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  • ItemOpen Access
    Interrogação, exploração e criação: exemplos do uso de pedagogias creativas no ensino superior
    (CIDU 2024 - XIII Congresso Ibero-americano de Docência Universitária, 2024-07-11) Oliveira, Gisela
    Esta comunicação pretende apresentar exemplos do uso de práticas pedagógicas creativas no ensino superior, incluindo desenhos ou diagramas, jogos de cartas e zines. Seguindo uma abordagem de reflexão autoetnográfica (como em Luetkemeyer et al., 2021), irei contextualizar a minha prática pedagógica creativa como uma oportunidade para gerar e explorar ideas, colaborar e co-criar conhecimento, e principalmente, como forma de desenvolver a autonomia dos alunos (Cremin & Chappell, 2021). Mais especificamente, pedagogias creativas podem ser definidas como a organização imaginativa e inovadora dos curricula e de estratégias de ensino na sala de aula (Dezuanni & Jetnikoff, 2011). Têm o potencial de levar alunos e professores a usar diferentes lentes de interpretação para explorar experiências de vida (Segalo, 2018) e refletir na sua aprendizagem de forma mais holística e multimodal. No entanto, é importante reconhecer que a ênfase crescente na performace académica e na avaliação tende a levar os professores para escolhas pedagógicas mais tradicionais (Moula, 2021) e ‘seguras’. Optar por pedagogias creativas pode parecer mais arriscado e difícil, e portanto, nesta comunicação irei problematizar os desafios e benefícios na escolha destas práticas, argumentando que são fundamentais para uma pedagogia expansiva (Engle et al., 2012). Palavras-chave: Pedagogias Creativas; Ensino Superior; Zines Referências: Cremin, T., Chappell, K. (2021). Creative pedagogies: a systematic review. Research Papers in Education, 36(3), 299–331. Dezuanni, M., Jetnikoff, A. (2011). Creative pedagogies and the contemporary school classroom. In J. Sefton-Green, Thompson, P., Bresler, L., & K. Jones, (Eds.), The Routledge International Handbook of Creative Learning (pp. 264-272). New York and London, Routledge. Engle, R. A., Lam, D. P., Meyer, X. S., Nix, S. E. (2012). How does expansive framing promote transfer? Several proposed explanations and a research agenda for investigating them. Educational Psychologist, 47(3), 215–231. Luetkemeyer, J., Adams, T., Davis, J., Redmond, T., Hash, P. (2021) Creative Practice in Higher Education: Decentering Academic Experiences. Journal of Education for Library and Information Science, 62(4), 403-422. Moula, Z. (2021). Academic perceptions of barriers and facilitators of creative pedagogies in higher education: a cross-cultural study between the UK and China. Thinking Skills and Creativity, 41. Segalo, P. (2018). Women speaking through embroidery: using visual methods and poetry to narrate lived experiences. Qualitative Research in Psychology, 15(2-3), 298-304.
  • ItemOpen Access
    Bacterial Filaments Induced by Antibiotic Minimal Inhibitory Concentrations in Persister Cells.
    (Mustansiriyah University, 2024-06-24) Mohammed, Haneen N.; Authman, Sawsan H.; AL Marjani, Mohammed F.; Samarasinghe, Shivanthi
    Background: The ability of minor subpopulations among clonal populations to survive antibiotics is referred to as bacterial persistence. It is believed that persisters come from latent cells, where antibiotic target areas are less active and incapable of being affected. Objective: 112 clinical Escherichia coli isolates were acquired out of diverse medical samples and genetically identified using the uspA gene, which is part of the housekeeping genes. Methods: The examination of persister cells was carried out by subjecting isolates of E. coli in the exponential phase with high dose of ciprofloxacin (20 fold MIC) and calculating the surviving persister cells using CFU (colony forming units) counts. The detection and measurement of bacterial filament production was done using scanning electron and light microscopy. Results: Results showed that the bacterial filament cells kept on lengthen but cease to divide (no septa formation) at sub-minimal inhibitory doses of ciprofloxacin. Persistent isolates were shown to exhibit a wide range of form and size variations, with cells up to 4.5 times longer than usual. Conclusions: The results showed the importance of antibiotic stress on persisted cells that result in the production of filaments as a means of survival and the need to examine these rare phenotypic variations. These occurrences may be the beginning of the spread of bacterial resistance.
  • ItemEmbargo
    Death and the Artificial Placenta
    (Oxford University Press, 2024-06-24) Nelson, Anna; Roberts, Elizabeth Chloe; Adkins, Victoria; Weis, Christina; Kuberska, Karolina
    Artificial Amnion and Placenta Technology (AAPT) – sometimes referred to as ‘Artificial Womb Technology’ – could provide an extracorporeal alternative to bodily gestations, allowing a fetus delivered prematurely from the human uterus to continue development while maintaining fetal physiology. As AAPT moves nearer to being used in humans, important ethical and legal questions remain unanswered. In this paper we explore how the death of the entity sustained by AAPT would be characterized in law. This question matters, as legal ambiguity in this area has the potential to compound uncertainty, and the suffering of newly bereaved parent(s). We first identify the existing criteria used to delineate the legal characterization of death which occurs before birth or during the immediate neonatal period in England and Wales. We then demonstrate that attempting to apply these in the context of AAPT gives rise to a number of challenges which make it impossible to reach a definitive conclusion as to the nature of death in AAPT using the current legal framework. In doing so, we demonstrate that the current legal framework in England and Wales may be unable to adequately capture the situation of an entity being sustained by AAPT.
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    The Horrendously Hungry Hoggle
    (Pegasus Publisher, 2024-07-27) Hing, Jennifer
    In the pages of this book, live creatures big and small, And a monster they must face, if they are to save them all. For the Horrendously Hungry Hoggle has pulled the moon from the sky, The creatures will need to work together to save it; they must try. But not everything is always as clear as it may seem, And on their brave adventure, they form an unlikely team. Can the creatures save the moon from the Hoggle's Hungry grip? Or will the light of the moon be lost in a permanent eclipse?
  • ItemOpen Access
    Will Including Health at COP28 Mean Transformation of Global Mental Health Action? And will Mental Health Professionals transform to help achieve it? i
    (Sciendo (De Gruyter) Mental Health: Global Challenges Journal., 2024-05-09) Illingworth, Paul
    Introduction: For the first time COP28 have included Public Health in their climate change discussions. Given progress on climate change has many hurdles, from domestic, economic and corporate pressures, it is pertinent to explore what impact this inclusion might have and what specific challenges there might be in relation to global mental health. Purpose: This positioning paper considers whether the implication of the inclusion of Health at COP28 might bring about transformation in the way Global Mental Health is addressed. It also considers how it might transform how mental health professionals, but also all others involved in working with people with mental health issues, transform mental health. The paper considers challenges to be faced going forward and potential solutions. The author acknowledges they are sharing their position on this subject, but in doing so, hopes to generate wider discussion. Methodology: As this is a positioning paper, data has been derived from the argument and counter argument within the paper. Therefore, there is a possibility of the risk of bias. Results: Plans to improve mental health globally have focused on replicating a Western, Global North model. Despite over 10 years of the WHO Mental Health Action Plan, there continues to be a growing mental health pandemic, worsened by Covid-19. Mental ill- health is caused by multiple factors, many are national, regional and even localized. The Western Global North model does not factor this in sufficiently to bring about improvement. Conclusion: This paper evaluated whether by including ‘Health’ at the recent COP28, it would help transform Global Mental Health. What became clear, after reviewing previous policies and action plans, was that significant change and improvement had not occurred. Policy makers and professionals approach needs to focus on preventing mental ill-health rather than treating after the event. Additionally, decolonisation of policies and professionals education is required to co-create sustainable resilience with people/communities and reduce mental ill-health.
  • ItemEmbargo
    You feel like you’re fairly disadvantaged with an advert over your head saying, "in final years of reproduction”': Social egg freezing, dating and the (unequal) sexual politics of reproductive ageing.
    (Taylor and Francis, 2024-05-01) Baldwin, Kylie
    Recent decades have seen an increasing gap occurring between the ‘desired’ and ‘actual’ family size of middle-class and professional women, this ‘unrealised fertility’ and ‘incomplete families’ have implications at a population, but also at the couple and individual level. This paper explores the way in which contemporary middle-class professional women make decisions about partnering and parenthood which are shaped by a contemporary neoliberal feminist discourse which articulates the possibility of ‘having it all’ by engaging in careful life planning, appropriate self-investment and through drawing on new technologies of reproductive biomedicine. Drawing on semi structured interviews with women at two different time points during their (non)reproductive journeys, it explores how these women approach and experience the process of relationship formation both as young professionals but also in the face of age-related fertility decline and examines how their use of social egg freezing shape their romantic and family building expectations but also their interactions with (potential) partners. In doing so it explores how gendered cultural dating scripts and unequal gender power relations shape the formation and progression of intimate relationships which sometimes work to disempower women as they age. It therefore questions whether egg freezing may be the ‘great equaliser’ that some may otherwise have hoped.
  • ItemOpen Access
    Anticholinesterase and Serotoninergic Evaluation of Benzimidazole–Carboxamides as Potential Multifunctional Agents for the Treatment of Alzheimer’s Disease
    (MPDI, 2023-08-19) Belinskaia, D.A.; Voronina, P.A.; Krivorotov, D.V.; Jenkins, R.O.; Goncharov, N. V.
    The etiology and pathogenesis of Alzheimer’s disease are multifactorial, so one of the treatment strategies is the development of the drugs that affect several targets associated with the pathogenesis of the disease. Within this roadmap, we investigated the interaction of several substituted 1,3-dihydro-2-oxo-1H-benzimidazol-2-ones with their potential molecular targets: cholinesterases (ChE) and three types of the Gs-protein-coupled serotonin receptors (5-HTR) 5-HT6, 5-HT4 and 5-HT7 (5-HT4R, 5-HT6R and 5-HT7R, respectively). A microplate modification of the Ellman method was used for the biochemical analysis of the inhibitory ability of the drugs towards ChE. Molecular modeling methods, such as molecular docking and molecular dynamics (MD) simulation in water and the lipid bilayer, were used to study the interaction of the compounds with ChE and 5-HTR. In vitro experiments showed that the tested compounds had moderate anticholinesterase activity. With the help of molecular modeling methods, the mechanism of interaction of the tested compounds with ChE was investigated, the binding sites were described and the structural features of the drugs that determine the strength of their anticholinesterase activity were revealed. Primary in silico evaluation showed that benzimidazole–carboxamides effectively bind to 5-HT4R and 5-HT7R. The pool of the obtained data allows us to choose N-[2-(diethylamino)ethyl]-2-oxo-3-(tert-butyl)-2,3-dihydro-1H-benzimidazole-1-carboxamide hydrochloride (compound 13) as the most promising for further experimental development.
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    Molecular Basis for the Involvement of Mammalian Serum Albumin in the AGE/RAGE Axis: A Comprehensive Computational Study
    (MPDI, 2024-03-11) Belinskaia, D. A.; Jenkins, R. O.; Goncharov, N. V.
    In mammals, glycated serum albumin (gSA) contributes to the pathogenesis of many metabolic diseases by activating the receptors (RAGE) for advanced glycation end products (AGEs). Many aspects of the gSA–RAGE interaction remain unknown. The purpose of the present paper was to study the interaction of glycated human albumin (gHSA) with RAGE using molecular modeling methods. Ten models of gHSA modified with different lysine residues to carboxymethyl-lysines were prepared. Complexes of gHSA–RAGE were obtained by the macromolecular docking method with subsequent molecular dynamics simulation (MD). According to the MD, the RAGE complexes with gHSA glycated at Lys233, Lys64, Lys525, Lys262 and Lys378 are the strongest. Three-dimensional models of the RAGE dimers with gHSA were proposed. Additional computational experiments showed that the binding of fatty acids (FAs) to HSA does not affect the ability of Lys525 (the most reactive lysine) to be glycated. In contrast, modification of Lys525 reduces the affinity of albumin for FA. The interspecies differences in the molecular structure of albumin that may affect the mechanism of the gSA–RAGE interaction were discussed. The obtained results will help us to learn more about the molecular basis for the involvement of serum albumin in the AGE/RAGE axis and improve the methodology for studying cellular signaling pathways involving RAGE.
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    Immunological Profile and Markers of Endothelial Dysfunction in Elderly Patients with Cognitive Impairments.
    (MPDI, 2024-02-04) Goncharov, N. V.; Popova, P. I.; KUDRYAVTSEV, I. V.; GOLOVKIN, A. S.; SAVITSKAYA, I. V.; AVDONIN, P. P.; KORF, E. A.; VOITENKO, N. G.; Belinskaia, D. A.; SEREBRYAKOVA, M. K.; MATVEEVA, N. V.; GERLAKH, N. O.; ANIKIEVICH, N. E.; GUBATENKO, M. A.; DOBRYLKO, I. A.; TRULIOFF, A. S.; AQUINO, A.; Jenkins, R. O.; AVDONIN, P. V.
    The process of aging is accompanied by a dynamic restructuring of the immune response, a phenomenon known as immunosenescence. Further, damage to the endothelium can be both a cause and a consequence of many diseases, especially in elderly people. The purpose of this study was to carry out immunological and biochemical profiling of elderly people with acute ischemic stroke (AIS), chronic cerebral circulation insufficiency (CCCI), prediabetes or newly diagnosed type II diabetes mellitus (DM), and subcortical ischemic vascular dementia (SIVD). Socio-demographic, lifestyle, and cognitive data were obtained. Biochemical, hematological, and immunological analyses were carried out, and extracellular vesicles (EVs) with endothelial CD markers were assessed. The greatest number of significant deviations from conditionally healthy donors (HDs) of the same age were registered in the SIVD group, a total of 20, of which 12 were specific and six were non-specific but with maximal differences (as compared to the other three groups) from the HDs group. The non-specific deviations were for the MOCA (Montreal Cognitive Impairment Scale), the MMSE (Mini Mental State Examination) and life satisfaction self-assessment scores, a decrease of albumin levels, and ADAMTS13 (a Disintegrin and Metalloproteinase with a Thrombospondin Type 1 motif, member 13) activity, and an increase of the VWF (vonWillebrand factor) level. Considering the significant changes in immunological parameters (mostly Th17-like cells) and endothelial CD markers (CD144 and CD34), vascular repair was impaired to the greatest extent in the DM group. The AIS patients showed 12 significant deviations from the HD controls, including three specific to this group. These were high NEFAs (non-esterified fatty acids) and CD31 and CD147 markers of EVs. The lowest number of deviations were registered in the CCCI group, nine in total. There were significant changes from the HD controls with no specifics to this group, and just one non-specific with a maximal difference from the control parameters, which was 1-AGP (alpha 1 acid glycoprotein, orosomucoid). Besides the DM patients, impairments of vascular repair were also registered in the CCCI and AIS patients, with a complete absence of such in patients with dementia (SIVD group). On the other hand, microvascular damage seemed to be maximal in the latter group, considering the biochemical indicators VWF and ADAMTS13. In the DMpatients, a maximum immune response was registered, mainly with Th17-like cells. In the CCCI group, the reaction was not as pronounced compared to other groups of patients, which may indicate the initial stages and/or compensatory nature of organic changes (remodeling). At the same time, immunological and biochemical deviations in SIVD patients indicated a persistent remodeling in microvessels, chronic inflammation, and a significant decrease in the anabolic function of the liver and other tissues. The data obtained support two interrelated assumptions. Taking into account the primary biochemical factors that trigger the pathological processes associated with vascular pathology and related diseases, the first assumption is that purine degradation in skeletal muscle may be a major factor in the production of uric acid, followed by its production by non-muscle cells, the main of which are endothelial cells. Another assumption is that therapeutic factors that increase the levels of endothelial progenitor cells may have a therapeutic effect in reducing the risk of cerebrovascular disease and related neurodegenerative diseases.
  • ItemOpen Access
    The Effects of SARS-CoV-2 on the Angiopoietin/Tie Axis and the Vascular Endothelium
    (MDPI, 0024-03-11) Janchivlamdan, Dolgormaa; Shivkumar, Maitreyi; Singh, Harprit
    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection can cause potentially life-threatening coronavirus disease (COVID-19). COVID-19 is a multisystem disease and is associated with significant respiratory distress, systemic hyperinflammation, vasculitis, and multi-organ failure. SARS-CoV-2 causes the deterioration of numerous systems, with increasing evidence implying that COVID-19 affects the endothelium and vascular function. The endothelium is important for preserving vascular tone and homeostasis. The overactivation and dysfunction of endothelial cells are significant outcomes of severity in patients with COVID-19. The Angiopoietin 1/Tie 2 pathway plays an important role in endothelium quiescence and vessel stability. The disruption of Angiopoietin/Tie balance affects the vessel contact barrier and leads to vessel leakage, and this in turn causes endothelial dysfunction. Although vascular instability through SARS-CoV-2 is associated with endothelial dysfunction, it is still not understood if the virus affects the Angiopoietin/Tie axis directly or via other mechanisms such as cytokine storm and/or immune response associated with the infection. This review provides an overview of the impact SARS-CoV-2 has on endothelial function and more specifically on the Angiopoietin/Tie pathway.
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    PROTECT: Relational safety based suicide prevention training frameworks
    (Wiley, 2019-12-26) Ray, Manaan Kar; Wyder, Marianne; Crompton, David; Kousoulis, Antonis A.; Arensman, Ella; Hafizi, Sepehr; Van Bortel, Tine; Lombardo, Chiara
    Preventing suicide is a global priority, and staff training is a core prevention strategy. However, frontline pressures make translating training into better care and better outcomes difficult. The aim of the paper was to highlight challenges in suicide risk assessment and management and introduce training frameworks to assist with mindful practice so professionals can strike a balance between risk and recovery. We combined the scientific literature with contemporary practice from two successful initiatives from Cambridgeshire, UK: 333 – a recovery-oriented model of inpatient/community crisis care and PROMISE – a programme to reduce coercion in care by enhancing patient experience. The resulting PROTECT (PROactive deTECTion) frameworks operationalize ongoing practice of relational safety in these programmes. PROTECT is a combination of novel concepts and adaptations of well-established therapeutic approaches. It has four training frameworks: AWARE for reflection on clinical decisions; DESPAIR for assessment; ASPIRE for management; and NOTES for documentation. PROTECT aims to improve self-awareness of mental shortcuts and risk-taking thresholds and increase rigour through time-efficient cross-checks. The training frameworks should support a relational approach to self-harm/suicide risk detection, mitigation, and documentation, making care safer and person-centred. The goal is to enthuse practitioners with recovery-oriented practice that draws on the strengths of the person in distress and their natural circle of support. It will provide the confidence to engage in participatory approaches to seek out unique individualized solutions to the overwhelming psychological pain of suicidal distress. Future collaborative research with people with lived and carer experience is needed for fine-tuning.
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    Resilience across the UK during the Coronavirus pandemic
    (Mental Health Foundation, 2020-09-03) Kousoulis, Antonis; McDaid, Shari; Crepaz-Keay, David; Solomon, Susan; Lombardo, Chiara; Yap, Jade; Weeks, Lauren; O’Sullivan, Chris; Baird, Rachel; Grange, Richard; Giugliano, Toni; Van Bortel, Tine; John, Ann; Lee, Sze; Morton, Alec; Davidson, Gavin; Morillo, Hannah
    -Resilience enables us as individuals, communities, nations and as a country, to cope with the stress of the coronavirus pandemic. -This study shows that most people (64%) say they are coping well with the stress of the pandemic. However, many are struggling with the current crisis. -Of those who have experienced stress due to the pandemic, almost nine out of ten (87%) are using at least one coping strategy. -People have used a wide range of strategies to cope; these most often included going for a walk, spending time in green spaces, and staying connected with others. -We found that some people are resorting to potentially harmful ways of coping, including increased alcohol consumption, substance misuse, and over-eating, putting their mental and physical health at greater risk. -While each nation has made available mental health literacy resources in response to COVID-19, this study’s findings point to where more policy and investment could be targeted to support people and communities to remain resilient in the face of local or national restrictions related to the coronavirus pandemic.
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    The COVID-19 pandemic, financial inequalities and mental health in the UK
    (Mental Health Foundation, 2020-05-01) Kousoulis, Antonis; McDaid, Shari; Crepaz-Keay, David; Solomon, Susan; Lombardo, Chiara; Yap, Jade; Weeks, Lauren; O’Sullivan, Chris; Baird, Rachel; Grange, Richard; Giugliano, Toni; Thorpe, Lucy; van Bortel, Tine; John, Ann; Lee, Sze; Morton, Alec; Davidson, Gavin; Knifton, Lee; Rowland, Mark
    We all can experience mental health problems, whatever our background or walk of life. But the risk of experiencing mental ill-health is not equally distributed across our society. Those who face the greatest disadvantages in life also face the greatest risk to their mental health. The distribution of infections and deaths during the COVID-19 pandemic, the lockdown and associated measures, and the longer-term socioeconomic impact are likely to reproduce and intensify the financial inequalities that contribute to the increased prevalence and unequal distribution of mental ill-health. This briefing discusses the mental health effects of these financial inequalities in the context of the COVID-19 pandemic. It draws evidence from the ‘Coronavirus: Mental Health in the Pandemic’ research – a UK-wide, long-term study of how the pandemic affects people’s mental health. The study is led by the Mental Health Foundation, in collaboration with the University of Cambridge, Swansea University, the University of Strathclyde and Queen’s University Belfast.
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    The divergence of mental health experiences during the Coronavirus pandemic in the UK
    (Mental Health Foundation, 2020-07-02) Kousoulis, Antonis; McDaid, Shari; Crepaz-Keay, David; Solomon, Susan; Lombardo, Chiara; Yap, Jade; Weeks, Lauren; O’Sullivan, Chris; Baird, Rachel; Grange, Richard; Giugliano, Toni; Thorpe, Lucy; Van Bortel, Tine; John, Ann; Lee, Sze; Morton, Alec; Davidson, Gavin
    The Coronavirus: Mental Health in the Pandemic study provides unique insights into the mental health effects of the pandemic since mid-March, with five waves of data collected so far across the UK specifically focused on mental health and well-being. We want to use good quality evidence to influence the actions that we need to take as a country to prevent a mental health crisis in the years to come. While we have all been affected by the COVID-19 crisis, the evidence from the Foundation’s Coronavirus: Mental Health in the Pandemic (‘our’) study shows a divergence in people’s experience depending on their social and/or economic context in society. As has been said: we are all in the same storm, but we are not all in the same boat. Even as the measures taken to curb the spread of COVID-19 change, with reduced restrictions for most and sustained isolation for a minority, with some having been affected directly by the virus and many less so, some returning to normal work life and many others experiencing changed employment status, differences in the mental health impact will persist and likely increase.
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    The long term mental health impact of covid-19 must not be ignored
    (BMJ, 2020-05-05) Kousoulis, Antonis A.; van Bortel, Tine; Hernandez, Priscila; John, Ann
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    Development of a Standardised International Protocol for Evaluation of the Disinfection Efficacy of Healthcare Laundry Wash Processes
    (MDPI, 2024-01-18) Owen, Lucy; Cayrou, Caroline; Page, Georgina; Grootveld, Martin; Laird, Katie
    This research aims to develop a standardised protocol for monitoring the disinfection efficacy of healthcare laundry processes in view of numerous differential methodologies currently being employed within the healthcare laundry sector, including agitation and surface sampling for post-laundering decontamination assessment and swatch and bioindicator testing for in-wash-process efficacy. Enterococcus faecium as an indicator species within industrial wash systems is preferable due to its high thermal and disinfectant tolerance. Methods for measuring laundry disinfection were compared; commercially available E. faecium bioindicators and contaminated cotton swatches (loose, in cloth bags or within nylon membranes) were laundered industrially at ambient temperature and microbial recovery determined. E. faecium was lost from cotton during laundering but retained by the bioindicator membrane, which allows disinfection efficacy to be measured without loss of microorganisms from the test swatch. Commercially available bioindicators were only permeable to disinfectants and detergents at ≥60 °C. Subsequently, polyethersulphone membranes for enclosing contaminated swatches were developed for low-temperature laundering, with permeability to industrial laundry chemistries at below ≤60 °C. This study demonstrates that bioindicators are the recommended methodology for laundry disinfection validation. The use of a universal healthcare laundry disinfection methodology will lead to standardised microbiological testing across the industry and improvements in infection control
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    Perceived causes of mental illness and views on appropriate care pathways among Indonesians
    (BioMed Central, 2021-09-23) Anjara, Sabrina Gabrielle; Brayne, Carol; Van Bortel, Tine
    Background The mental health system in Indonesia comprises attempts to modernise a colonial relic. There is still a disconnect between available services and help-seeking behaviours at the grassroots level. This study aims to explore the perceptions of Javanese people on the aetiology of mental illness and their ideas on how to deal with individuals who may have mental illness. Methods This qualitative study involves semi-structured interviews, embedded in a cluster randomised trial examining the clinical and cost-effectiveness of primary mental health services. Interviews were conducted with Indonesian and Javanese. The recruitment procedure was aligned to the trial. Participants were primary care patients recruited from 21 sites across Yogyakarta province. Interviews were recorded, transcribed, and translated into English. Thematic analysis was used to analyse the interview transcripts. Results 75 participants took part in the study: 51 women (68%) and 24 men (32%). Key themes emerged around perceived causes of mental health problems (including ‘extrinsic factors’; ‘intrinsic factors’; and ‘spiritual factors’), and perceived appropriate pathways of care (‘modern medical science’; ‘social support and activities’; and ‘religious or spiritual interventions’). Gender potentially influenced some of the responses. Conclusions Themes indicate the variety of preconceptions towards mental health problems and assumptions regarding the best management pathways. Some of these preconceptions and assumptions support the utility of modern medical care, while the rest promote spiritual or religious healers. Participants’ ideas of the appropriate care pathways largely correspond to their perception of what the symptoms are caused by. Despite hints to some understanding of the bio-psycho-social model of mental illness, most participants did not capture the complexity of mental health and illness, indicating the importance of contextual (especially culturally and religiously-aligned) public education around mental health, illness and care.
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    Using the GHQ-12 to screen for mental health problems among primary care patients: psychometrics and practical considerations
    (BioMed Central, 2020-08-10) Anjara, S. G.; Bonetto, C.; Van Bortel, T.; Brayne, C.
    Background This study explores the factor structure of the Indonesian version of the GHQ-12 based on several theoretical perspectives and determines the threshold for optimum sensitivity and specificity. Through a focus group discussion, we evaluate the practicality of the GHQ-12 as a screening tool for mental health problems among adult primary care patients in Indonesia. Methods This is a prospective study exploring the construct validity, criterion validity and reliability of the GHQ-12, conducted with 676 primary care patients attending 28 primary care clinics randomised for participation in the study. Participants’ GHQ-12 scores were compared with their psychiatric diagnosis based on face-to-face clinical interviews with GPs using the CIS-R. Exploratory and Confirmatory Factor Analyses determined the construct validity of the GHQ-12 in this population. The appropriate threshold score of the GHQ-12 as a screening tool in primary care was determined using the receiver operating curve. Prior to data collection, a focus group discussion was held with research assistants who piloted the screening procedure, GPs, and a psychiatrist, to evaluate the practicality of embedding screening within the routine clinic procedures. Results Of all primary care patients attending the clinics during the recruitment period, 26.7% agreed to participate (676/2532 consecutive patients approached). Their median age was 46 (range 18–82 years); 67% were women. The median GHQ-12 score for our primary care sample was 2, with an interquartile range of 4. The internal consistency of the GHQ-12 was good (Cronbach’s α = 0.76). Four factor structures were fitted on the data. The GHQ-12 was found to best fit a one-dimensional model, when response bias is taken into consideration. Results from the ROC curve indicated that the GHQ-12 is ‘fairly accurate’ when discriminating primary care patients with indication of mental disorders from those without, with average AUC of 0.78. The optimal threshold of the GHQ-12 was either 1/2 or 2/3 point depending on the intended utility, with a Positive Predictive Value of 0.68 to 0.73 respectively. The screening procedure was successfully embedded into routine patient flow in the 28 clinics. Conclusions The Indonesian version of the GHQ-12 could be used to screen primary care patients at high risk of mental disorders although with significant false positives if reasonable sensitivity is to be achieved. While it involves additional administrative burden, screening may help identify future users of mental health services in primary care that the country is currently expanding.
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    Public health programmes to promote mental health in young people: a systematic integrative review protocol
    (BMJ, 2020-09-25) Wickramasinghe, Nuwan Darshana; Samarutilake, Nelum; Wettasinghe, Mihiri Chami; Feiler, Julie; Morgan, Antony; Kousoulis, Antonis A.; Bortel, Tine Van
    Introduction In light of the ever-growing mental health disease burden among young people worldwide, we aim to systematically review the global literature to identify the public health programmes targeted at promoting mental health and well-being in young people, the reported/anticipated mental health-related outcomes of the implemented public health programmes and the reported facilitators and barriers in relation to the implementation of those public health programmes. Methods and analysis A comprehensive literature search will be carried out in the following electronic bibliographic databases: MEDLINE, EMBASE, PsycINFO, Scopus, ASSIA, Web of Science, Global Health, AMED, Health Source and The Cochrane Library. Further, a manual search of the reference lists of eligible studies and reviews will be carried out. The search strategy will include combinations of three key blocks of terms, namely: ‘young people’, ‘mental health’ and ‘public health programme’, using database-specific subject headings and text words. Two reviewers will independently screen, assess data quality and extract data for synthesis. Disagreements at any stage will be resolved by consensus with the involvement of a third reviewer. Given the anticipated methodological pluralism of the potential eligible studies, we will provide a narrative synthesis of the findings on public health programmes aimed at promoting the mental health and well-being of young people according to identified thematic areas. Furthermore, a narrative synthesis of the reported facilitators and barriers in relation to the implementation of public health programmes will be provided. Ethics and dissemination Given that the review findings will be focused on understanding the breadth and depth of the global research into public health programmes to promote mental health in young people with a particular emphasis on the facilitators and barriers of programmatic implementation, the findings will be of great value to inform future interventions, programmes and approaches to promote mental health and well-being of young people worldwide. PROSPERO registration number CRD42018099551.
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    Mental health in the pandemic: a repeated cross-sectional mixed-method study protocol to investigate the mental health impacts of the coronavirus pandemic in the UK
    (BMJ, 2021-08-27) Bortel, Tine Van; John, Ann; Solomon, Susan; Lombardo, Chiara; Crepaz-Keay, David; McDaid Shari; Yap, Jade; Weeks, Lauren; Martin, Steven; Guo, Lijia; Seymour, Catherine; Thorpe, Lucy; Morton, Alexander D.; Davidson, Gavin; Kousoulis, Antonis A.
    Introduction The WHO declared a global pandemic on 11 March 2020. Since then, the world has been firmly in the grip of the COVID-19. To date, more than 211 730 035 million confirmed cases and more than 4 430 697 million people have died. While controlling the virus and implementing vaccines are the main priorities, the population mental health impacts of the pandemic are expected to be longer term and are less obvious than the physical health ones. Lockdown restrictions, physical distancing, social isolation, as well as the loss of a loved one, working in a frontline capacity and loss of economic security may have negative effects on and increase the mental health challenges in populations around the world. There is a major demand for long-term research examining the mental health experiences and needs of people in order to design adequate policies and interventions for sustained action to respond to individual and population mental health needs both during and after the pandemic. Methods and analysis This repeated cross-sectional mixed-method study conducts regular self-administered representative surveys, and targeted focus groups and semi-structured interviews with adults in the UK, as well as validation of gathered evidence through citizens’ juries for contextualisation (for the UK as a whole and for its four devolved nations) to ensure that emerging mental health problems are identified early on and are properly understood, and that appropriate policies and interventions are developed and implemented across the UK and within devolved contexts. STATA and NVIVO will be used to carry out quantitative and qualitative analysis, respectively. Ethics and dissemination Ethics approval for this study has been granted by the Cambridge Psychology Research Ethics Committee of the University of Cambridge, UK (PRE 2020.050) and by the Health and Life Sciences Research Ethics Committee of De Montfort University, UK (REF 422991). While unlikely, participants completing the self-administered surveys or participating in the virtual focus groups, semi-structured interviews and citizens’ juries might experience distress triggered by questions or conversations. However, appropriate mitigating measures have been adopted and signposting to services and helplines will be available at all times. Furthermore, a dedicated member of staff will also be at hand to debrief following participation in the research and personalised thank-you notes will be sent to everyone taking part in the qualitative research. Study findings will be disseminated in scientific journals, at research conferences, local research symposia and seminars. Evidence-based open access briefings, articles and reports will be available on our study website for everyone to access. Rapid policy briefings targeting issues emerging from the data will also be disseminated to inform policy and practice. These briefings will position the findings within UK public policy and devolved nations policy and socioeconomic contexts in order to develop specific, timely policy recommendations. Additional dissemination will be done through traditional and social media. Our data will be contextualised in view of existing policies, and changes over time as-and-when policies change.