Schwartz Centre Rounds: qualitative exploration of panel members' experiences within a forensic mental health service.

Schwartz Centre Rounds (SCRs) provide a structured forum for staff from all disciplines to meet and discuss the difficult emotional and social challenges that arise in caring for patients. Research into the implementation of SCRs has shown that staff who attend report increased insight into the emotional and social aspects of care; greater understanding of the roles of their colleagues; improved teamworking and decreased feelings of isolation and stress. However, little research has explored the implementation of SCRs within forensic settings, and no research has focused solely on the experiences of panel members. Three focus groups were facilitated with participants who had participated in a SCR panel within a forensic mental health service. Semi-structured interviews were carried out, audio-recorded and subsequently transcribed. Interpretive phenomenological analysis was utilised to analyse the transcripts, and four key themes were identified. These themes were: feeling vulnerable, the importance of validation, exposure to intense emotional experiences and improved understanding and connection. We conclude that SCRs can be an emotionally challenging but rewarding experience, with the potential to enhance teamworking and general well-being. Limitations and recommendations for future research are also discussed.

Culturally Adapting Caring Contacts for Suicide Prevention in Four Alaska Native and American Indian Communities.

AIM: Despite substantial tribal, state, and federal effort, American Indian and Alaska Native (AI/AN) suicide rates have changed little in the last 30 years, prompting attention to new and innovative approaches to this persistent health disparity. Suicide prevention interventions with demonstrated success in other populations may be useful in AI/AN communities. Caring Contacts is a suicide prevention intervention that has been adapted and shown to reduce suicide ideation, attempts, and deaths in other populations. CONCLUSION: Overall, AI/AN study participants in four diverse AI/AN communities endorsed the use of Caring Contacts for suicide prevention in their communities. Intervention adaptations for use in these communities centered primarily on message frequency and timing as well as expanding access to Caring Contacts. The results of this study may be applicable to other populations that experience suicide-related health disparities. METHODS: We used a community-based participatory research approach to gather qualitative data from community members, healthcare providers, and leaders in four AI/AN communities. These data were analyzed thematically and used to adapt Caring Contacts for use in a subsequent clinical trial with AI/AN people at high risk for suicide. RESULTS: A total of 189 community members and other health system stakeholders in four tribal communities participated in focus groups and interviews. Caring Contacts was perceived in all communities to be acceptable. Feedback for intervention adaptations focused on the themes of trial eligibility criteria; instruments; message frequency, timing, and content; and cultural considerations.

A Culturally-Grounded Biopsychosocial Assessment Utilizing Indigenous Ways of Knowing with the Cowichan Tribes.

Extant research foregrounds the need for culturally responsive, evidence-based mental health practices when working with Indigenous communities. This study presents an Indigenous biopsychosocial assessment designed by members of the Cowichan Tribes to evaluate the social, developmental, and mental health histories of Cowichan youth. The assessment takes the form of an in-depth narrative interview whose parameters were developed through a culturally grounded, community-based process. This process supported a focus on relationality, interdependence, and intergenerational transmission of knowledge during the interview. Five participants aged 12-18 years completed interviews, which yielded sufficient data to enable completion of both Indigenous and standard biopsychosocial assessments.

Insights from Cowichan: A Hybrid Approach to Understanding Suicide in One First Nations' Collective.

Explanations for suicide are theorized primarily in terms of the individual, seldom considering the interdependent orientation of Indigenous communities. Drawing on the interpersonal theory of suicide and settler colonial theory, this study addresses Indigenous suicide on two levels: the individual and the collective. Twenty-one interviews were conducted with members of the Cowichan Tribes to understand reasons for suicide in one community. Qualitative analysis identified explanatory constructs proposed by the interpersonal theory as well as negative conditions stemming from colonialism, as proposed by settler colonial theory. These results argue that Indigenous suicidal behavior is best understood from an interdependent standpoint.

"It's good, they're like me; the same but different." An interpretative phenomenological analysis of the identities of women with down's syndrome.

BACKGROUND: For people with disabilities, identity formation is based on responses to hierarchical values determined by able populations. Some adopt a disability identity, whereas others may seek to conceal their disability. No research has focused on how women with Down's Syndrome form an identity. DESIGN: Eight women with Down's Syndrome took part in semi-structured interviews designed to find out more about their individual and shared identities. The transcripts were analysed using interpretive phenomenological analysis. FINDINGS: Negative assumptions of others and oppressive, paternalistic care often lead to a lack of ownership over narratives. "Finding a place in society" is an attempt to challenge this and gain a sense of ownership over their lives. CONCLUSIONS: This research uncovered the individual and shared identities that women with Down's Syndrome construct. Services need to be aware of the role they have in supporting these women to develop autonomy and ownership over their lives.

Incorporation of calcium salts into xanthan gum matrices: hydration, erosion and drug release characteristics.

Xanthan gum (XG), a hydrophilic biopolymer with modified release properties, was used to produce directly compressed matrix tablets containing a model drug, sodium p-aminosalicylate. Three formulations were prepared, each containing a different calcium dihydrate salt: calcium chloride, calcium sulfate or dibasic calcium phosphate. The aim of the investigation was to relate the calcium ion content and solubility of the calcium salt to the in vitro drug release profile of the xanthan matrices. Tablet hydration, erosion and drug release were determined in distilled water using the British Pharmacopoeia (BP) paddle method. The data showed that the overall drug release was the greatest with addition of calcium sulfate, followed by calcium chloride and dibasic calcium phosphate. The chloride salt formulation displayed the greatest percentage erosion due to rapid mass loss during the initial phase, followed by those with sulfate or phosphate salts. As xanthan gel viscosity increased and drug release was also found to be lower, it can be concluded that drug release is influenced by the solubility of the salt present in the formulation, since these parameters determine the viscosity and structure of the gel layer.

The Medicago truncatula reference accession A17 has an aberrant chromosomal configuration.

Medicago truncatula (barrel medic) has emerged as a model legume and accession A17 is the reference genotype selected for the sequencing of the genome. In the present study we compare the A17 chromosomal configuration with that of other accessions by examining pollen viability and genetic maps of intraspecific hybrids. Hybrids derived from crosses between M. truncatula accessions, representative of the large genetic variation within the germplasm collection, were evaluated for pollen viability using Alexander's stain. Genetic maps were generated for the following crosses: SA27063 x SA3054 (n = 94), SA27063 x A17 (n = 92), A17 x Borung (n = 99) and A17 x A20 (n = 69). All F(1) individuals derived from crosses involving A17 showed 50% pollen viability or less. Examination of the recombination frequencies between markers of chromosomes 4 and 8 revealed an apparent genetic linkage between the lower arms of these chromosomes in genetic maps derived from A17. Semisterility and unexpected linkage relationship are both good indicators of a reciprocal translocation. The implications of the A17 distinctive chromosomal rearrangement on studies of genetic mapping, genome sequencing and synteny between species are discussed.