School-based universal mental health promotion intervention for adolescents in Vietnam: Two-arm, parallel, controlled trial.

The aim of this study was to evaluate the effects of Happy House, a universal school-based programme, in reducing adolescents' depressive symptoms and improving their mental well-being, coping self-efficacy and school connectedness. This was a school-based, two-arm parallel controlled trial. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale. Data were collected at recruitment, and at 2 weeks and 6 months post-intervention. Mixed-effect models were conducted to estimate the effects of the intervention on the outcomes. A total of 1,084 students were recruited. At 2 weeks post-intervention, the effect size on depressive symptoms was 0.11 (p = 0.011) and the odds of having clinically significant depressive symptoms were lower in the intervention compared to the control (0.56, p = 0.027). Both of these were no longer significant at 6 months post-intervention. Psychological well-being mean scores in the intervention were significantly higher than in the control at 2 weeks post-intervention (effect size 0.13). Coping self-efficacy mean scores were significantly higher in the intervention group at both 2-week and 6-month post-intervention (effect sizes from 0.17 to 0.26). Data support the potential of Happy House to reduce the prevalence of adolescent mental health problems and to promote positive mental health in the school context in Vietnam.

Coping Self-Efficacy and Thoughts of Self-Harm Among Adolescents in Vietnam: A Longitudinal Study.

We aimed to determine the effect of coping self-efficacy on thoughts of self-harm among adolescents attending high school in Hanoi, Vietnam. Longitudinal data were collected using the Center for Epidemiologic Studies Depression Scale Revised and the Coping Self-Efficacy Scale among 552 Year 10 students. The prevalence of thoughts of death and/or self-injury on at least 1 day in the past week was 16.9% at baseline and 14.5% at 8-month follow-up. When baseline coping self-efficacy was greater by one standard deviation, the odds of having thoughts of self-harm at follow-up were reduced by 42%. Our findings suggest that school-based programs that aim to strengthen coping strategies may be useful in preventing self-harm among adolescents.

Adaptation of a school-based mental health program for adolescents in Vietnam.

INTRODUCTION: Cultural adaptation of a school-based mental health intervention developed in a high-income country is a cost-effective method to address the mental health needs of adolescents in resource-constrained settings. The aim of this study was to translate and culturally adapt the Resourceful Adolescent Program for Adolescents (RAP-A) for adolescents attending high school in Vietnam. METHODS: The translation and adaptation were conducted using a five-step process including (1) initial stakeholder consultation, (2) forward translation, (3) backward translation, (4) adaptation, and (5) finalising the adapted version. An adaptation panel was established, including the RAP-A authors and mental health and public health experts from Australia, and psychology and public health experts from Vietnam. The panel collaborated closely with a group of stakeholders, including bilingual psychologists and psychiatrists, high school (grades 10-12) students and teachers throughout the adaptation process. RESULTS: The adapted version of RAP-A was named 'Happy House'. Happy House was adapted to be delivered in larger groups and in longer sessions than the RAP-A. The 11 sessions in RAP-A were restructured to 6 sessions in Happy House. Major changes were not required for any of the materials. However, some content, illustrations and videos were adapted to be more feasible for the school context and to enhance the comprehensibility, acceptability and appropriateness. CONCLUSION: Happy House has great potential to be relevant, comprehensible and acceptable for Vietnamese adolescents. Further research is warranted to examine the relevance, comprehensibility, acceptability, and effectiveness of this program on adolescents' mental health before advocating for scaling up program delivery in high schools throughout Vietnam.

Validation of the Behavioral Anger Response Questionnaire for Children (BARQ-C) in a large community sample of Vietnamese middle adolescents in Hanoi.

BACKGROUND: Depression and other forms of psychological distress are common among Vietnamese adolescents and increase the risk of mental health problems in adulthood. As anger coping is a robust predictor of adolescent mental health difficulties, and there appear to be cultural variations in anger coping, a measure of adolescent anger coping styles that has been validated using a non-Western adolescent sample is required to inform and support early intervention to prevent or treat mental health difficulties in Vietnamese adolescents. This study examined the construct validity (structural and external) of the Behavioral Anger Response Questionnaire for Children in Vietnam (BARQC-V). METHODS: Baseline data sourced from a recent randomised control trial conducted with Grade 10 Vietnamese adolescents aged 14 to 16 (N = 1084) were used to examine multiple aspects of construct validity: factorial structure (evaluated using factor analysis); internal consistency (tested using Cronbach's alpha coefficient); and external aspect (assessed using Pearson's correlation coefficients between the BARQC-V and Vietnamese translations of the Coping Self-Efficacy Scale, Centre for Epidemiologic Studies Depression Scale Revised, Mental Health Continuum Short Form, and the Depression Anxiety and Stress Scale). RESULTS: Evaluating factorial structure using confirmatory factor analysis failed to converge on a solution. Exploratory factor analysis yielded a 5-factor structure model that explained 49.32% of the BARQC-V's total variance and was deemed to be a good fit by the final confirmatory factor analysis. Cronbach's alpha coefficients of the 5 factors demonstrated acceptable internal reliability for the BARQC-V's sub-scales. Concerning concurrent validity, three sub-scales predicted well-being and mental health difficulties: the maladaptive anger coping styles Rumination and Direct Anger-out were positively associated with depression and distress, and negatively associated with coping self-efficacy and mental well-being; and the adaptive anger coping style Assertion was positively associated with coping self-efficacy and mental well-being, and negatively associated with depression. CONCLUSIONS: The BARQC-V provides a validated measure of three anger coping strategies used by adolescents in Vietnam (Rumination, Direct Anger-out, and Assertion) that can be used to improve detection and treatment of mental health difficulties in this population, and as a starting point by future research to develop a much-needed gold standard measure of anger coping for adults, adolescents and children world-wide.

Validation of the coping self-efficacy scale: Vietnamese version for adolescents.

BACKGROUND: This study aimed to examine the construct validity of the Coping Self-Efficacy Scale-Vietnamese Version (CSES-V) among Vietnamese adolescents. METHODS: This study selected Grade 10 students from eight schools in Hanoi using a multiple-stage sampling method. Multiple aspects of the construct validity were examined including: factorial structure (evaluated using exploratory factor analysis); internal consistency (tested using Cronbach's alpha coefficient); measurement invariance between male and female participants and longitudinal measurement invariance (tested by employing multiple group confirmatory factor analysis) and external aspect (tested using Pearson's correlation coefficients between CSES-V and the Depression Anxiety and Stress Subscales of Depression (DASS21-D), Anxiety (DASS21-A), and Stress (DASS21-S) and a measure of mental well-being, Mental Health Continuum Short Form (MHC-SF)). RESULTS: A total of 1082 adolescents (aged 14-16 years) was included in this study. Data supported a three-factor structure (comprising 24 items) that explained 97.6% of the total variance of the CSES-V. Cronbach's alpha coefficients of all three factors were acceptable. All levels of measurement invariance between male and female participants and longitudinal measurement invariance were well-supported. The three factors of the CSES-V were positively correlated with MHC-SF and were negatively correlated with the DASS21 subscales at a low or moderate level, supporting the external aspect of the construct validity. CONCLUSIONS: CSES-V is recommended to assess coping self-efficacy among Vietnamese adolescents who are attending school.

School-based, two-arm, parallel, controlled trial of a culturally adapted resilience intervention to improve adolescent mental health in Vietnam: study protocol.

INTRODUCTION: The Resourceful Adolescent Program (RAP) is an evidence-based resilience intervention for adolescents. Operating in a strength-focused paradigm, the programme uses an integration of cognitive behavioural therapy and interpersonal psychotherapy to improve coping skills and build resilience. This study aims to establish whether a culturally and linguistically adapted intervention informed by RAP principles is effective in increasing resilience, enhancing coping skills and preventing symptoms of depression and anxiety. METHODS AND ANALYSIS: We will translate, back-translate and culturally adapt the RAP for adolescents and training materials for facilitators, and the adapted intervention will be called Happy House. A two-arm parallel controlled trial will be conducted in eight high schools in the north of Vietnam. In each of the selected schools, all students from four randomly selected grade 10 classes (an estimation of about 1204 students) will be invited to participate. The control group will receive the usual curriculum. The intervention group will receive six weekly 90 min school-based group sessions of Happy House in addition to the usual curriculum. The primary outcome, depressive symptoms, will be measured using a locally validated version of the Centre for Epidemiologic Studies Depression Scale Revised. Secondary outcomes are mental well-being, coping self-efficacy, school connectedness, anger management and health risk behaviours. Data will be collected at recruitment, and at two weeks and six months post intervention. Mixed-effect logistic regression for the main outcome and mixed-effect linear and logistic regression models for the secondary outcomes will be conducted to estimate the effects of the intervention on the outcomes. ETHICS AND DISSEMINATION: This trial has been approved by Monash University Human Research Ethics Committee (No. 21455) and the Institutional Review Board of the Hanoi School of Public Health (488/2019/YTCC-HD3). Dissemination of findings will include peer-reviewed publications, international and national conferences, seminar and media presentations, national policy briefings in Vietnam, local language reports and lay language summaries for participants. TRIAL REGISTRATION NUMBERS: Registered with the Australian New Zealand Clinical Trials Registry, registration number: ACTRN12620000088943 (3/2/2020).WHO Universal Trial Number: U1111-1246-4079.

Psychosocial resources developed and trialled for Indigenous people with autism spectrum disorder and their caregivers: a systematic review and catalogue.

BACKGROUND: People with autism spectrum disorder (ASD) face many psychosocial challenges throughout life, highlighting the need for programs and resources promoting psychosocial wellbeing. Indigenous peoples with ASD and/or other neurodevelopmental disorders must overcome cultural and social barriers to access such supports. This study aimed to identify psychosocial programs and resources developed world-wide for this population by systematically reviewing research evaluating programs aiming to promote the psychosocial wellbeing of this population and/or their caregivers; and collating and reviewing resources developed to promote their psychosocial wellbeing. METHODS: Searches were last conducted in December 2019. The systematic review searched 28 electronic databases, and 25 electronic databases were searched for resources promoting psychosocial wellbeing. Additional published and unpublished studies were identified from relevant reviews, authors of eligible articles, and experts working in Indigenous Health. Articles and resources were screened for inclusion using pre-defined criteria. Articles included in the systematic review were assessed for quality using the Mixed Methods Assessment Tool. The diversity and paucity of outcomes reported precluded pooling of study findings for meta-analysis. RESULTS: Seven articles situated in the USA (2), Canada (3) and Australia (2); and eleven resources developed in Australia (9), Canada (1) and New Zealand (1) met inclusion criteria. All articles showed some promising findings for improving psychosocial wellbeing for Indigenous children with ASD and/or another neurodevelopmental disorder, and 5 of 7 evaluated the cultural adaptation of an existing evidence-based program for an Indigenous population. However, methodological quality was moderate or low (57% and 43% of articles respectively) and no studies had adult participants. The psychosocial wellbeing supports provided by the 11 resources included psychoeducation, community support, and services/workshops. CONCLUSIONS: Despite the paucity of research and resources found, important exemplars demonstrate that existing programs can be adapted to support Indigenous people with ASD and other neurodevelopmental disorders. While future policy should endeavour to facilitate Indigenous people's access to support services, and encourage researchers to develop and evaluate programs promoting psychosocial wellbeing for this population, given complexities of designing and evaluating new programs, careful and appropriate cultural adaptations of existing evidence-based programs would increase feasibility of ongoing research without compromising outcomes.

Perinatal mortality in 23 beef herds in Orkney: incidence, risk factors and aetiology.

BACKGROUND: Perinatal mortality in beef calves impacts on profitability and animal welfare, but the incidence and causes in UK herds are not well known. METHODS: Data from 11 herds were analysed to establish the risk factors for and incidence of perinatal mortality (full-term calves born dead or died within 48 hours). To establish cause of death, 23 herds in total submitted dead calves for postmortem examination (nine herds submitted all calves, 14 herds submitted calves on an ad hoc basis) and the results were reviewed by a panel. RESULTS: The incidence of perinatal mortality for all 1059 calvings was 5.1 per cent (range 1.6-12.4 per cent across herds; median 4 per cent). The incidence of stillbirth and neonatal mortality was 3.9 per cent (range 0-10.1 per cent) and 1.2 per cent (range 0-2.6 per cent), respectively. Sex of the calf, plurality and level of calving assistance were associated with significantly greater risk of perinatal loss. Parturition-related deaths (n=20), intrauterine infections (n=13), congenital malformations (n=6) and postpartum infections (n=6) were among the diagnosis recorded from 54 calves investigated. Parturition-related deaths and congenital malformations were recorded more commonly from herds submitting all losses than from those submitting on an ad hoc basis. CONCLUSION: Variation in perinatal incidence across herds exists and many fail to reach the 2 per cent target. Some significant risk factors and common causes of death identified have the potential to decrease perinatal mortality rates through improved herd management.

Clinical and magnetic resonance imaging findings of a cerebellar medulloblastoma in a heifer.

Reports of medulloblastoma in cattle are scarce; however, this neoplasm should be included as a differential diagnosis in cases of cerebellar or central vestibular signs in young cattle. The MRI appearance of the medulloblastoma reported here, previously unreported in cattle, consisted of a T1-weighted hypointense and T2-weighted heterogeneously hyperintense intra-axial mass.

A Strength-Focused Parenting Intervention May Be a Valuable Augmentation to a Depression Prevention Focus for Adolescents with Autism.

High depression rates for adolescents with autism indicate a need for a comprehensive prevention approach. Parents can promote parent-child factors that buffer adolescents from depression. However, parenting adolescents with autism presents challenges which can diminish parental self-efficacy and mental wellbeing with potential negative sequelae for their adolescents. This proof-of-concept study investigated the value of adding a strength-focused parenting intervention to a depression-prevention intervention for adolescents with autism. A Consensual Qualitative Research framework analysed 15 parents' intervention experience. Parents reported that feeling isolated and unsupported by existing services motivated their participation, and they valued interacting with other parent participants. They also reported that the program enhanced wellbeing and parenting efficacy, reduced isolation, increased ability to parent calmly, and improved parent-adolescent relationships.

Ruminant neurological disease: a retrospective cohort study.

Between January 2006 and June 2016, 96 ruminants with neurological signs were donated to the Scottish Centre for Production Animal Health and Food Safety (SCPAHFS), University of Glasgow, by veterinarians in the field representing 5.4 per cent of all submissions. Forty-seven different neurological presenting signs were reported with 79 per cent of the donated patients presenting with abnormal gait. All cases presenting with abnormalities in more than 4 out of 10 neurological categories died or were euthanased on welfare grounds. Calves were significantly more likely to present with neurological disorders than adult cattle compared with the proportion of calves: cows in the Scottish cattle population and total case population donated to SCPAHFS. Lesions were most commonly localised to the spinal cord in sheep 47 per cent (16), the peripheral nervous system in cattle 45 per cent (28) and to the brain in the overall population 41 per cent (39). The most common aetiology of neurological pathologies observed was infectious or inflammatory 28 per cent (27). Definitive diagnoses could be reached in 84 per cent (81) of patients. When postmortem reports were available, they produced a diagnosis in 70 per cent (52) of cases and contradicted clinical diagnoses in 38 per cent (26) of cases. The most frequently diagnosed conditions in ruminants over the 10 years were spastic paresis, vertebral osteomyelitis and listeriosis.

A Pilot Randomised Controlled Trial of a School-Based Resilience Intervention to Prevent Depressive Symptoms for Young Adolescents with Autism Spectrum Disorder: A Mixed Methods Analysis.

Despite increased depression in adolescents with Autism Spectrum Disorder (ASD), effective prevention approaches for this population are limited. A mixed methods pilot randomised controlled trial (N = 29) of the evidence-based Resourceful Adolescent Program-Autism Spectrum Disorder (RAP-A-ASD) designed to prevent depression was conducted in schools with adolescents with ASD in years 6 and 7. Quantitative results showed significant intervention effects on parent reports of adolescent coping self-efficacy (maintained at 6 month follow-up) but no effect on depressive symptoms or mental health. Qualitative outcomes reflected perceived improvements from the intervention for adolescents' coping self-efficacy, self-confidence, social skills, and affect regulation. Converging results remain encouraging given this population's difficulties coping with adversity, managing emotions and interacting socially which strongly influence developmental outcomes.

Understanding the Therapist Contribution to Psychotherapy Outcome: A Meta-Analytic Approach.

Understanding the role that therapists play in psychotherapy outcome, and the contribution to outcome made by individual therapist differences has implications for service delivery and training of therapists. In this study we used a novel approach to estimate the magnitude of the therapist contribution overall and the effect of individual therapist differences. We conducted a meta-analysis of studies in which participants were randomised to receive the same treatment either through self-help or through a therapist. We identified a total of 15 studies (commencement N = 910; completion N = 723) meeting inclusion criteria. We found no difference in treatment completion rate and broad equivalence of treatment outcomes for participants treated through self-help and participants treated through a therapist. Also, contrary to our expectations, we found that the variability of outcomes was broadly equivalent, suggesting that differences in efficacy of individual therapists were not sufficient to make therapy outcomes more variable when a therapist was involved. Overall, the findings suggest that self-help, with minimal therapist input, has considerable potential as a first-line intervention. The findings did not suggest that individual differences between therapists play a major role in psychotherapy outcome.

The Cooperative Research Centre for Living with Autism (Autism CRC) Conceptual Model to Promote Mental Health for Adolescents with ASD.

Despite an increased risk of mental health problems in adolescents with autism spectrum disorder (ASD), there is limited research on effective prevention approaches for this population. Funded by the Cooperative Research Centre for Living with Autism, a theoretically and empirically supported school-based preventative model has been developed to alter the negative trajectory and promote wellbeing and positive mental health in adolescents with ASD. This conceptual paper provides the rationale, theoretical, empirical and methodological framework of a multilayered intervention targeting the school, parents and adolescents on the spectrum. Two important interrelated protective factors have been identified in community adolescent samples, namely the sense of belonging (connectedness) to school and the capacity for self and affect regulation in the face of stress (i.e. resilience). We describe how a confluence of theories from social psychology, developmental psychology and family systems theory, along with empirical evidence (including emerging neurobiological evidence), supports the interrelationships between these protective factors and many indices of wellbeing. However, the characteristics of ASD (including social and communication difficulties, and frequently difficulties with changes and transitions, and diminished optimism and self-esteem) impair access to these vital protective factors. The paper describes how evidence-based interventions at the school level for promoting inclusive schools (using the Index for Inclusion) and interventions for adolescents and parents to promote resilience and belonging [using the Resourceful Adolescent Program (RAP)] are adapted and integrated for adolescents with ASD. This multisite proof-of-concept study will confirm whether this multilevel school-based intervention is promising, feasible and sustainable.

Mobile phone SMS messages can enhance healthy behaviour: a meta-analysis of randomised controlled trials.

Healthy behaviour, such as smoking cessation and adherence to prescribed medications, mitigates illness risk factors but health behaviour change can be challenging. Mobile phone short-message service (SMS) messages are increasingly used to deliver interventions designed to enhance healthy behaviour. This meta-analysis used a random-effects model to synthesise 38 randomised controlled trials that investigated the efficacy of SMS messages to enhance healthy behaviour. Participants (N = 19,641) lived in developed and developing countries and were diverse with respect to age, ethnicity, socioeconomic background and health behaviours targeted for change. SMS messages had a small, positive, significant effect (g = 0.291) on a broad range of healthy behaviour. This effect was maximised when multiple SMS messages per day were used (g = 0.395) compared to using lower frequencies (daily, multiple per week and once-off) (g = 0.244). The low heterogeneity in this meta-analysis (I (2) = 38.619) supports reporting a summary effect size and implies that the effect of SMS messaging is robust, regardless of population characteristics or healthy behaviour targeted. SMS messaging is a simple, cost-effective intervention that can be automated and can reach any mobile phone owner. While the effect size is small, potential health benefits are well worth achieving.

A case report of Mycoplasma wenyonii associated immune-mediated haemolytic anaemia in a dairy cow.

BACKGROUND AND CASE PRESENTATION: A three year old, second lactation Holstein dairy cow presented to the Scottish Centre for Production Animal Health and Food Safety, Glasgow University Veterinary School in November 2014 with a history of post-calving vulval/vaginal bleeding nine days prior to presentation, followed by a sudden reduction in milk yield. Subsequent investigations resulted in a diagnosis of immune-mediated haemolytic anaemia secondary to infection with Mycoplasma wenyonii. CONCLUSION: This report of a novel presentation of Mycoplasma wenyonii in a dairy cow illustrates the need to consider M.wenyonii as a potential differential diagnosis when a cow presents with anaemia and will discuss the potential implications of the condition at herd-level.