Cross-cultural equivalence of the Kessler Psychological Distress Scale (K10) across four African countries in a multi-national study of adults.

The Kessler Psychological Distress Scale (K10) has been widely used to screen psychological distress across many countries. However, its performance has not been extensively studied in Africa. The present study sought to evaluate and compare measurement properties of the K10 across four African countries: Ethiopia, Kenya, Uganda, and South Africa. Our hypothesis is that the measure will show equivalence across all. Data are drawn from a neuropsychiatric genetic study among adult participants (N = 9179) from general medical settings in Ethiopia (n = 1928), Kenya (n = 2556), Uganda (n = 2104), and South Africa (n = 2591). A unidimensional model with correlated errors was tested for equivalence across study countries using confirmatory factor analyses and the alignment optimization method. Results displayed 30 % noninvariance (i.e., variation) for both intercepts and factor loadings across all countries. Monte Carlo simulations showed a correlation of 0.998, a good replication of population values, indicating minimal noninvariance, or variation. Items "so nervous," "lack of energy/effortful tasks," and "tired" were consistently equivalent for intercepts and factor loadings, respectively. However, items "depressed" and "so depressed" consistently differed across study countries (R2 = 0) for intercepts and factor loadings for both items. The K10 scale likely functions equivalently across the four countries for most items, except "depressed" and "so depressed." Differences in K10 items were more common in Kenya and Ethiopia, suggesting cultural context may influence the interpretation of some items and the potential need for cultural adaptations in these countries.

Advancing Equity Through Centering Societal Values to Operationalize Racism as a Public Health Crisis: The KKey Values Inequities Model.

Background: The past two decades have been marked by increased efforts to advance equity in various disciplines, including social sciences, public health, environmental health, and medicine. In 2020, a national movement of municipalities declared racism a public health crisis. These efforts have coincided and likely shaped a growing sphere of federal and philanthropic funding for health equity, which frequently calls for practical interventions toward reducing and ultimately eliminating disparities. Disparities in health such as maternal mortality, infant mortality, diabetes, cancer, and stroke have been linked to root causes such as racism. Often, root causes are also linked to disparities in other sectors (i.e., finance/wealth attainment, educational attainment, career attainment, and home ownership). In 2021, in a study published in the New England Journal of Medicine, suggested that racist policies were root causes of U.S. racial health inequities. While racism, sexism, and classism, etc., are characterized as root causes, we posit that there is a deeper driver that has yet to be advanced. This presents a disparity-inequity model that maps disparities and inequities to the societal value system, not root causes. Methods: The KKey Values Inequities Disparities Model described in this article combines a case study of the Flint Water Crisis to explore the historic impact of human devaluation and its role in systemic racism and classism, which ultimately creates and exacerbates inequities that produce disparities in communities. The model integrates the value system and its contribution to societal causes (formerly known as root causes). Conclusions: A broadly defined values-inequities-disparities model will allow researchers, practitioners, decision makers, lawmakers, and community members to (1) assess the core root of inequities and disparities; (2) identify solutions in the human value domain; (3) design appropriate course corrective programming, interventions, processes, and procedures; and (4) create actions to integrate new systemic procedures and practices in our laws and governance to advance equity.

'Living in a Material World': Frankenstein and new materialism.

This paper uses concepts from Karen Barad's theories from quantum physics and other theoretical approaches from new materialism to show how Frankenstein can be used to introduce this new framework and to challenge an older one based on dualism, representationalism and individualism. A new ethical understanding of the message of the text emerges from this reading-one that rethinks the prohibitions against 'playing God' or creating the unnatural and relies instead on an ethics of care.

Understanding forensic psychiatry in healthcare practices and collaboration between legal nurse consultants and physicians.

In 2000, the Institute of Medicine stunned many professionals with their published report that noted the vast number of deaths that occur each year in hospitals across the United States which reach as many as 98,000. Therefore, it comes as no surprise that the healthcare arena faces litigious issues regularly, with some specialties budgets being significantly impacted by the cost of maintaining liability insurance. Legal Nurse Consultants and forensic physicians working in tandem but who work independently from treating clinicians can carry out forensic independent medical examinations (IME). This can help to assess the validity of malpractice claims, including issues of causation and degree of injuries claimed due to the incident(s) and recommend treatment strategies where appropriate. Reviews can cover a wide range of issues such as a person's past or current testamentary capacity, a prisoner or an accused person's mental health and/or mental impairment where necessary sending them for more assessment or treatment outside prison. This article argues that independent medical reviews are a useful tool that can assist the civil and criminal courts processes.

Mental Health Care Disparities Now and in the Future.

In 2014, the USA spent $3 trillion dollars in health care the most per capita in the world. However, the USA lacks universal health coverage, and lags behind other highly developed and wealthy countries in life expectancy (even some "non wealthy" countries have better outcomes). The USA also has deficits in other health outcome measures. Health care costs in the USA continue to rise annually and many patients receive only mediocre care. In addition, clear disparities exist across different communities, socioeconomic groups, and race and ethnicity groups. As a result, individuals with mental illness are at an increased risk of being homeless, committing suicide, and having problems maintaining a job. This paper will address mental health disparities and review the efforts some states are taking to improve the lifesaving services offered to citizens with mental illness, in order for them to recover and reach their full potentials.

N-Benzylnicotinamide and N-benzyl-1,4-dihydronicotinamide: useful models for NAD+ and NADH.

3-Aminocarbonyl-1-benzylpyridinium bromide (N-benzylnicotinamide, BNA), C13H13N2O+·Br-, (I), and 1-benzyl-1,4-dihydropyridine-3-carboxamide (N-benzyl-1,4-dihydronicotinamide, rBNA), C13H14N2O, (II), are valuable model compounds used to study the enzymatic cofactors NAD(P)+ and NAD(P)H. BNA was crystallized successfully and its structure determined for the first time, while a low-temperature high-resolution structure of rBNA was obtained. Together, these structures provide the most detailed view of the reactive portions of NAD(P)+ and NAD(P)H. The amide group in BNA is rotated 8.4 (4)° out of the plane of the pyridine ring, while the two rings display a dihedral angle of 70.48 (17)°. In the rBNA structure, the dihydropyridine ring is essentially planar, indicating significant delocalization of the formal double bonds, and the amide group is coplanar with the ring [dihedral angle = 4.35 (9)°]. This rBNA conformation may lower the transition-state energy of an ene reaction between a substrate double bond and the dihydropyridine ring. The transition state would involve one atom of the double bond binding to the carbon ortho to both the ring N atom and the amide substituent of the dihydropyridine ring, while the other end of the double bond accepts an H atom from the methylene group para to the N atom.

Digital divide and stability of access in African American women visiting urban public health centers.

This exploratory study examines access to communication technologies, its association with health-related variables and study attrition, and its stability over time in a study of lower income African American women visiting urban public health centers. Participants (n = 1,227) provided information about cancer-related behaviors in a baseline questionnaire that also assessed their e-mail and cell phone/pager access. Interviews conducted at 1-, 6-, and 18-month follow up determined attrition, and an e-mail message sent to participants at 6-month follow up determined stability of access. Fewer than 10% of women reported e-mail access; 26% reported cell/phone pager access. At 6-month follow up, 45% of e-mail accounts were inactive; accounts from pay access providers were more likely to be inactive than work- or school-based accounts (58% versus 25%). Cell phone/pager access was positively associated with mammography knowledge. Attrition rates were lower among women with access than among those without access. Priorities for future research based on these preliminary findings are discussed.