How public health nurses' deal with sexting among young people: a qualitative inquiry using the critical incident technique.

BACKGROUND: Globally, the potentially harmful effects of using cell phone technology for 'sexting' among young people, is a public health concern. The background literature indicates that sexting might have adverse psychosocial consequences for some young people who share partially nude images ('selfies'). Public health nurses (PHNs) could offer guidance to children and young people on digital safety, yet little is known about their role in this regard. This study explored PHNs' knowledge and confidence in addressing the issue among young people. METHOD: A qualitative study was undertaken using the Critical Incident Technique. The study took place in 2016. Eighteen semi-structured interviews were conducted with PHNs in a region of England. Data were analysed through thematic analysis, and managed through the use of NViVo 11 software. From the entire data set, thirteen critical incidents were identified of which nine were deemed relevant for reporting in this paper. RESULTS: PHNs regarded sexting as a contemporary 'normalised' practice that takes place in what young people consider to be trusting relationships. PHNs' knowledge was informed by media reports that supported their beliefs about young peoples' vulnerability to risk-taking sexual behaviour. They were not confident about discussing sexting with young people, even though some PHNs had done so in light of concerns about potential child sexual exploitation. CONCLUSION: PHNs have a role to play in advising young people on digital safety, but findings of the study show that their role is not fully realised. They have some knowledge of sexting as a possible signifier of abusive behaviour. However, they are not always confident in dealing with the issue. Improving PHNs ability to promote digital safety through better understanding of technology use among young people is good safeguarding practice. This may, in turn, better define this important nursing contribution to public health.

Treatment of a highly-concentrated sulphate-rich synthetic wastewater using calcium hydroxide in a fluidised bed crystallizer.

This study aimed to investigate factors that affect the conversion of sulphates and magnesium, and the recovery of gypsum and magnesium hydroxide in the neutralization of a sulphate rich stream using calcium hydroxide, in a laboratory scale seeded fluidised bed crystallizer. Particular focus was on reducing the precipitated fines that escaped with the treated water, through the use of seeds, while removing as much sulphate-compounds from the waste stream as possible. The composition of the total sulphate salts was as follows: 80% magnesium sulphate, calcium sulphate remaining at its saturation concentration (1.5 g/L), with the remainder being sodium sulphate based on typical reverse osmosis retentate concentrations ranging from 1.5 - 120 g/L of total sulphate salts. The fluidised bed crystallizer, using silica seeds, was found to be effective at reducing the formation of gypsum and magnesium hydroxide fines by almost half. Feed concentrations of 35 g/L of total salts yielded better sulphate conversions (±75%), compared to a feed concentration of 8 g/L (±30%). It was possible to remove 99% of the magnesium in the saline wastewater stream using a calcium to sulphate ratio of 1:1 for feed concentrations of 15 g/L and higher. Excess calcium hydroxide suspension improved sulphate conversions.

Critical reflections on early career research development in public health nursing.

Clinical academic careers for nurses, midwives and allied health professionals are gaining recognition internationally and nationally, yet public health nurses appear underrepresented. The purpose of this paper is to share our learning through a clinical-academic partnership. We critique our experiences and in the context of public health nursing, share some of the challenges we experienced. We aim to build on a capability framework for early career research development, applying it specifically to public health nursing. In so doing, we hope to provide insight and motivation for public health nurses seeking to engage with research through clinical academic career opportunities. Our experience shows that the framework can be useful in identifying strengths, but also capabilities that need to be developed. We recognise that uncertainties about public health nursing roles may limit individual wherewithal for continuing professional development. Nonetheless, we recommend public health nurses consider clinical academic careers to advance research in practice.

"It Shook My Whole Parenting Plan": Parents' Experiences of Being at Home with Their Newborn Baby During the COVID-19 Pandemic.

A cross-sectional online survey was undertaken (July-August 2020) to ascertain parents' experiences during the COVID-19 pandemic of being at home with their newborn baby in the first 6 weeks. Participants (n = 371) were mostly biological mothers (n = 369, 99.4%), white British (n = 351, 94,5%), first baby (n = 186, 50%). A statistically significant positive correlation was found between maternal confidence and number of children (rho (369) = 0.295, p < .001) and baby's age at time of participation (rho (369) = 0.139, p = .009). Participants without higher educational qualifications (median = 62, SIQR = 3.5) had statistically significant higher confidence (U = 11831.500, p < .001) than participants with higher educational qualifications (median = 58, SIQR = 2). Parents of babies without health issues at birth (median, 61, SIQR = 3.5) had statistically significant higher confidence (U = 13213.500, p < .001) than parents of babies with health issues at birth (median = 58, SIQR = 5). Three qualitative themes have emerged: the impact of "no partner" restrictions; mixed emotions and lack of information and support. In conclusion, parenting during a pandemic created anxiety and fear, affected by "no partner" restrictions, not being allowed to appointments, scans, and during labor. Some parents were more confident and indicated benefits including heightening bonding with baby and partner during social distancing.

The strain of the pandemic on the mental health and well-being of parents could have a negative impact on future parenting.Healthcare professionals should not underestimate the potential consequences of declining perinatal mental health and should be vigilant to screen, enquire, and refer.Further research on this cohort of parents and children exploring the long-term impact of the COVID-19 pandemic on their ongoing health and wellbeing could be beneficial for future health-care policies and guidance.

Systematic Review of Single-Agent vs. Multi-Agent Chemotherapy for Advanced Pancreatic Adenocarcinoma in Elderly vs. Younger Patients.

PURPOSE: To systematically review all studies comparing multi-agent to single-agent chemotherapy in the first and second-line setting for unresectable pancreatic adenocarcinoma, so as to compare the outcomes of young and elderly patients. METHODS: This review searched three databases for relevant studies. The inclusion criteria were diagnosis of locally advanced or metastatic pancreatic adenocarcinoma, comparison of an elderly versus young population, comparison of single-agent versus multi-agent chemotherapy, data on survival outcomes, and randomised controlled trials. The exclusion criteria were phase I trials, incomplete studies, retrospective analyses, systematic reviews, and case reports. A meta-analysis was performed on second-line chemotherapy in elderly patients. RESULTS: Six articles were included in this systematic review. Three of these studies explored first-line treatment and three explored second-line treatment. In the subgroup analysis, the meta-analysis showed statistically improved overall survival for elderly patients receiving single-agent second-line treatment. CONCLUSIONS: This systematic review confirmed that combination chemotherapy improved survival in the first-line treatment of advanced pancreatic adenocarcinoma, regardless of age. The benefit of combination chemotherapy in second-line studies for elderly patients with advanced pancreas cancer was less clear.

"I keep hearing reports on the news that it's a real problem at the moment": Public health nurses' understandings of sexting practices among young people.

Over the past decade, the potential harms regarding young people's use of technology have attracted mounting political, media and research attention worldwide. One practice engaged in by many young people is that of "sexting" and the sharing of partially, or complete nude images ("selfies"). Such images are not always retained within private spaces and are prone to be shared, with significant psychosocial consequences for young people involved. A significant risk is the hidden nature of some online interactions, with potential for grooming and child sexual exploitation. As key professionals working with young people, public health nurses have potential to educate and explore the risks with them. Yet to date, to our knowledge there has been no research in relation to public health nurses' understandings of the practices involved or their potential harms. A qualitative study was undertaken drawing theoretically on the common-sense model (CSM) to frame the analysis. Eighteen semi-structured interviews were conducted with public health nurses in a region of England in 2016. Data were analysed through thematic analysis, and mapped to the five domains of CSM. Public health nurses' understandings of young people's sexting practices were shaped largely by media reports, rather than scientific, disciplinary knowledge. Sexting did not resonate with many public health nurses' own experiences of being a young person and was therefore difficult to understand. All were able to express an opinion about the causes and consequences of sexting and we present these as a "perceived hierarchy of risk". All public health nurses acknowledged the importance of their role in dealing with harm reduction associated with sexting among young people, but they need education and support to do this effectively and confidently. Findings can be transferred carefully to many contexts and countries because sexting is a practice among young people that transcends geographical boundaries.

Developmental changes in children's understanding of the similarity between photographs and their referents.

In a series of three experiments, we investigated the development of children's understanding of the similarities between photographs and their referents. Based on prior work on the development of analogical understanding (e.g. Gentner & Rattermann, 1991), we suggest that the appreciation of this relation involves multiple levels. Photographs are similar to their referents both in terms of the constituent objects and in terms of the relations among these objects. We predicted that children would appreciate object similarity (whether photographs depict the same objects as in the referent scene) before they would appreciate relational similarity (whether photographs depict the objects in the same spatial positions as in the referent scene). To test this hypothesis, we presented 3-, 4-, 5-, 6-, and 7-year-old children and adults with several candidate photographs of an arrangement of objects. Participants were asked to choose which of the photographs was 'the same' as the arrangement. We manipulated the types of information the photographs preserved about the referent objects. One set of photographs did not preserve the object properties of the scene. Another set of photographs preserved the object properties of the scene, but not the relational similarity, such that the original objects were depicted but occupied different spatial positions in the arrangement. As predicted, younger children based their choices of the photographs largely on object similarity, whereas older children and adults also took relational similarity into account. Results are discussed in terms of the development of children's appreciation of different levels of similarity.

Unveiling the Concentration-Dependent Grain Growth of Perovskite Films from One- and Two-Step Deposition Methods: Implications for Photovoltaic Application.

In order to achieve high-efficiency perovskite solar cells, understanding both the crystal structure and the optoelectronic properties of perovskite layers is of importance. This paper uses crystallization analysis and the modeling study of two different perovskite deposition methods (two- and one-step methods) and thereby shows that the one-step method embodies a film formation process that is dominated by crystal growth, while the dominant mechanism of the two-step procedure is nucleation. Our data based on experimental and theory shows that the one-step recipe is superior in terms of morphology control, and, hence, reproducibility, compared to the two-step recipe.

A mathematical model of a high sulphate wastewater anaerobic treatment system.

As an aid to the design and operation of anaerobic digesters treating high sulphate waste waters, a mathematical model describing this treatment process has been developed. Apart from sulphate reduction, the model includes those reactions which occur either prior to sulphate reduction or in competition with it. These include, hydrolysis of solid substrates, acidogenesis. beta oxidation of long chain fatty acids, acetogenesis and methanogenesis. By incorporating terms for these reactions the model is able to simulate sulphate reduction using a wide range of carbon sources. Acid/base equilibrium chemistry is included in order to predict the pH and unionized component concentrations, needed for calculating inhibition. An activity based model is used, with the activity coefficients calculated using Debye-Hückle theory. The mass transfer rates of hydrogen, methane, carbon dioxide and hydrogen sulphide from the liquid to the vapour phase are also included. A number of different reactor types may be simulated, including a dynamic batch. steady state CSTR and dynamic CSTR. By separating the hydraulic and solids residence times, high rate reactors such as UASB and packed bed reactors may also be simulated. The model has been used to successfully predict the dynamic and steady state behaviour of a number of different reactor types, utilizing both simple and complex carbon sources.

Biased parameter estimates and inflated Type I error rates in analysis of covariance (and analysis of partial variance) arising from unreliability: alternatives and remedial strategies.

Miller and Chapman (2001) argued that 1 major class of misuse of analysis of covariance (ANCOVA) or its multiple regression counterpart, analysis of partial variance (APV), arises from attempts to use an ANCOVA/APV to answer a research question that is not meaningful in the 1st place. Unfortunately, there is another misuse of ANCOVAs/APVs that arises frequently in psychopathology studies even when addressing consensually meaningful research questions. This misuse arises from inflated Type I error rates in ANCOVA/APV inferential tests of the unique association of the independent variable with the dependent variable when the covariate and independent variables are correlated and measured with error. Alternatives to conventional ANCOVAs/APVs are discussed, as are steps that can be taken to minimize the impact of this bias on drawing valid inferences when conventional ANCOVAs/APVs are used.

The relationship between anxiety sensitivity and latent symptoms of emotional problems: A structural equation modeling approach.

A large body of research suggests that common and specific psychopathology dimensions underlie the symptoms that occur within mood and anxiety disorders. As of yet, it is unclear precisely how the facets of Anxiety Sensitivity (AS), or fear of the symptoms of fear and anxiety, relate to these latent factors. Using data from 606 adolescents participating in the baseline phase of a longitudinal study on risk factors for emotional disorders, we modeled the facets of AS as measured by the Anxiety Sensitivity Index-Expanded Form (ASI-X) and related these facets to a hierarchical model of latent symptoms of psychological distress. Results suggest that one facet of AS is associated with a broad General Distress factor underlying symptoms of most emotional disorders while others relate to intermediate-level and conceptually-meaningful narrow factors representing aspects of psychological distress specific to particular emotional disorders.

Osmotic stress activates Rac and Cdc42 in neutrophils: role in hypertonicity-induced actin polymerization.

Hypertonicity inhibits a variety of neutrophil functions through poorly defined mechanisms. Our earlier studies suggest that osmotically induced actin polymerization and cytoskeleton remodeling is a key component in the hypertonic block of exocytosis and cell movement. To gain insight into the signaling mechanisms underlying the hyperosmotic F-actin response, we investigated whether hypertonicity stimulates Rac and Cdc42 and, if so, whether their activation contributes to the hypertonic rise in F-actin. Using a recently developed pull-down assay that specifically captures the active forms of these small GTPases, we found that hypertonicity caused an ~2.5- and ~7.2-fold activation of Rac and Cdc42, respectively. This response was rapid and sustained. Small GTPase activation was not mediated by the osmotic stimulation of Src kinases, heterotrimeric G proteins, or phosphatidylinositol 3-kinase. Interestingly, an increase in intracellular ionic strength was sufficient to activate Rac even in the absence of cell shrinkage. Inhibition of Rac and Cdc42 by Clostridium difficile toxin B substantially reduced but did not abolish the hypertonicity-induced F-actin response. Thus hypertonicity is a potent activator of Rac and Cdc42, and this effect seems to play an important but not exclusive role in the hyperosmolarity-triggered cytoskeleton remodeling.

Osmotic stress-induced remodeling of the cortical cytoskeleton.

Osmotic stress is known to affect the cytoskeleton; however, this adaptive response has remained poorly characterized, and the underlying signaling pathways are unexplored. Here we show that hypertonicity induces submembranous de novo F-actin assembly concomitant with the peripheral translocation and colocalization of cortactin and the actin-related protein 2/3 (Arp2/3) complex, which are key components of the actin nucleation machinery. Additionally, hyperosmolarity promotes the association of cortactin with Arp2/3 as revealed by coimmunoprecipitation. Using various truncation or phosphorylation-incompetent mutants, we show that cortactin translocation requires the Arp2/3- or the F-actin binding domain, but the process is independent of the shrinkage-induced tyrosine phosphorylation of cortactin. Looking for an alternative signaling mechanism, we found that hypertonicity stimulates Rac and Cdc42. This appears to be a key event in the osmotically triggered cytoskeletal reorganization, because 1) constitutively active small GTPases translocate cortactin, 2) Rac and cortactin colocalize at the periphery of hypertonically challenged cells, and 3) dominant-negative Rac and Cdc42 inhibit the hypertonicity-provoked cortactin and Arp3 translocation. The Rho family-dependent cytoskeleton remodeling may be an important osmoprotective response that reinforces the cell cortex.