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This article describes lessons learned from the incorporation of language justice as an antiracism praxis for an academic Center addressing cardiometabolic inequities. Drawing from a thematic analysis of notes and discussions from the Center’s community engagement core, we present lessons learned from three examples of language justice: inclusion of bilingual team members, community mini-grants, and centering community in community-academic meetings. Facilitating strategies included preparing and reviewing materials in advance for interpretation/translation, live simultaneous interpretation for bilingual spaces, and in-language documents. Barriers included: time commitment and expenses, slow organizational shifts to collectively practice language justice, and institutional-level administrative hurdles beyond the community engagement core’s influence. Strengthening language justice means integrating language justice institutionally and into all research processes; dedicating time and processes to learn about and practice language justice; equitably funding language justice within research budgets; equitably engaging bilingual, bicultural staff and language justice practitioners; and creating processes for language justice in written and oral research and collaborative activities. Language justice is not optional and necessitates buy-in, leadership, and support of community engagement cores, Center leadership, university administrators, and funders. We discuss implications for systems and policy change to advance language justice in research to promote health equity.
Cross-sectional studies have shown that the COVID-19 pandemic has had a significant impact on the mental health of healthcare staff. However, it is less well understood how working over the long term in successive COVID-19 waves affects staff well-being.
Aims
To identify subpopulations within the health and social care staff workforce with differentiated trajectories of mental health symptoms during phases of the COVID-19 pandemic.
Method
The COVID-19 Staff Wellbeing Survey assessed health and social care staff well-being within an area of the UK at four time points, separated by 3-month intervals, spanning November 2020 to August 2021.
Results
Growth mixture models were performed on the depression, anxiety and post-traumatic stress disorder longitudinal data. Two class solutions provided the best fit for all models. The vast majority of the workforce were best represented by the low-symptom class trajectory, where by symptoms were consistently below the clinical cut-off for moderate-to-severe symptoms. A sizable minority (13–16%) were categorised as being in the high-symptom class, a group who had symptom levels in the moderate-to-severe range throughout the peaks and troughs of the pandemic. In the depression, anxiety and post-traumatic stress disorder models, the high-symptom class perceived communication from their organisation to be less effective than the low-symptom class.
Conclusions
This research identified a group of health service staff who reported persistently high mental health symptoms during the pandemic. This group of staff may well have particular needs in terms of the provision of well-being support services.
Throughout the coronavirus disease 2019 (COVID-19) pandemic, health and social care workers have faced unprecedented professional demands, all of which are likely to have placed considerable strain on their psychological well-being.
Aims
To measure the national prevalence of mental health symptoms within healthcare staff, and identify individual and organisational predictors of well-being.
Method
The COVID-19 Staff Wellbeing Survey is a longitudinal online survey of psychological well-being among health and social care staff in Northern Ireland. The survey included four time points separated by 3-month intervals; time 1 (November 2020; n = 3834) and time 2 (February 2021; n = 2898) results are presented here. At time 2, 84% of respondents had received at least one dose of a COVID-19 vaccine. The survey included four validated psychological well-being questionnaires (depression, anxiety, post-traumatic stress and insomnia), as well as demographic and organisational measures.
Results
At time 1 and 2, a high proportion of staff reported moderate-to-severe symptoms of depression (30–36%), anxiety (26–27%), post-traumatic stress (30–32%) and insomnia (27–28%); overall, significance tests and effect size data suggested psychological well-being was generally stable between November 2020 and February 2021 for health and social care staff. Multiple linear regression models indicated that perceptions of less effective communication within their organisation predicted greater levels of anxiety, depression, post-traumatic stress and insomnia.
Conclusions
This study highlights the need to offer psychological support to all health and social care staff, and to communicate with staff regularly, frequently and clearly regarding COVID-19 to help protect staff psychological well-being.
To identify whether staff from the PATH Early Intervention in Psychosis (EIP) Service routinely ask female service users of child bearing age about their plans for pregnancy, whether risks of medication in pregnancy are routinely discussed and whether contraception is routinely discussed.
Method
In May 2019, a report was run capturing all female PATH service users of child bearing age (16-50 years) who were on the pathway at this time. This totalled 177 service users, all of whom were included in the sample. We used the search terms “pregnant”, “pregnancy”, “having children”, “contraception”, “conceive”, “baby”, “conception”, “miscarriage”, “abortion”, “IVF”, “still born” to interrogate the patient records . Auditors searched case notes, clinic letters, recent physical health assessment and recent wellbeing plan for evidence as to whether staff had asked about pregnancy plans, contraception, offered a referral to the Community Perinatal Team, and discussed risks about medication in pregnancy.
Result
Of the 177 service users, 34 were asked whether they had plans for pregnancy (19%). Of the 177 service users, 28 were given advice regarding contraception (16%). Of the 34 service users who were asked about pregnancy plans, 27 did have plans for pregnancy. Of these 27 service users, 15 were offered a referral to the Community Perinatal Team (56%). Of the 27 service users who did have plans for pregnancy, 12 received advice and or information about risks of antipsychotic medication in pregnancy (44%).
Conclusion
It is clear that PATH staff are not routinely having discussions with female service users of child bearing age about their plans for pregnancy or contraception; this audit has identified that this occurs in less than 20% of cases. Of service users that did have plans for pregnancy, only 56% were offered a referral to the Community Perinatal Team; we should strive for this to be 100% so service users can access specialist support and advice. Work is underway to include information on pregnancy in the PATH service information leaflet to ensure women referred to PATH expect staff to ask them about their plans for pregnancy and contraception. Questions about pregnancy planning and contraception are to be embedded in the Trust's Physical Health Assessment care document to act as a prompt for staff. Finally, the topics of pregnancy and contraception in women with psychosis have been incorporated into the PATH physical health training programme which will be delivered with support from the Community Perinatal Team.
OBJECTIVES/GOALS: There is increased recognition that patients and community members are critical to creating impactful research. To this end the UCLA CTSI Community Engagement & Research Program modified an established multidisciplinary team science communication module to train academic-community research teams. METHODS/STUDY POPULATION: Community partners who have had previous experience in participatory research provided input such as limiting the emphases of individual academic introductions to group icebreakers (to level the playing field), reduced academic jargon to lay language, reducing the amount of text to key principles, and changed academic team scenarios for the team activity to represent community-academic teams. Academic partners articulated institutional barriers to integrating community into institutional systems. Iterative testing and modifications occurred through pilots with eleven teams (49 individuals). RESULTS/ANTICIPATED RESULTS: Embedding community partners in team science training involved creating a level playing field with less emphasis on academic credentials, using lay language in the didactic sessions and ensuring accessibility in all aspects of the training. An example of modifications: communication scenarios were read out loud by participants, which community partners felt were not inclusive of potential varying literacy levels and all partners may not feel comfortable reading aloud in a group setting. The vignettes were replaced with short videos of the scenarios with audio recordings. Several modifications were made the training’s team activity of the training module. DISCUSSION/SIGNIFICANCE OF IMPACT: Traditional academic team science training required significant modifications for an academic/community-partnered team to allow for optimal collaboration, inclusion, and strategically reduce the power dynamics that can naturally occur. Long-term followup to assess their effectiveness is needed.
Although there is some evidence that duration of untreated psychosis (DUP) is geographically stable, few have examined whether the phenomenon is temporally stable. We examined DUP in two cohorts within two discrete time periods (1995–1999 and 2003–2005) spanning a decade in the same geographically defined community psychiatric service with no early intervention programme. Patients were diagnosed by Structured Clinical Interview for DSM (SCID) and we determined the DUP using the Beiser Scale. The DUP of the 240 participants did not differ significantly between study periods.
We present a detailed overview of the cosmological surveys that we aim to carry out with Phase 1 of the Square Kilometre Array (SKA1) and the science that they will enable. We highlight three main surveys: a medium-deep continuum weak lensing and low-redshift spectroscopic HI galaxy survey over 5 000 deg2; a wide and deep continuum galaxy and HI intensity mapping (IM) survey over 20 000 deg2 from $z = 0.35$ to 3; and a deep, high-redshift HI IM survey over 100 deg2 from $z = 3$ to 6. Taken together, these surveys will achieve an array of important scientific goals: measuring the equation of state of dark energy out to $z \sim 3$ with percent-level precision measurements of the cosmic expansion rate; constraining possible deviations from General Relativity on cosmological scales by measuring the growth rate of structure through multiple independent methods; mapping the structure of the Universe on the largest accessible scales, thus constraining fundamental properties such as isotropy, homogeneity, and non-Gaussianity; and measuring the HI density and bias out to $z = 6$. These surveys will also provide highly complementary clustering and weak lensing measurements that have independent systematic uncertainties to those of optical and near-infrared (NIR) surveys like Euclid, LSST, and WFIRST leading to a multitude of synergies that can improve constraints significantly beyond what optical or radio surveys can achieve on their own. This document, the 2018 Red Book, provides reference technical specifications, cosmological parameter forecasts, and an overview of relevant systematic effects for the three key surveys and will be regularly updated by the Cosmology Science Working Group in the run up to start of operations and the Key Science Programme of SKA1.
${\rm Au}_{25}\lpar {{\rm C}_6{\rm H}_{14}{\rm S}} \rpar_{18}{}^-$ icosahedron and [Au25(PPh)10(C6H14S)5Cl2]2+ bi-icosahedron clusters were synthesized. Ligand exchange reactions were carried out with a new coumarin-derived fluorophore (Cou-SH) to label both clusters. Labeled and unlabeled Au25 were compared and the changes in the electronic structure were determined. The labeled clusters showed marked changes in electronic states, as evidenced by the quenching in the UV region and enhancement in the near infrared. The quantum yield from Cou-SH decreased and the quantum yield from the labeled Au25 increased. Second, the authors observed changes in the electrochemical band gap.
Effective community engagement in T3–T4 research is widespread, however, similar stakeholder involvement is missing in T1–T2 research. As part of an effort to embed community stakeholders in T1–T2 research, an academic community partnered team conducted discussion groups with researchers to assess perspectives on (1) barriers/challenges to including community stakeholders in basic science, (2) skills/training required for stakeholders and researchers, and (3) potential benefits of these activities. Engaging community in basic science research was perceived as challenging but with exciting potential to incorporate “real-life” community health priorities into basic research, resulting in a new full-spectrum translational research model.
OBJECTIVES/SPECIFIC AIMS:.Outline the development and purpose of the partnership brokering database in REDCap. Provide an overview of the tool and how it works. Discuss how this tool facilitates partnership-brokering activities and discuss plans for future use METHODS/STUDY POPULATION: Research Electronic Data Capture (REDCap) is a secure, web-based application developed at Vanderbilt University to assist with systematic data management of small and medium sized projects. CCH utilized REDCap to build a custom data management warehouse entitled the Partnership Brokering Tool. Information compiled in various formats (handwritten notes, spreadsheets, etc.) over the past 10 years by CCH staff, was then systematically organized and entered into the Partnership Brokering Tool. The tool captures information such as individual contact information, organizational affiliation (academic, community, faith, government etc.), research interests (35 categories - asthma, diabetes, heart disease, etc.), communities of foci (children, elderly, LGBTQ, ethnicity, etc.), and target geographic community served (Chicago north, south, suburban, Illinois, etc.). RESULTS/ANTICIPATED RESULTS: Data was compiled on 451 community groups and organizations and 77 partners in academia thus far. Community organizations represent a range of community sectors including advocacy and policy groups, community-based, faith-based organizations, foundations, media, schools, etc. throughout the Chicagoland area. Data analysis activities are underway, however, results will also be shared regarding characteristics of the communities these organizations serve including:. Age range. Special populations (as defined by the CSTI grant). Underrepresented racial and ethnic communities. DISCUSSION/SIGNIFICANCE OF IMPACT: The Partnership Brokering Tool has provided a format for CCH to systematically gather information about the relationships staff have cultivated with community groups and organizations. Unlike an email management system, this REDCap project is highly useful in capturing the parameters of our partner pool, identifying partnership gaps, and matching individuals interested in collaborating with researchers or community organizations that have a particular skill set or research interest. The Partnership Brokering Tool has also facilitated stakeholder engagement dedicated to guiding the centers’ overall goals, objectives, and programming. Finally, utilizing REDCap has streamlined efforts in reporting quantitative and qualitative data about these organizations. In the next phase of this project, CCH will utilize the database to assess the nature of the relationship between CCH and community groups and organizations.
Immigration and its consequences is one of the most contentious issues in the contemporary world, and historians are engaged in this debate by offering a longer-term perspective. In recent years, research on the United Kingdom's population has placed greater emphasis on population movement in shaping Britain's story, identifying waves of migrants from elsewhere alongside migration within Britain. One neglected aspect of this narrative, however, is the migration of Scots to England, particularly in the age of the regal and parliamentary union, when the changing political relationship between the two kingdoms had an impact on the scale, geographic spread, and opportunities and obstacles of that migration. While a minority of Scottish migrants were unwelcome, or chose to return home, the overwhelming weight of evidence is for those migrants who remained in England. The focus in this article is on that majority group for whom migration was a positive experience, thus raising questions about why these Scots were so successful and why they faced so little native opposition. That process of segmented assimilation offers an insight into the formation of Britain and the shifting ground of national identity associated with the emerging British state. The Scots, moreover, provide a model for “successful” migration, suggesting that a range of factors—principally, an educated, culturally malleable, and economically responsive migrant population, alongside an institutionally and attitudinally flexible host community—need to be in place in order to optimize the chances of migrant assimilation.
Children with CHD and acquired heart disease have unique, high-risk physiology. They may have a higher risk of adverse tracheal-intubation-associated events, as compared with children with non-cardiac disease.
Materials and methods
We sought to evaluate the occurrence of adverse tracheal-intubation-associated events in children with cardiac disease compared to children with non-cardiac disease. A retrospective analysis of tracheal intubations from 38 international paediatric ICUs was performed using the National Emergency Airway Registry for Children (NEAR4KIDS) quality improvement registry. The primary outcome was the occurrence of any tracheal-intubation-associated event. Secondary outcomes included the occurrence of severe tracheal-intubation-associated events, multiple intubation attempts, and oxygen desaturation.
Results
A total of 8851 intubations were reported between July, 2012 and March, 2016. Cardiac patients were younger, more likely to have haemodynamic instability, and less likely to have respiratory failure as an indication. The overall frequency of tracheal-intubation-associated events was not different (cardiac: 17% versus non-cardiac: 16%, p=0.13), nor was the rate of severe tracheal-intubation-associated events (cardiac: 7% versus non-cardiac: 6%, p=0.11). Tracheal-intubation-associated cardiac arrest occurred more often in cardiac patients (2.80 versus 1.28%; p<0.001), even after adjusting for patient and provider differences (adjusted odds ratio 1.79; p=0.03). Multiple intubation attempts occurred less often in cardiac patients (p=0.04), and oxygen desaturations occurred more often, even after excluding patients with cyanotic heart disease.
Conclusions
The overall incidence of adverse tracheal-intubation-associated events in cardiac patients was not different from that in non-cardiac patients. However, the presence of a cardiac diagnosis was associated with a higher occurrence of both tracheal-intubation-associated cardiac arrest and oxygen desaturation.
from
Part II
-
The Social Context of Mental Health and Illness: Introduction to Part II
By
Verna M. Keith, Professor, Department of Sociology, Texas A & M University,
Diane R. Brown, Professor, Health Education and Behavioral Science, Rutgers School of Public Health
Keith and Brown present a conceptual model for understanding the way in which the interrelationships among race, gender, and socioeconomic status (SES) influence mental well-being for African American women. Mental well-being is affected by social, cultural, and psychological factors as well as by physical health and health behavior; in turn these factors are influenced by one's social status (i.e., race, gender, SES). African American women are subject to racism, sexism, and for some, heterosexism, which diminish their educational attainment, personal and household incomes, occupational status, wealth accumulation, and opportunities for socioeconomic advancement. Consequently, African American women have fewer resources than their white counterparts and are far more limited in their capacity to cope with crises and adversities. Stressors such as poverty and economic hardship also challenge the adaptive abilities of many African American women. They are less likely to be married and, if married, more likely to be employed and responsible for more household chores than white married women. Parenthood often is another source of stress as many African American women are single parents. The particular set of roles that African American women must fulfill may also expose them to more stressful life circumstances. Combining employment and parenthood roles increases the likelihood that they will experience role overload and role conflict, especially when coping resources are limited. A key argument made by Keith and Brown is that there is a strong connection between mental and physical health. African American women have poorer physical health with higher rates of diabetes, hypertension, HIV infection, and lupus, which lead to higher mortality rates than white women. Additionally, African American women are less likely to use health care, which may be due to a lack of access, among other factors. However, the extended social networks of African American women may provide important sources of social support. What other types of social support would help African American women cope with the many sources of stress in their lives and would immigrant and LGBT women need additional supportive resources?
Introduction
African American women, including immigrants, are disproportionately challenged by a host of social conditions that are linked to higher risk for poor mental health, including low incomes, high levels of poverty and unemployment, single motherhood, poor physical health, and residence in economically disadvantaged neighborhoods where these problems are compounded (Murry et al., 2008; Schulz et al., 2000).
A variety of paleoecological and sedimentary techniques were used to investigate the storage of sediment within a small lowland catchment during the Holocene. Radiocarbon dating of vertically accreted floodplain deposits allowed the calculation of inorganic accumulation rates. These rates show a dramatic increase in sediment deposition during the late Bronze Age and early Iron Age (2900-2300 yr B.P.) due to deforestation and cultivation of the catchment slopes and resultant soil erosion. The soils within the catchment were susceptible to structural damage, surface waterlogging, and slope-wash erosion. From the calculated increases in sediment storage estimates of catchment erosion were made which vary from around 20 to 140 tons km−2 yr−1. The study of alluvial chronology at this scale can provide unique information on the source areas of Holocene floodplain sediments and provide long-term erosion rates.
Radiocarbon (14C) dating of total soil organic matter (SOM) often yields results inconsistent with the stratigraphic sequence. The onerous chemical extractions for SOM fractions do not always produce satisfactory 14C dates. In an effort to develop an alternative method, the pyrolysis-combustion technique was investigated to partition SOM into pyrolysis volatile (Py-V) and pyrolysis residue (Py-R) fractions. The Py-V fractions obtained from a thick glacigenic loess succession in Illinois yielded 14C dates much younger but more reasonable than the counterpart Py-R fractions for the soil residence time. Carbon isotopic composition (δ13C) was heavier in the Py-V fractions, suggesting a greater abundance of carbohydrate- and protein-related constituents, and δ13C was lighter in the Py-R fractions, suggesting more lignin- and lipid-related constituents. The combination of 14C dates and δ13C values indicates that the Py-V fractions are less biodegradation resistant and the Py-R fractions are more biodegradation resistant. The pyrolysis-combustion method provides a less cumbersome approach for 14C dating of SOM fractions. With further study, this method may become a useful tool for analyzing unlithified terrestrial sediments when macrofossils are absent.