Maximising impactful and locally relevant mental health research::Ethical considerations

Background: Achieving ethical and meaningful mental health research in diverse global settings requires approaches to research design, conduct, and dissemination that prioritise a contextualised approach to impact and local relevance. Method: Through three case studies presented at the 2021 Global Forum on Bioethics in Research meeting on the ethical issues arising in research with people with mental health conditions, we consider the nuances to achieving ethical and meaningful mental health research in three diverse settings. The case studies include research with refugees Rwanda and Uganda; a neurodevelopmental cohort study in a low resource setting in India, and research with Syrian refugees displaced across the Middle East. Results: Key considerations highlighted across the case studies include how mental health is understood and experienced in diverse contexts to ensure respectful engagement with communities, and to inform the selection of contextually-appropriate and feasible research methods and tools to achieve meaningful data collection.  Related to this is a need to consider how communities understand and engage with research to avoid therapeutic misconception, exacerbating stigma, or creating undue inducement for research participation, whilst also ensuring meaningful benefit for research participation. Central to achieving these is the meaningful integration of the views and perspectives of local stakeholders to inform research design, conduct, and legacy. The case studies foreground the potential tensions between meeting local community needs through the implementation of an intervention, and attaining standards of scientific rigor in research design and methods; and between adherence to procedural ethical requirements such as ethical review and documenting informed consent, and ethical practice through attention to the needs of the local research team. Conclusions: We conclude that engagement with how to achieve local relevance and social, practice, and academic impact offer productive ways for researchers to promote ethical research that prioritises values of solidarity, inclusion, and mutual respect.</ns4:p

Maximising impactful, locally relevant global mental health research conducted in low and middle income country settings:Ethical considerations

Background: Achieving ethical and meaningful mental health research in diverse global settings requires approaches to research design, conduct, and dissemination that prioritise a contextualised approach to impact and local relevance. Method: Through three case studies presented at the 2021 Global Forum on Bioethics in Research meeting on the ethical issues arising in research with people with mental health conditions, we consider the nuances to achieving ethical and meaningful mental health research in three diverse settings. The case studies include research with refugees Rwanda and Uganda; a neurodevelopmental cohort study in a low resource setting in India, and research with Syrian refugees displaced across the Middle East. Results: Key considerations highlighted across the case studies include how mental health is understood and experienced in diverse contexts to ensure respectful engagement with communities, and to inform the selection of contextually-appropriate and feasible research methods and tools to achieve meaningful data collection.  Related to this is a need to consider how communities understand and engage with research to avoid therapeutic misconception, exacerbating stigma, or creating undue inducement for research participation, whilst also ensuring meaningful benefit for research participation. Central to achieving these is the meaningful integration of the views and perspectives of local stakeholders to inform research design, conduct, and legacy. The case studies foreground the potential tensions between meeting local community needs through the implementation of an intervention, and attaining standards of scientific rigor in research design and methods; and between adherence to procedural ethical requirements such as ethical review and documenting informed consent, and ethical practice through attention to the needs of the local research team. Conclusions: We conclude that engagement with how to achieve local relevance and social, practice, and academic impact offer productive ways for researchers to promote ethical research that prioritises values of solidarity, inclusion, and mutual respect

ACHIEVING ORGANIZATIONAL PERFORMANCE THROUGH TRANSFORMATIONAL LEADERSHIP APPROACH: A STUDY OF SELECTED PUBLIC SECTOR ORGANIZATIONS

The aim of this study was to investigate ways of achieving organizational performance through transformational leadership approach, a study of selected public sector organizations in Anambra State Nigeria. The survey research design was used for this study. The study population was three thousand four hundred and thirty six staff (3436) while the sample size was three hundred and forty five (345) arrived at using Krejcie and Morgan (1970) formula. Bowley’s Population Allocation Formula (1964) was used in arriving at the number of questionnaire allocated to each sampled organization because of the differences in the number of employees. Questionnaire was used for data collection. The reliability of the questionnaire was tested by using Cronbach's alpha to access the internal consistency of the items. The study employed expert judgment approach to access content validity. Pearson’s product moment correlation technique was adopted to analyze the data at 0.05 level of significance. The findings indicate that transformational leadership and organizational performance in the selected public sector organizations had a strong positive and significant correlation. Keywords: Transformational Leadership, Public Sector Organization, Organizational Performance, Social Exchange Theory

Plan de mejora asistencial en la atención prehospitalaria del paciente con accidente cerebrovascular

Introducción: Un accidente cerebrovascular (ACV) o Ictus es un síndrome clínico secundario a un trastorno agudo del flujo sanguíneo en una parte determinada del encéfalo, dando lugar a daños reversibles e irreversibles, pudiéndose alterar de forma transitoria o permanente la función de esa zona debido a la muerte celular ocasionada.Un primer grupo son las Isquemias Cerebrales (hasta un 85% de los casos) y son aquellas alteraciones del encéfalo causadas por un trastorno del aporte circulatorio.El segundo grupo lo constituyen las Hemorragias Cerebrales (hasta un 20% de los casos) y se producen cuando hay una rotura de un vaso, dando lugar a una extravasación de sangre al interior de la cavidad craneal.El ictus constituye uno de los principales problemas a nivel de Salud Pública, suponiendo la segunda causa de muerte en el mundo occidental (11,9%), y la primera causa de discapacidad permanente, ocasionando secuelas incapacitantes en el 35-45% de los casos.El Código Ictus es un sistema de coordinación multidisciplinar ideado para la atención inmediata al ictus a nivel extrahospitalario e intrahospitalario, pudiéndose activar ante sospecha para actuar con anticipación y eficacia en sus distintas fases.Consiste en el reconocimiento precoz de síntomas y signos de un ictus, la priorización de cuidados y traslado a centros hospitalarios capacitados. Objetivo: Desarrollar una escala enfermera que permita ayudar a discriminar el ictus hemorrágico del isquémico en la fase prehospitalaria de manera precoz.Metodología: Para la realización de este trabajo se realizó una búsqueda en las principales bases de datos científicas. También se emplearon artículos y protocolos vigentes de fuentes como el 061 Aragón.Para el diseño del programa se empleó el ciclo de Deming, y para el diagnóstico relacionado con el problema se utilizó la taxonomía NANDA. Conclusiones: Con este programa se persigue una aceleración de los tiempos entre valoración inicial y aplicación del tratamiento a los pacientes con Ictus; una consecuente mejora de la asistencia, y una potencial reducción de secuelas posteriores.Palabras clave: "ictus", "stroke", "código", "accidente", "cerebrovascular".<br /

Economic Impact of COVID-19 Lockdown on households

Introduction:&nbsp;this study evaluated the economic impact of the COVID-19 lockdown on individuals and households. Methods:&nbsp;a cross-sectional online survey was used to collect data. Nigerian citizens who were domiciled or restricted from travelling abroad for no less than one month since the COVID-19 restrictions and lockdown were recruited into the study through focal persons purposively selected across the different states in Nigeria. Using WhatsApp® platform, the respondents completed the survey on household income and expenditure before and during the lockdown. Economic burden of COVID-19 lockdown on individuals and families was estimated using a prevalence-based cost of illness approach. Results:&nbsp;four hundred and four (male = 242; female = 162) individuals have participated in the study. The mean (SD) age of the respondents was 30.98 (10.92) years. Monthly income showed no statistically significant difference (p = 0.73) before and during lockdown. The overall household expenditure before and during the lockdown periods were USD 320 and USD 290. The total mean monthly costs for COVID-19 and non-COVID-19 health related problems were ₦11746.25 (USD30.79) and ₦11784.9 (USD 30.89), respectively. Household expenditure for hand sanitizers, facemasks, hand gloves, and disinfectants increased significantly during the COVID-19 restriction lockdown (p &lt; 0.05). However, expenditure on education, water, electricity, fuel, internet data, clothing and wears, toiletries decreased significantly during the lockdown period (p &lt; 0.05). Conclusion:&nbsp;this study suggests that the costs of continuing COVID-19 restrictions could have huge economic consequences on households and health system

A Loop Region in the N-Terminal Domain of Ebola Virus VP40 Is Important in Viral Assembly, Budding, and Egress

Ebola virus (EBOV) causes viral hemorrhagic fever in humans and can have clinical fatality rates of ~60%. The EBOV genome consists of negative sense RNA that encodes seven proteins including viral protein 40 (VP40). VP40 is the major Ebola virus matrix protein and regulates assembly and egress of infectious Ebola virus particles. It is well established that VP40 assembles on the inner leaflet of the plasma membrane of human cells to regulate viral budding where VP40 can produce virus like particles (VLPs) without other Ebola virus proteins present. The mechanistic details, however, of VP40 lipid-interactions and protein-protein interactions that are important for viral release remain to be elucidated. Here, we mutated a loop region in the N-terminal domain of VP40 (Lys127, Thr129, and Asn130) and find that mutations (K127A, T129A, and N130A) in this loop region reduce plasma membrane localization of VP40. Additionally, using total internal reflection fluorescence microscopy and number and brightness analysis we demonstrate these mutations greatly reduce VP40 oligomerization. Lastly, VLP assays demonstrate these mutations significantly reduce VLP release from cells. Taken together, these studies identify an important loop region in VP40 that may be essential to viral egress

Refining understanding of working memory buffers through the construct of binding:Evidence from a single case informs theory and clinical practice

International audienceBinding operations carried out in working memory enable the integration of information from different sources during online performance. While available evidence suggests that working memory may involve distinct binding functions, whether or not they all involve the episodic buffer as a cognitive substrate remains unclear. Similarly, knowledge about the neural underpinnings of working memory buffers is limited, more specifically regarding the involvement of medial temporal lobe structures. In the present study, we report on the case of patient KA, with developmental amnesia and selective damage to the whole hippocampal system. We found that KA was unable to hold shape-colours associations (relational binding) in working memory. In contrast, he could hold integrated coloured shapes (conjunctive binding) in two different tasks. Otherwise, and as expected, KA was impaired on three relational memory tasks thought to depend on the hippocampus that are widely used in the early detection of Alzheimer's disease. Our results emphasize a dissociation between two binding processes within working memory, suggesting that the visuo-spatial sketchpad could support conjunctive binding, and may rely upon a large cortical network including sub-hippocampal structures. By contrast, we found evidence for a selective impairment of relational binding in working memory when the hippocampal system is compromised, suggesting that the long-term memory deficit observed in amnesic patients may be related to impaired short-term relational binding at encoding. Finally, these findings may inform research on the early detection of Alzheimer's disease as the preservation of conjunctive binding in KA is in sharp contrast with the impaired performance demonstrated very early in this disease

Activating words without language: beta and theta oscillations reflect lexical access and control processes during verbal and non-verbal object recognition tasks

The intention to name an object modulates neural responses during object recognition tasks. However, the nature of this modulation is still unclear. We established whether a core operation in language, i.e. lexical access, can be observed even when the task does not require language (size-judgment task), and whether response selection in verbal versus non-verbal semantic tasks relies on similar neuronal processes. We measured and compared neuronal oscillatory activities and behavioral responses to the same set of pictures of meaningful objects, while the type of task participants had to perform (picture-naming versus size-judgment) and the type of stimuli to measure lexical access (cognate versus non-cognate) were manipulated. Despite activation of words was facilitated when the task required explicit word-retrieval (picture-naming task), lexical access occurred even without the intention to name the object (non-verbal size-judgment task). Activation of words and response selection were accompanied by beta (25-35 Hz) desynchronization and theta (3-7 Hz) synchronization, respectively. These effects were observed in both picture-naming and size-judgment tasks, suggesting that words became activated via similar mechanisms, irrespective of whether the task involves language explicitly. This finding has important implications to understand the link between core linguistic operations and performance in verbal and non-verbal semantic tasks