Supporting the mental health needs of young people: The spatial practices of school nurses

Purpose The purpose of this paper is to raise awareness of an understanding of how school nurses work in multiple spaces, supporting young people in relation to promoting and protecting their emotional and mental health and wellbeing. It is argued that young people’s emotional health needs are still as prevalent today as they were over 150 years ago, when Charles Dickens wrote about them in the novel Nicholas Nickleby. Design/methodology/approach Soja’s (1996) typology of spatial practice is applied to school nursing practice in an attempt to explore how different types of space influence how support is given to young people. Findings Examples are provided from previous research (Sherwin, 2016) of how Soja’s theory of Firstspace, Secondspace and Thirdspace can be identified within school nurses’ practice, thereby providing an understanding of how school nurses provide support to young people on an everyday basis. It is proposed that in an addition Fourthspace also exists and a new conceptual model of spatial practice is proposed. Originality/value School nurses have the potential to make a significant impact on preventing and protecting young people’s mental health. They provide valuable support to young people to enable them to cope with the complexities of their lives, yet relatively little is known about their everyday practice as this is an under-reported area of nursing. A new conceptual model is proposed to help provide an understanding of their practice

Using Neighborhood Beyond One Hop in Disruption-Tolerant Networks

Most disruption-tolerant networking (DTN) protocols available in the literature have focused on mere contact and intercontact characteristics to make forwarding decisions. Nevertheless, there is a world behind contacts: just because one node is not in contact with some potential destination, it does not mean that this node is alone. There may be interesting end-to-end transmission opportunities through other nearby nodes. Existing protocols miss such possibilities by maintaining a simple contact-based view of the network. In this paper, we investigate how the vicinity of a node evolves through time and whether such information can be useful when routing data. We observe a clear tradeoff between routing performance and the cost for monitoring the neighborhood. Our analyses suggest that limiting a node's neighborhood view to three or four hops is more than enough to significantly improve forwarding efficiency without incurring prohibitive overhead.Comment: 5 pages, 5 figures, 1 tabl

Antimicrobial resistance: a biopsychosocial problem requiring innovative interdisciplinary and imaginative interventions

To date, antimicrobials have been understood through largely biomedical perspectives. There has been a tendency to focus upon the effectiveness of pharmaceuticals within individual bodies. However, the growing threat of antimicrobial resistance demands we reconsider how we think about antimicrobials and their effects. Rather than understanding them primarily within bodies, it is increasingly important to consider their effects between bodies, between species and across environments. We need to reduce the drivers of antimicrobial resistance (AMR) at a global level, focusing on the connections between prescribing in one country and resistance mechanisms in another. We need to engage with the ways antimicrobials within the food chain will impact upon human healthcare. Moreover, we need to realise what happens within the ward will impact upon the environment (through waste water). In the future, imaginative interventions will be required that must make the most of biomedicine but draw equally across a wider range of disciplines (e.g. engineering, ecologists) and include an ever-increasing set of professionals (e.g. nurses, veterinarians and farmers). Such collective action demands a shift to working in new interdisciplinary, inter-professional ways. Mutual respect and understanding is required to enable each perspective to be combined to yield synergistic effects

Distance metric choice can both reduce and induce collinearity in geographically weighted regression

This paper explores the impact of different distance metrics on collinearity in local regression models such as geographically weighted regression. Using a case study of house price data collected in Hà Nội, Vietnam, and by fully varying both power and rotation parameters to create different Minkowski distances, the analysis shows that local collinearity can be both negatively and positively affected by distance metric choice. The Minkowski distance that maximised collinearity in a geographically weighted regression was approximate to a Manhattan distance with (power = 0.70) with a rotation of 30°, and that which minimised collinearity was parameterised with power = 0.05 and a rotation of 70°. The results indicate that distance metric choice can provide a useful extra tuning component to address local collinearity issues in spatially varying coefficient modelling and that understanding the interaction of distance metric and collinearity can provide insight into the nature and structure of the data relationships. The discussion considers first, the exploration and selection of different distance metrics to minimise collinearity as an alternative to localised ridge regression, lasso and elastic net approaches. Second, it discusses the how distance metric choice could extend the methods that additionally optimise local model fit (lasso and elastic net) by selecting a distance metric that further helped minimise local collinearity. Third, it identifies the need to investigate the relationship between kernel bandwidth, distance metrics and collinearity as an area of further work

A knowledge translation project on community-centred approaches in public health

This paper examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice. The paper outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilisation as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency

Using intervention mapping to develop a home-based parental-supervised toothbrushing intervention for young children

BACKGROUND: Dental caries in young children is a major public health problem impacting on the child and their family in terms of pain, infection and substantial financial burden on healthcare funders. In the UK, national guidance on the prevention of dental caries advises parents to supervise their child's brushing with fluoride toothpaste until age 7. However, there is a dearth of evidence-based interventions to encourage this practice in parents. The current study used intervention mapping (IM) to develop a home-based parental-supervised toothbrushing intervention to reduce dental caries in young children. METHODS: The intervention was developed using the six key stages of the IM protocol: (1) needs assessment, including a systematic review, qualitative interviews, and meetings with a multi-disciplinary intervention development group; (2) identification of outcomes and change objectives following identification of the barriers to parental-supervised toothbrushing (PSB), mapped alongside psychological determinants outlined in the Theoretical Domains Framework (TDF); (3) selection of methods and practical strategies; (4) production of a programme plan; (5) adoption and implementation and (6) Evaluation. RESULTS: The comprehensive needs assessment highlighted key barriers to PSB, such as knowledge, skills, self-efficacy, routine setting and behaviour regulation and underlined the importance of individual, social and structural influences. Parenting skills (routine setting and the ability to manage the behaviour of a reluctant child) were emphasised as critical to the success of PSB. The multi-disciplinary intervention development group highlighted the need for both universal and targeted programmes, which could be implemented within current provision. Two intervention pathways were developed: a lower cost universal pathway utilising an existing national programme and an intensive targeted programme delivered via existing parenting programmes. A training manual was created to accompany each intervention to ensure knowledge and standardise implementation procedures. CONCLUSIONS: PSB is a complex behaviour and requires intervention across individual, social and structural levels. IM, although a time-consuming process, allowed us to capture this complexity and allowed us to develop two community-based intervention pathways covering both universal and targeted approaches, which can be integrated into current provision. Further research is needed to evaluate the acceptability and sustainability of these interventions

Evaluation of a systematic substitution of zidovudine for stavudine-based HAART in a program setting in rural Cambodia

Mexico AIDS Conference 200

Promoter hypermethylation of HS3ST2, SEPTIN9 and SLIT2 combined with FGFR3 mutations as a sensitive/specific urinary assay for diagnosis and surveillance in patients with low or high-risk non-muscle-invasive bladder cancer

International audienceBackgroundNon-muscle-invasive bladder cancer (NMIBC) is a high incidence form of bladder cancer (BCa), where genetic and epigenetic alterations occur frequently. We assessed the performance of associating a FGFR3 mutation assay and a DNA methylation analysis to improve bladder cancer detection and to predict disease recurrence of NMIBC patients.MethodsWe used allele specific PCR to determine the FGFR3 mutation status for R248C, S249C, G372C, and Y375C. We preselected 18 candidate genes reported in the literature as being hypermethylated in cancer and measured their methylation levels by quantitative multiplex-methylation specific PCR. We selected HS3ST2, SLIT2 and SEPTIN9 as the most discriminative between control and NMIBC patients and we assayed these markers on urine DNA from a diagnostic study consisting of 167 NMIBC and 105 controls and a follow-up study consisting of 158 NMIBC at diagnosis time’s and 425 at follow-up time. ROC analysis was performed to evaluate the diagnostic accuracy of each assay alone and in combination.ResultsFor Diagnosis: Using a logistic regression analysis with a model consisting of the 3 markers’ methylation values, FGFR3 status, age and known smoker status at the diagnosis time we obtained sensitivity/specificity of 97.6 %/84.8 % and an optimism-corrected AUC of 0.96. With an estimated BCa prevalence of 12.1 % in a hematuria cohort, this corresponds to a negative predictive value (NPV) of 99.6 %. For Follow-up: Using a logistic regression with FGFR3 mutation and the CMI at two time points (beginning of the follow-up and current time point), we got sensitivity/specificity/NPV of 90.3 %/65.1 %/97.0 % and a corrected AUC of 0.84. We also tested a thresholding algorithm with FGFR3 mutation and the two time points as described above, obtaining sensitivity/specificity/NPV values of, respectively, 94.5 %/75.9 %/98.5 % and an AUC of 0.82.ConclusionsWe showed that combined analysis of FGFR3 mutation and DNA methylation markers on urine can be a useful strategy in diagnosis, surveillance and for risk stratification of patients with NMIBC. These results provide the basis for a highly accurate noninvasive test for population screening and allowing to decrease the frequency of cystoscopy, an important feature for both patient quality of life improvement and care cost reduction

Enhancement of moment resistance of steel beams with initial imperfections and residual stresses by using stiffeners and GFRP plates

The present study proposes three strengthening solutions for wide flange steel beams having residual stresses and initial imperfections. In Solution 1, a midspan web stiffener is applied to such beams, aiming at reducing local web buckling. In Solution 2, two GFRP plates are bonded to the beam flanges in order to reduce local flange buckling. Solution 3 is a combination of the Solutions 1 and 2. Moment resistances of the strengthening systems are numerically evaluated and compared against those of the corresponding bare beam. Key observations obtained include (i) All Solutions 1, 2 and 3 are effective in increasing the moment resistance of the beam structure, (ii) When initial imperfection and residual stresses are excluded, the failure mode of the bare beams is mostly governed by local flange buckling. The moment resistances of the steel beam in Solution 1 are approximately equal to a fully plastic section moment. Meanwhile, the moment resistances of Solutions 2 and 3 are based on GFRP rupture failure mode. The strengthening solutions by using GFRP plates are the most effective while the addition of a web stiffener only plays a minor role, (iii) When initial imperfection and residual stresses are included, the failure mode of the steel beams is governed by local web buckling. The web stiffener in Solutions 1 and 3 plays an important role to increase the beam moment resistances. And (iv) For long spans, the moment resistances of Solutions 2 and 3 are significantly higher than those of Solution 1

Statistical-Mechanical Measure of Stochastic Spiking Coherence in A Population of Inhibitory Subthreshold Neurons

By varying the noise intensity, we study stochastic spiking coherence (i.e., collective coherence between noise-induced neural spikings) in an inhibitory population of subthreshold neurons (which cannot fire spontaneously without noise). This stochastic spiking coherence may be well visualized in the raster plot of neural spikes. For a coherent case, partially-occupied "stripes" (composed of spikes and indicating collective coherence) are formed in the raster plot. This partial occupation occurs due to "stochastic spike skipping" which is well shown in the multi-peaked interspike interval histogram. The main purpose of our work is to quantitatively measure the degree of stochastic spiking coherence seen in the raster plot. We introduce a new spike-based coherence measure $M_s$ by considering the occupation pattern and the pacing pattern of spikes in the stripes. In particular, the pacing degree between spikes is determined in a statistical-mechanical way by quantifying the average contribution of (microscopic) individual spikes to the (macroscopic) ensemble-averaged global potential. This "statistical-mechanical" measure $M_s$ is in contrast to the conventional measures such as the "thermodynamic" order parameter (which concerns the time-averaged fluctuations of the macroscopic global potential), the "microscopic" correlation-based measure (based on the cross-correlation between the microscopic individual potentials), and the measures of precise spike timing (based on the peri-stimulus time histogram). In terms of $M_s$, we quantitatively characterize the stochastic spiking coherence, and find that $M_s$ reflects the degree of collective spiking coherence seen in the raster plot very well. Hence, the "statistical-mechanical" spike-based measure $M_s$ may be used usefully to quantify the degree of stochastic spiking coherence in a statistical-mechanical way.Comment: 16 pages, 5 figures, to appear in the J. Comput. Neurosc