Care-experienced young people's views on what they want from mental health services.

This study explores what care-experienced young people want from mental health services. Six care-experienced young people were interviewed, and an interpretative phenomenological analysis applied. Three key themes emerged demonstrating that the way support is delivered, the people who deliver it, and the environment of mental health services are all important to care-experienced young people. Along with these findings, this study demonstrates that engaging vulnerable young people in research and service design is beneficial.

This study explores what care-experienced young people want from mental health services. Six care-experienced young people were interviewed. Themes that emerged from interviews showed that the type of support that was delivered, the people who deliver the support, and the environment in which the support is delivered were all important to young people. This study shows that engaging young people in research and service design is beneficial.

Preparing health professional students for interprofessional practice related to neurodevelopmental disabilities: a pilot program.

Many health professional students have insufficient general knowledge about individuals with neurodevelopmental disabilities. Students lack the expertise required to work with this population and their families. Interprofessional practice education (IPE) programs, designed for working with individuals with specialized needs and their families, are needed to improve overall care provided. An IPE program related to neurodevelopmental disabilities for health professional students was implemented focusing on applied learning and community engagement to develop competencies for students related to neurodevelopmental disabilities at a state university in the U.S. The purpose of this research was to describe the development and implementation of an IPE program and to examine the effectiveness of the IPE program aimed at developing identified competencies and increase awareness related to care of individuals with ND for health professional students. The findings suggest the IPE program enhanced health professional students' perceived competencies to identify and provide culturally sensitive and family-centered care for individuals with neurodevelopmental disabilities and their families. This experience also provided an opportunity for personal/professional growth and increased awareness of the unique needs of these individuals with neurodevelopmental disabilities and their families.

Social workers' experiences of psychological consultation on high risk youth: Helpful, unhelpful, and mediating elements.

Psychological consultation is a key means of informing care and practice with psychological theory and evidence. The current paper sought to investigate what elements of psychological consultation are useful for social workers when consulting on high-risk youth, due to the current gap in the literature. Seven social workers shared their experiences during one-to-one interviews. The data was analysed through thematic analysis and the emerging themes were organised into three categories: Helpful elements, such as a safe space, independent expertise, and a shared understanding; Unhelpful elements, including consultee anxiety and the unheard young person; A Mediating element in the form of feasible recommendations. The implications of these findings are discussed, as well as the limitations of this paper and recommendations for future research.

Design refinement and evaluation of a mobile manual standing wheelchair.

PURPOSE: There are no manually propelled wheelchairs on the market that are mobile in both seated and standing positions. In response to this product gap, our group formerly designed a mobile manual standing wheelchair (MMSW) and gathered stakeholder feedback. The purpose of this study was to refine the MMSW based on feedback, including weight and width reduction, and evaluate its performance. MATERIALS AND METHODS: The MMSW was subjected to ANSI/RESNA stability testing, and three male participants completed a subset of the wheelchair skills test, including a 100-m roll test in the MMSW (seated and standing) and in their ultralight wheelchair. RESULTS: The MMSW met ANSI/RESNA stability safety standards. During the 100-m roll test, participants reached speeds with the MMSW in both the standing and sitting postures similar or greater than those typical of moving in the home environment (1.11 m/s seated; 0.79 m/s standing). Mobility speeds in the MMSW in the standing position were about three times faster than average walking speeds in exoskeletons (0.26 m/s exoskeletons). With the addition of chain drive bracing to the MMSW, one user was able to reach speeds in the standing position similar to average neurotypical walking speeds indicating the possibility for wheelchair users to be able to move in pace with family and friends. CONCLUSION: All participants expressed interest in the MMSW to facilitate improved quality of life. Further work is needed to test the utility of the MMSW in home and community settings, and its potential effects on standing time and health outcomes.Implications for rehabilitationManual standing wheelchairs with standing mobility may increase functional utility and length of standing time for manual wheelchair usersIncreased standing time may lead to several health benefits for manual wheelchair users.

Divergent semantic integration (DSI): Extracting creativity from narratives with distributional semantic modeling.

We developed a novel conceptualization of one component of creativity in narratives by integrating creativity theory and distributional semantics theory. We termed the new construct divergent semantic integration (DSI), defined as the extent to which a narrative connects divergent ideas. Across nine studies, 27 different narrative prompts, and over 3500 short narratives, we compared six models of DSI that varied in their computational architecture. The best-performing model employed Bidirectional Encoder Representations from Transformers (BERT), which generates context-dependent numerical representations of words (i.e., embeddings). BERT DSI scores demonstrated impressive predictive power, explaining up to 72% of the variance in human creativity ratings, even approaching human inter-rater reliability for some tasks. BERT DSI scores showed equivalently high predictive power for expert and nonexpert human ratings of creativity in narratives. Critically, DSI scores generalized across ethnicity and English language proficiency, including individuals identifying as Hispanic and L2 English speakers. The integration of creativity and distributional semantics theory has substantial potential to generate novel hypotheses about creativity and novel operationalizations of its underlying processes and components. To facilitate new discoveries across diverse disciplines, we provide a tutorial with code (osf.io/ath2s) on how to compute DSI and a web app ( osf.io/ath2s ) to freely retrieve DSI scores.

Dead detector element detection in flat panels using convolutional neural networks.

BACKGROUND: Independent testing of image quality metrics is important to provide an unbiased determination of medical imaging performance. Due to the underreporting by vendors of dead detector elements, which are elements that do not function but may be corrected using information from surrounding pixels, the health of all imaging detector elements is infrequently reported and extraordinarily difficult to independently determine or verify through traditional means without vendor largesse. In many instances, dead detector data, or dead pixel maps, are only available at the discretion of the vendors, which renders these data inaccessible to many medical physicists. PURPOSE: We provide a mechanism to predict which detector elements are dead from a single flat field image and describe a convolutional neural network (CNN) to address this task. This technique provides a vendor-independent and potential correction algorithm-independent means for obtaining this information, which directly relates to the image quality of the diagnostic imaging system. METHODS: A data set of 61 flat field images was obtained from two Varian on-board imaging (OBI) systems. These images were taken with a range of kVp and mAs settings and with differing levels of copper filtration in the beam path. The dead pixel maps for these detectors were also acquired and used to label the ground truth subimages-or small square images from the original, larger image-from the flat field images. This data set was then used to train, test, and validate five unique CNNs on the task of identifying dead detector elements from subimages derived from the flat field images. RESULTS: The CNNs were validated with an average precision of 0.96, an average recall of 0.48, and an average F1 score of 0.55 attributed to the scarcity and imbalanced nature of available data, and the difficulty in training neural networks using flat-field images. However, performance drastically improved when utilizing a subset of the data with a high dynamic range. CONCLUSION: This work shows the feasibility of using a CNN to detect dead detector elements from flat field images taken on a detector. Robust training of this type of algorithm could lead to a generalized model that may provide an independent evaluation of dead detectors for a wide range of vendors and models. Ultimately, this method can be a valuable tool for physicists performing quality assurance procedures on all digital diagnostic imaging systems, including X-ray, mammography, and fluoroscopy.

Automating creativity assessment with SemDis: An open platform for computing semantic distance.

Creativity research requires assessing the quality of ideas and products. In practice, conducting creativity research often involves asking several human raters to judge participants' responses to creativity tasks, such as judging the novelty of ideas from the alternate uses task (AUT). Although such subjective scoring methods have proved useful, they have two inherent limitations-labor cost (raters typically code thousands of responses) and subjectivity (raters vary on their perceptions and preferences)-raising classic psychometric threats to reliability and validity. We sought to address the limitations of subjective scoring by capitalizing on recent developments in automated scoring of verbal creativity via semantic distance, a computational method that uses natural language processing to quantify the semantic relatedness of texts. In five studies, we compare the top performing semantic models (e.g., GloVe, continuous bag of words) previously shown to have the highest correspondence to human relatedness judgements. We assessed these semantic models in relation to human creativity ratings from a canonical verbal creativity task (AUT; Studies 1-3) and novelty/creativity ratings from two word association tasks (Studies 4-5). We find that a latent semantic distance factor-comprised of the common variance from five semantic models-reliably and strongly predicts human creativity and novelty ratings across a range of creativity tasks. We also replicate an established experimental effect in the creativity literature (i.e., the serial order effect) and show that semantic distance correlates with other creativity measures, demonstrating convergent validity. We provide an open platform to efficiently compute semantic distance, including tutorials and documentation ( https://osf.io/gz4fc/ ).

Geriatric Hedgehogs.

African hedgehogs are susceptible to aging changes like those of other small exotic mammals. Common conditions of the geriatric hedgehog include heart disease, chronic renal disease, and dental/periodontal disease. Hedgehogs are unique in that they have an unusually short life span and a propensity for neoplasia. These 2 factors make it especially common for exotic animal practitioners to encounter geriatric hedgehogs affected by one of the many conditions outlined in this article.

Validation of the Massachusetts Youth Screening Instrument with a looked after population.

The Massachusetts Youth Screening Instrument-version 2 (MAYSI-2) was developed to help identify mental health needs of young people admitted to youth detention centres. Only one study has applied the tool to a UK population and none have looked at young people who live in residential and secure care in Scotland. This study aimed to assess the validity of the MAYSI-2 in Scotland with a looked after and accommodated population. Boys and girls in a large education and care centre were asked to complete the MAYSI-2 within 72 hours of being accommodated. A total of 168 males and 69 females with a mean age of 15 completed the tool. Substantial levels of mental health need were identified. Girls appeared to have higher needs on all areas, bar alcohol and substance misuse. The MAYSI-2 had good internal consistency and exploratory factor analysis showed good overlap with the tool's original factor model. As a result, there can be more confidence in the validity and consistency of the tool with this population. This is also further evidence of the high need of this population, particularly girls.

Parental emotion and pain control behaviour when faced with child's pain: the emotion regulatory role of parental pain-related attention-set shifting and heart rate variability.

This study investigated the moderating role of parental pain-related attention-set shifting and heart rate variability (HRV) for parental distress and pain control behaviour when faced with their child's pain. Participants were 54 schoolchildren and one of their parents. Parental HRV was assessed at study commencement followed by a cued-switching task indexing parental ability to flexibly shift attention between pain-related and neutral attentional sets. In a subsequent phase, parents observed their child perform a cold-pressor task [CPT], allowing for assessment of parental pain control behavior (indexed by latency to stop their child's CPT performance) and parental distress-assessed through self-report following observation of child CPT performance. Findings indicated that parental facilitated attentional shifting (ie, engage) towards a pain-related attentional set contributed to higher levels of pain control behaviour when faced with increasing levels of child facial display of pain. Pain control behaviour among parents who demonstrated impeded attentional shifting to a pain-related attentional set was equally pronounced regardless of low or high levels of child pain expression. Parental ability to shift attention away (ie, disengage) from a pain-related set to a neutral set did not impact findings. Results further indicated that although high levels of parental HRV buffer the impact of child facial pain display on parental emotional distress and pain control behaviour, low levels of HRV constitute a risk factor for higher levels of parental distress and pain control behaviour when faced with increased child facial pain display. Theoretical/clinical implications and further research directions are discussed.

Threat to the Group's Image Can Motivate High Identifiers to Take Action Against In-group Transgressions.

When transgressions are committed by a group, those highly identified with the group are often least likely to recognize the transgressions, feel collective guilt, and engage in action to address them. We hypothesized that especially among high identifiers, demonstrating that in-group transgressions threaten the group's image can induce normative conflict and thus collective guilt and action. In the first study, we demonstrate that high (vs. low) image threat increases normative conflict among high identifiers. In Study 2, we show that inducing normative conflict through image threat leads to increased collective guilt and collective action among high identifiers. In Study 3, we replicate this effect with the addition of a control condition to demonstrate increased normative conflict and collective guilt relative to both a low threat and baseline conditions. In Study 4, we again replicate these effects with a modified manipulation that more precisely manipulated image threat. Together, these studies indicate that image threat can be an effective motivator for high identifiers to address in-group transgressions.

Polar auxin transport is implicated in vessel differentiation and spatial patterning during secondary growth in Populus.

PREMISE OF THE STUDY: Dimensions and spatial distribution of vessels are critically important features of woody stems, allowing for adaptation to different environments through their effects on hydraulic efficiency and vulnerability to embolism. Although our understanding of vessel development is poor, basipetal transport of auxin through the cambial zone may play an important role. METHODS: Stems of Populus tremula ×alba were treated with the auxin transport inhibitor N-1-naphthylphthalamic acid (NPA) in a longitudinal strip along the length of the lower stem. Vessel lumen diameter, circularity, and length; xylem growth; tension wood area; and hydraulic conductivity before and after a high pressure flush were determined on both NPA-treated and control plants. KEY RESULTS: NPA-treated stems formed aberrant vessels that were short, small in diameter, highly clustered, and angular in cross section, whereas xylem formed on the untreated side of the stem contained typical vessels that were similar to those of controls. NPA-treated stems had reduced specific conductivity relative to controls, but this difference was eliminated by the high-pressure flush. The control treatment (lanolin + dimethyl sulfoxide) reduced xylem growth and increased tension wood formation, but never produced the aberrant vessel patterning seen in NPA-treated stems. CONCLUSIONS: These results are consistent with a model of vessel development in which basipetal polar auxin transport through the xylem-side cambial derivatives is required for proper expansion and patterning of vessels and demonstrate that reduced auxin transport can produce stems with altered stem hydraulic properties.

Metacognition in argument generation: the misperceived relationship between emotional investment and argument quality.

Overestimation of one's ability to argue their position on socio-political issues may partially underlie the current climate of political extremism in the U.S. Yet very little is known about what factors influence overestimation in argumentation of socio-political issues. Across three experiments, emotional investment substantially increased participants' overestimation. Potential confounding factors like topic complexity and familiarity were ruled out as alternative explanations (Experiments 1-3). Belief-based cues were established as a mechanism underlying the relationship between emotional investment and overestimation in a measurement-of-mediation (Experiment 2) and manipulation-of-mediator (Experiment 3) design. Representing a new bias blind spot, participants believed emotional investment helps them argue better than it helps others (Experiments 2 and 3); where in reality emotional investment harmed or had no effect on argument quality. These studies highlight misguided beliefs about emotional investment as a factor underlying metacognitive miscalibration in the context of socio-political issues.

Residential staff responses to adolescent self-harm: The helpful and unhelpful.

Adolescent self-harm is prevalent in residential and secure care and is the cause of distress to those harming themselves, to the staff caring for them and for other young people living with them. This article sought service user views on what staff supports were effective and what were counter-productive in order to improve the care offered to young people. Seven young people living in residential or secure care were interviewed. Thematic analysis was used to elicit key themes. Global themes of safety and care were elicited. The young people understood and accepted that the role of staff was to provide these. Within these themes, they noted numerous responses that had both helpful and unhelpful effects, including increased observation, removal of means and extra collaborative support. Service users made numerous recommendations to increase the helpful effects of staff support. Young people provided informed and helpful guidance on how best to care for them. Their views can help mental health professionals and care staff increase their helpful responses making them more effective and less counter-productive. This study is a rare representation of the views of young people in residential and secure care and how to respond to their self-harm behaviour.

Reflecting on explanatory ability: A mechanism for detecting gaps in causal knowledge.

People frequently overestimate their understanding-with a particularly large blind-spot for gaps in their causal knowledge. We introduce a metacognitive approach to reducing overestimation, termed reflecting on explanatory ability (REA), which is briefly thinking about how well one could explain something in a mechanistic, step-by-step, causally connected manner. Nine experiments demonstrated that engaging in REA just before estimating one's understanding substantially reduced overestimation. Moreover, REA reduced overestimation with nearly the same potency as generating full explanations, but did so 20 times faster (although only for high complexity objects). REA substantially reduced overestimation by inducing participants to quickly evaluate an object's inherent causal complexity (Experiments 4-7). REA reduced overestimation by also fostering step-by-step, causally connected processing (Experiments 2 and 3). Alternative explanations for REA's effects were ruled out including a general conservatism account (Experiments 4 and 5) and a covert explanation account (Experiment 8). REA's overestimation-reduction effect generalized beyond objects (Experiments 1-8) to sociopolitical policies (Experiment 9). REA efficiently detects gaps in our causal knowledge with implications for improving self-directed learning, enhancing self-insight into vocational and academic abilities, and even reducing extremist attitudes.

Use of a Nitinol Wire Stent for Management of Severe Tracheal Stenosis in an Eclectus Parrot (Eclectus roratus).

A 25-year-old, female eclectus parrot (Eclectus roratus) presented for dyspnea 3 weeks after anesthesia and surgery for egg yolk coelomitis. Radiography, computed tomography, and tracheoscopy revealed multiple tracheal strictures spanning a length of 2.6 cm in the mid to distal trachea. Histopathologic examination revealed mild fibrosis, inflammation, and hyperplasia consistent with acquired tracheal strictures. Tracheal resection was not considered possible because of the length of the affected trachea. The strictures were resected endoscopically, and repeated balloon dilation under fluoroscopic guidance over the course of 10 months resulted in immediate but unsustained improvement. Computed tomography was used to measure the stenotic area. A 4 × 36-mm, custom-made, nitinol wire stent was inserted into the trachea under fluoroscopic guidance. After stent placement, intermittent episodes of mild to moderate dyspnea continued, and these responded to nebulization with a combination of saline, acetylcysteine, and dexamethasone. Multiple attempts to wean the patient off nebulization therapy and to switch to a corticosteroid-free combination were unsuccessful. The parrot eventually developed complications, was euthanatized, and necropsy was performed. Histologically, the tracheal mucosa had widespread erosion to ulceration, with accumulation of intraluminal exudate and bacteria, severe degeneration of skeletal muscle and tracheal rings, prominent fibrosis, and mild to moderate, submucosal inflammation. Clinicopathologic findings in this case suggested tracheomalacia, which has not been previously described in birds. Custom-made tracheal stents can be used for severe tracheal stenosis in birds when tracheal resection and anastomosis is not possible. Complications of tracheal stent placement in birds may include tracheitis and tracheomalacia. To our knowledge, this is the first report of tracheal stent placement in an avian species.

A systems approach to healthcare: agent-based modeling, community mental health, and population well-being.

PURPOSE: Explore whether agent-based modeling and simulation can help healthcare administrators discover interventions that increase population wellness and quality of care while, simultaneously, decreasing costs. Since important dynamics often lie in the social determinants outside the health facilities that provide services, this study thus models the problem at three levels (individuals, organizations, and society). METHODS: The study explores the utility of translating an existing (prize winning) software for modeling complex societal systems and agent's daily life activities (like a Sim City style of software), into a desired decision support system. A case study tests if the 3 levels of system modeling approach is feasible, valid, and useful. The case study involves an urban population with serious mental health and Philadelphia's Medicaid population (n=527,056), in particular. RESULTS: Section 3 explains the models using data from the case study and thereby establishes feasibility of the approach for modeling a real system. The models were trained and tuned using national epidemiologic datasets and various domain expert inputs. To avoid co-mingling of training and testing data, the simulations were then run and compared (Section 4.1) to an analysis of 250,000 Philadelphia patient hospital admissions for the year 2010 in terms of re-hospitalization rate, number of doctor visits, and days in hospital. Based on the Student t-test, deviations between simulated vs. real world outcomes are not statistically significant. Validity is thus established for the 2008-2010 timeframe. We computed models of various types of interventions that were ineffective as well as 4 categories of interventions (e.g., reduced per-nurse caseload, increased check-ins and stays, etc.) that result in improvement in well-being and cost. CONCLUSIONS: The 3 level approach appears to be useful to help health administrators sort through system complexities to find effective interventions at lower costs.

Priming with a double-stranded DNA virus alters Brassica rapa seed architecture and facilitates a defense response.

BACKGROUND: Abiotic and biotic stresses alter genome stability and physiology of plants. Under some stressful situations, a state of stress tolerance can be passed on to the offspring rendering them more suitable to stressful events than their parents. In plants, the exploration of transgenerational response has remained exclusive to model species, such as Arabidopsis thaliana. Here, we expand transgenerational research to include Brassica rapa, a close relative to economically important plant canola (Brassica napus), as it is exposed to the biotic stress of a double-stranded DNA virus Cauliflower mosaic virus (CaMV). RESULTS: Parent plants exposed to a low dose of 50ng purified CaMV virions just prior to the bolting stage produced significantly larger seeds than mock inoculated and healthy treatments. The progeny from these large seeds displayed resistance to the pathogen stress applied in the parental generation. Differences in defense pathways involving fatty acids, and primary and secondary metabolites were detected by de novo transcriptome sequencing of CaMV challenged progeny exhibiting different levels of resistance. CONCLUSIONS: Our study highlights biological and cellular processes that may be linked to the growth and yield of economically important B. rapa, in a transgenerational manner. Although much remains unknown as to the mechanisms behind transgenerational inheritance, our work shows a disease resistance response that persists for several weeks and is associated with an increase in seed size. Evidence suggests that a number of changes involved in the persistent stress adaption are reflected in the transcriptome. The results from this study demonstrate that treating B. rapa with dsDNA virus within a critical time frame and with a specified amount of infectious pathogen produces economically important agricultural plants with superior coping strategies for growing in unfavorable conditions.