troponin positive or negative, non-ST-segment elevation acute coronary syndrome), and anticipated use of immediate percutaneous coronary intervention. Outcome assessors were masked to treatment allocation. The 30-day coprimary outcomes were major adverse cardiovascular events, defined as death, myocardial infarction, or stroke, and net adverse clinical events, defined as major adverse cardiovascular events or Bleeding Academic Research Consortium (BARC) major bleeding unrelated to coronary artery bypass graft surgery. The analysis was by intention to treat. The two-sided α was prespecified at 0·025. The trial is registered at ClinicalTrials.gov, number NCT01433627. Findings We randomly assigned 8404 patients with acute coronary syndrome, with or without ST-segment elevation, to radial (4197) or femoral (4207) access for coronary angiography and percutaneous coronary intervention. 369 (8·8%) patients with radial access had major adverse cardiovascular events, compared with 429 (10·3%) patients with femoral access (rate ratio [RR] 0·85, 95% CI 0·74-0·99; p=0·0307), non-significant at α of 0·025. 410 (9·8%) patients with radial access had net adverse clinical events compared with 486 (11·7%) patients with femoral access (0·83, 95% CI 0·73-0·96; p=0·0092). The difference was driven by BARC major bleeding unrelated to coronary artery bypass graft surgery (1·6% vs 2·3%, RR 0·67, 95% CI 0·49-0·92; p=0·013) and all-cause mortality (1·6% vs 2·2%, RR 0·72, 95% CI 0·53-0·99; p=0·045). Interpretation In patients with acute coronary syndrome undergoing invasive management, radial as compared with femoral access reduces net adverse clinical events, through a reduction in major bleeding and all-cause mortality. Funding The Medicines Company and Terumo. © 2015 Elsevier Ltd

Working County Lines: Child Criminal Exploitation and Illicit Drug Dealing in Glasgow and Merseyside

This article explores recent developments within the U.K. drug market: that is, the commuting of gang members from major cities to small rural urban areas for the purpose of enhancing their profit from drug distribution. Such practice has come to be known as working “County Lines.” We present findings drawn from qualitative research with practitioners working to address serious and organized crime and participants involved in street gangs and illicit drug supply in both Glasgow and Merseyside, United Kingdom. We find evidence of Child Criminal Exploitation (CCE) in County Lines activity, often as a result of debt bondage; but also, cases of young people working the lines of their own volition to obtain financial and status rewards. In conclusion, we put forward a series of recommendations which are aimed at informing police strategy, practitioner intervention, and wider governmental policy to effectively address this growing, and highly problematic, phenomenon

Therapeutic jurisprudence and procedural justice in Scottish drug courts

Scotland, like other Western jurisdictions, has recently witnessed the development of problem-solving courts aimed at responding more effectively to issues that underlie certain types of offending behaviour. The first to be established were two pilot Drug Courts which drew upon experience of Scottish Drug Treatment and Testing Orders. In common with Drug Courts elsewhere, the Scottish pilots combined treatment, drug testing, supervision and judicial oversight. This article focuses upon the role of judicial involvement in the ongoing review of Drug Court participants’ progress, drawing upon court observation and interviews with offenders and Drug Court professionals. Drug Court dialogues were typically encouraging on the part of sheriffs, aimed at recognising and reinforcing the progress made by participants and motivating then to maintain and build upon their achievements to date, while participants were generally responsive to the positive feedback they received from the sheriffs as their orders progressed. Interactions within the Scottish Drug Courts reflect key features of procedural justice (Tyler, 1990), including ethicality, efforts to be fair and representation. By contributing to enhanced perceptions of procedural justice, Drug Court dialogues may, it is argued, increase the perceived legitimacy of the court and by so doing encourage increased compliance with treatment and desistance from crime

Meta-review of the barriers and facilitators to women accessing perinatal mental healthcare

Perinatal mental health (PMH) problems are common and can have an adverse impact on women and their families. However, research suggests that a substantial proportion of women with PMH problems do not access care. OBJECTIVES: To synthesise the results from previous systematic reviews of barriers and facilitators to women to seeking help, accessing help, and engaging in PMH care, and to suggest recommendations for clinical practice and policy. DESIGN: A meta-review of systematic reviews. REVIEW METHODS: Seven databases were searched and reviewed using a Preferred Reporting Items for Systematic Reviews and Meta Analyses search strategy. Studies that focused on the views of women seeking help and accessing PMH care were included. Data were analysed using thematic synthesis. Assessing the Methodological Quality of Systematic Reviews-2 was used to assess review methodology. To improve validity of results, a qualitative sensitivity analysis was conducted to assess whether themes remained consistent across all reviews, regardless of their quality rating. RESULTS: A total of 32 reviews were included. A wide range of barriers and facilitators to women accessing PMH care were identified. These mapped across a multilevel model of influential factors (individual, healthcare professional, interpersonal, organisational, political and societal) and across the care pathway (from decision to consult to receiving care). Evidence-based recommendations to support the design and delivery of PMH care were produced based on identified barriers and facilitators. CONCLUSION: The identified barriers and facilitators point to a complex interplay of many factors, highlighting the need for an international effort to increase awareness of PMH problems, reduce mental health stigma, and provide woman-centred, flexible care, delivered by well trained and culturally sensitive primary care, maternity, and psychiatric health professionals. PROSPERO REGISTRATION NUMBER: CRD42019142854