Better access to mental health program : influence of mental health occupational therapy

Background/aim

The Better Access to Mental Health program has enabled eligible occupational therapists to provide services to people with a mental health condition. No studies have yet reported the influence of occupational therapy under this scheme. The aim of this study was to investigate whether attending an occupational therapist under this initiative influences change in psychological distress of clients as measured by the Kessler Psychological Distress Scale (K10).
Method

A quasi-experimental pretest–posttest design, using pre-existing data collected in the process of regular treatment was used. Data from a total of 31 clients (mean = 17.13 years, SD = 3.603) were accessed for this study. Pre- and post-intervention scores on the K10 were used to determine if psychological distress had changed over the course of intervention.
Results

Highly significant improvements (P < 0.001) were found between the K10 pre-intervention score (mean = 25.68, SD = 9.944) and the K10 post-intervention score (mean = 21.00, SD = 9.212). Male K10 post-intervention scores (mean = 17.64, SD = 5.3) significantly improved (P = 0.05), whereas results for females were not statistically significant. Medication use, diagnosis, age, number of sessions and prior contact with health services did not influence the results. Results from specific evidence-based interventions were not able to be considered in this study.
Conclusion

The results of this study demonstrate effectiveness of occupational therapy services for adolescents and provide support for the ongoing participation of occupational therapists in this scheme.

Genetic basis for the increased expression of vacuolar H+ translocating ATPase genes upon imatinib treatment in human lymphoblastoid cells

Purpose The role of v-ATPases in cancer biology is being increasingly recognized. Yeast studies indicate that the tyrosine kinase inhibitor imatinib may interact with the v-ATPase genes and alter the course of cancer progression. Data from humans in this regard are lacking.

Methods We constructed 55 lymphoblastoid cell lines from pedigreed, cancer-free human subjects and treated them with IC20 concentration of imatinib mesylate. Using these cell lines, we (i) estimated the heritability and differential expression of 19 genes encoding several subunits of the v-ATPase protein in response to imatinib treatment; (ii) estimated the genetic similarity among these genes; and (iii) conducted a high-density scan to find cis-regulating genetic variation associated with differential expression of these genes.

Results We found that the imatinib response of the genes encoding v-ATPase subunits is significantly heritable and can be clustered to identify novel drug targets in imatinib therapy. Further, five of these genes were significantly cis-regulated and together represented nearly half-log fold change in response to imatinib (p = 0.0107) that was homogenous (p = 0.2598).

Conclusions Our results proffer support to the growing view that personalized regimens using proton pump inhibitors or v-ATPase inhibitors may improve outcomes of imatinib therapy in various cancers.

Methods for the analysis of histone H3 and H4 acetylation in blood

LBH589 is one of the many histone deacetylase inhibitors (HDACi) that are currently in clinical trial. Despite their wide-spread use, there is little literature available describing the typical levels of histone acetylation in untreated peripheral blood, the treatment and storage of samples to retain optimal measurement of histone acetylation nor methods by which histone acetylation analysis may be monitored and measured during the course of a patient’s treatment. In this study, we have used cord or peripheral blood as a source of human leukocytes, performed a comparative analysis of sample processing methods and developed a flow cytometric method suitable for monitoring histone acetylation in isolated lymphocytes and liquid tumors. Western blotting and immunohistochemistry techniques have also been addressed. We have tested these methods on blood samples collected from four patients treated with LBH589 as part of an Australian Children’s Cancer Clinical Trial (CLBH589AAU03T) and show comparable results when comparing in vitro and in vivo data. This paper does not seek to correlate histone acetylation levels in peripheral blood with clinical outcome but describes methods of analysis that will be of interest to clinicians and scientists monitoring the effects of HDACi on histone acetylation in blood samples in clinical trials or in related research studies.

An evaluation of the effect of an educational intervention for Australian social workers on competence in delivering brief cognitive behavioural strategies : a randomised controlled trial

Background Broad community access to high quality evidence-based primary mental health care is an ongoing challenge around the world. In Australia one approach has been to broaden access to care by funding psychologists and other allied health care professionals to deliver brief psychological treatments to general practitioners' patients. To date, there has been a scarcity of studies assessing the efficacy of social worker delivered psychological strategies. This study aims to build the evidence base by evaluating the impact of a brief educational intervention on social workers' competence in delivering cognitive behavioural strategies (strategies derived from cognitive behavioural therapy). Methods A randomised controlled trial design was undertaken with baseline and one-week follow-up measurement of both objective and self-perceived competence. Simulated consultations with standardised depressed patients were recorded on videotape and objective competence was assessed by blinded reviewers using the Cognitive Therapy Scale. Questionnaires completed by participants were used to measure self-perceived competence. The training intervention was a 15 hour face-to-face course involving presentations, video example consultations, written materials and rehearsal of skills in pairs. Results 40 Melbourne-based (Australia) social workers enrolled and were randomised and 9 of these withdrew from the study before the pre training simulated consultation. 30 of the remaining 31 social workers (97%) completed all phases of the intervention and evaluation protocol (16 from intervention and 14 from control group). The intervention group showed significantly greater improvements than the control group in objective competence (mean improvement of 14.2 (7.38-21.02) on the 66 point Cognitive Therapy Scale) and in subjective confidence (mean improvement of 1.28 (0.84-1.72) on a 5 point Likert scale). On average, the intervention group improved from below to above the base competency threshold on the Cognitive Therapy Scale whilst the control group remained below. Conclusions Social workers can attain significant improvements in competency in delivering cognitive behavioural strategies from undertaking brief face to face training. This is relevant in the context of health reforms that involve social worker delivery of evidence based psychological care. Further research is required to assess how these improvements in competence translate into performance in practice and clinical outcomes for patients.

Midwifery work and the making of narrative

This paper draws on a study of birth support conducted across three Melbourne maternity units. Midwife informants were asked to participate in semistructured interviews with two researchers and describe the activity and role of lay birth support people. In the course of the study, the activity of the midwives themselves became a research focus. The study found that one of the key tasks midwives described was assisting birthing women to develop and negotiate satisfactory birth narratives that could encompass the intense and sometimes difficult experience of birth. Midwife informants offered strategies for the development of such narratives as part of their professional and personal labour in the birth room.

Sex differences in the Toll-like receptor-mediated response of plasmacytoid dendritic cells to HIV-1

Manifestations of viral infections can differ between women and men, and marked sex differences have been described in the course of HIV-1 disease. HIV-1-infected women tend to have lower viral loads early in HIV-1 infection but progress faster to AIDS for a given viral load than men. Here we show substantial sex differences in the response of plasmacytoid dendritic cells (pDCs) to HIV-1. pDCs derived from women produce markedly more interferon-alpha (IFN-alpha) in response to HIV-1-encoded Toll-like receptor 7 (TLR7) ligands than pDCs derived from men, resulting in stronger secondary activation of CD8(+) T cells. In line with these in vitro studies, treatment-naive women chronically infected with HIV-1 had considerably higher levels of CD8(+) T cell activation than men after adjusting for viral load. These data show that sex differences in TLR-mediated activation of pDCs may account for higher immune activation in women compared to men at a given HIV-1 viral load and provide a mechanism by which the same level of viral replication might result in faster HIV-1 disease progression in women compared to men. Modulation of the TLR7 pathway in pDCs may therefore represent a new approach to reduce HIV-1-associated pathology.

Serum levels of brain-derived neurotrophic factor in patients with schizophrenia and bipolar disorder.

There is evidence that major psychiatric discords such as schizophrenia (SZ) and bipolar disorder (BD) are associated with dysregulation of synaptic plasticity with downstream alterations of neurotrophins. Brain-derived neurotrophic factor (BDNF) is the most widely distributed neurotrophin in the central nervous system (CNS), and performs many biological functions such as promoting the survival, differentiation, and plasticity of neurons. Variants in the BDNF gene increase the risk of SZ and bipolar disorder. Chronic administration of drugs used to treat SZ and BD, such as lithium, valproate, quetiapine, clozapine, and olanzapine, increases BDNF expression in rat brain. To examine serum BDNF, three groups of chronically medicated DSM-IV SZ patients, on treatment with clozapine (n=27), typical (n=14), and other atypical antipsychotics (n=19), 30 euthymic BD patients, and 26 healthy control had 5 ml blood samples collected by venipuncture. Serum BDNF levels were significantly higher in SZ patients (p<0.001) when compared to either controls or euthymic BD patients. Increased BDNF in SZ patients might be related to the course of illness or to treatment variables. Prospective studies are warranted.

The feasibility of implementing cross-curricular studies of Asia

The prioritising and mandating of cross-curricular studies of Asia in the Australian curriculum reflects public policy promoting the benefits of a citizenry able to engage in intercultural relationships with people living in and with links to Asian countries. However, widespread school-based implementation of this substantial mandate requires the addressing of several impediments. Firstly, teachers perceive themselves to be unprepared to respond to the mandate to incorporate teaching of Asia-related studies; and secondly, cross-curricular pedagogies are under-theorised, with a proliferation of forms, nomenclature and interpretations evident. Far from being singular, easily understood and widely accepted, cross-curricula approaches can be mapped as a continuum of possible pedagogies; from teachers remaining within their disciplinary areas to fully integrated, whole school, inquiry based approaches that cut across subject silos. Clarity about these pedagogies and their contextual affordances and teacher confidence in engaging students in studies of Asia are required for the profession to respond positively. This chapter explores theoretical literature on cross-curricular teaching approaches; analyses teacher perceptions of their preparedness and capacities for teaching studies of Asia; and investigates an exemplary teacher’s implementation of studies of Asia in light of theorisations of cross curricularity.

The Maltreatment-Offending Association: a systematic review of the methodological features of prospective and longitudinal studies

Although the association between childhood maltreatment and the subsequent development of offending behavior is well documented, the association does not necessarily reflect a causal relationship. This paper provides a systematic review of prospective and longitudinal studies using official records of maltreatment to gain insights into the extent to which methodological variations are likely to influence the conclusions drawn about the likely relationship between maltreatment and offending. Sixty-two original studies met the inclusion criteria. These studies were assessed according to a set of seven methodological criteria: (1) inclusion of comparison groups, (2) the use of statistical controls, (3) valid outcome measures, (4) operationalization of maltreatment, (5) proper temporal order of associations, (6) data relating to unsubstantiated maltreatment, and (7) consideration of mediating and moderating factors. The strength of evidence in support of the maltreatment-offending association was influenced by a number of methodological factors. Despite the increasing sophistication of studies, there is a need to be mindful of how these factors are taken into account in future research in order to gain a deeper understanding of the adverse consequences of maltreatment and how this might influence outcomes and inform interventions.

In search of academic identity : physical education, sport science and the field of human movement studies

This thesis addresses the problem of the academic identity of the area traditionally referred to as physical education. The study is a critical examination of the argu ments for the justi cation of this area as an autonomous branch of knowledge. The investigation concentrates on a selected number of arguments. The data collection comprised articles books and proceedings of conferences. The preliminary assessment of these materials resulted in a classi cation of the arguments into three groups. The rst group comprises the arguments in favour of physical education as an academic discipline. The second includes the arguments supporting a science of sport. The third consists of the arguments in favour of to a eld of human movement study. The examination of these arguments produced the following results. (a) The area of physical education does not satisfy the conditions presupposed by the de nition of academic discipline. This is so because the area does not form an integrated system of scienti c theories. (b) The same di culty emerges from the examination of the ar guments for sport science. There is no science of sport because there is no integrated system of scienti c theories related to sport. (c) The arguments in favour of a eld of study yielded more productive results. However di culties arise from the de nition of human movement. The analysis of this concept showed that its limits are not well demarcated. This makes it problematic to take human movement as the focus of a eld of studies. These aspects led to the conclusion that such things as an academic discipline of physical education sport science and eld of human movement studies do not exist. At least there are not such things in the sense of autonomous branches of knowledge. This does not imply that a more integrated inquiry based on several disciplines is not possible and desirable. This would enable someone entering phys ical education to nd a more organised structure of knowledge with some generally accepted problem situations procedures and theories on which to base professional practice.

Speak now or forever hold your peace: an empirical investigation of whistleblowing in Brazilian organizations

À medida que ajudam as organizações a prevenir condutas irregulares e a manter um ambiente de trabalho mais éticos, as denúncias (whistleblowing) são frequentemente apontadas pela literatura como um benefício à sociedade como um todo. Entretanto, pouco se sabe a respeito de muitos aspectos associados à decisão de denunciar uma irregularidade. No Brasil, em especial, onde o assunto permanece sendo negligenciado por pesquisadores, elementos culturais específicos podem obstruir o caminho da denuncia, além de impor restrições à generalização dos resultados de pesquisas anteriores, quase sempre voltadas para a realidade anglo-saxônica. Com base nesses pressupostos, este estudo busca identificar os antecedentes do whistleblowing interno nas organizações brasileiras. De modo geral, os resultados da pesquisa empírica realizada com uma ampla amostra de profissionais oriundos de empresas púbicas e privadas dão suporte ao modelo proposto e reforçam a noção de que o ato de denunciar é o resultado complexo da interação entre fatores da organização, do indivíduo da situação observada. Em particular, os resultados sugerem que os indivíduos são mais propensos a realizar a denúncia quando a irregularidade observada é percebida como grave e quando a própria denuncia é vista como um curso de ação ético. Por outro lado, os indivíduos podem optar pelo silêncio se o alvo da denúncia for alguém com alto status na organização, se eles não sentirem apoio da organização ou se temerem retaliações. A influência negativa do medo de retaliação sobre a intenção de denunciar, contudo, pode ser atenuada se o indivíduo está convencido de que o correto a fazer é denunciar. Por fim, os resultados também sugerem que profissionais em posição gerencial são mais propensos a denunciar irregularidades do que os demais membros de uma organização. As implicações desses resultados, bem como as limitações e contribuições do estudo para a teoria e para a prática são discutidas em detalhe, juntamente com sugestões para pesquisas futuras.

Testicular structure and spermatogenesis of Amazonian freshwater cururu stingray Potamotrygon cf. histrix

The cururu stingray Potamotrygon cf. histrix, a new and endemic Amazonian freshwater species, presents appropriate characteristics for fish keeping and is exploited from its natural environment. The present study identified the testicular structure and spermatogenesis of this species. Gonads from adult male specimens were dissected, fixed and processed for histological analysis. The testes were of testicular/epigonial type. The presence of germinal papillae was observed in the upper portion of organ with primordial germ cells and Sertoli cell precursors. The testis was lobular with zonal organization and cystic gametogenesis, with the occurrence of spermatoblasts. The Sertoli cells underwent morphological modifications over the course of gamete formation. The spermatozoids had long heads and were spiraled on their own axis. Information on the reproductive biology will serve as basis for studies on the reproduction and phylogeny of this peculiar group of cartilaginous fish.

Vegetal polymer in repair of defects of the orbital floor: an experimental study in rabbits

Background: An experimental study was done to assess the ability of the vegetal polymer miniplates and screws to repair defects of the orbital floor.Methods: An artificial standard-sized defect was created in the bony floor of right orbit of 45 albino rabbits. The animals were divided into three experimental groups: control group (G1) involving animals with orbital floor defect and no treatment; titanium group (G2) containing animals with orbital floor defect repaired by titanium miniplates and screws; vegetal polymer group (G3) composed of animals with similar orbital floor defects repaired by vegetal polymer miniplates and screws. Throughout the course of the experiment, the animals were clinically evaluated. At 15, 30 and 60 days after surgery, the animals were killed. They were X-rayed immediately after the floor defect and at the moment of sacrifice. Histological and morphometric evaluation of inflammatory reaction and bone healing was done. Data were statistically evaluated.Results: No implants were extruded. Bone consolidation was similar in G2 and G3 and better than in G1 group animals. Inflammatory reaction was most pronounced in animals of G3 15 days after surgery, and it subsided over time.Conclusion: Vegetal polymer miniplates and screws induces small inflammatory reaction and had the ability to stimulate bone growth with good integration in the orbital floor defect allowing to consider the vegetal polymer adequate option to treat orbital floor defects. Future studies involving long-term follow-up and biomechanical tests to evaluate material resistance to traction are needed.

The shared influence of phylogeny and ecology on the reproductive patterns of Myrteae (Myrtaceae)

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Branch formation in Pulvinularia suecica (Nostocales, Cyanoprokaryota) and considerations on the classification of dichotomously and pseudodichotomously branched genera

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)