Redefining Fatherhood in a Migratory Context: A Narrative Inquiry into the Experiences of African First-time Fathers in Belgium

Many African fathers face practices in their host countries that conflict with the conceptions of fatherhood in their countries of origin. They deal with negative stereotypes, including notions of paternal irresponsibility when it comes to embracing child care. This article looks at how exposure to the Belgian norms of fatherhood may redefine the fatherhood practices of African first-time fathers residing in Belgium. Drawing on a qualitative narrative approach, this article explores the perceptions and experiences of African migrant fathers in Belgium and examines how they adapt to a different fathering culture. The findings show that while African first-time fathers acknowledged their primary role as providers, they also embraced new practices that transgress defined gender lines in African culture. In the absence of a larger family support network, respondents face the responsibility of providing prenatal and postnatal support and sharing in child care responsibilities. Findings also shed light on how African fathers with European partners engage in shared decision-making and negotiate on core African values such as male circumcision.

'There Were Moments We Wished She Could Just Die': The Highly Gendered Burden of Nodding Syndrome in Northern Uganda

Nodding Syndrome (NS) occurs within a wide spectrum of epilepsies seen in onchocerciasis endemic areas of sub-Saharan Africa. It has debilitating consequences on affected individuals and increases the socio-economic, physical and psychological burden on care-givers and their households, diminishing their standing within the community. Social science research on the disproportionate burden of the disease on females is limited. Based on ethnographic research over 3 years in northern Uganda, we explored the burden of being ill and care-giving for persons with NS from a gendered perspective. We found that NS-affected females were at greater risk of physical and psychological abuse, sexual violence, unwanted pregnancies, sexually transmitted infections and stigma, in a context of deteriorating socio-economic conditions. Primary care-givers of the NS-affected, mostly women, struggled to make ends meet and were subjected to stigma and abandonment. Targeted interventions, including legal protection for affected females, stigma reduction, and psycho-social and financial support are needed.

Prenatal Exposure to a Climate-Related Disaster Results in Changes of the Placental Transcriptome and Infant Temperament

Maternal stress during pregnancy exerts long-term effects on the mental well-being of the offspring. However, the long-term effect of prenatal exposure on the offspring's mental status is only partially understood. The placenta plays a vital role in connecting the maternal side to the fetus, thereby serving as an important interface between maternal exposure and fetal development. Here, we profiled the placental transcriptome of women who were pregnant during a hurricane (Superstorm Sandy), which struck New York City in 2012. The offspring were followed longitudinally and their temperament was assessed during the first 6-12 months of age. The data identified a significant correlation between a Superstorm Sandy stress factor score and infant temperament. Further, analysis of the placental transcriptomes identified an enrichment of functional pathways related to inflammation, extracellular matrix integrity and sensory perception in the specimen from those infants with "Slow-to-Warm-up" temperament during the first year of life. Together, these findings provide initial evidence that maternal exposure to climate-related disasters results in altered placental transcriptome, which may be related to long-term emotional and behavioral consequences in children.

Chatbots to Support Mental Wellbeing of People Living in Rural Areas: Can User Groups Contribute to Co-design?

Digital technologies such as chatbots can be used in the field of mental health. In particular, chatbots can be used to support citizens living in sparsely populated areas who face problems such as poor access to mental health services, lack of 24/7 support, barriers to engagement, lack of age appropriate support and reductions in health budgets. The aim of this study was to establish if user groups can design content for a chatbot to support the mental wellbeing of individuals in rural areas. University students and staff, mental health professionals and mental health service users (N = 78 total) were recruited to workshops across Northern Ireland, Ireland, Scotland, Finland and Sweden. The findings revealed that participants wanted a positive chatbot that was able to listen, support, inform and build a rapport with users. Gamification could be used within the chatbot to increase user engagement and retention. Content within the chatbot could include validated mental health scales and appropriate response triggers, such as signposting to external resources should the user disclose potentially harmful information or suicidal intent. Overall, the workshop participants identified user needs which can be transformed into chatbot requirements. Responsible design of mental healthcare chatbots should consider what users want or need, but also what chatbot features artificial intelligence can competently facilitate and which features mental health professionals would endorse.

Outcomes of preoperative real-time polymerase chain reaction testing for SARS CoV-2 in elective otolaryngology surgical patients during the pandemic: a prospective cohort study

Real-time polymerase chain reaction (RT-PCR) is used to rule out SARS-CoV-2 prior to surgery, however few studies have evaluated patients with negative testing after surgery. Some 499 patients with negative tests were followed for 14 days after surgery, 39 were retested but none developed positive RT-PCR after operation. The risk of developing a positive RT-PCR after surgery was 0.74 per cent.

The Consequences of Female Genital Mutilation on Psycho-Social Well-Being: A Systematic Review of Qualitative Research

The health consequences of female genital mutilation (FGM) have been described previously; however, evidence of the social consequences is more intangible. To date, few systematic reviews have addressed the impact of the practice on psycho-social well-being, and there is limited understanding of what these consequences might consist. To complement knowledge on the known health consequences, this article systematically reviewed qualitative evidence of the psycho-social impact of FGM in countries where it is originally practiced (Africa, the Middle East, and Asia) and in countries of the diaspora. Twenty-three qualitative studies describing the psycho-social impact of FGM on women's lives were selected after screening. This review provides a framework for understanding the less visible ways in which women and girls with FGM experience adverse effects that may affect their sense of identity, their self-esteem, and well-being as well as their participation in society.

Attitudes of health care providers regarding female genital mutilation and its medicalization in Guinea

Background

Guinea has a high prevalence of female genital mutilation (FGM) (95%) and it is a major concern affecting the health and the welfare of women and girls. Population-based surveys suggest that health care providers are implicated in carrying out the practice (medicalization). To understand the attitudes of health care providers related to FGM and its medicalization as well as the potential role of the health sector in addressing this practice, a study was conducted in Guinea to inform the development of an intervention for the health sector to prevent and respond to this harmful practice.

Methodology

Formative research was conducted using a mixed-methods approach, including qualitative in-depth interviews with health care providers and other key informants as well as questionnaires with 150 health care providers. Data collection was carried out in the provinces of Faranah and Labé and in the capital, Conakry.

Results

The majority of health care providers participating in this study were opposed to FGM and its medicalization. Survey data showed that 94% believed that it was a serious problem; 89% felt that it violated the rights of girls and women and 81% supported criminalization. However, within the health sector, there is no enforcement or accountability to the national law banning the practice. Despite opposition to the practice, many (38%) felt that FGM limited promiscuity and 7% believed that it was a good practice.

Conclusion

Health care providers could have an important role in communicating with patients and passing on prevention messages that can contribute to the abandonment of the practice. Understanding their beliefs is a key step in developing these approaches.

Rethinking the Anti-FGM Zero-Tolerance Policy: from Intellectual Concerns to Empirical Challenges

Purpose of Review

Based on the discussions of a symposium co-organized by the Université Libre de Bruxelles (ULB) and the University of Lausanne (UNIL) in Brussels in 2019, this paper critically reflects upon the zero-tolerance strategy on “Female Genital Mutilation” (FGM) and its socio-political, legal and moral repercussions. We ask whether the strategy is effective given the empirical challenges highlighted during the symposium, and also whether it is credible.

Recent Findings

The anti-FGM zero-tolerance policy, first launched in 2003, aims to eliminate all types of “female genital mutilation” worldwide. The FGM definition of the World Health Organization condemns all forms of genital cutting (FGC) on the basis that they are harmful and degrading to women and infringe upon their rights to physical integrity. Yet, the zero-tolerance policy only applies to traditional and customary forms of genital cutting and not to cosmetic alterations of the female genitalia. Recent publications have shown that various popular forms of cosmetic genital surgery remove the same tissue as some forms of “FGM”. In response to the zero-tolerance policy, national laws banning traditional forms of FGC are enforced and increasingly scrutinize the performance of FGC as well as non-invasive rituals that are culturally meaningful to migrants. At the same time, cosmetic procedures such as labiaplasty have become more popular than ever before and are increasingly performed on adolescents.

Summary

This review shows that the socio-legal and ethical inconsistencies between “FGM” and cosmetic genital modification pose concrete dilemmas for professionals in the field that need to be addressed and researched.

Impact of C-Terminal Chemistry on Self-Assembled Morphology of Guanosine Containing Nucleopeptides

Herein, we report the design and characterization of guanosine-containing self-assembling nucleopeptides that form nanosheets and nanofibers. Through spectroscopy and microscopy analysis, we propose that the peptide component of the nucleopeptide drives the assembly into β-sheet structures with hydrogen-bonded guanosine forming additional secondary structures cooperatively within the peptide framework. Interestingly, the distinct supramolecular morphologies are driven not by metal cation responsiveness common to guanine-based materials, but by the C-terminal peptide chemistry. This work highlights the structural diversity of self-assembling nucleopeptides and will help advance the development of applications for these supramolecular guanosine-containing nucleopeptides.

Guidelines for the management of diabetes in care homes during the Covid-19 pandemic

The National Diabetes Stakeholders Covid-19 Response Group was formed in early April 2020 as a rapid action by the Joint British Diabetes Societies for Inpatient Care, Diabetes UK, the Association of British Clinical Diabetologists, and Diabetes Frail to address and support the special needs of residents with diabetes in UK care homes during Covid-19. It was obvious that the care home sector was becoming a second wave of Covid-19 infection and that those with diabetes residing in care homes were at increased risk not only of susceptibility to infection but also to poorer outcomes. Its key purposes included minimising the morbidity and mortality associated with Covid-19 and assisting care staff to identify those residents with diabetes at highest risk of Covid-19 infection. The guidance was particularly created for care home managers, other care home staff, and specialist and non-specialist community nursing teams. The guidance covers the management of hyperglycaemia by discussion of various clinical scenarios that could arise, the management of hypoglycaemia, foot care and end of life care. In addition, it outlines the conditions where hospital admission is required. The guidance should be regarded as interim and will be updated as further medical and scientific evidence becomes available.

Longitudinal associations of active renal disease with irreversible organ damage accrual in systemic lupus erythematosus

Objective

To examine longitudinal associations of active lupus nephritis with organ damage accrual in patients with systemic lupus erythematosus (SLE).

Methods

This study was performed using data from a large multinational prospective cohort. Active lupus nephritis at any visit was defined by the presence of urinary casts, proteinuria, haematuria or pyuria, as indicated by the cut-offs in the SLE Disease Activity Index (SLEDAI)-2K, collected at each visit. Organ damage accrual was defined as a change of SLICC-ACR Damage Index (SDI) score >0 units between baseline and final annual visits. Renal damage accrual was defined if there was new damage recorded in renal SDI domains (estimated glomerular filtration rate <50%/proteinuria >3.5 g per 24 h/end-stage kidney disease). Time-dependent hazard regression analyses were used to examine the associations between active lupus nephritis and damage accrual.

Results

Patients ( N = 1735) were studied during 12,717 visits for a median (inter-quartile range) follow-up period of 795 (532, 1087) days. Forty per cent of patients had evidence of active lupus nephritis at least once during the study period, and active lupus nephritis was observed in 3030 (24%) visits. Forty-eight per cent of patients had organ damage at baseline and 14% accrued organ damage. Patients with active lupus nephritis were 52% more likely to accrue any organ damage compared with those without active lupus nephritis (adjusted hazard ratio = 1.52 (95% confidence interval (CI): 1.16, 1.97), p < 0.02). Active lupus nephritis was strongly associated with damage accrual in renal but not in non-renal organ domains (hazard ratios = 13.0 (95% CI: 6.58, 25.5) p < 0.001 and 0.96 (95% CI: 0.69, 1.32) p = 0.8, respectively). There was no effect of ethnicity on renal damage accrual, but Asian ethnicity was significantly associated with reduced non-renal damage accrual.

Conclusion

Active lupus nephritis measured using the SLEDAI-2K domain cut-offs is associated with renal, but not non-renal, damage accrual in SLE.

"Those who died are the ones that are cured". Walking the political tightrope of Nodding Syndrome in northern Uganda: Emerging challenges for research and policy

Background

Nodding Syndrome was first reported from Tanzania in the 1960s but appeared as an epidemic in Northern Uganda in the 1990s during the LRA civil war. It is characterized by repetitive head nodding, often followed by other types of seizures, developmental retardation and growth faltering with onset occurring in children aged 5–15 years. More than 50 years after the first reports, the aetiology remains unknown and there is still no cure. The recent hypothesis that Nodding Syndrome is caused by onchocerciasis also increases the relevance of onchocerciasis control. Northern Uganda, with its unique socio-political history, adds challenges to the prevention and treatment for Nodding Syndrome. This article aims to show how and why Nodding Syndrome has been politicised in Uganda; how this politicisation has affected health interventions including research and dissemination; and, the possible implications this can have for disease prevention and treatment.

Methodology

Ethnographic research methods were used triangulating in-depth interviews, focus group discussions, informal conversations and participant observation, for an understanding of the various stakeholders’ perceptions of Nodding Syndrome and how these perceptions impact future interventions for prevention, treatment and disease control.

Principal findings

Distrust towards the government was a sentiment that had developed in Northern Uganda over several decades of war and was particularly linked to the political control and ethnic divisions between the north and south. This coincided with the sudden appearance of Nodding Syndrome, an unknown epidemic disease of which the cause could not be clearly identified and optimal treatment had not clearly been established. Additionally, the dissemination of the inconclusive results of research conducted in the area lacked sufficient community involvement which further fueled this political distrust. Disease perceptions revolved around rumours that the entire Acholi ethnic group of the north would be annihilated, or that international researchers were making money by stealing study samples. This discouraged some community members from participating in research or from accepting the mass drug administration of ivermectin for prevention and treatment of onchocerciasis. Such rumour and distrust led to suspicions concerning the integrity of the disseminated results, which may negatively impact future disease management and control interventions.

Conclusions and recommendations

Trust must be built up gradually through transparency and by de-politicising interventions. This can be done by engaging the community at regular intervals during research and data collection and the dissemination of results in addition to involvement during service delivery for prevention and treatment. Maintaining a regular feedback loop with the community will help control rumours, build trust, and improve the preparations for adequate dissemination.

Nodding Syndrome, a form of epilepsy that occurs in onchocerciasis-endemic areas has affected about 3000 children in Northern Uganda where the epidemic emerged at the time of the civil war. Although an association with onchocerciasis has been established, the disease etiology has not yet been identified. In conjunction with the area’s history of war, political conflict and ethnic divides, many affected people were suspicious of government health interventions and scientific studies. Furthermore, ambiguities around the disease etiology leaves room for several interpretations, which in addition to distrust leads to rumours, that may hinder future interventions. In view of improving adherence to health interventions, this article explains the socio-political nature of Nodding Syndrome in Northern Uganda. We show how and why this disease has been politicised in Uganda; how this politicisation has affected research and dissemination; and, the implications this has for disease control. The insights presented will be critical for reducing resistance to research, to treatment and to the dissemination of knowledge which is necessary for the prevention and control of Nodding Syndrome and onchocerciasis in Northern Uganda.

Acute sensory and motor response to 45-s heavy isometric holds for the plantar flexors in patients with Achilles tendinopathy

PURPOSE

The purpose of this study was to explore the immediate effects of heavy isometric plantar flexor exercise on sensory output (pain during a functional task and mechanical pain sensitivity) and motor output (plantar flexor torque) in individuals with Achilles tendinopathy.

METHODS

Sixteen subjects with Achilles tendinopathy participated in the study, mean (SD) age 48.6 (8.9) years and Victorian institute assessment-Achilles (VISA-A) score 61.3 (23.0). Sensory testing assessing pain during a functional task, mechanical pain sensitivity and motor output, and plantar flexor peak torque was completed prior to the intervention. All subjects completed a 45-s heavy isometric plantar flexor contraction and were then re-tested using the same sensory and motor tests. Motor output was assessed using isokinetic dynamometry at speeds previously identified as of interest in subjects with Achilles tendinopathy.

RESULTS

Only 9 of the 16 subjects experienced pain during a functional task, self-reported pain was 4.2 (1.9) numerical rating scale (NRS) pre-intervention and 4.9 (3.2) NRS postintervention (n.s.). Mechanical pressure sensitivity was 446.5 (± 248.5) g/mm² pre-intervention and 411.8 (± 211.8) g/mm² post-intervention (n.s.). Mean concentric plantar flexor torque at 90 and 225°/s was 47.1 (14.5) and 33.6 (11.6) Nm, respectively, pre-intervention and 53.0 (18.5) and 33.4 (6.6) Nm post-intervention (p = 0.039 and n.s.). Eccentric torque at 90°/s was 98.5 (34.2) Nm preintervention versus 106.0 (41.4) Nm post-intervention (n.s.).

CONCLUSION

In this exploratory study, patients with Achilles tendinopathy had a varied sensory and motor output response to heavy isometric contractions. Using the recommended approach of heavy 45-s isometric contractions did not offer a meaningful acute benefit for sensory or motor output for subjects with Achilles tendinopathy. Based on this study, heavy 45-s isometric contractions cannot be recommended for immediate pain relief or improved motor output for patients with Achilles tendinopathy.

LEVEL OF EVIDENCE

IV, prospective cohort study.

The blackfly vectors and transmission of Onchocerca volvulus in Mahenge, south eastern Tanzania

The Mahenge Mountains onchocerciasis focus in south eastern Tanzania was historically one of the most heavily infected areas in the country. The vectors of Onchocerca volvulus are mainly Simulium damnosum complex blackflies, but a species of the Simulium neavei group may also contribute to transmission in some areas. The only detailed studies of parasite transmission in Mahenge were conducted in the late 1960s. The taxonomy of the S. damnosum complex has since been revised and onchocerciasis control through annual community directed treatment with ivermectin (CDTI) commenced in 1997. This study aimed to provide a cytogenetic and molecular update of the S. damnosum complex cytoforms present in Mahenge, and to evaluate the current status of O. volvulus transmission by blackflies following 19 years of annual CDTI. Rivers were surveyed to identify sites of S. damnosum s.l. breeding among the eastern slopes of the mountains, and human landing collections of adult female blackflies were made close to breeding sites. Identification of S. damnosum complex cytoforms was by cytotaxonomy of late-instar larvae and ITS1 amplicon size polymorphisms of larvae and adults. Adult blackflies were pool screened for O. volvulus infection using a triplex real-time PCR. The cytoforms 'Nkusi', Simulium kilibanum and 'Turiani' were found breeding in perennial rivers. 'Nkusi' and S. kilibanum were collected on human bait at 7/7 catch sites and possessed ITS1 profiles most closely resembling the molecular forms 'Nkusi J' and S. kilibanum 'T'. Whereas 'Turiani' was present in rivers, it was not collected on human bait and appears to be zoophilic. Simulium nyasalandicum was collected in low numbers on human bait at 3/7 catch sites. In total, 12,452 S. damnosum s.l. were pool screened and O. volvulus infection was detected in 97/104 pools of bodies and 51/104 pools of heads. The estimated percentage of S. damnosum s.l. carrying infective L3 stage parasites was 0.57% (95% CI 0.43%-0.74%). Onchocerca volvulus transmission by S. damnosum s.l. is continuing in the Mahenge Mountains after 19 years of annual CDTI. Infection rates appear similar to those reported in the 1960s, but a more detailed study is required to fully understand the epidemiological significance of the ongoing transmission. These results provide further evidence that annual CDTI may be insufficient to eliminate the parasite in formerly hyperendemic foci.

Recovery from DSM-IV post-traumatic stress disorder in the WHO World Mental Health surveys

BACKGROUND

Research on post-traumatic stress disorder (PTSD) course finds a substantial proportion of cases remit within 6 months, a majority within 2 years, and a substantial minority persists for many years. Results are inconsistent about pre-trauma predictors.

METHODS

The WHO World Mental Health surveys assessed lifetime DSM-IV PTSD presence-course after one randomly-selected trauma, allowing retrospective estimates of PTSD duration. Prior traumas, childhood adversities (CAs), and other lifetime DSM-IV mental disorders were examined as predictors using discrete-time person-month survival analysis among the 1575 respondents with lifetime PTSD.

RESULTS

20%, 27%, and 50% of cases recovered within 3, 6, and 24 months and 77% within 10 years (the longest duration allowing stable estimates). Time-related recall bias was found largely for recoveries after 24 months. Recovery was weakly related to most trauma types other than very low [odds-ratio (OR) 0.2-0.3] early-recovery (within 24 months) associated with purposefully injuring/torturing/killing and witnessing atrocities and very low later-recovery (25+ months) associated with being kidnapped. The significant ORs for prior traumas, CAs, and mental disorders were generally inconsistent between early- and later-recovery models. Cross-validated versions of final models nonetheless discriminated significantly between the 50% of respondents with highest and lowest predicted probabilities of both early-recovery (66-55% v. 43%) and later-recovery (75-68% v. 39%).

CONCLUSIONS

We found PTSD recovery trajectories similar to those in previous studies. The weak associations of pre-trauma factors with recovery, also consistent with previous studies, presumably are due to stronger influences of post-trauma factors.

The Importance of Blood Is Infinite: Conceptions of Blood as Life Force, Rumours and Fear of Trial Participation in a Fulani Village in Rural Gambia

BACKGROUND

Clinical trials require high levels of participation and low drop-out rates to be successful. However, collecting blood samples from individuals recruited into clinical trials can be challenging when there is reticence about blood-taking. In addition to concerns regarding the feasibility of medical research, fears of 'blood-stealing' and 'blood-selling' have ethical implications related to cultural sensitivity and informed consent. This study explores anxieties around blood-taking during a malaria treatment trial in the Gambia.

METHODS

This case study is based on ethnographic research in one theoretically selected village due to the high reticence to screening for the clinical trial 'Primaquine's gametocytocidal efficacy in malaria asymptomatic carriers treated with dihydroartemisinin-piperaquine' carried out in the Gambia between 2013 and 2014. Data collection tools included in-depth interviews, participant observation, informal conversations and group discussions.

RESULTS

In total only 176 of 411 habitants (42%) in the village accepted having a bloodspot taken to screen for malaria. Although trial recruitment was initially high in the village, some families refused screening when rumours started spreading that the trial team was taking too much blood. Concerns about 'loss of blood' were equated to loss of strength and lack of good food to replenish bodily forces. Families in the study village were concerned about the weakness of their body while they had to harvest their crops at the time of recruitment for the trial.

CONCLUSION

A common recommendation to prevent and avoid rumours against public health interventions and trials is the provision of full and consistent information during the consent procedure, which is assumed to lead to more accurate knowledge of the purpose of the intervention and increased trial participation. However, even when information provision is continuous, the emergence of rumours can be related to times of uncertainty and perceptions of vulnerability, which are often a reflection of structural inequalities and diverging value orientations between communities and public health institutions.

Abstracts from the 5th International Conference for Healthcare and Medical Students (ICHAMS)

O1: Assessing the protective effect of dexrazoxane against doxorubicin-induced toxicity in HL-1 cardiomyocytes

Yvonne Sweeney, Hugh O’Neill, Garry Duffy

O2: Role of KCNQ1 in epithelial barrier repair

Daniel Creegan, Viviana Bustos, Brian J. Harvey

O3: The suitability of non-small cell lung cancer cytology preparations for the analysis of anaplastic lymphoma kinase gene rearrangements

Alexander Dalphy, Anthony O’Grady, Elaine Kay

O4: Penetrating keratoplasty and descemet’s stripping automated endothelial keratoplasty may lead to deterioration in glaucoma management

Katarzyna Samelska, Justyna Izdebska, Anna Kurowska

O5: The effect of Resolvin D1 on normal and cystic fibrosis human bronchial epithelium

Rena Al-Zubaidy, Magdalena Mroz, Brian Harvey

O6: Validity of clinical assessment compared with plantar fascia thickness on ultrasound for plantar fasciitis: a cross-sectional study

Ryan Fagan, Helen French, Vanessa Cuddy, Jennifer Ashton, Michelle Clarke

P1: Undergraduate medical research in Gulf Cooperation Council (GCC) countries: A descriptive study of students’ views

Zaid Sayedalamin, Mukhtiar Baig, Osama Almutairi, Hassan Allam, Taher F. Halawa, Hazem M. Atta

P2: Positive fluid balance as a prognostic factor in children with sepsis during first 3 hours of resuscitation in intensive care unit

Linda Sirone, Renars Erts, Jana Pavare

P3: Patients on aspirin: Too little or too much?

Louis Richter, Joseph Morris, Irene Oglesby, Eimear Dunne, Dermot Kenny

P4: Beta catenin/TCF4 activation reduces KCNQ1 current in colonic monolayers

Ibrahim Mohammed Mahdi Khayyat, Viviana Bustos Salgado, Brian J. Harvey

P5: Size Matters. Abdominal aortic aneurysm: adherence to surveillance imaging guidelines

Jonavan Tan, Daragh Moneley, Austin Leahy, Patricia Fitzgerald

P6: Endoscopic retrograde cholangiopancreatography in the west of Ireland: Procedural outcomes and peri-procedural complications

Evelyn Fennelly, Grace Harkin, John Lee

P7: The effect of the extracellular redox environment on polyamine-platelet interactions

Erica O’Sullivan, Brian Kirby, Sarah O’Neill

P8: Functionalized gold nanoparticles: preliminary data on in vitro toxicity and comparative photothermal effect

Diana Gonciar, Teodora Mocan, Cristian Matea, Lucian Mocan, Cornel Iancu

P9: Imaging proteasomal inhibition after seizures in the brain: A study into cellular activity in the hippocampus of epileptic transgenic mice

Chloe Doran, Sarah Hoolahan, Tobias Engel

P10: Investigating the ability of the Olfactory epithelial stem cells to differentiate into glial cells by assessing cell morphology and marker expression

Maha Alkhattab, Tijna Alekseeva, William Lackington, Fergal O’Brien

P11: Beaumont Hospital cystic fibrosis service audit and annual report

Nabeehah Moollan, Chloe Doran, Noel Gerry McElvaney, Cedric Gunaratnam

P12: Quick cognitive screening: the 6-item cognitive impairment test and the temporal orientation score

Lorraine Scanlon, Noeleen Brady, Suzanne Timmons

P13: Granular analysis of causes of peritoneal dialysis technique failure in the first six months of therapy

Richard Bresler, Zita Abreu, Stefan Trohonel, Joanne Bargman

P14: Job satisfaction of surgeons working in hajj pilgrimage: a multicenter study

Ahmad A. Mirza, Ahmed Badrek-Amoudi, Rakan H. Aun, Hussam A. Senan, Abdulrahim A. Mirza, Mohammed S. Binsaad, Mian U. Farooq

P15: Investigation of the role of Bok using wild-type, bax-, bok-, and bax/bok-double-deficient mice

Saheli Nandi, Beatrice D’Orsi, Jochen Prehn

P16: Is it possible to predict resistance of an organism to stress based on the level of corticosterone?

Mariia Zharova, Pavel Umrukhin

P17: Investigating the strength model of self-regulation (ego depletion) and medical decision making and error in medical students

Wendy Evans-Uhegbu, Frank Doyle, Hope Kudryashova, Derek Dorris, Anthony Cummins

P18: Does bladder drainage with intermittent catheterisation preserve kidney function in boys with posterior urethral valves?

Jemma Doheny-Shanley, Mark Woodward, Wesley Hayes

P19: Investigating the role of Stonin 2, a Clathrin Mediated Endocytosis adaptor protein, in altered hippocampal synaptic transmission characterized in schizophrenia

Marina Yostos, David Cotter, Melanie Focking

P20: Predicting complications after colon resection

Samantha Stancu, Florin Iordache, Bogdan A. Popescu

P21: Knowledge, attitude and practice of the methods of primary and secondary prevention of cervical cancer among NYSC members in Lagos state, Nigeria

Muhammad-Mujtaba A. Akanmu, Alero A. Robert, Ezekiel O. Oridota

P22: Incidental glucose and lipid metabolisms disorders among office workers: a cross sectional study

Ahmad A. Mirza, Ali K. Alzahrani, Omar Alfarhan, Essam Nour Eldin

P23: Differentiating clinically significant spinal injuries; a review of emergency department presentations

Bronagh MacManus, Owen Keane, Patrick Hillery, James Lee, Hugh O’Reilly, Niamh Collins

P24: Pattern of renal colic occurrence due to urinary stones during Ramadan and other months of the year at King Abdulaziz Medical City, Riyadh, KSA

Ibrahim Abu saq, Abdullah Al Mufarrih, Muath Jaafari, Abdullah Al Mahayni, Amen Bawazir, Sultan Alkhateeb

P25: Proteomic analysis reveals novel AIB1 co-factors that may contribute to acquired endocrine resistance in breast cancer

Amenah Dhannoon, Damir Vareslija, Arnold Hill, Leonie Young

P26: Improving sedation practice in general ICU in Beaumont Hospital

Declan Donoghue, Criona Walsh, Aileen McCabe, John Pope, Saturnino Pasco, Caroline Fallon, Don Solanki, Fiona Kiernan, Sinead Galvin, Jquan Mucvimicc, Johanna Mulvihill

P27: Diagnosis and control of hypertension as indicators of the level of awareness among relatives of medical students

Ahmad A. Mirza, Soha A. Elmosry

P28: Evaluation of the antitumor potential from extracts of endemic plants of Brazilian caatinga against melanoma and hepatocarcinoma

Lorenza Andres Ameida De Souza, Yuri de Oliveira, Diego Menezes, Alene Vanessa Santos

P29: The role of Chromogranin A as a biomarker in drug resistant neuroblastoma

Ahmad Zaki Asraf, Raymond Stallings, Olga Piskareva, Ross Conlon

P30: Membrane sweep at term gestation in CUMH; a case-control study

Siún Sweeney-Landers, Cathy Burke

P31: Study of the variability of glucose levels in patients with diabetes undergoing continuous glucose monitoring

Paraic Behan, Seamus Sreenan

P32: Inflammatory cytokine response to decreased plasma alpha-1 antitrypsin levels in individuals with the MZ genotype

Ahmed Organjee, Tatsiana Crosbie-Staunton, Emer Reeves, Noel McElvaney

P33: Analysing the role of SRC-1 in breast cancer stem cell formation and activity

Crystal Mieres, Leonie Young, Sara Charmsaz

P34: Screening Streptococcus pneumoniae isolates for virulence genes

Aya Al-Jalamdeh, Mary Corcoran, Martha McElligott, Niall Stevens, Hilary Humphreys

P35: Assessment of the relevance of admission clerking criteria taught to medical students at King Abdulaziz University to real hospital practice

Rashid Barnawi, Abdulaziz Ghurab, Sultan Alfaer, Hassan Balubaid, Kamal Hanbazazah, Mohammed Bukhari

P36: Pattern of emergency department visits during Hajj period

Mohammed Alsakkaf, Ahmad Mirza, Amrallah Mohammed

P37: Anti-Dengue activity of Aspergillus terreus (sulochrin); An in vitro study

Anastasia Pratanata, Maria Nathania, Tsabita Annisa, Beti Dewi

P38: The comorbidome in alpha-1 antitrypsin deficiency

Kuok Zhen Lee, Tomas P. Carroll, Laura Fee, Noel G. McElvaney

P39: MLO-Y4 cells behave more like osteocytes in response to mechanical stimulation when cultured in 3D

Rachel C. White, Robert T Brady, Fergal O’Brien

Factors Associated with Non-Participation and Non-Adherence in Directly Observed Mass Drug Administration for Malaria in The Gambia

Introduction

The potential benefits of Mass Drug Administration (MDA) for malaria elimination are being considered in several malaria endemic countries where a decline in malaria transmission has been reported. For this strategy to work, it is important that a large proportion of the target population participates, requiring an in-depth understanding of factors that may affect participation and adherence to MDA programs.

Methodology

This social science study was ancillary to a one-round directly observed MDA campaign with dihydroartemisinin-piperaquine, carried out in 12 villages in rural Gambia between June and August 2014. The social science study employed a mixed-methods approach combining qualitative methods (participant observation and in-depth interviewing) and quantitative methods (structured follow-up interviews among non-participating and non-adhering community members).

Results

Of 3942 people registered in the study villages, 67.9% adhered to the three consecutive daily doses. For the remaining villagers, 12.6% did not attend the screening, 3.5% was not eligible and 16% did not adhere to the treatment schedule. The main barriers for non-participation and adherence were long and short-term mobility of individuals and specific subgroups, perceived adverse drug reactions and rumors, inconveniences related to the logistics of MDA (e.g. waiting times) and the perceived lack of information about MDA.

Conclusion

While, there was no fundamental resistance from the target communities, adherence was 67.9%. This shows the necessity of understanding local perceptions and barriers to increase its effectiveness. Moreover, certain of the constraining factors were socio-spatially clustered which might prove problematic since focal areas of residual malaria transmission may remain allowing malaria to spread to adjacent areas where transmission had been temporarily interrupted.

Barriers to mental health treatment: results from the WHO World Mental Health surveys

BACKGROUND

To examine barriers to initiation and continuation of mental health treatment among individuals with common mental disorders.

METHOD

Data were from the World Health Organization (WHO) World Mental Health (WMH) surveys. Representative household samples were interviewed face to face in 24 countries. Reasons to initiate and continue treatment were examined in a subsample (n = 63,678) and analyzed at different levels of clinical severity.

RESULTS

Among those with a DSM-IV disorder in the past 12 months, low perceived need was the most common reason for not initiating treatment and more common among moderate and mild than severe cases. Women and younger people with disorders were more likely to recognize a need for treatment. A desire to handle the problem on one's own was the most common barrier among respondents with a disorder who perceived a need for treatment (63.8%). Attitudinal barriers were much more important than structural barriers to both initiating and continuing treatment. However, attitudinal barriers dominated for mild-moderate cases and structural barriers for severe cases. Perceived ineffectiveness of treatment was the most commonly reported reason for treatment drop-out (39.3%), followed by negative experiences with treatment providers (26.9% of respondents with severe disorders).

CONCLUSIONS

Low perceived need and attitudinal barriers are the major barriers to seeking and staying in treatment among individuals with common mental disorders worldwide. Apart from targeting structural barriers, mainly in countries with poor resources, increasing population mental health literacy is an important endeavor worldwide.

Association between variation in neuropsychological development and trajectory of ADHD severity in early childhood

OBJECTIVE

This longitudinal study examined if changes in neuropsychological functioning were associated with the trajectory of symptoms related to attention deficit hyperactivity disorder (ADHD) and impairment between preschool and school age.

METHOD

The sample consisted of 3- and 4-year-old children (N=138) who were identified as being at risk for ADHD based on parent and teacher reports. Neuropsychological functioning was measured annually using the NEPSY at four time points (mean ages, 4.19, 5.36, 6.35, and 7.35 years). ADHD symptoms and impairment were assessed with semiannual parent and teacher reports using the ADHD Rating Scale-IV and the Children's Problems Checklist at 10 time points (mean ages at baseline and final assessment, 4.19 and 8.81 years, respectively). Hierarchical linear modeling was used to assess the trajectories of change in neuropsychological functioning and ADHD severity as well as the association of change in neuropsychological functioning with change in ADHD severity over time.

RESULTS

Baseline neuropsychological functioning was not significantly associated with the slope of change in ADHD severity. However, the magnitude of change in neuropsychological functioning was linearly associated with the trajectory of ADHD symptom severity and impairment, such that individuals with greater neuropsychological growth over time had a greater diminution of ADHD severity and impairment. Family socioeconomic status at baseline was significantly associated with initial ADHD severity and impairment, but not with change over time.

CONCLUSIONS

Interventions that enhance neuropsychological functioning at an early age may be beneficial in attenuating long-term ADHD severity and impairment.

Ligand switching in cell-permeable peptides: manipulation of the alpha-integrin signature motif

A synthetic cell-permeable peptide corresponding to the highly conserved alpha-integrin signature motif, Palmityl-K(989)VGFFKR(995) (Pal-FF), induces integrin activation and aggregation in human platelets. Systematic replacement of the F(992)-F(993) with amino acids of greater or lesser hydrophobicity to create Pal-KVGxxKR peptides demonstrate that hydrophobic amino acids (isoleucine, phenylalanine, tyrosine, tryptophan) are essential for agonist potency. In marked contrast, substitution with small and/or hydrophilic amino acids (glycine, alanine, serine) causes a switch in the biological activity resulting in inhibition of platelet aggregation, adhesion, ADP secretion, and thromboxane synthesis. These substituted, hydrophilic peptides are not true pharmacological antagonists, as they actively induce a phosphotyrosine signaling cascade in platelets. Singly substituted peptides (Pal-AF and Pal-FA) cause preferential retention of pro- or anti-thrombotic properties, respectively. Because the alpha-integrin signature motif is an established docking site for a number of diverse cytoplasmic proteins, we conclude that eliminating critical protein-protein interactions mediated through the hydrophobic amino acids, especially F(993), favors an anti-thrombotic pathway in platelets. Agents derived from the inhibitory peptides described in this study may represent a new therapeutic strategy for anti-platelet or anti-integrin drug development.