Managing depression in primary health care centers: The highlights of the program and further improvements

Many people with probable depression present at primary health care centers (PHC) with physical complaints. Clinical psychologists (CPs) in Sleman district and Yogyakarta city, Special Province of Yogyakarta, Indonesia, have been integrated into PHC to provide psychological services. The study on which we draw aimed to explore how depression is managed in PHC. Thirty four CPs and twenty people diagnosed with mild to moderate depression participated in semi-structured interviews. Based on the thematic analysis of their transcribed interviews, seven themes emerged: community education and support, referral pathways, assessing depression, diagnosis, communicating a diagnosis, accepting diagnosis, and treatment of depression. The co-location of CPs with other medical services at the PHC level supports community understandings of mental health problems. It also encourages community members to use PHC services and to have access to various behavioral interventions for people with depression. Recommendations and directions for further research are discussed

The impact of an intensive inpatient violent offender treatment programme on intermediary treatment targets, violence risk and aggressive behaviour in a sample of mentally disordered offenders

This study examined the impact of an intensive inpatient violent offender treatment programme, Life Minus Violence - Enhanced (LMV- E, Ireland, 2008), on intermediary treatment targets, risk for violence, and aggressive behaviour during treatment in a sample of male mentally disordered offenders. Using quasi-experimental design, offenders who completed LMV-E and a comparison group showed reduced problems with impulsivity and anger regulation and improvements in social problem solving. Aggregate risk for future violence lessened in both treatment and comparison groups, although by a significantly greater degree for the comparison group. The aggressive behaviour of both groups reduced. Completion of the LMV-E conferred additional improvements in some facets of social problem solving and anger regulation. Neither group showed improvements in empathic responses, coping skills or problematic interpersonal style. Overall, these results suggest anger regulation, impulsivity and social problem solving are most amenable to change, that reductions in certain facets of these dynamic risk factors transpires with nonspecific psychiatric inpatient treatment, but that the LMV-E, a cognitive behavioural violence specific psychological treatment, confers greater change in some facets of social problem solving and anger regulation

Interactions between aphids and their host plants under drought stress

Interactions between host plants and aphids under water stress conditions were examined. Two controlled environment room studies, a Veld experiment and phenological modelling analysis were used to investigate three different plant-aphid relationships. The aim of these studies was to determine the results of water shortage on plant and pest populations, which are likely to result under climate change scenarios. The central hypothesis was that mild drought stress would lead to greater aphid populations through a beneficial increase of small nitrogenous molecules in the phloem sap providing improved diet quality — the Plant Stress Hypothesis (White, 1969). Myzus persicae (the peach–potato aphid) is a broad-range feeder with a preference for senescent foliage. Contrary to expectations, on young cabbage plants, Brassica oleracea var capitata, it was found to increase faster and to a greater extent on well-watered hosts. Aphids were also found to prevent osmoregulation in droughted plants. Despite this, the aphid infestation led to a drought-like response in all plants irrespective of watering regime, causing significantly reduced growth. Metopolophium dirhodum (the rose–grain aphid) overwinters as eggs on Rosa spp. but most of its life-cycle is spent on grasses and cereal crops. As with M. persicae, aphid infestation caused drought-like symptoms even in well-watered plants. The mechanism of reduction in plant health is most likely through aphid damage to the efficiency of Photosystem a within 7 days of infestation. On young barley plants, Hordeum vulgare, the rose–grain aphid was found to increase faster and to greater extent on droughted hosts. In contrast to M. persicae, the study strongly supported the Plant Stress Hypothesis, Finding that even mild water stress of approximately −0.3 MPa could lead to conditions favourable to rapid aphid population increase. The difference in the response of different species of aphids may be associated more with the levels of soluble nitrogen in their diet than specifically host plant water status. Drepanosiphum platanoidis is an aphid specific to sycamore, Acer pseudoplatanus and spends its entire life-cycle on that species. In the Veld, the total number of aphids supported by a single tree was found to correlate most strongly with soluble leaf nitrogen. In addition, the number of aphids on individual leaves was found to correlate strongly and negatively with stomatal conductance and leaf water potential. Finally, analysis of historical aphid suction-trap data was carried out. UK Rothamsted suction-traps are 12.2 m tall and sample air at 0.75 m3 s-1, with daily aphid sampling between April and November. The traps are designed to catch the largest proportion of aphids in the total insect sample and to reduce the effect of surrounding land-use on the sample. The area represented by a trap may be as much as 700 km2 (Harrington and Woiwod, 2007). The dataset is the longest and most geographically extensive for aphid populations, comprising 46 sites across Europe as of 2011. In this analysis, aphid and meteorological data from the Edinburgh East Craigs site were used. This also enabled comparison with D. platanoidis numbers collected in the Veld, which showed a strongly significant positive relationship between the two. Since the data collected in suction-traps are correlated with numbers in the Veld, aphid population analysis can be improved with use of these longer datasets, without reliance on shorter-term Veld surveys. The various population characteristics examined were found to be strongly correlated with each other, but were unconnected to data from previous years. The date of first catch was found to be significantly advancing over time, with strong influences from daily minimum temperatures and vapour pressure deficits of the air within the year. Higher temperatures with lower humidity tend to bring forward the date of first catch. Lower tends to depress the population in the summer. The overall hypothesis that mild drought would benefit aphid populations cannot be accepted, but in two cases of the experiment sections of the work there were strong relationships between aphid numbers and both leaf temperature and soil moisture. The meteorological data analysis indicates that climatic changes towards a hotter, drier climate could substantially alter population dynamics. Harrington, R. and Woiwod, I. (2007). Foresight from hindsight: The Rothamsted Insect Survey. Outlooks on Pest Management, 18, 9–14. White, T. (1969). An index to measure weather-induced stress of trees associated with outbreaks of psyllids in Australia. Ecology, 50, 905–909

Prospectus, November 4, 1998

https://spark.parkland.edu/prospectus_1998/1028/thumbnail.jp

Cyber incivility and spillover effects: A proposed mediation model

Background Incivility is pervasive in the workplace, affecting upwards of 96% of employees across their work lives, with approximately 50% of employees indicating they experience incivility regularly, on a weekly basis. Recent research indicates that given the massive shift to virtual work, the incidence and impact of cyber incivility associated with work is an increasing issue. Although the individual and organizational effects of cyber incivility on work outcomes are well researched, less is known about how this low-intensity, deviant behavior affects the target of cyber incivility in other domains, such as the home domain. The present study will examine the association of cyber incivility on target angry and withdrawn behaviors at home, through the spillover mechanism of affective rumination via affective events theory. It is hypothesized that daily experienced cyber incivility will be positively associated with both angry behavior (H1) and withdrawal behavior (H2) at home. Additionally, work-related affective rumination is hypothesized to mediate the relationship between daily experienced cyber incivility and both aggression (H3a) and withdrawal (H3b) at home. Proposed Method Approximately 100 participants who work full-time will be enrolled in the study via Prolific Academic, an online participant crowdsourcing site. To date, the sample size consists of 63 participants who have completed 10-day daily surveys. Participants will be pre-screened to ensure they are 18 or older, work full-time, and interact with coworkers and supervisors daily. Proposed Analyses Hypotheses H1-H3b will be assessed using multilevel path analysis because of the hierarchical nature of the data (daily observations will be nested within individuals). Daily variables (level 1) will be person-mean centered, while between-person variables (e.g., aggregate means of constructs of interest, demographics, and trait characteristics) will be grand-mean centered and controlled for at the between-person level (level 2). Because mediation is hypothesized, indirect effects will be examined using bootstrapped estimates and confidence interval coverage. Expected Results & Implications Results from this study are expected to provide support for the episodic occurrence of work-related cyber incivility and its effects on at-home behavior, providing support for spillover effects between work and home. This is significant because work-related cyber incivility is on the rise with the shift to virtual work and is an understudied phenomenon. Understanding how experienced work-related cyber incivility impacts employees at home behavior will allow for the development of targeted interventions

Are in vitro estimates of cell diffusivity and cell proliferation rate sensitive to assay geometry?

AbstractCells respond to various biochemical and physical cues during wound-healing and tumour progression. in vitro assays used to study these processes are typically conducted in one particular geometry and it is unclear how the assay geometry affects the capacity of cell populations to spread, or whether the relevant mechanisms, such as cell motility and cell proliferation, are somehow sensitive to the geometry of the assay. In this work we use a circular barrier assay to characterise the spreading of cell populations in two different geometries. Assay 1 describes a tumour-like geometry where a cell population spreads outwards into an open space. Assay 2 describes a wound-like geometry where a cell population spreads inwards to close a void. We use a combination of discrete and continuum mathematical models and automated image processing methods to obtain independent estimates of the effective cell diffusivity, D, and the effective cell proliferation rate, λ. Using our parameterised mathematical model we confirm that our estimates of D and λ accurately predict the time-evolution of the location of the leading edge and the cell density profiles for both assay 1 and assay 2. Our work suggests that the effective cell diffusivity is up to 50% lower for assay 2 compared to assay 1, whereas the effective cell proliferation rate is up to 30% lower for assay 2 compared to assay 1

Hepatitis E virus (HEV) in Scotland:evidence of recent increase in viral circulation in humans

Background: Previous studies showed low levels of circulating hepatitis E virus (HEV) in Scotland. We aimed to reassess current Scottish HEV epidemiology. Methods: Blood donor samples from five Scottish blood centres, the minipools for routine HEV screening and liver transplant recipients were tested for HEV antibodies and RNA to determine seroprevalence and viraemia. Blood donor data were compared with results from previous studies covering 2004-08. Notified laboratory-confirmed hepatitis E cases (2009-16) were extracted from national surveillance data. Viraemic samples from blood donors (2016) and chronic hepatitis E transplant patients (2014-16) were sequenced. Results: Anti-HEV IgG seroprevalence varied geographically and was highest in Edinburgh where it increased from 4.5% in 2004-08) to 9.3% in 2014-15 (p = 0.001). It was most marked in donors < 35 years. HEV RNA was found in 1:2,481 donors, compared with 1:14,520 in 2011. Notified laboratory-confirmed cases increased by a factor of 15 between 2011 and 2016, from 13 to 206. In 2011-13, 1 of 329 transplant recipients tested positive for acute HEV, compared with six cases of chronic infection during 2014-16. Of 10 sequenced viraemic donors eight and all six patients were infected with genotype 3 clade 1 virus, common in European pigs. Conclusions: The seroprevalence, number of viraemic donors and numbers of notified laboratory-confirmed cases of HEV in Scotland have all recently increased. The causes of this change are unknown, but need further investigation. Clinicians in Scotland, particularly those caring for immunocompromised patients, should have a low threshold for testing for HEV

International observational atopic dermatitis cohort to follow natural history and treatment course: TARGET-DERM AD study design and rationale

INTRODUCTION: As new topical and systemic treatments become available for atopic dermatitis (AD), there is a need to understand how treatments are being used in routine clinical practice, their comparative effectiveness and their long-term safety in diverse clinical settings. METHODS AND ANALYSIS: The TARGET-DERM AD cohort is a longitudinal, observational study of patients with AD of all ages, designed to provide practical information on long-term effectiveness and safety unobtainable in traditional registration trials. Patients with physician-diagnosed AD receiving prescription treatment (topical or systemic) will be enrolled at academic and community clinical centres. Up to 3 years of retrospective medical records, 5 years of prospective medical records, and optional biological samples and patient-reported outcomes will be collected. The primary aims include characterisation of AD treatment regimens, evaluation of response to therapy, and description of adverse events. ETHICS AND DISSEMINATION: TARGET-DERM has been approved by a central IRB (Copernicus Group IRB, 5000 Centregreen Way Suite 200, Cary, North Carolina 27513) as well as local and institutional IRBs. No additional Ethics Committee reviews. Results will be reviewed by a publications committee and submitted to peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT03661866, pre-results

Patients' ratings of genetic conditions validate a taxonomy to simplify decisions about preconception carrier screening via genome sequencing

Advances in genome sequencing and gene discovery have created opportunities to efficiently assess more genetic conditions than ever before. Given the large number of conditions that can be screened, the implementation of expanded carrier screening using genome sequencing will require practical methods of simplifying decisions about the conditions for which patients want to be screened. One method to simplify decision making is to generate a taxonomy based on expert judgment. However, expert perceptions of condition attributes used to classify these conditions may differ from those used by patients. To understand whether expert and patient perceptions differ, we asked women who had received preconception genetic carrier screening in the last 3 years to fill out a survey to rate the attributes (predictability, controllability, visibility, and severity) of several autosomal recessive or X-linked genetic conditions. These conditions were classified into one of five taxonomy categories developed by subject experts (significantly shortened lifespan, serious medical problems, mild medical problems, unpredictable medical outcomes, and adult-onset conditions). A total of 193 women provided 739 usable ratings across 20 conditions. The mean ratings and correlations demonstrated that participants made distinctions across both attributes and categories. Aggregated mean attribute ratings across categories demonstrated logical consistency between the key features of each attribute and category, although participants perceived little difference between the mild and serious categories. This study provides empirical evidence for the validity of our proposed taxonomy, which will simplify patient decisions for results they would like to receive from preconception carrier screening via genome sequencing