Examining the impact of a universal social and emotional learning intervention (Passport) on internalising symptoms and other outcomes among children, compared to the usual school curriculum: study protocol for a school-based cluster randomised trial.

BACKGROUND: School-based universal social and emotional learning (SEL) interventions implemented during the transition to adolescence may be efficacious in preventing the development of mental health difficulties. This protocol describes a two-arm parallel cluster randomised controlled trial to investigate the impact of a universal SEL intervention (Passport, compared to usual provision) on internalising symptoms (primary outcome), emotion regulation, well-being, loneliness, social support, bullying, academic attainment, and health-related quality of life in English primary school pupils aged 9-11 years. A developer-led trial demonstrated the feasibility, acceptability, and utility of Passport; this will be the first independent trial. METHODS: Sixty primary schools will be recruited across the Greater Manchester city region and surrounding areas, involving 2400 pupils aged 8-9 at baseline. Schools will be allocated to the intervention arm to implement Passport over 18 weekly sessions or to the control arm to implement the usual school curriculum. Random allocation will be at school level following completion of baseline measures, with minimisation to ensure balance across trial arms in school size and free school meal eligibility. Measures will be collected at baseline, post-intervention (12 months post-baseline), and at 12 months follow-up (24 months post-baseline). The primary outcome analysis (intervention effects on internalising symptoms at post-intervention) will comprise a two-level (school, child) hierarchical linear model, following the intention-to-treat principle. Additional analyses will be undertaken to assess intervention effects on secondary outcomes, maintenance effects for all outcomes, intervention compliance moderator effects, subgroup moderator effects, and mechanisms underpinning intervention effects on the primary outcome. A mixed-methods implementation and process evaluation will examine factors that influence implementation, and a health economic evaluation will assess the cost-effectiveness of the intervention. DISCUSSION: Findings will provide educators with crucial knowledge of whether and how increasing emotion regulation through a universal intervention impacts internalising symptoms and a range of related outcomes. Findings will also inform policy related to the promotion of mental health among children and young people. If the intervention is found to be efficacious in reducing internalising symptoms and is also cost-effective, it may offer high potential as a preventative intervention for widespread implementation. TRIAL REGISTRATION: ISRCTN12875599; registered on 24 November 2022.

Workplace wellbeing in emergency departments in Aotearoa New Zealand 2020.

AIM: To quantify staff burnout and wellbeing in emergency departments (EDs) throughout New Zealand (NZ). METHODS: A national cross sectional electronic survey of New Zealand clinical and non-clinical ED staff was conducted between 9 March and 3 April 2020. Burnout and wellbeing were assessed using the Copenhagen Burnout Inventory (CBI) and a variety of quantitative measures. Differences between measures were assessed by demography and work role using univariate analyses. Multivariate analyses assessed associations between burnout and wellbeing. RESULTS: 1,372 staff responded from 22 EDs around New Zealand (response rate 43%). Most were female (n=678, 63%), NZ European (n=799, 59%), aged 20-39 years (n=743, 54%) and nurses (n=711, 52%). The overall prevalence of personal burnout was 60%, work-related burnout 55% and patient-related burnout 19%. There was a wide variation of burnout across all EDs. Females and nurses showed the highest degree of burnout by gender and role, respectively. Measures of wellbeing with significant negative correlations with burnout were work-related happiness, work-life balance, job satisfaction and perceived workplace excellence. Work stress had significant positive correlation with burnout. CONCLUSION: New Zealand ED staff have a high degree of burnout. Safety, financial sustainability and quality of care are likely being adversely affected. Stakeholders can be informed by findings from this study to inspire meaningful interventions in EDs and throughout the New Zealand healthcare system.

Facilitators, barriers and opportunities in workplace wellbeing: A national survey of emergency department staff.

INTRODUCTION: Emergency department (ED) staff face daily exposure to the illness, injury, intoxication, violence and distress of others. Rates of clinician burnout are high and associated with poor patient outcomes. This study sought to measure the prevalence of burnout in ED personnel as well as determine the important facilitators of and barriers to workplace wellbeing. METHOD: An anonymous online survey including six open-ended questions on workplace wellbeing was completed by 1372 volunteer participants employed as nurses, doctors, allied health or nonclinical roles at 22 EDs in Aotearoa, New Zealand in 2020. Responses to the questions were analysed using a general inductive approach. RESULTS: The three key themes that characterise what matters most to participants' workplace wellbeing are: (1) Supportive team culture (2) Delivering excellent patient-centred care and (3) Professional development opportunities. Opportunities to improve wellbeing also focused on enhancements in these three areas. CONCLUSION: In order to optimise workplace wellbeing, emergency departments staff value adequate resourcing for high-quality patient care, supportive and cohesive teams and professional development opportunities. Initiatives in these areas may facilitate staff wellbeing as well as improving safety and quality of patient care.

Validation of a Food Frequency Questionnaire for Bone Nutrients in Pregnant Women.

PURPOSE: The aim was to validate a food frequency questionnaire (FFQ) against a 3-day food record (3DFR) for pregnant women with a focus on nutrients important for bone health from food and supplements. METHODS: The FFQ and 3DFR were administered to pregnant women (n = 42) aged 18-45 years in their third trimester of pregnancy in Hamilton, Ontario. Nutrient analysis of intakes was conducted using an FFQ calculator and Nutritionist-Pro software. The average daily serving consumption of Milk and alternatives group and Vegetable subgroup from Canada's Food Guide were also compared. RESULTS: There was a high positive correlation between methods for total dietary vitamin D (r = 0.83). Low positive associations were observed for total protein (r = 0.37), calcium (r = 0.36), vitamin K (r = 0.41), and servings of Milk and alternatives (r = 0.36). A cross-classification analysis using participants' intake quartiles revealed no major misclassifications. Bland-Altman analysis showed that the FFQ mildly underestimated the intake for protein, whereas it grossly overestimated the intake of vitamin K, and daily servings of Milk and alternatives and Vegetable. CONCLUSIONS: This FFQ can serve as a useful tool in clinical and research settings to assess key bone nutrients from foods and supplement sources in pregnant women.

Use of an Accelerated Diagnostic Pathway allows rapid and safe discharge of 70% of chest pain patients from the emergency department.

INTRODUCTION: The majority of patients who present to the Emergency Department (ED) with chest pain, do not have Acute Coronary Syndrome (ACS). Rapid, safe discharge home for this large group is hampered by clinical uncertainty. A pragmatic Accelerated Diagnostic Pathway (ADP) used in our ED achieves this goal. AiIM: To demonstrate the safety and utility of a locally developed ADP. The primary outcome for patients who were identified as non-high risk by our ADP was death or acute myocardial infarction (AMI) at 30 days. Secondary outcomes were ED length of stay, discharge rates, provocative testing and revascularisation rates. METHOD: This is a prospective observational convenience cohort study of chest pain patients presenting to a regional ED excluding ST-elevation myocardial infarction (STEMI). Using a locally derived ADP, patients were classified as high risk or non-high risk for 30-day death or AMI. Patients could be classified as high risk on the basis of ECG change, troponin elevation, or senior clinician "gestalt" irrespective of negative serial ECGs and troponins. All others were classified non-high risk and were followed up at 30 days. RESULTS: There were 452 patient events with the ADP identifying 75% as non-high-risk (93% of these patients were actually discharged). All patients were successfully followed up for 30-day outcomes. The sensitivity and negative predictive value of the ADP was 100% (95% CI: 99-100%). Specificity was 83% (95% CI: 79-87%). The average ED length of stay was 4 hours 5 minutes. There were low rates of revascularisation (1.5%) and provocative testing (6.2%) in the non-high risk group. CONCLUSION: This ED ADP for chest pain rapidly and safely identified patients who were not at high risk of a short-term AMI or death.

Chemical reactivity on gas-phase metal clusters driven by blackbody infrared radiation.

We report the observation of chemical reactions in gas-phase Rh(n)(N2O)m(+) complexes driven by absorption of blackbody radiation. The experiments are performed under collision-free conditions in a Fourier transform ion cyclotron resonance mass spectrometer. Mid-infrared absorption by the molecularly adsorbed N2O moieties promotes a small fraction of the cluster distribution sufficiently to drive the N2O decomposition reaction, leading to the production of cluster oxides and the release of molecular nitrogen. N2O decomposition competes with molecular desorption and the branching ratios for the two processes show marked size effects, reflecting variations in the relative barriers. The rate of decay is shown to scale approximately linearly with the number of infrared chromophores. The experimental findings are interpreted in terms of calculated infrared absorption rates assuming a sudden-death limit.

Collisional activation of N2O decomposition and CO oxidation reactions on isolated rhodium clusters.

The reactions of nitrous oxide decorated rhodium clusters, RhnN2O(+) (n = 5, 6), have been studied by Fourier transform ion cyclotron resonance mass spectrometry. Collision induced dissociation with Ar is shown to lead to one of two processes; desorption of the intact N2O moiety (indicating molecular adsorption in the parent cluster) or N2O decomposition liberating molecular nitrogen with the latter becoming increasingly dominant at higher collision energies. Consistent with the results of earlier studies, which employed infrared excitation [Hermes, A. C.; et al. J. Phys. Chem. Lett. 2011, 2, 3053], Rh5ON2O(+) is observed to behave qualitatively differently to Rh5N2O(+) with decomposition of the nitrous oxide dominating the chemistry of the former. In other experiments, the reactivity of RhnN2O(+) clusters with CO has been studied. Chemisorption of (13)CO is calculated to deposit ca. 2 eV into the parent cluster, initiating a range of chemical processes on the cluster surface, which are fit to a simple reaction mechanism. Clear differences are again observed in the reaction branching ratios for Rh5N2O(+) and Rh6N2O(+) parent cluster ions. For the n = 5 cluster, the combined N2O reduction/CO oxidation is the most significant reaction channel, while the n = 6 cluster preferentially is oxidized to Rh6O(+) with loss of N2 and CO. Even larger differences are observed in the reactions of the N2O decorated cluster oxides, RhnON2O(+), for which more reaction possibilities arise. The results of all studies are discussed in relation to infrared driven processes on the same parent cluster species [Hamilton, S. M.; et al. J. Am. Chem. Soc. 2010, 132, 1448; J. Phys. Chem. A, 2011, 115, 2489].

Infrared driven CO oxidation reactions on isolated platinum cluster oxides, Pt(n)O(m)+.

This collaboration has recently shown that infrared excitation can drive decomposition reactions of molecules on the surface of gas-phase transition metal clusters. We describe here a significant extension of this work to the study of bimolecular reactions initiated in a similar manner. Specifically, we have observed the infrared activated CO oxidation reaction (CO(ads) + O(ads) --> CO2(g)) on isolated platinum oxide cations, Pt(n)O(m)+. Small platinum cluster oxides Pt(n)O(m)+ (n = 3-7, m = 2, 4), have been decorated with CO molecules and subjected to multiple photon infrared excitation in the range 400-2200 cm(-1) using the Free Electron Laser for Infrared eXperiments (FELIX). The Pt(n)O(m)CO+ clusters have been characterised by infrared multiple photon dissociation spectroscopy using messenger atom tagging. Evidence is observed for isomers involving both dissociatively and molecularly adsorbed oxygen on the cluster surface. Further information is obtained on the evolution of the cluster structure with number of platinum atoms and CO coverage. In separate experiments, Pt(n)O(m)CO+ clusters have been subjected to infrared heating via the CO stretch around 2100 cm(-1). On all clusters investigated, the CO oxidation reaction, indicated by CO2 loss and production of Pt(n)O(m) = 1+, is found to compete effectively with the CO desorption channel. The experimental observations are compared with the results of preliminary DFT calculations in order to identify both cluster structures and plausible mechanisms for the surface reaction.

Infrared-induced reactivity of N2O on small gas-phase rhodium clusters.

Far- and mid-infrared multiple photon dissociation spectroscopy has been employed to study both the structure and surface reactivity of isolated cationic rhodium clusters with surface-adsorbed nitrous oxide, Rh(n)N(2)O(+) (n = 4-8). Comparison of experimental spectra recorded using the argon atom tagging method with those calculated using density functional theory (DFT) reveals that the nitrous oxide is molecularly bound on the rhodium cluster via the terminal N-atom. Binding is thought to occur exclusively on atop sites with the rhodium clusters adopting close-packed structures. In related, but conceptually different experiments, infrared pumping of the vibrational modes corresponding with the normal modes of the adsorbed N(2)O has been observed to result in the decomposition of the N(2)O moiety and the production of oxide clusters. This cluster surface chemistry is observed for all cluster sizes studied except for n = 5. Plausible N(2)O decomposition mechanisms are given based on DFT calculations using exchange-correlation functionals. Similar experiments pumping the Rh-O stretch in Rh(n)ON(2)O(+) complexes, on which the same chemistry is observed, confirm the thermal nature of this reaction.

Infrared induced reactivity on the surface of isolated size-selected clusters: dissociation of N2O on rhodium clusters.

Multiple photon infrared excitation of size-selected Rh(6)N(2)O(+) clusters drives surface chemistry resulting in partially oxidized clusters.

The electronic spectrum of vanadium monoxide across the visible: new bands and new insight.

Resonance enhanced multiphoton ionization spectra of vanadium monoxide (VO) have been measured in the 16,000-23,300 cm(-1) region. A series of intense peaks, identified as the VO C (4)Sigma(-) (v('))-X (4)Sigma(-) (v(")=0) progression, has been recorded up to v(')=7 and vibrational and rotational parameters have been extracted by simulation of the rotationally resolved spectra. Additional weak transitions in the spectrum are assigned to the 2 (2)Pi-X (4)Sigma(-) spin-forbidden band system allowing the first direct determination of a spin-orbit coupling constant within the doublet spin manifold of VO. Together, the spectra provide absolute energies for several doublet electronic states with respect to the X (4)Sigma(-) ground state. A further vibronic progression observed at 22,000 cm(-1) is assigned as a second spin-forbidden excitation from the X (4)Sigma(-) ground state to a (2)Pi state which has not previously been characterized.

Mnt1p and Mnt2p of Candida albicans are partially redundant alpha-1,2-mannosyltransferases that participate in O-linked mannosylation and are required for adhesion and virulence.

The MNT1 gene of the human fungal pathogen Candida albicans is involved in O-glycosylation of cell wall and secreted proteins and is important for adherence of C. albicans to host surfaces and for virulence. Here we describe the molecular analysis of CaMNT2, a second member of the MNT1-like gene family in C. albicans. Mnt2p also functions in O-glycosylation. Mnt1p and Mnt2p encode partially redundant alpha-1,2-mannosyltransferases that catalyze the addition of the second and third mannose residues in an O-linked mannose pentamer. Deletion of both copies of MNT1 and MNT2 resulted in reduction in the level of in vitro mannosyltransferase activity and truncation of O-mannan. Both the mnt2Delta and mnt1Delta single mutants were significantly reduced in adherence to human buccal epithelial cells and Matrigel-coated surfaces, indicating a role for O-glycosylated cell wall proteins or O-mannan itself in adhesion to host surfaces. The double mnt1Deltamnt2Delta mutant formed aggregates of cells that appeared to be the result of abnormal cell separation. The double mutant was attenuated in virulence, underlining the importance of O-glycosylation in pathogenesis of C. albicans infections.