Search

Abstract Background Parents were at the forefront of responding to the needs of children during the COVID-19 pandemic. This study used the RE-AIM framework to examine the Reach, Effectiveness, Adoption, Implementation, and Maintenance of a global inter-agency initiative that adapted evidence-based parenting programs to provide immediate support to parents. Methods Data were collected via short surveys sent via email, online surveys, and analysis of social media metrics and Google Analytics. Retrospective surveys with 1,303 parents and caregivers in 11 countries examined impacts of the resources on child maltreatment, positive relationship building, parenting efficacy, and parenting stress. Results The parenting resources were translated into over 135 languages and dialects; reached an estimated minimum 212.4 million people by June 2022; were adopted by 697 agencies, organizations, and individuals; and were included in 43 national government COVID-19 responses. Dissemination via social media had the highest reach (n = 144,202,170, 67.9%), followed by radio broadcasts (n = 32,298,525, 15.2%), text messages (n = 13,565,780, 6.4%), and caseworker phone calls or visits (n = 8,074,787, 3.8%). Retrospective surveys showed increased parental engagement and play, parenting self-efficacy, confidence in protecting children from sexual abuse, and capacity to cope with stress, as well as decreased physical and emotional abuse. Forty-four organizations who responded to follow-up surveys in April 2021 reported sustained use of the resources as part of existing services and other crisis responses. Conclusion This study highlights the importance of a) establishing an international collaboration to rapidly adapt and disseminate evidence-based content into easily accessible resources that are relevant to the needs of parents; b) creating open-source and agile delivery models that are responsive to local contexts and receptive to further adaptation; and c) using the best methods available to evaluate a rapidly deployed global emergency response in real-time. Further research is recommended to empirically establish the evidence of effectiveness and maintenance of these parenting innovations.

Perceived control is an important psychosocial resource for health and well-being across the lifespan. Global control (i.e., overall perceived control) decreases over time in studies following people every few years to upwards of 10 years. Changes across wider intervals of the lifespan, however, have yet to be examined. Further, how perceived control changes for specific aspects of daily life, such as stressors, remains comparatively less clear. Using data from the Midlife in the United States National Study of Daily Experiences (NSDE, N = 1,940, M = 56.25 years, SD = 12.20, 57% female), we examined longitudinal changes in global control across 20 years and daily stressor control across 10 years. Global control was assessed in the first wave of the NSDE ([approximately]1996). In follow-up waves, conducted in [approximately] 2008 and [approximately] 2017, participants again not only reported their global control but also reported their perceived control over stressors they experience across 8 consecutive days. Longitudinal analyses revealed differential change trajectories for global control across 20 years and stressor control across 10 years (ps < 0.001). Global control declined for younger and older adults but stayed relatively stable for individuals in midlife. The rate of decline in daily stressor control was steeper than the decline in global control and did not vary by age at baseline. In addition, declines were amplified among individuals with higher global control at baseline. Results suggest that daily stressor control is a specific aspect of control beliefs that follows a different rate of change than global control.

The 3D stereoscopic technique consists in providing the illusional perception of depth of a given object using two different images mimicking how the right and left eyes capture the object. Both images are slightly different and when overlapped gives a three-dimensional (3D) experience. Considering the limitations for establishing surgical laboratories and dissections courses in some educational institutions, techniques such as stereoscopy and photogrammetry seem to play an important role in neuroanatomy and neurosurgical education. The aim of this study was to describe how to combine and set up realistic models acquired with photogrammetry scans in 3D stereoscopic projections. Three donors, one dry skull, embalmed brain and head, were scanned using photogrammetry. The software used for displaying the final realistic 3D models (Blender, Amsterdam, the Netherlands) is a free software and allows stereoscopic projection without compromising the interactivity of each model. By default, the model was exported and immediately displayed as a red cyan 3D mode. The 3D projector used in the manuscript required a side-by-side 3D mode which was set up with simple commands on the software. The final stereoscopy projection offered depth perception and a visualization in 360° of each donor; this perception was noted especially when visualizing donors with different cavities and fossae. The combination of 3D techniques is of paramount importance for neuroanatomy education. Stereoscopic projections could provide a valuable tool for neuroanatomy instruction directed at clinical trainees and could be especially useful when access to laboratory-based learning is limited.

Abstract Superconducting quantum bits (qubits) rely on ultra-thin, amorphous oxide tunneling barriers that can have significant inhomogeneities and defects as grown. This can result in relatively large uncertainties and deleterious effects in the circuits, limiting the scalability. Finding a robust solution to the junction reproducibility problem has been a long-standing goal in the field. Here, we demonstrate a transformational technique for controllably tuning the electrical properties of aluminum-oxide tunnel junctions. This is accomplished using a low-voltage, alternating-bias applied individually to the tunnel junctions, with which resistance tuning by more than 70% can be achieved. The data indicates an improvement of coherence and reduction of two-level system defects. Transmission electron microscopy shows that the treated junctions are predominantly amorphous, albeit with a more uniform distribution of alumina coordination across the barrier. This technique is expected to be useful for other devices based on ionic amorphous materials.

Abstract Background Clinicians and researchers should consider the expected benefits and potential harms of an intervention. Parenting programmes are a widely used evidence-based intervention for child behaviour problems. However, few data are available on potential negative effects. The aims of this paper were to increase systematic knowledge of adverse event (AE) assessment in parenting programmes and to provide an AE assessment tool. Methods As part of the RISE project (prevention of child mental health problems in South-eastern Europe—adapt, optimise, test and extend parenting for lifelong health), we developed and tested an AE assessment procedure in three sequential studies for parents of children with child behaviour problems aged 2 to 9 years in North Macedonia, Republic of Moldova, and Romania. This paper reports on the development of the assessment tool in phase 1 (N = 140), phase 2 (N = 835), and the final experiences with using the optimised procedures in phase 3 (multisite randomised controlled trial, N = 823) in which AEs were assessed before, three times during intervention delivery, and at 1 year follow-up. At each time point, the participants completed a 12-item AE checklist. If moderate-to-severe problems of parent or child were reported, a structured follow-up interview was conducted. Results The response rate on the AE assessment tool increased from 6% (phase 1) to 100% (phase 3) indicating improvement in collecting these data based on the experiences of each phase. Results of the RCT (phase 3) showed generally low (S)AE frequencies with the finally optimised procedure: During the intervention, no serious adverse events (SAE) were registered; at least one AE was reported by 10% (after the first session), 7% (after the third session), and 4% (after the last fifth session) of participants. None of the identified (S)AEs was causally related to the study or intervention. Cost–benefit considerations are needed to determine the best way to ensure participant safety in parenting programmes. Conclusion The applied active AE assessment procedure provides a comprehensive AE assessment tool that can be used by others—with adaptations for the specific context, if needed. Based on our experiences, we outline recommendations for future studies. Trial registration ClinicalTrials.gov, registration number phase 1: NCT03552250; phase 2: NCT03865485, phase 3: NCT04721730 . Registered on 13 January 2021.

Abstract Background In 2021, more than two-thirds of the world’s children lived in a conflict-affected country. In 2022, 13 million Ukrainians were forced to flee their homes after Russia’s full-scale invasion. Hope Groups are a 12-session psychosocial, mental health, and parenting support intervention designed to strengthen parents, caregivers, and children affected by war and crisis. The primary objective of this study is to evaluate the effectiveness of Hope Groups among Ukrainians affected by war, compared to a wait-list control group. This protocol describes a promising decentralized intervention delivery model and an innovative research design, which estimates the causal effect of Hope Groups while prioritizing prompt delivery of beneficial services to war-affected participants. Methods This protocol describes a pragmatic cluster randomized controlled trial (RCT) among Ukrainians externally displaced, internally displaced within Ukraine, and living at home in war-affected areas. This study consists of 90 clusters with 4–7 participants per cluster, totaling approximately n = 450 participants. Intervention clusters will receive 12-session Hope Groups led by peer facilitators, and control clusters will be wait-listed to receive the intervention after the RCT concludes. Clusters will be matched on the facilitator performing recruitment and intervention delivery. Primary outcomes are caregiver mental health, violence against children, and positive parenting practices. Secondary outcomes include prevention of violence against women and caregiver and child well-being. Outcomes will be based on caregiver report and collected at baseline and endline (1-week post-intervention). Follow-up data will be collected among the intervention group at 6–8 weeks post-intervention, with aims for quasi-experimental follow-ups after 6 and 12 months, pending war circumstances and funding. Analyses will utilize matching techniques, Bayesian interim analyses, and multi-level modeling to estimate the causal effect of Hope Groups in comparison to wait-list controls. Discussion This study is the first known randomized trial of a psychosocial, mental health, and parenting intervention among Ukrainians affected by war. If results demonstrate effectiveness, Hope Groups hold the potential to be adapted and scaled to other populations affected by war and crisis worldwide. Additionally, methodologies described in this protocol could be utilized in crisis-setting research to simultaneously prioritize the estimation of causal effects and prompt delivery of beneficial interventions to crisis-affected populations. Trial registration This trial was registered on Open Science Framework on November 9, 2023. Registration: OSF.IO/UVJ67 .

Reações transfusionais agudas (RTs) são definidas como aquelas que ocorrem dentro de 24h da administração de sangue ou componentes sanguíneos, variando em gravidade e caracterizadas por reações febris menores até eventos que representem ameaça à vida. Reações transfusionais não-hemolíticas febris são as mais comumente relatados, contudo, a real incidência é incerta, uma vez que sistemas de hemovigilância tendem a coletar apenas informações mais graves. Este estudo objetiva uma análise da prevalência de reações transfusionais imediatas e dos fatores associados a ocorrência dessas reações, além da subnotificação desses eventos. Trata-se de um estudo retrospectivo, com pacientes que desenvolveram reações imediatas, no período de Jan/2014 a Dez/2023. Foram revisados prontuários médicos para identificar os casos e coletadas informações sobre características dos pacientes, como sexo, idade, tipagem sanguínea e sintomas. Outrossim, a literatura presente nas bases de dados PubMed e Ministério da Saúde foi visitada. Foram notificadas 111 reações imediatas (63) e tardias (48). Observou-se subnotificação em 2018 (1,9) e 2020 (1,7). Em relação à faixa etária, pacientes entre 30-39 anos foram os mais acometidos (22%). Com relação ao sexo, homens foram mais afetados (58,73%). O grupo ABO mais presente entre aqueles com reação imediata foi o tipo O (55,5%). Ainda, indivíduos Rh positivo foram mais relacionados (90,47%). Outrossim, a Reação Febril Não-Hemolítica foi a reação mais prevalente (42,86%), seguida por Sobrecarga Volêmica (15,87%). Ademais, as queixa mais referidas foram febre (63,4%) e calafrios (34,9%). Com base nos resultados, seguindo o Caderno de Informação de Sangue e Hemoderivados do Ministério da Saúde, que prevê a notificação de 3 reações a cada 1000, infere-se subnotificação nos anos de 2018 e 2020. Com relação ao sexo, os resultados concordam com Lucchini (2022) e Grandi et al. (2018), que mostraram prevalência de reações transfusionais em homens, com 62,5% e 50,7%, respectivamente. Em relação a faixa etaria houve discordância com Grandi et al. Enquanto neste presente estudo, os indivíduos mais afetados foram os de 30-39 anos, Grandi expõe maior prevalência na faixa de 50 a 59 anos. Ainda, o mesmo estudo acima traz como principal sistema ABO acometido, o tipo O+ (43,6%), seguido pelo A+ (40%), o que também concorda com os dados obtidos no presente estudo, com o tipo O representando 55,5% e o tipo A, 36%. Grandi et al e Luchinni, trazem a reação febril não hemolítica como a de maior prevalência, 56,6% e 75% respectivamente. Por fim, em relação a Oliveira (2018), o estudo traz discordâncias quanto as queixas. Olivera traz urticária (20,6%) e tremores (12,5%) como predominantes, enquanto este estudo apontou a febre (63,4%) e calafrios (34,9%) como principais. Reações transfusionais imediatas são condições clínicas que, apesar dos esforços para reduzí-las, além de ainda presentes, podem significar risco à vida do paciente. Desse modo, identificar corretamente e notificar tais ocorrências é de extrema importância, a fim de permitir maior organização e menor subnotificação, tanto a nível hospitalar, quanto municipal e estadual.

BackgroundProsody voice measures, especially jitter and shimmer, have been associated with cognitive impairment and hold potential as early indicators of risk for cognitive decline. Prior research suggests that voice measures assessed concurrently with longitudinal cognitive outcomes are associated with 10-year cognitive declines in middle-age and older adults from Midlife in the U.S. (MIDUS) study.ResultsUsing a subsample from the same study, we expanded previous research to examine voice measures that were (1) collected 8 years before cognitive outcomes, (2) derived from narrative speech in logical memory tests instead of word list recall tests, and (3) independent of the cognitive outcomes. Multilevel analyses controlled for covariates of age, sex, education, neurological conditions, depressive symptoms, and chronic conditions. The results indicated that higher jitter and lower shimmer predicted greater 10-year declines in episodic memory and working memory.ConclusionThese findings extend previous research by highlighting prosody voice measures assessed 8 years earlier as predictors of subsequent cognitive declines over a decade.

BackgroundParenting interventions are crucial for promoting family well-being, reducing violence against children, and improving child development outcomes; however, scaling these programs remains a challenge. Prior reviews have characterized the feasibility, acceptability, and effectiveness of other more robust forms of digital parenting interventions (eg, via the web, mobile apps, and videoconferencing). Recently, chatbot technology has emerged as a possible mode for adapting and delivering parenting programs to larger populations (eg, Parenting for Lifelong Health, Incredible Years, and Triple P Parenting). ObjectiveThis study aims to review the evidence of using chatbots to deliver parenting interventions and assess the feasibility of implementation, acceptability of these interventions, and preliminary outcomes. MethodsThis review conducted a comprehensive search of databases, including Web of Science, MEDLINE, Scopus, ProQuest, and Cochrane Central Register of Controlled Trials. Cochrane Handbook for Systematic Review of Interventions and PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were used to conduct the search. Eligible studies targeted parents of children aged 0 to 18 years; used chatbots via digital platforms, such as the internet, mobile apps, or SMS text messaging; and targeted improving family well-being through parenting. Implementation measures, acceptability, and any reported preliminary measures of effectiveness were included. ResultsOf the 1766 initial results, 10 studies met the inclusion criteria. The included studies, primarily conducted in high-income countries (8/10, 80%), demonstrated a high mean retention rate (72.8%) and reported high acceptability (10/10, 100%). However, significant heterogeneity in interventions, measurement methods, and study quality necessitate cautious interpretation. Reporting bias, lack of clarity in the operationalization of engagement measures, and platform limitations were identified as limiting factors in interpreting findings. ConclusionsThis is the first study to review the implementation feasibility and acceptability of chatbots for delivering parenting programs. While preliminary evidence suggests that chatbots can be used to deliver parenting programs, further research, standardization of reporting, and scaling up of effectiveness testing are critical to harness the full benefits of chatbots for promoting family well-being.

BackgroundThe second victim phenomenon refers to the emotional trauma healthcare professionals experience following adverse events (AEs) in patient care, which can compromise their ability to provide safe care. This issue has significant implications for patient safety, with AEs leading to substantial human and economic costs.AnalysisCurrent evidence indicates that AEs often result from systemic failures, profoundly affecting healthcare workers. While patient safety initiatives are in place, the psychological impact on healthcare professionals remains inadequately addressed. The European Researchers’ Network Working on Second Victims (ERNST) emphasizes the need to support these professionals through peer support programs, systemic changes, and a shift toward a just culture in healthcare settings.Policy OptionsKey options include implementing peer support programs, revising the legal framework to decriminalize honest errors, and promoting just culture principles. These initiatives aim to mitigate the second victim phenomenon, enhance patient safety, and reduce healthcare costs.ConclusionAddressing the second victim phenomenon is essential for ensuring patient safety. By implementing supportive policies and fostering a just culture, healthcare systems can better manage the repercussions of AEs and support the wellbeing of healthcare professionals.

BackgroundEncouraging positive parenting practices through evidence-based interventions is vital for the achievement of SDG target 16.2, which aims to eradicate all forms of violence against children while promoting their safety and mental wellbeing. As low- and middle- income countries increasingly adopt parenting programs, policymakers and implementers face the challenge of efficiently transporting, adapting, and implementing them across multiple settings.PurposeThis study seeks to evaluate the real-world experiences, challenges, and best practices in implementing parent support programs in Botswana.MethodA series of interviews with program implementers and stakeholders from governmental and non-governmental organizations were conducted. Key informants from governmental and non-governmental institutions were recruited through purposive and snowball sampling and 17 practitioners participated in the study. Data collection was carried out through online Zoom video conferencing at a convenient time and location for participants.FindingsThe findings indicate several factors that contribute to the successful implementation of parenting programs in Botswana, including (a) enabling factors such as supportive policies, regulations and guidelines, (b) innovative factors such as capacity building, program adaptation and mixed method program delivery, (c) bridging factors through collaborations with skilled organizations, and (d) intra-organizational factors such as organizational resources, program sustainability, and support for program staff.ConclusionNo single organization or strategy can sustainably foster positive parenting support in Botswana. Instead, a collective and collaborative learning approach is necessary to develop lasting and scalable solutions.

Abstract We present a transmon qubit fabrication technique that yields systematic improvements in T 1 relaxation times. We encapsulate the surface of niobium and prevent the formation of its lossy surface oxide. By maintaining the same superconducting metal and only varying the surface, this comparative investigation examining different capping materials, such as tantalum, aluminum, titanium nitride, and gold, as well as substrates across different qubit foundries demonstrates the detrimental impact that niobium oxides have on coherence times of superconducting qubits, compared to native oxides of tantalum, aluminum or titanium nitride. Our surface-encapsulated niobium qubit devices exhibit T 1 relaxation times 2–5 times longer than baseline qubit devices with native niobium oxides. When capping niobium with tantalum, we obtain median qubit lifetimes above 300 μs, with maximum values up to 600 μs. Our comparative structural and chemical analysis provides insight into why amorphous niobium oxides may induce higher losses compared to other amorphous oxides.

Background: Cannabis is the most widely used substance worldwide, and its use is much higher among adolescents. However, adolescents are at higher risk of negative sequelae secondary to this use, including the possible development of mental disorders. On 31 March 2017, the South African High Court ruled that cannabis use by an adult in a private dwelling should be decriminalised. Aim: This study aimed to determine the clinical profile of adolescents who use cannabis, who use, who present to a tertiary hospital in Cape Town, South Africa, before and after the high court ruling in 2017. Setting: Folder review of adolescents admitted at Groote Schuur Hospital (GSH) in the Emergency Psychiatric Unit. Methods: This study was a retrospective folder review of adolescents admitted from April 2015 to March 2019. Results: Cannabis was the most commonly used substance in the study, with increased use seen post-ruling. The most common frequency of cannabis use reported was daily. A significantly higher proportion of patients who used cannabis pre-ruling had psychotic disorder (p 0.001) and cannabis use disorder (p = 0.01). Post-ruling, the results were statistically significant (p 0.001) for both. Conclusion: The study showed an increasing prevalence of cannabis use in adolescents admitted with mental illness after the high court ruling in 2017. This study also demonstrates that adolescents remain a vulnerable population to the effects of cannabis and highlights the need for further research. Contribution: The findings of this study call for more focussed adolescent interventions and services.

More than 100 genes have been associated with significantly increased risks of autism spectrum disorders (ASD) with an estimate of ∼1000 genes that may contribute. The new challenge is to investigate the molecular and cellular functions of these genes during neural and brain development, and then even more challenging, to link the altered molecular and cellular phenotypes to the ASD clinical manifestations. In this study, we used single-cell RNA-seq analysis to study one of the top risk genes, CHD8, in cerebral organoids, which models early neural development. We identified 21 cell clusters in the organoid samples, representing non-neuronal cells, neural progenitors, and early differentiating neurons at the start of neural cell fate commitment. Comparisons of the cells with one copy of a CHD8 knockout allele, generated by CRISPR/Cas9 editing, and their isogenic controls uncovered thousands of differentially expressed genes, which were enriched with functions related to neural and brain development, cilium organization, and extracellular matrix organization. The affected genes were also enriched with genes and pathways previously implicated in ASD, but surprisingly not for schizophrenia and intellectual disability risk genes. The comparisons also uncovered cell composition changes, indicating potentially altered neural differential trajectories upon CHD8 reduction. Moreover, we found that cell-cell communications were affected in the CHD8 knockout organoids, including the interactions between neural and glial cells. Taken together, our results provide new data and information for understanding CHD8 functions in the early stages of neural lineage development and interaction.

Aims We undertook a service evaluation obtaining feedback from service users in an inpatient rehabilitation setting about a weekly Boxercise class. The aim was to assess the experiences of service users, and the role it has in their recovery. We hypothesised that the class would be well received by service users in aspects of enjoyment, impact on biopsychosocial wellbeing and recovery based on positive comments made by service users. There is an increasing trend to utilise physical activity as an adjunct to improve mental health within healthcare settings; to increase motivation, educate on healthier lifestyles and to enhance well-being outcomes. This Boxercise programme has been developed by the Healthy Living Advisor within the rehabilitation inpatient facility at Leeds and York Partnership Trust. The programme has run for one year, and there has been a large uptake of service users who participate in the group. The Boxercise classes aim to encourage discipline, communication, spatial awareness, and cognitive skills in a modality that is interesting to service users. Methods Service users who are regular participants in a Boxercise programme at an inpatient rehabilitation centre completed a questionnaire. A five-point Likert scale assessed participant views across seven domains. Participants were then asked to write three words that describe their feelings about the Boxercise programme, complete a drawing showing their thoughts after a Boxercise class and provide suggestions for improvement. Results Eleven participants completed the questionnaire. Average scores for the domains were as follows: enjoyability 4.45/5 (89%), physical health 4.55/5 (91%), mental health 4.27/5 (85%), recovery 4.09/5 (82%), socialising 3.91/5 (82%), safety 4.64/5 (93%), continue after discharge 3.36/5 (67%). The ‘three words' were put in a word cloud generator with highest weighted words: ‘Fun', ‘Good', ‘Energetic', ‘Confident'. Common themes from the pictures shown were smiling faces and ‘strongman' images. Six participants gave feedback that more equipment (pads and gloves) would help to improve their experience in the classes. Conclusion The Boxercise programme received positive feedback from participants that aligns with the hypothesis; particularly in safety, enjoyability, benefit to physical health and benefit to mental health. The participants had positive views on the class as an adjunct to the management of their physical and mental wellbeing. The feedback from all the participants is that they felt safe during the classes. This service evaluation indicates that the participants value the Boxercise classes as an enjoyable activity and as an adjunct to their treatment.