Barriers to treatment of mental health problems for Palestinian people in refugee camps in Jordan: a cross-sectional study

Background

About 2·1 million Palestinians live in Jordan, and 370?000 Palestinians live in Jordanian refugee camps. Conflict in their country of origin, poverty, unemployment, and squalid camp conditions are some of the environmental factors that render Palestine refugees susceptible to mental health problems. The aim of this study was to identify the barriers that contribute to the treatment gap in mental health-care services for Palestinian refugees in the Baqa'a refugee camp north of Amman, Jordan.

Canadian Registry of Implantable Electronic Device Outcomes: Surveillance of High-Voltage Leads

Background

Cardiac implantable electrical devices (CIEDs) are subject to advisories and complications that can result in morbidity and mortality for patients; there is currently no system in Canada to track these.

Commonalities and Challenges in the Development of Clinical Trial Measures in Neurology

As neurologists and neuroscientists, we are trained to evaluate disorders of the nervous system by thinking systematically. Clinically, we think in terms of cognition, behavior, motor function, sensation, balance and co-ordination, and autonomic system function. But when we assess symptoms of neurological disorders for the purpose of drug development, we tend to create disease-specific outcome measures, often using a variety of methods to assess the same types of dysfunction in overlapping, related disorders. To begin to explore the potential to simplify and harmonize the assessment of dysfunction across neurological disorders, a symposium, entitled, "Commonalities in the Development of Outcome Measures in Neurology" was held at the 16th annual meeting of the American Society for Experimental NeuroTherapeutics (ASENT), in February 2014. This paper summarizes the presentations at the symposium. The authors hope that readers will begin to view Clinical Outcome Assessment (COA) development in a new light. We hope that in presenting this material, we will stimulate discussions and collaborations across disease areas to develop common concepts of neurological COA development and construction.

Electronic supplementary material

The online version of this article (doi:10.1007/s13311-014-0310-1) contains supplementary material, which is available to authorized users.     

On the Stability of Reported Pregnancy Intentions from Pregnancy to 1 Year Postnatally: Impact of Choice of Measure,Timing of Assessment,Women’s Characteristics and Outcome of Pregnancy

Objectives

Retrospective, cross-sectional estimates of pregnancy intention, as used in the Demographic Health Survey (DHS), are the global norm. The London Measure of Unplanned Pregnancy (LMUP) is a newer, psychometrically validated measure which may be more reliable. This paper assesses the reliability of the LMUP and the DHS question over the first postnatal year and explores the effects of maternal characteristics or pregnancy outcome on reported pregnancy intention.

Methods

We compared the test–retest reliability of the LMUP (using the AC coefficient) and DHS question (using the weighted Kappa) over the first postnatal year using data from Malawian women. We investigated the effect of maternal characteristics and pregnancy outcome using t-tests, Chi squared or Fisher’s exact tests, and calculated odds ratios to estimate effect size.

Results

The DHS question was associated with a statistically significant decrease in the prevalence of unplanned pregnancies from 1-to-12 months postnatally; the LMUP was not. The LMUP had moderate to substantial reliability (0.51–0.66); the DHS had moderate reliability (0.56–0.58). The LMUP’s stability was not related to any of the factors examined; the stability of the DHS varied by marital status (p?=?0.033), number of children (p?=?0.048) and postnatal depression (p?<?0.001). Both underestimated unintended pregnancy postnatally vis-à-vis the LMUP in pregnancy.

Conclusions for Practice

The LMUP is a more reliable measure of pregnancy intention than the DHS in the first postnatal year and does not vary by maternal characteristics or pregnancy outcome. The LMUP should become the gold-standard for measuring pregnancy intention and should be collected in pregnancy or at the first postnatal opportunity.

     

Confronting the avian influenza threat: vaccine development for a potential pandemic

Sporadic human infection with avian influenza viruses has raised concern that reassortment between human and avian subtypes could generate viruses of pandemic potential. Vaccination is the principal means to combat the impact of influenza. During an influenza pandemic the immune status of the population would differ from that which exists during interpandemic periods. An emerging pandemic virus will create a surge in worldwide vaccine demand and new approaches in immunisation strategies may be needed to ensure optimum protection of unprimed individuals when vaccine antigen may be limited. The manufacture of vaccines from pathogenic avian influenza viruses by traditional methods is not feasible for safety reasons as well as technical issues. Strategies adopted to overcome these issues include the use of reverse genetic systems to generate reassortant strains, the use of baculovirus-expressed haemagglutinin or related non-pathogenic avian influenza strains, and the use of adjuvants to enhance immunogenicity. In clinical trials, conventional surface-antigen influenza virus vaccines produced from avian viruses have proved poorly immunogenic in immunologically naive populations. Adjuvanted or whole-virus preparations may improve immunogenicity and allow sparing of antigen.     

Genetic analysis of the 15;17 chromosome translocation associated with acute promyelocytic leukemia.

Somatic cell hybrids have been constructed between a thymidine kinase-deficient mouse cell line and blood leukocytes from a patient with acute promyelocytic leukemia showing the 15q+;17q- chromosome translocation frequently associated with this disease. One hybrid contains the 15q+ translocation chromosome and very little other human material. We have shown that the c-fes oncogene, which has been mapped to chromosome 15, is not present in this hybrid and, therefore, probably is translocated to the 17q- chromosome. Analysis of the genetic markers present in this hybrid has enabled a more precise localization of the translocation breakpoints on chromosomes 15 and 17. Our experiments also have enabled an ordering and more precise mapping of several genetic markers on chromosomes 15 and 17.     

Psychometric Analysis of the Parenting Concerns Questionnaire in Women With Metastatic Cancer

Context

Parenting concerns are a major source of distress for patients with advanced cancer. However, validated tools to measure this construct in advanced cancer patients are lacking.