Admixture in Humans of Two Divergent Plasmodium knowlesi Populations Associated with Different Macaque Host Species.

Human malaria parasite species were originally acquired from other primate hosts and subsequently became endemic, then spread throughout large parts of the world. A major zoonosis is now occurring with Plasmodium knowlesi from macaques in Southeast Asia, with a recent acceleration in numbers of reported cases particularly in Malaysia. To investigate the parasite population genetics, we developed sensitive and species-specific microsatellite genotyping protocols and applied these to analysis of samples from 10 sites covering a range of >1,600 km within which most cases have occurred. Genotypic analyses of 599 P. knowlesi infections (552 in humans and 47 in wild macaques) at 10 highly polymorphic loci provide radical new insights on the emergence. Parasites from sympatric long-tailed macaques (Macaca fascicularis) and pig-tailed macaques (M. nemestrina) were very highly differentiated (FST = 0.22, and K-means clustering confirmed two host-associated subpopulations). Approximately two thirds of human P. knowlesi infections were of the long-tailed macaque type (Cluster 1), and one third were of the pig-tailed-macaque type (Cluster 2), with relative proportions varying across the different sites. Among the samples from humans, there was significant indication of genetic isolation by geographical distance overall and within Cluster 1 alone. Across the different sites, the level of multi-locus linkage disequilibrium correlated with the degree of local admixture of the two different clusters. The widespread occurrence of both types of P. knowlesi in humans enhances the potential for parasite adaptation in this zoonotic system

Factors affecting interorganizational learning networks in youth care services:What do we know and what are the research gaps?

Background: Children with behavioral and psychological problems and their families often need integrated care involving innovative methods such as Signs of safety and Wrap-around care. The implementation of these methods depends on interdisciplinary collaboration and the capacity to learn and innovate by the professionals concerned, often participating in interorganizational learning networks. The aim of this scoping review is to provide an overview of the characteristics of learning organizations that affect the learning and innovative performance of interorganizational networks in youth care services. Method: We used the databases Scopus, PsycInfo and PubMed. We included 24 of the 166 papers that emerged from our literature search. We subsequently used the High-Performance Organizations framework and its characteristics (organization design, strategy, process, technology, leadership, individuals and roles, culture, and external orientation) as a basis for analyzing the literature. Results: The reviewed papers often stressed the importance of leadership, communication and culture for learning networks, but were less specific about the practical implementation of these factors. We also found less emphasis in the literature on the conditions required to organize learning networks, in particular the external orientation of networks and the use of technology. Conclusion: The literature on factors that affect the learning and innovation potential of learning networks in youth care services is sparse. It focuses on common learning features and less on organizational conditions. There should be a particular emphasis on establishing competent workforces with excellent skills in the areas of cross-organizational collaboration and the use of technology. We advise more research into the impact of networks on the outcomes of youth care services.</p

RE: Securing improved primary health care for children and adolescents post-COVID-19:[Rapid response]

Dear Editor,The COVID-19 crisis so far seems to be less intruding for children’s physical condition and it affects older people disproportionately. Much effort must be spent to control COVID-19 in this older age group and improve their living conditions, including quality of care. But this first impression is misleading. Once mortality and morbidity caused by COVID-19 are controlled in Western countries, the current state of primary health care for children also requires a forward view to improve the primary health care of the youngest generation.Despite the expected economic shortfalls foreseen in the coming years, we must guarantee prolongation of effective primary health care systems available for children and adolescents. But we also need to thrive for the improvements recommended in the EU financed Models of Child Health Care Appraised (MOCHA) research project.[...]<br/

Resilience-based interventions in the public sector workplace:a systematic review

BACKGROUND: Previous studies have advocated the benefits of resilience-based interventions for creating a healthy and sustainable workforce. However, resilience is defined and measured in diverse ways. Therefore, the aim of this systematic review is (1) to identify how resilience is defined within different workplace interventions, translated into intervention content, and measured in these interventions; and (2) to synthesize the effectiveness of these interventions. METHODS: A systematic literature search was conducted and included articles from 2013 - 2023. Twenty-four studies met the inclusion criteria, covering a total of 26 unique interventions. Definitions were categorized as: resilience as a trait, process, or outcome. Cohen's D was calculated to depict the effect sizes within the intervention groups from pre-test to post-test and, when possible, from pre-test to 3-month follow-up. RESULTS: Included studies applied a wide range of definitions; most definitions fitted within the trait-orientation, conceptualizing resilience as an individual characteristic or ability, or the process-orientation, conceptualizing resilience as a dynamic process. No studies solely used the outcome-orientation, but some did combine elements of all three orientations. Various definitions, measures and intervention strategies were applied, however, almost half of the studies (46%) showed inconsistencies within these choices. Furthermore, findings show that most resilience-based interventions in the workplace have a positive impact. While educational workshops with a higher frequency and duration had medium to large effects, solely digital interventions had small effects, changing to small to medium when combined with non-digital elements. CONCLUSIONS: Findings suggest that resilience-based can benefit employees by enhancing their psychological well-being. This, in turn, can lead to improved work-related outcomes such as productivity, thereby offering advantages to employers as well. This underscores the growing recognition that resilience should be viewed as a shared responsibility between the individual and the organization. Further advancement in the field of resilience-based interventions in the workplace calls for future research to focus on maintaining consistency when choosing a definition of resilience, developing intervention content, and choosing an outcome measure. PREREGISTRATION: The search protocol was preregistered in the Open Science Framework, see Hollaar et al. (2023). https://doi.org/10.17605/OSF.IO/UKYF7 .</p

Exploring peer education for migrant informal caregivers of mentally ill loved ones:a realist evaluation protocol

Introduction:Informal caregivers with a migration background who care for someone with a mental illness often experience elevated caregiver burdens due to factors such as discrimination, language barriers, and stigma. In The Netherlands, a peer education intervention called ‘They Are not Mental?!’ (TANM) addresses these challenges by reducing stigma, increasing help-seeking behaviors, and improving access to healthcare. This transdisciplinary study evaluates how contextual factors and mechanisms influence its outcomes. Description: This research protocol outlines a realist evaluation of the intervention using a mixed-methods design, including interviews, post-questionnaires, and observations. The study will develop and refine the program theory to determine for whom, in what contexts, why, and how the intervention works. Discussion: This protocol shows how we plan to investigate how, why, for whom and under what circumstances TANM produces its intended outcomes, using a realist evaluation approach. This approach is well-suited for evaluating complex interventions because it accommodates for dynamic and iterative interventions. Its focus is on understanding patterns and mechanisms within specific contexts, using program theories. Conclusion: The evaluation of TANM will inform future intervention adaptations and guide future efforts to support vulnerable populations, particularly migrants navigating caregiving challenges.</p

Parents' expected barriers to psychosocial care for children with complex problems

Background and objective: Even though children with complex problems frequently need psychosocial care, two thirds does not receive treatment. Various barriers, particularly expectations of barriers, can hinder effective access of care. Our aim was to assess the practical barriers expected by parents, and the child, family and need factors associated with these expected barriers. Methods: We sent web-based questionnaires to parents of a random sample of children known to have or be at risk of having complex problems (response = 77%). We used backward regression analyses to examine which factors were associated with expected barriers for children using psychosocial care, or no care at all. Results: Seventy-three percent of all parents expected practical barriers. Parents of children using psychosocial care expected more barriers than when using no care at all. For children who used no care, parents of girls expected more barriers (regression coefficient 0.54; 95%—confidence interval 0.16, 0.92) as did families having less social support (−0.30; −0.50, −0.11). When children used psychosocial care, parents expected more barriers when their child was of school-age (0.38; 0.01, 0.75), of non-western origin (vs. native) (0.52; 0.17, 0.88), when parents were older (i.e., 36+ years) (−0.77; −1.12, −0.42), experienced more adverse life events (0.29; 0.13, 0.45) or had less social support (−0.17; −0.34, 0.00). Conclusion: Even when their child is already receiving treatment, parents continue to expect practical barriers to psychosocial care. Psychosocial care services and their gatekeepers should address these concerns. Access to psychosocial care can be improved by removing practical barriers, especially if children already receive psychosocial care, or when parents have a limited network or belong to an ethnic minority.</p

Availability and implementation of guidelines in European child primary health care:how can we improve?

Background Clinical guidelines are important for providing high-quality child primary health care. We aimed to assess the availability, use and achieved delivery of guidelines in the European Union (EU). Methods We used a case study design to ascertain expert views on guidelines in six countries representing the EU. The experts completed an online questionnaire (response 49%), asking about their perception of guideline availability and implementation regarding three topics that represent prevention and care, i.e. vaccination, assessment of mental health and asthma care. Results According to the respondents all countries had guidelines available for asthma care. For vaccination and mental health assessment respondents agreed to a lesser degree that guidelines were available. Implementation of guidelines for vaccination was mostly perceived as intended, but implementation of the guidelines for mental health assessment and asthma care was limited. Notable barriers were complexity of performance, and lack of training of professionals and of financial resources. Important facilitators for guideline implementation were the fit with routine practice, knowledge and skills of professionals and policy support. We found no clear relationship of guideline availability and implementation with type of child primary health care system of countries, but strong governance and sufficient financial resources seemed important for guideline availability. Conclusions Availability and implementation of clinical guidelines in child primary health care vary between EU countries. Implementation conditions can be strongly improved by adequate training of professionals, stronger governance and sufficient financial resources as facilitating factors. This can yield major gains in child health across Europe