Electric Field Effects in Hybrid Perovskites Studied via Picosecond Kerr Microscopy.

We present time-resolved Kerr rotation (TRKR) spectra in thin films of CH3NH3PbI3 (MAPI) hybrid perovskite using a unique picosecond microscopy technique at 4 K having a spatial resolution of 2 µm and temporal resolution of 1 ps, subjected to both an in-plane applied magnetic field up to 700 mT and an electric field up to 104 V/cm. We demonstrate that the obtained TRKR dynamics and spectra are substantially inhomogeneous across the MAPI films with prominent resonances at the exciton energy and interband transition of this compound. From the obtained quantum beating response as a function of magnetic field in the Voigt configuration, we also extract the inhomogeneity of the electron and hole Lande g-values and spin coherence time, T2*. We also report the TRKR dependence on both the applied magnetic field and electric field. From the change in the quantum beating dynamics, we found that T2* substantially decreases upon the application of an electric field. At the same time, from the induced spatial TRKR changes, we show that the electric field induced effects are caused by ion migration in the MAPI films.

Outcomes of Peer-Provided Individual Placement and Support Services in a Mental Health Peer-Run Vocational Program.

OBJECTIVE: The authors sought to determine whether staff at a peer-run agency could deliver supported employment services with high fidelity to the individual placement and support (IPS) model and whether employment outcomes of peer-delivered IPS plus work-specific health promotion were superior to usual supported employment services. METHODS: Two teams from a vocational program of a large peer-run agency were studied from July 2015 to July 2017. One team received training and supervision in delivering IPS plus employment-focused physical wellness support and mentoring. The other team continued providing usual supported employment services. Study data included vocational outcomes from 348 clients served by the two teams (IPS, N=184; comparison condition, N=164) and the results of IPS fidelity reviews of the IPS team at study baseline, midpoint, and end. The authors modeled the primary outcome of competitive employment with random-effects logistic regression and adjusted propensity scores for age, gender, race, ethnicity, education, and months of service receipt. RESULTS: Following training, the IPS team demonstrated acceptable and increasing fidelity to the IPS model, achieving "good fidelity" by the end of the 25-month observation period. Among IPS recipients, 43% achieved competitive employment versus 21% of comparison recipients (p<0.001). Multivariable analysis indicated that IPS recipients were significantly more likely to achieve competitive employment than individuals in the comparison group (OR=4.06, p<0.001). CONCLUSIONS: Providing training in IPS along with health promotion to the behavioral health peer workforce may help address the severe shortage of IPS services and enhance the competitive employment outcomes of people served by peer-run programs.

"Just be a light": Experiences of peers working on acute inpatient psychiatric units.

OBJECTIVE: The study aimed to clarify the potential role and impact of behavioral health peer support providers on community hospital acute inpatient psychiatric units. METHOD: Qualitative interviews were conducted to examine perspectives of peer support providers (peers) and individuals who initially received peer services (recipients) during an inpatient stay on a community hospital psychiatric unit. Interviews elicited perspectives on interactions between peers and recipients, the role of peers vis-à-vis the clinical treatment team, and involvement of peers in discharge planning and transitions to community-based care. Fourteen interviews were completed (6 peers and 8 recipients of peer services); all were recorded, transcribed, and coded using a thematic analysis approach. RESULTS: Emergent themes were grouped into 3 domains: (a) initial impressions and client engagement, (b) peer interventions to support discharge planning, and (c) shared or sharing experiences in an inpatient setting. Recipients described inpatient experiences as disempowering and humiliating and reported powerful positive initial reactions to peers who had had similar experiences but who also displayed competence and professionalism. Peers and recipients described strong emotional connections that differed from traditional attitudes and relationships with clinical staff. Peers described challenges and obstacles related to interactions with the clinical treatment team, and both peers and recipients strongly endorsed the role of peers in facilitating successful care transitions. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Behavioral health peers can play important roles in acute inpatient psychiatric care, supplementing clinical treatment team activities and filling important gaps related to engagement, discharge planning, and care transitions. (PsycINFO Database Record

Participation in peer support services and outcomes related to recovery.

OBJECTIVE: This article presents findings from a naturalistic study that explored the impact of peer support participation on recovery-related outcomes over a 6-month period. In particular, this study hoped to fill gaps in the literature regarding the process through which personal change occurs in peer support organizations. METHOD: Fifty people newly involved in services provided by Baltic Street AEH (Advocacy, Employment, Housing), a consumer-operated organization, participated in the study. Participants were interviewed at entry and 3- and 6-month follow-up. Attendance records were reviewed to determine the number of days attended, and the sample was divided into 2 categories: minimal or nonattenders (n = 25) and moderate or high attenders (n = 21). The relationship between attendance and outcomes related to recovery over time was examined using a mixed effect regression analysis, allowing data to be included for participants with at least 1 follow-up interview (n = 38). RESULTS: Relative to minimal or nonattenders, moderate or high attenders showed statistically significant improvements over time in internalized stigma, self-esteem-self-efficacy, and community activism-autonomy. No statistically significant differences were observed between groups in hopelessness, social functioning, symptom severity, coping with symptoms, or substance use. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: This study demonstrates the potential impact of engagement in peer support services on some subjective aspects of mental health recovery. Namely, change mechanisms could be hypothesized to include identity transformation (from patient to peer). Future directions should continue to investigate potential mechanisms of change with larger samples in randomized studies. (PsycINFO Database Record

Characteristics and service use of participants in a large consumer-operated service agency.

OBJECTIVE: Administrative data were used to examine the demographic and service-use characteristics of participants in a large consumer-operated agency in New York City (NYC). METHOD: Demographic characteristics for all consumer-operated agency participants in 2011 (N = 3,296) were compared with data from the 2011 Office of Mental Health Patient Characteristics Survey (N = 87,131). RESULTS: Consumer-operated participants were more likely to be male and diagnosed with a mood disorder, and less likely to be Latino/a than public mental health recipients. "Advocacy" and "Self-Help Services" were used by 80% of service recipients, and lengths-of-stay averaged less than 6 months. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Self-help services were the most common consumer-operated service used in NYC. Given the demographic differences noted, consumer-operated service providers may need to take additional steps to engage women, Latinos, and persons diagnosed with schizophrenia-spectrum disorders to reach the full range of public mental health consumers.

Political engagement as an element of social recovery: a qualitative study.

OBJECTIVE: Taking a qualitative approach, this study sought to describe consumer attitudes toward political participation and the association between political engagement and social recovery. METHODS: This study used data from seven focus groups of self-identified consumers of mental health services in the New York City area (N=52). Attitudes and behaviors related to voting and other forms of political engagement were identified and classified according to grounded theory, with a focus on the relationship between political engagement and broader social functioning, participation, and recovery. RESULTS: Participants described the symbolic meaning of voting and political participation in terms of connection to social inclusion versus exclusion. Participants described political participation as a component of empowerment for minority groups in general, including persons who use mental health services and those from racial-ethnic minority groups. CONCLUSIONS: Qualitative studies of the symbolic meanings of political participation are an important component of understanding the broad yet interconnected dimensions of social recovery.

Developmental changes in hepatic antioxidant capacity are age-and sex-dependent.

Developmental inadequacy in hepatic antioxidant defenses may contribute to chemical toxicity and pediatric liver diseases. We measured a comprehensive panel of antioxidants in liver tissue from 27 normal pediatric donors. Glutathione reductase declined with age (P = 0.008, r = -0.54, Spearman) while microsomal glutathione-S-transferase increased (GST, P<0.001, r = 0.81). Males had significantly lower superoxide dismutase and vitamin E (P<0.05) and may have lower glutathione reductase (P = 0.06), while females show less cytosolic GST (P = 0.07). Hepatic antioxidants are high in neonates, decline throughout childhood, and then increase in adolescence to adult levels.

Coping with thoughts of suicide: techniques used by consumers of mental health services.

OBJECTIVE: Suicide is a devastating public health problem, and research indicates that people with prior attempts are at the greatest risk of completing suicide, followed by persons with depression and other major mental and substance use conditions. Because there has been little direct input from individuals with serious mental illness and a history of suicidal behavior concerning suicide prevention efforts, this study examined how this population copes with suicidal thoughts. METHODS: Participants in 14 regional consumer-run Hope Dialogues in New York State (N=198) wrote up to five strategies they use to deal with suicidal thoughts. Strategies were classified according to grounded theory. RESULTS: First responses included spirituality, talking to someone, positive thinking, using the mental health system, considering consequences of suicide to family and friends, using peer supports, and doing something pleasurable. Although a majority reported that more formal therapeutic supports were available, only 12% indicated that they considered the mental health system a frontline strategy. Instead, respondents more frequently relied on family, friends, peers, and faith as sources of hope and support. CONCLUSIONS: Consumers' reliance on formal therapeutic supports and support from peers and family suggests that education and support for dealing with individuals in despair and crisis should be targeted to the social networks of this high-risk population. The disparity between availability of formal mental health services and reliance on them when consumers are suicidal suggests that suicide prevention efforts should evaluate whether they are effectively engaging high-risk populations as they struggle to cope with despair.

Sharing the true stories: improving communication between Aboriginal patients and healthcare workers.

OBJECTIVES: To identify factors limiting the effectiveness of communication between Aboriginal patients with end-stage renal disease and healthcare workers, and to identify strategies for improving communication. DESIGN: Qualitative study, gathering data through (a) videotaped interactions between patients and staff, and (b) in-depth interviews with all participants, in their first language, about their perceptions of the interaction, their interpretation of the video record and their broader experience with intercultural communication. SETTING: A satellite dialysis unit in suburban Darwin, Northern Territory. The interactions occurred between March and July 2001. PARTICIPANTS: Aboriginal patients from the Yolngu language group of north-east Arnhem Land and their medical, nursing and allied professional carers. MAIN OUTCOME MEASURES: Factors influencing the quality of communication. RESULTS: A shared understanding of key concepts was rarely achieved. Miscommunication often went unrecognised. Sources of miscommunication included lack of patient control over the language, timing, content and circumstances of interactions; differing modes of discourse; dominance of biomedical knowledge and marginalisation of Yolngu knowledge; absence of opportunities and resources to construct a body of shared understanding; cultural and linguistic distance; lack of staff training in intercultural communication; and lack of involvement of trained interpreters. CONCLUSIONS: Miscommunication is pervasive. Trained interpreters provide only a partial solution. Fundamental change is required for Aboriginal patients to have significant input into the management of their illness. Educational resources are needed to facilitate a shared understanding, not only of renal physiology, disease and treatment, but also of the cultural, social and economic dimensions of the illness experience of Aboriginal people.