Childhood and adulthood trauma exposure: Associations with perinatal mental health and psychotherapy response.

Trauma exposure is strongly linked to maternal posttraumatic stress disorder (PTSD) and depressive symptoms during the perinatal period; however, childhood trauma exposure is often assessed without accounting for adult exposure. This study tested the unique impacts of childhood and adulthood trauma exposure on PTSD and depressive symptoms among pregnant women (N = 107, 82.9% Latina) enrolled in a nonrandomized intervention study. Regression analyses at baseline showed positive associations between trauma exposure and PTSD symptoms irrespective of trauma timing, childhood: B = 1.62, t(91) = 2.11, p = .038; adulthood: B = 2.92, t(91) = 3.04, p = .003. However only adulthood trauma exposure, B = 1.28, t(94) = 2.94, p = .004, was positively associated with depressive symptoms. Mixed-effects analyses of variance revealed interaction effects of time and adulthood trauma exposure, indicating that women with high degrees of adulthood trauma exposure had higher baseline levels of PTSD, F(1, 76.4) = 6.45, p = .013, and depressive symptoms, F(1, 87.2) = 4.88, p = .030, but showed a more precipitous decrease posttreatment than women with lower levels of adulthood trauma exposure. These findings support the clinical relevance of assessing both childhood and adulthood trauma exposure during the perinatal period given their impacts on baseline symptoms and psychotherapy response.

Invisible borders in educational technology research? A comparative analysis.

Educational research is reflective of the nature and structure of national and regional education systems and their historical evolution. Educational technology research, as an area within educational research, reflects this case particularly prominently. Although individual countries and regions have varying research traditions, the publication of research in English as the scientific lingua franca can lead to missing nuances in terminology, which is often not reflected upon. Despite this, the exploration of research from different countries can still uncover diverse topical clusters. This study aims to identify the research topics in educational technology research in three countries (Germany, Spain and the United Kingdom), each with their own research traditions, through the terms used. To this end, a bibliometric analysis of 3034 article abstracts and keywords from 29 English-language Web of Science journals in the field of education and educational research was conducted, with a focus on educational technology. In addition, the quantitative findings are comparatively analysed by considering the corresponding cultural clusters. Main findings include diverse research foci in the three countries, also showing that distinct research traditions are still present, despite using English as lingua franca. Therefore, research articles written in English by non-English authors often do not reflect the same meanings in each country, despite using the same words. The conclusions reflect upon the need to establish ways of understanding the traditions behind those research articles and build collaborative systems to illustrate nuances in this research.

Negotiating (dis-)engagement in K-12 blended learning.

It is well-recognised that engagement is critical for learning and school success. Engagement (and disengagement) are, however, also influenced by context. Thus, as digital technologies add complexity to the educational context, they influence classroom leadership, lesson designs and related practices, and thereby engagement. Despite being critical, engagement and disengagement are not well explored concerning these influences, with a lack of research undertaken within socially disadvantaged schools. In this qualitative study, 14 classroom observations were conducted, during five months, in twelve classes in an upper secondary school in Sweden, along with dialogues with teachers (n=12) and students (n=32). The data were analysed using thematic analysis and descriptive statistics. Identified themes include digital context, teacher leadership, engagement and disengagement. A network of relations between the (dis-)engagement compound and themes is presented. The results identified processes in which engagement shifted into disengagement and vice versa; in particular, that the intention of active learning does not automatically translate to active learning for all students, although teachers employed a higher work pace than did their students. Teacher self-efficacy and awareness of how to manage digital technologies in and outside the classroom was found to play a vital role in facilitating engagement. Understanding the (dis-)engagement compound in blended learning environments is key to inform active and visible learning for future research and supportive organisational structures.

Palliative care in northern Tanzania: doing a lot with a little.

The number of people in need of palliative care is growing worldwide, particularly in the developing world. The World Health Organization recognises palliative care as a basic human right, but there are many challenges for delivering palliative care in low- and middle-income countries. In the African continent, the African Palliative Care Association (APCA) provides guidance for political advocacy for developing palliative care programmes and has developed the APCA Palliative Outcome Score (POS), an evidence-based tool for measuring outcomes of palliative care. This article focuses on palliative care delivery in Shirati, Tanzania, located in the Rorya District in the Mara Region in northern Tanzania, highlighting the impressive work done with limited resources and despite many challenges. Recommendations for future research include evaluation of outcomes using the APCA POS, the application of mobile technology, and governmental advocacy for increased access to opioid medications, which have shown promise in broadening the reach of palliative care in the East African Community.

Burden on informal caregivers of elderly cancer survivors: risk versus resilience.

This study assessed psychological morbidity and resilience, including the subjective burden of 76 caregivers of elderly cancer survivors utilizing a cross-sectional questionnaire. Participants were mainly elderly female spouses, sole-caregiving > 35 hours per week; 19.1% and 23.6% reported moderate or greater anxiety and depression, respectively. A significant regression model found depression, emotion-focused coping, and greater years since diagnosis as significant predictors of subjective caregiver burden. Thus, caregiving appears a dominant role for this group and the Brief Assessment Scale for Caregivers of the Medically Ill (BASC) appears to be an efficient screening tool for psychological morbidity in this under-supported group.

Predicting Mental Health Care Enrollment and Treatment Uptake among Newly Arrived Refugees in U.S. Resettlement Programs.

This article examines variables that predict mental health care enrollment and engagement among refugees. The authors explore a mental health care model designed to identify mental health needs early among refugee arrivals that may interfere with adjustment and overall health outcomes using data from a Midwest refugee resettlement program. Using ecological models of mental distress and theories on help-seeking behaviors, the authors used logistic and count regressions to predict enrollment in mental health care services and utilization rates. Gender, nationality, and presenting problems were significant predictors of enrollment and length of engagement in services. The findings provide guidance to practitioners and resettlement agencies on refugee mental health and opportunities to increasing access and engagement in mental health care.

PROTOCOL: Methods used in the development, production and updating of evidence and gap maps: A scoping review.

Evidence and gap maps (EGMs) are an increasinly popular approach used in evidence synthesis. As an approach they address broad research questions, describing the existing evidence base, highlighting evidence gaps and providing an interactive visual tool for knowledge users. The purpose of this methodological study is to explore the the processes used in the development of EGM's and how they are reported. The aim is to better understand current practice and identify where clearer guidance is needed to support their production.

Using Dynamic Structural Equation Modeling to Examine Between- and Within-Persons Factor Structure of the DASS-21.

The recent integration of traditional time series analysis and confirmatory factor analysis techniques allows researchers to evaluate the psychometric properties of measurement instruments at between- and within-persons levels while accounting for autoregressive dependencies. The current study applies a dynamic structural equation modeling (SEM) latent factor analysis (i.e., DSEM-CFA) to a sample of 333 individuals who completed the DASS-21 at their regular therapy sessions. The results of the DSEM-CFA illuminate the reliability, invariance, and structural features of each DASS-21 subscale both between and within persons. The results suggest that the DASS-21 reliably measures depression, anxiety, and stress symptoms when evaluating differences between persons, but does not reliably assess within-persons fluctuations in symptoms over time. The results also suggest that currently accepted methods of modeling sensitivity to change within an instrument are likely lacking and the DSEM-CFA provides insight into reliability within and between persons, which is extremely important for instruments used across time.

Faculty perceptions, awareness and use of open educational resources for teaching and learning in higher education: a cross-comparative analysis.

This paper explores faculty's perspectives and use of open educational resources (OER) and their repositories across different countries by conducting a multiple case study to find similarities and differences between academics' awareness, perceptions and use of OER, as well as examining related aspects of institutional policy and quality that may influence individual views. Data were collected through nine expert reports on each country studied (Australia, Canada, China, Germany, Japan, South Africa, South Korea, Spain and Turkey) and were analyzed through qualitative content analysis using thematic coding. Findings show the impact on individual OER adoption with regard to the individual control of diverse factors by faculty members; of institutional policies and quality measures on the externally determined factors (by the institution); and of institutional professional development and provision of incentives in more internally determined factors (by the faculty members themselves). These findings carry implications for higher education institutions around the world in their attempt to boost OER adoption by faculty members.

Emergency remote teaching in higher education: mapping the first global online semester.

Due to the Covid-19 pandemic that spread globally in 2020, higher education courses were subsequently offered in fully remote, online formats. A plethora of primary studies began investigating a range of topics exploring teaching and learning in higher education, particularly during the initial semester. In order to provide an overview and initial understanding of this emerging research field, a systematic mapping review was conducted that collates and describes the characteristics of 282 primary empirical studies. Findings reveal that research was carried out mostly descriptively and cross-sectionally, focusing predominantly on undergraduate students and their perceptions of teaching and learning during the pandemic. Studies originate from a broad range of countries, are overwhelmingly published open access, and largely focused on the fields of Health & Welfare and Natural Sciences, Mathematics & Statistics. Educational technology used for emergency remote teaching are most often synchronous collaborative tools, used in combination with text-based tools. The findings are discussed against pre-pandemic research on educational technology use in higher education teaching and learning, and perspectives for further research are provided. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41239-021-00282-x.

Development and usability of a Spanish/English smoking cessation website: lessons learned.

BACKGROUND: Smoking cessation Internet interventions have been shown to be comparable in effectiveness to the nicotine patch. The aim of this study was to develop a Spanish/English smoking cessation web app using input from low-income smokers, and to evaluate modifications to the online intervention in terms of its ability to engage smokers. METHODS: Three versions of a smoking cessation web app were developed and tested. Measures of engagement, such as completion of study registration, utilization of cigarette, mood, and craving trackers, and completion of follow-up assessments, were collected to determine whether changes in the website resulted in increased engagement. RESULTS: The third version of the website, which featured improved look-and-feel and fewer barriers to engagement, markedly increased tracker engagement from the first two versions. However, follow-up rates remained low across all three versions. CONCLUSIONS: The increase in engagement was attributed to the following modifications: A more inviting landing page with key intervention elements available immediately; an easily accessible dashboard with users' data; and tracking tools that were more user friendly. We conclude that in addition to adequate and functional elements, design principles are key factors in increasing engagement in online interventions.

Effect of Three Types of Activities on Improving Mood and Enjoyment in a Brief Online Depression Study.

The goal of this study is to determine whether different types of activities have a differential effect on mood and enjoyment. Methods. A secondary analysis of the data of 754 participants (M age = 35.8 years, SD age = 12.6; M PHQ-9 = 7.6, SD PHQ-9 = 7.0) who were recruited via Amazon Mechanical Turk (AMT) to participate in a brief online study. Participants completed an activity log and reported retrospectively about three types of activities (Pleasant, Meaningful, and Mastery) at baseline and one week follow-up. A mixed effects ANOVA was used to analyze the effect of weekly activities on mood, and a temporal analysis model was used to test for the effect of daily activities on enjoyment. Results. Participants who reported higher number of Mastery activities for the week had higher mood ratings at follow-up (F (1, 39) = 4.89, p < .05), regardless of depression status at baseline. Pleasant and Meaningful activities did not have a significant effect on mood. Daily engagement in any of the three activity types increased enjoyment of that day (Pleasant: b = 0.312, t (1811) = 46.73, p < .001; Meaningful: b = 0.254, t (1814) = 11.65, p < .001; Mastery: b = 0.290, t (1816) = 13.07, p < .001]. Conclusions. These findings contribute to the understanding on how brief behavioral activation interventions delivered online may influence participants' mood and enjoyment, and can inform clinicians' recommendations about types of activities.

Perinatal depression among a global sample of Spanish-speaking women: A sequential-process latent growth-curve analysis.

BACKGROUND: Despite high rates of perinatal depression among women from diverse backgrounds, the understanding of the trajectory of depressive symptoms is limited. The aim of this study was to investigate the trajectories of depressive symptoms from pregnancy to postpartum among an international sample of pregnant women. METHODS: Hispanic/Latina (79.2%), Spanish-speaking (81%) pregnant women (N = 1796; Mean age = 28.32, SD = 5.51) representing 78 unique countries/territories participated in this study. A sequential-process latent growth-curve model was estimated to examine general trajectories of depression as well as risk and protective factors that may impact depression levels throughout both the prenatal and postpartum periods. RESULTS: Overall, depression levels decreased significantly across the entire perinatal period, but this decrease slowed over time within both the prenatal and postpartum periods. Spanish-speaking women, those who were partnered, and those with no history of depression reported lower levels of depression during early pregnancy, but this buffer effect reduced over time. Depression levels at delivery best predicted postpartum depression trajectories (i.e., women with higher levels of depression at delivery were at greater risk for depression postpartum). LIMITATIONS: Given the emphasis on language and not country or culture of origin this study was limited in its ability to examine the impact of specific cultural norms and expectations on perinatal depression. CONCLUSIONS: Given these findings, it is imperative that providers pay attention to, and assess for, depressive symptoms and identified buffers for depression, especially when working with women from diverse communities.

Facebook for recruiting Spanish- and English-speaking smokers.

BACKGROUND: Recruitment for research is usually expensive and time consuming. Facebook (FB) recruitment has become widely utilized in recent years. The main aim of this study was to assess FB as a recruitment tool in a study for Spanish- and English-speaking smokers. Additionally, the study set out to compare performance of ads by language (Spanish vs. English), location (U.S. vs. San Francisco) and content (self-efficacy ad vs. fear appeal ad). METHODS: Participants of a one-condition smoking cessation webapp study were recruited utilizing FB ads and posts through two phases: a recruitment-focused phase and an experimental phase comparing language, location and content. RESULTS: During the recruitment phase 581 participants in total (U.S. = 540, San Francisco = 41) provided consent. Of the U.S. participants 275 were Spanish-speakers and 265 English-speakers. The cost-per-consent was $25.81 for Spanish-speakers, and $15.49 for English-speakers. During the experimental phase U.S. users performed better (i.e. more clicks, engagement and social reach) than San Francisco users, Spanish-speakers engaged more than English-speakers, and the self-efficacy ad performed better than the fear appeal ad. CONCLUSIONS: This study showed that although there were differences in cost-per-consent for Spanish- and English-speakers, recruitment of Spanish-speakers through Facebook is feasible. Furthermore, comparing performance of ads by location, language, and ad content may contribute to developing more efficient campaigns.

Comparing Amazon Mechanical Turk with unpaid internet resources in online clinical trials.

Internet interventions face significant challenges in recruitment and attrition rates are typically high and problematic. Finding innovative yet scientifically valid avenues for attaining and retaining participants is therefore of considerable importance. The main goal of this study was to compare recruitment process and participants characteristics between two similar randomized control trials of mood management interventions. One of the trials (Bunge et al., 2016) was conducted with participants recruited from Amazon's Mechanical Turk (AMT), and the other trial recruited via Unpaid Internet Resources (UIR). METHODS: The AMT sample (Bunge et al., 2016) consisted of 765 adults, and the UIR sample (recruited specifically for this study) consisted of 329 adult US residents. Participants' levels of depression, anxiety, confidence, motivation, and perceived usefulness of the intervention were assessed. The AMT sample was financially compensated whereas the UIR was not. RESULTS: AMT yielded higher recruitment rates per month (p < .05). At baseline, the AMT sample reported significantly lower depression and anxiety scores (p < .001 and p < .005, respectively) and significantly higher mood, motivation, and confidence (all p < .001) compared to the UIR sample. AMT participants spent significantly less time on the site (p < .05) and were more likely to complete follow-ups than the UIR sample (p < .05). Both samples reported a significant increase in their level of confidence and motivation from pre- to post-intervention. AMT participants showed a significant increase in perceived usefulness of the intervention (p < .0001), whereas the UIR sample did not (p = .1642). CONCLUSIONS: By using AMT, researchers can recruit very rapidly and obtain higher retention rates; however, these participants may not be representative of the general online population interested in clinical interventions. Considering that AMT and UIR participants differed in most baseline variables, data from clinical studies resulting from AMT samples should be interpreted with caution.