Integrated care is associated with increased behavioral health access and utilization for youth in crisis.

INTRODUCTION: Pediatric integrated care is well-positioned to play a substantial role in crisis intervention; however, few studies have investigated the impact of these services. METHOD: We investigated differences in service utilization for youth experiencing a crisis in a large, predominantly rural health system by comparing outcomes for 171 youth who received a crisis evaluation in a primary care behavioral health (PCBH) setting to 171 youth presenting to the emergency department at the main hospital campus using a retrospective cohort study design. RESULTS: PCBH patients were less likely to be male, more likely to be diagnosed with an Adjustment Disorder and less likely to be diagnosed with Autism Spectrum Disorder. Youth evaluated in PCBH were more likely to receive a psychiatric admission, had a shorter latency to the next BH appointment, and had higher rates of completing at least 1 visit in the year following the evaluation. A statistically nonsignificant reduction in frequency of psychiatric admission was observed in the year after the index date, with 3 integrated care patients (vs. 18 on index date) and 5 ED patients (vs. 6 on index date) admitted. DISCUSSION: Opportunities for future research on cost-effectiveness of care and continuous improvement aligned with quadruple aim outcomes are discussed. Overall, this study is among few others investigating the potential for pediatric integrated care models to contribute to youth suicide prevention and the study demonstrated promising increases in access and engagement with timely behavioral health care. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A Hybrid-Body Containing Constituents of Both P-Bodies and Stress Granules Forms in Response to Hypoosmotic Stress in Saccharomyces cerevisiae.

The cytoplasm of the eukaryotic cell is a highly compartmentalized space that contains a variety of ribonucleoprotein (RNP) granules in addition to its complement of membrane-bound organelles. These RNP granules contain specific sets of proteins and mRNAs and form in response to particular environmental and developmental stimuli. Two of the better-characterized of these RNP structures are the stress granule and Processing-body (P-body) that have been conserved from yeast to humans. In this report, we examined the cues regulating stress granule assembly and the relationship between stress granule and P-body foci. These two RNP structures are generally thought to be independent entities in eukaryotic cells. However, we found here that stress granule and P-body proteins were localized to a common or merged granule specifically in response to a hypoosmotic stress. Interestingly, these hybrid-bodies were found to be transient structures that were resolved with time into separate P-body and stress granule foci. In all, these data suggest that the identity of an RNP granule is not absolute and that it can vary depending upon the nature of the induction conditions. Since the activities of a granule are likely influenced by its protein constituency, these observations are consistent with the possibility of RNP granules having distinct functions in different cellular contexts.

The Activity-Dependent Regulation of Protein Kinase Stability by the Localization to P-Bodies.

The eukaryotic cytoplasm contains a variety of ribonucleoprotein (RNP) granules in addition to the better-understood membrane-bound organelles. These granules form in response to specific stress conditions and contain a number of signaling molecules important for the control of cell growth and survival. However, relatively little is known about the mechanisms responsible for, and the ultimate consequences of, this protein localization. Here, we show that the Hrr25/CK1δ protein kinase is recruited to cytoplasmic processing bodies (P-bodies) in an evolutionarily conserved manner. This recruitment requires Hrr25 kinase activity and the Dcp2 decapping enzyme, a core constituent of these RNP granules. Interestingly, the data indicate that this localization sequesters active Hrr25 away from the remainder of the cytoplasm and thereby shields this enzyme from the degradation machinery during these periods of stress. Altogether, this work illustrates how the presence within an RNP granule can alter the ultimate fate of the localized protein.

Predictability affects the perception of audiovisual synchrony in complex sequences.

The ability to make accurate audiovisual synchrony judgments is affected by the "complexity" of the stimuli: We are much better at making judgments when matching single beeps or flashes as opposed to video recordings of speech or music. In the present study, we investigated whether the predictability of sequences affects whether participants report that auditory and visual sequences appear to be temporally coincident. When we reduced their ability to predict both the next pitch in the sequence and the temporal pattern, we found that participants were increasingly likely to report that the audiovisual sequences were synchronous. However, when we manipulated pitch and temporal predictability independently, the same effect did not occur. By altering the temporal density (items per second) of the sequences, we further determined that the predictability effect occurred only in temporally dense sequences: If the sequences were slow, participants' responses did not change as a function of predictability. We propose that reduced predictability affects synchrony judgments by reducing the effective pitch and temporal acuity in perception of the sequences.

Audio-visual organisation and the temporal ventriloquism effect between grouped sequences: evidence that unimodal grouping precedes cross-modal integration.

Cross-modal grouping interactions between auditory and visual sequences have previously been demonstrated (O'Leary and Rhodes 1984, Perception & Psychophysics 33 565-569; Rahne et al 2008, Brain Research 1220 118-131). Three experiments were conducted here to determine whether cross-modal interaction precedes unimodal grouping and whether the temporal ventriloquism effect could be found between grouped auditory and visual sequences. We used a repeating four-tone auditory sequence (high-middle-middle-low) where the middle tones could group with either the high tone or the low tone, paired with a sequence of light flashes with a single flash one side and three the other. Experiment 1 showed that the temporal position of the isolated flash in the visual sequence had no effect on which of the auditory tones were perceived as isolated. Experiments 2 and 3 demonstrated that the temporal ventriloquism effect occurs between grouped auditory and visual sequences, as participants reported that the isolated light and tone from grouped visual and auditory sequences seemed to synchronise when they were between 120 and 240 ms apart. These results suggest that unisensory grouping can occur prior to cross-modal interaction.