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Effective mental health primary prevention and early detection strategies targeting perinatal mental healthcare settings are vital. Poor maternal mental health places the developing foetus at risk of lasting cognitive, developmental, behavioural, physical, and mental health problems. Indigenous women endure unacceptably poor mental health compared to all other Australians and disproportionately poorer maternal and infant health outcomes. Mounting evidence demonstrates that screening practices with Indigenous women are neither effective nor acceptable. Improved understanding of their perinatal experiences is necessary for optimizing successful screening and early intervention. Achieving this depends on adopting culturally safe research methodologies.
Methodology:
Decolonizing translational research methodologies are described. Perspectives of Australian Indigenous peoples were centred on leadership in decision-making throughout the study. This included designing the research structure, actively participating throughout implementation, and devising solutions. Methods included community participatory action research, codesign, and yarning with data analysis applied through the cultural lenses of Indigenous investigators to inform culturally meaningful outcomes.
Discussion:
The Indigenous community leadership and control, maintained throughout this research, have been critical. Allowing time for extensive community collaboration, fostering mutual trust, establishing strong engagement with all stakeholders and genuine power sharing has been integral to successfully translating research outcomes into practice. The codesign process ensured that innovative strengths-based solutions addressed the identified screening barriers. This process resulted in culturally sound web-based perinatal mental health and well-being assessment with embedded potential for widespread cultural adaptability.
Indigenous Peoples in Canada are comprised of First Nations, Inuit and Métis and are the youngest and fastest growing population in the country. However, there is limited knowledge of how they are affected by multiple sclerosis (MS), the most common nontraumatic neurological disease of young adults, with Canada having one of the highest prevalences in the world. In this narrative review, we outline the limited studies conducted with Indigenous Peoples living with MS in Canada and the gaps in the literature. From the limited data we have, the prevalence of MS in Indigenous Peoples is lower, but the disease appears to be more aggressive. Given the dearth of Canadian data, we explore the worldwide MS studies of Indigenous populations. Lastly, we explore ways in which we can improve our understanding of MS among Indigenous Peoples in Canada, which entails building trust and meaningful relationships with these communities and acknowledging past and ongoing injustices. Furthermore, healthcare professionals conducting research with Indigenous Peoples should undergo training in cultural safety and data sovereignty, including principles of ownership, control, access and possession to have greater engagement with Indigenous communities to conduct more relevant research. With joint efforts between healthcare professionals and Indigenous communities, the scientific research community can be positioned to conduct better, more appropriate and desperately needed research, ultimately with improvements in the delivery of care to Indigenous Peoples living with MS in Canada.
In this article, we analyse how anti-globalist conspiracy theories were mobilised online to delegitimise national authorities and policies designed to curb the Covid-19 pandemic in Canada. These conspiracy theories attacked the political authority underpinning public health measures and targeted purportedly ‘liberal’ policies and ‘globalist’ actors. Our case study examines the Freedom Convoy, a series of protests against Covid-19 vaccine mandates that began in Canada but inspired global demonstrations. The Freedom Convoy fostered and relied upon anti-globalist conspiracy theories, including the ‘Great Reset’ and ‘Great Replacement’, both of which posit a global conspiracy to erode national sovereignty and impose a ‘liberal’ international order. We investigate far-right social media commentary from 4chan’s Politically Incorrect imageboard /pol/, Infowars, and Rebel News, showing how conspiratorial claims were marshalled in alt-tech spaces. These narratives were used to delegitimise public health measures to combat Covid-19 and the Liberal Trudeau government by linking them to various ‘globalist’ forces. In exploring three mechanisms of delegitimation – externalisation, personification, and Othering – we argue that far-right movements like the Freedom Convoy, motivated by anti-globalist conspiracism, mobilise the international realm by leveraging the legitimacy gap of international organisations and agendas to undermine the political authority of actors at the national level.
Several studies have shown associations between maternal interpersonal violence-related posttraumatic stress disorder (PTSD), child mental health problems, and impaired socioemotional development. However, the existing literature lacks evidence linking constellations of risk factors such as maternal interpersonal-violence-related PTSD, psychopathology, and interactive behavior with toddlers and outcome measures at school-age.
Methods
This study involved a prospective, longitudinal investigation of 62 mothers and examined the relationship between maternal variables measured when children were in early childhood (mean age 27 months), and child outcomes when children were school-age (age mean = 83.2 months) while retaining a focus on the context of maternal PTSD. To identify and weigh associated dimensions comparatively, we employed sparse canonical correlation analysis (sCCA) aimed at associating dimensions of a dataset of 20 maternal variables in early childhood with that of more than 20 child outcome variables (i.e., child psychopathology, life-events, and socioemotional skills) at school-age.
Results
Phase 1 variables with the highest weights were those of maternal psychopathology: PTSD, depressive and dissociative symptoms, and self-report of parental stress. The highest weighted Phase 2 child outcome measures were those of child psychopathology: PTSD, anxiety, and depressive symptoms as well as peer bullying and victimization.
Conclusions
sCCA revealed that trauma-related concepts in mothers were significantly and reliably associated with child psychopathology and other indicators of risk for intergenerational transmission of violence and victimization. The results highlight the dimensional and multifaceted nature—both for mothers as well as children—of the intergenerational transmission of violence and associated psychopathology.
From 2014 to 2020, we compiled radiocarbon ages from the lower 48 states, creating a database of more than 100,000 archaeological, geological, and paleontological ages that will be freely available to researchers through the Canadian Archaeological Radiocarbon Database. Here, we discuss the process used to compile ages, general characteristics of the database, and lessons learned from this exercise in “big data” compilation.
Glyphosate’s efficacy is influenced by the amount absorbed and translocated throughout the plant to inhibit 5-enolpyruvyl shikimate-3-phosphate synthase (EPSPS). Glyphosate resistance can be due to target-site (TS) or non–target site (NTS) resistance mechanisms. TS resistance includes an altered target site and gene overexpression, while NTS resistance includes reduced absorption, reduced translocation, enhanced metabolism, and exclusion/sequestration. The goal of this research was to elucidate the mechanism(s) of glyphosate resistance in common ragweed (Ambrosia artemisiifolia L.) from Ontario, Canada. The resistance factor for this glyphosate-resistant (GR) A. artemisiifolia biotype is 5.1. No amino acid substitutions were found at positions 102 or 106 of the EPSPS enzyme in this A. artemisiifolia biotype. Based on [14C]glyphosate studies, there was no difference in glyphosate absorption or translocation between glyphosate-susceptible (GS) and GR A. artemisiifolia biotypes. Radio-labeled glyphosate metabolites were similar for GS and GR A. artemisiifolia 96 h after application. Glyphosate resistance in this A. artemisiifolia biotype is not due to an altered target site due to amino acid substitutions at positions 102 and 106 in the EPSPS and is not due to the NTS mechanisms of reduced absorption, reduced translocation, or enhanced metabolism.
As the US faced its lowest levels of reported trust in government, the COVID-19 crisis revealed the essential service that various federal agencies provide as sources of information. This Element explores variations in trust across various levels of government and government agencies based on a nationally-representative survey conducted in March of 2020. First, it examines trust in agencies including the Department of Health and Human Services, state health departments, and local health care providers. This includes variation across key characteristics including party identification, age, and race. Second, the Element explores the evolution of trust in health-related organizations throughout 2020 as the pandemic continued. The Element concludes with a discussion of the implications for agency-specific assessments of trust and their importance as we address historically low levels of trust in government. This title is also available as Open Access on Cambridge Core.
Strong associations between neural tube defects (NTDs) and monozygotic (MZ) twinning have long been noted, and it has been suggested that NTD cases who do not present as MZ twins may be the survivors of MZ twinning events. We have recently shown that MZ twins carry a strong, distinctive DNA methylation signature and have developed an algorithm based on genomewide DNA methylation array data that distinguishes MZ twins from dizygotic twins and other relatives at well above chance level. We have applied this algorithm to published methylation data from five fetal tissues (placental chorionic villi, kidney, spinal cord, brain and muscle) collected from spina bifida cases (n = 22), anencephalic cases (n = 15) and controls (n = 19). We see no difference in signature between cases and controls, providing no support for a common etiological role of MZ twinning in NTDs. The strong associations therefore continue to await elucidation.
The COVID-19 pandemic has had a major impact on clinical practice. Safe standards of practice are essential to protect health care workers while still allowing them to provide good care. The Canadian Society of Clinical Neurophysiologists, the Canadian Association of Electroneurophysiology Technologists, the Association of Electromyography Technologists of Canada, the Board of Registration of Electromyography Technologists of Canada, and the Canadian Board of Registration of Electroencephalograph Technologists have combined to review current published literature about safe practices for neurophysiology laboratories. Herein, we present the results of our review and provide our expert opinion regarding the safe practice of neurophysiology during the COVID-19 pandemic in Canada.
Understanding the clinical risk factors for COVID-19 disease severity and outcomes requires a combination of data from electronic health records and patient reports. To facilitate the collection of patient-reported data, as well as accelerate and standardize the collection of data about host factors, we have constructed a COVID-19 survey. This survey is freely available to the scientific community to send electronically for patients to complete online. This patient survey is designed to be comprehensive, yet not overly burdensome, to gather data useful for a range of clinical investigations, and to accommodate a wide variety of implementation settings including at a COVID-19 testing site, at home during infection or after recovery, and/or for individuals while they are hospitalized. A widely adopted standardized survey that can be implemented online with minimal resources can serve as a critical tool for combining and comparing data across studies to improve our understanding of COVID-19 disease.
Carbapenem-resistant Enterobacterales (CRE) are common causes of healthcare-associated infections and are often multidrug resistant with limited therapeutic options. Additionally, CRE can spread within and between healthcare facilities, amplifying potential harms.
Objective:
To better understand the burden, risk factors, and source of acquisition of carbapenemase genes in clinical Escherichia coli and Klebsiella spp isolates from patients in Washington to guide prevention efforts.
Design:
Multicenter prospective surveillance study.
Methods:
Escherichia coli and Klebsiella spp isolates meeting the Washington state CRE surveillance case definition were solicited from clinical laboratories and tested at Washington Public Health Laboratories using polymerase chain reaction (PCR) for the 5 most common carbapenemase genes: blaKPC, blaNDM, blaIMP, blaVIM, and blaOXA-48. Case patients positive by PCR were investigated by the public health department.
Results:
From October 2012 through December 2017, 363 carbapenem-resistant E. coli and Klebsiella spp isolates were tested. Overall, 45 of 115 carbapenem-resistant K. pneumoniae (39%), 1 of 8 K. oxytoca (12.5%), and 28 of 239 carbapenem-resistant E. coli (11.7%) were carbapenemase positive. Of 74 carbapenemase-positive isolates, blaKPC was most common (47%), followed by blaNDM (30%), blaOXA-48 (22%), and blaIMP (1%). Although all cases had healthcare exposure, blaKPC acquisition was associated with US health care, whereas non-blaKPC acquisition was associated with international health care or travel.
Conclusions:
We report that blaKPC, the most prevalent carbapenemase in the United States, accounts for nearly half of carbapenemase cases in Washington state and that most KPC-cases are likely acquired through in-state health care.
Punctuated equilibrium theory seeks to explain policy volatility and stability in government attention. In previous research into the temporal dynamics of punctuations, scholars found that punctuations occur in clusters – a recent budgetary punctuation increases the likelihood of a subsequent punctuation. This article examines the direction, positive or negative, of budgetary punctuations over time. Are budgetary punctuations corrective, grouping positive and negative changes? Or, do budgetary punctuations occur in cumulative trends of positive or negative changes? These questions address the heart of the theoretical metaphor for punctuated equilibrium. In an analysis of over 1,000 Texas school districts for nearly a 20-year-period, results support the notion of reactive patterns of budgetary punctuations – positive and negative budgetary punctuations pair up at a rate much higher than expected by chance. The findings demonstrate that even though it is likely to see consecutive positive and negative punctuations, they are not always fully corrective.
Many novel therapeutic options for depression exist that are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such ‘non-standard’ interventions. This analysis proposes a framework to aid this decision.
Declaration of interest
In the past 3 years R.H.M.W. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending advisory boards) from various pharmaceutical companies including Astra Zeneca, Cyberonics, Eli Lilly, Janssen, LivaNova, Lundbeck, MyTomorrows, Otsuka, Pfizer, Roche, Servier, SPIMACO and Sunovion. D.M.B.C. has received fees from LivaNova for attending an advisory board. In the past 3 years A.J.C. has received fees for lecturing from Astra Zeneca and Lundbeck; fees for consulting from LivaNova, Janssen and Allergan; and research grant support from Lundbeck.
In the past 3 years A.C. has received fees for lecturing from pharmaceutical companies namely Lundbeck and Sunovion. In the past 3 years A.L.M. has received support for attending seminars and fees for consultancy work (including advisory board) from Medtronic Inc and LivaNova. R.M. holds joint research grants with a number of digital companies that investigate devices for depression including Alpha-stim, Big White Wall, P1vital, Intel, Johnson and Johnson and Lundbeck through his mindTech and CLAHRC EM roles. M.S. is an associate at Blueriver Consulting providing intelligence to NHS organisations, pharmaceutical and devices companies. He has received honoraria for presentations and advisory boards with Lundbeck, Eli Lilly, URGO, AstraZeneca, Phillips and Sanofi and holds shares in Johnson and Johnson. In the past 3 years P.R.A.S. has received support for research, expenses to attend conferences and fees for lecturing and consultancy work (including attending an advisory board) from life sciences companies including Corcept Therapeutics, Indivior and LivaNova. In the past 3 years P.S.T. has received consultancy fees as an advisory board member from the following companies: Galen Limited, Sunovion Pharmaceuticals Europe Ltd, myTomorrows and LivaNova. A.H.Y. has undertaken paid lectures and advisory boards for all major pharmaceutical companies with drugs used in affective and related disorders and LivaNova. He has received funding for investigator initiated studies from AstraZeneca, Eli Lilly, Lundbeck and Wyeth.
Halosulfuron-methyl, a sulfonylurea herbicide, was registered for broadleaf weed control in dry bean. This herbicide has an adequate margin of crop safety in white bean, but causes unacceptable injury to adzuki bean. Halosulfuron-methyl absorption, translocation, and metabolism were evaluated in white and adzuki bean using radiolabeled herbicide to determine if differences in these parameters could explain the difference in crop safety between these two species. Adzuki bean had more rapid halosulfuron-methyl absorption than white bean. Adzuki bean reached 90% absorption (t90) 26.2 h after treatment (HAT), whereas white bean required 40.1 HAT to reach t90. The maximum halosulfuron-methyl absorption was higher in adzuki bean (75.7%) than in white bean (65.3%). More 14C-halosulfuron was translocated to the apex, first trifoliate, stem above the treated leaf, and roots in aduzki bean than in white bean. The maximum radioactivity translocated out of treated leaf was higher in adzuki bean (17.7%) than in white bean (12.1%). Halosulfuron-methyl was broken down to the same metabolites in white and adzuki bean. The half-life of halosulfuron-methyl in adzuki bean was 16 HAT, compared with less than 6 HAT in white bean. More herbicide remained as the free acid in adzuki bean compared with white bean over the entire 48-h time course. The differential tolerance of white and adzuki bean to halosulfuron can be attributed to greater absorption and translocation and decreased metabolism in adzuki bean.
Background: Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a recently described life-threatening autoimmune disorder associated with a characteristic multi-stage neuropsychiatric syndrome. Although it is known that the majority of patients experience neuropsychological disturbance post-treatment, some aspects of the cognitive profile remain unclear. Methods: This study sought to investigate patterns of cognitive functioning in a sample of anti-NMDAR encephalitis patients. Seven (6F:1M; mean age, 26.4 years; range, 16–37 years) treated patients completed a comprehensive set of neurocognitive and social functioning measures. Performance was analyzed using normative data (where available), and comparison with matched controls (10F:4M; mean age, 25.8 years; range, 16–38 years). Results: Individual cognitive profiles ranged from within normal limits to extensive dysfunction. Relative to controls, the patient group’s performance was affected in the domains of verbal/ visual memory, working memory, attention, processing speed, executive functioning, and social cognition. The patient group also reported significantly higher levels of anxiety compared to controls. Conclusions: These results add to the accumulating evidence that neurocognitive deficits, consistent with the distribution and functions of the NMDAR system can persist during recovery from anti-NMDAR encephalitis. This is the first study to provide evidence of performance decrements on measures of social cognition, including some involving theory of mind. (JINS, 2016, 22, 828–838)
In a number of important articles and books—most notably Agendas and Instability in American Politics (1993), The Politics of Attention: How Government Prioritizes Problems (2005)—Frank R. Baumgartner and Bryan D. Jones have pioneered a distinctive approach to the study of agenda setting that has shaped research in both the U.S. politics and comparative politics subfields. The Politics of Information: Problem Definition and the Course of Public Policy in America further expands on the theme of the political determinants, and implications, of “the organization and prioritization of information.” And so we have invited a number of political scientists from a range of subfields to comment on the book and on the research agenda more generally.