Perceptions of mental health providers of the barriers and facilitators of using and engaging youth in digital mental-health-enabled measurement based care.

Objectives: Increased rates of mental health disorders and substance use among youth and young adults have increased globally, furthering the strain on an already burdened mental health system. Digital solutions have been proposed as a potential option for the provision of timely mental health services for youth, with little research exploring mental health professional views about using such innovative tools. In Alberta, Canada, we are evaluating the implementation and integration of a digital mental health (dMH) platform into existing service pathways. Within this paper we seek to explore mental health professionals' perceptions of the barriers and facilitators that may influence their utilization of digital MH-enabled measurement-based care (MBC) with the youth who access their services. Methods: A qualitative, descriptive methodology was used to inductively generate themes from focus groups conducted with mental health professionals from specialized mental health services and primary care networks in Alberta. Results: As mental health professionals considered the barriers and facilitators of using dMH with youth, they referenced individual and family barriers and facilitators to consider. Providers highlighted perceived barriers, including: first, cultural stigma, family apprehension about mental health care, and parental access to dMH and MBC as deterrents to providers adopting digital platforms in routine care; second, perceptions of increased responsibility and liability for youth in crisis; third, perception that some psychiatric and neurodevelopmental disorders in youth are not amenable to dMH; fourth, professionals contemplated youth readiness to engage with dMH-enabled MBC. Participants also highlighted pertinent facilitators to dMH use, noting: first, the suitability of dMH for youth with mild mental health concerns; second, youth motivated to report their changes in mental health symptoms; and lastly, youth proficiency and preference for dMH options. Conclusions: By identifying professionals' perceptions of barriers and facilitators for youth users, we may better understand how to address misconceptions about who is eligible and appropriate for dMH through training and education.

Germ cell specific expression of c-kit in the human fetal gonad.

The proto-oncogene receptor, c-kit, and its ligand have been demonstrated to be essential to the processes of germ cell migration, proliferation and survival in the rodent. The aim of the present study was to investigate the expression of c-kit mRNA and protein in human fetal ovary and testis across the gestational period 13-21 weeks. In the ovary, this crucial period of development spans the transition from oogonial replication by mitosis to primordial follicle formation. In the testis, germ cells (gonocytes) are mitotically active. Expression of c-kit mRNA was demonstrated by reverse transcription-polymerase chain reaction (RT-PCR) in both ovary and testis at all gestational ages examined. Testicular germ cell specific expression of c-kit mRNA was confirmed by RT-PCR using specific cell types recovered by laser capture microscopy. The expression of c-kit protein by both male and female germ cells was demonstrated by immunohistochemistry at all gestational ages examined, and was confirmed by immunoblotting. In both, c-kit was localized to the cell membrane except in oocytes within primordial follicles where it was localized to the cytoplasm. These data demonstrate that the expression of c-kit mRNA and protein is germ cell specific in human fetal gonads and are consistent with an important role for the c-kit/kit ligand signalling system in germ cell proliferation and survival in the developing human gonad.

Characterisation of a novel Drosophila melanogaster testis specific PP1 inhibitor related to mammalian inhibitor-2: identification of the site of interaction with PP1.

A novel Drosophila melanogaster protein, termed inhibitor-t, that bears 41% sequence similarity to human protein phosphatase inhibitor-2 has been identified using human protein phosphatase 1 (PP1) in the yeast two hybrid system. Inhibitor-t mRNA is detected in adult males, larvae and pupae and the 184 amino acid thermostable protein located only in testis. The gene for inhibitor-t maps to cytological location 86F1 on the third chromosome. Bacterially expressed inhibitor-t specifically inhibits both mammalian and D. melanogaster PP1 catalytic subunits with an IC50 of approximately 200 nM. A motif -FEX1X2RK-, conserved between inhibitor-t, inhibitor-2 and its Saccharomyces cerevisiae homologue Glc8, is demonstrated to be required for binding to PP1.