Post-Natal Short-Term Home Visiting Programs: An Overview and a Volunteers-Based Program Pilot.

Post-natal home visits have been shown to be one of the most effective ways to prevent child maltreatment and reduce risks among children. Unfortunately, these programs tend to be expensive and thus not accessible or practical in many contexts. To address this problem, this paper reviews the literature on home visits conducted shortly after giving birth, considering different types of programs and their outcomes, while focusing on short-term and volunteer-based programs, two approaches that can answer the gap in accessibility. It then introduces a new, innovative, short-term, home visiting program that was developed in Israel. This post-natal program is uniquely structured as volunteer-based to allow it to be culturally informed and inexpensive and therefore accessible to municipalities. The paper describes how experts in the field developed the program and how the volunteers were trained. It elaborates on the protocol for the three defined home visits, each with a specific focus: (1) preventing risks at home, (2) providing parents with emotional support and tools to deal with stress, and (3) connecting them to community resources. We detail the pilot implementation process and some of the challenges that arise. Finally, we describe the design of the evaluation study that is currently collecting data in an Arab town in the north of Israel, with a final discussion on insights gained thus far from the overall process in light of the literature.

"Care About us First": Israeli Youths' Perspectives on Child Neglect.

Child neglect is considered the most common form of child maltreatment with severe implications for children's development. Nonetheless, there is a dearth of scholarly literature examining child neglect, possibly stemming from a lack of consistent definition. The current qualitative study addresses this gap by aiming to understand the phenomena of child neglect from the direct perspective of youth from the general population, a perspective that has so far barely been considered. Data were collected by 10 focus groups conducted among multicultural youth aged 12 to 15 years in the north of Israel. The qualitative-thematic analysis generated three main themes, each including several subthemes: (a) experience of neglectful behavior (lack of parental care, lack of parental priority, dynamics of blaming the child, rejection, and relinquishment of the child); (b) instrumental characteristics of neglect (lack of material and financial investment in the child, expressions of neglect in providing food and nutrition, poor appearance and hygiene of the child and home); (c) lack of parental involvement (lack of parental guidance, lack of communication and availability, lack of presence in the child's life). The perspectives of the Israeli youth resembled existing conceptualizations of child neglect. The youth also added a new dimension to the conceptualizations in their focus on the emotional context involved in the range of neglectful behaviors they described. This new conceptualization of child neglect is discussed together with some suggestions for how it can inform better professional practice.

Electrochemical Doping of Halide Perovskites by Noble Metal Interstitial Cations.

Metal halide perovskites are an attractive class of semiconductors, but it has proven difficult to control their electronic doping by conventional strategies due to screening and compensation by mobile ions or ionic defects. Noble-metal interstitials represent an under-studied class of extrinsic defects that plausibly influence many perovskite-based devices. In this work, doping of metal halide perovskites is studied by electrochemically formed Au+ interstitial ions, combining experimental data on devices with a computational analysis of Au+ interstitial defects based on density functional theory (DFT). Analysis suggests that Au+ cations can be easily formed and migrate through the perovskite bulk via the same sites as iodine interstitials (Ii + ). However, whereas Ii + compensates n-type doping by electron capture, the noble-metal interstitials act as quasi-stable n-dopants. Experimentally, voltage-dependent, dynamic doping by current density-time (J-t), electrochemical impedance, and photoluminescence measurements are characterized. These results provide deeper insight into the potential beneficial and detrimental impacts of metal electrode reactions on long-term performance of perovskite photovoltaic and light-emitting diodes, as well as offer an alternative doping explanation for the valence switching mechanism of halide-perovskite-based neuromorphic and memristive devices.

Young Bereaved Siblings of Security Personnel in Israel: The Role of Parents and Professional Helpers in Satisfying Their Needs.

This paper addresses bereavement of young siblings of security personnel in Israel. It focuses on their needs and their satisfaction. It examines interactions between the siblings, their parents, and professional helpers in this respect. This paper is based on a qualitative study utilizing focus groups of adult bereaved siblings, bereaved parents, and professional helpers. The cross-referencing analysis of the findings revealed distinct patterns of behavior, family dynamics, and interactions with professional helpers, often causing the needs of young bereaved siblings to remain unmet. Professional intervention with young bereaved siblings is recommended through all stages of bereavement, in order to better meet their needs.

Community Change Programs for Children and Youth At-Risk: A Review of Lessons Learned.

The significant role of the community in the lives of children and youth at-risk has become increasingly clear to social work academics and professionals over the last three decades. Alongside the more traditional individual and family responses, community interventions have been designed to catalyze change in the environment of children and youth at-risk and supply holistic and sustainable responses to their needs. Ten such community intervention programs were identified from the United States, Australia, Canada, and Israel. Most employed the community development model, focused on developing leadership and social capital (improving community networking) and advancing coordination between the organizations and sectors in the field of risk among children and youth. The diverse programs reviewed focused both on at-risk children and youth in general or specifically on child abuse and neglect. The programs originated from different health, education, and welfare disciplines and sponsoring authorities. The majority were funded originally by private foundations; however, government involvement was significant, particularly in the adoption and support of initiatives after their development. The current analysis of the programs refers to core issues that arose from the review: professional orientation, main target unit, main initiator, and research and evaluation. Analysis of program characteristics enables identifying relevant aspects of these programs for use by policy, governmental, and nonprofit sector stakeholders seeking to develop similar programs. Conclusions and recommendations to advance the field are suggested considering the current context of government cuts in welfare funds.

SDM Training Modules for Health and Social Care Professionals in Israel.

While the strategy of Shared Decision Making (SDM) originated in the medical field and was later adopted into the mental health arena, little attention has been paid to practice in the broader fields of the allied health and social care professions. These professions are grounded in the recognition of a need for practice that reflects the partnership and collaboration of the professional and the service user working together to further the health and well-being of the user. A pilot training module was developed to introduce and support students in their journey from exposure to the co-production ideology and the SDM strategy into clinical practice in the allied health and social care professions. The aim of the present article is to describe the students' experiences while learning about SDM and their use of this knowledge in their field practice in Israel. The students' experiences highlighted the complexity of integrating SDM into practice both at the individual student level as well as the macro environment. Moreover, it pointed to the need to further develop this co-production paradigm and the SDM strategy into the education of the allied health and social care professions.

COVID-19 related difficulties and perceived coping among university and college students: the moderating role of media-related exposure and stress.

Background: University and college students are not usually identified as a population at risk during the COVID-19 pandemic. Yet, there is growing evidence of their specific distress associated with facing multiple abrupt changes and the need for rapid adaptation to a variety of academic, social, and financial challenges. The extent of their exposure to COVID-19 media and the associated media-related stress may further impair students' perceived coping. Objective: This study assessed COVID-19-related functional difficulties and perceived coping among higher education students in Israel and explored the moderating role played by media coverage of the pandemic in inducing stress and exacerbating COVID-19-related difficulties in perceived coping among students. Method: Data was collected from 7,446 students from seven academic centres in Israel through online questionnaires about four to six weeks after the outbreak of the pandemic in Israel. Results: The findings showed positive associations between COVID-19-related difficulties, media exposure, media-related stress, and decreased levels of perceived coping with the pandemic. Moreover, media-related stress (but not the level of media exposure) moderated the relationship between COVID-19-related difficulties and perceived coping: the associations were significantly stronger for students reporting high media-related stress in comparison to individuals reporting low media-related stress. Conclusions: These results highlight the specific role of media-related stress and the need to distinguish this risk factor from the global impact of exposure to media coverage. The need for self-monitoring of the subjective level of stress associated with media exposure should be part of the psychoeducation efforts provided by public health authorities for promoting self-care during the COVID-19 pandemic.

Antecedentes: Los estudiantes universitarios generalmente no se identifican como una población en riesgo durante la pandemia de COVID-19. Sin embargo, existe una creciente evidencia de angustia específica asociada con enfrentar cambios abruptos múltiples y la necesidad de una rápida adaptación a una variedad de desafíos académicos, sociales y financieros. El alcance de la exposición a los medios de comunicación acerca del COVID-19, y el estrés relacionado a esta exposición, pueden afectar aún más a los estudiantes universitarios en sus estrategias de afrontamiento percibidas.Objetivo: Este estudio evaluó las dificultades funcionales relacionadas con el COVID-19 y el afrontamiento percibido entre los estudiantes de educación superior en Israel y exploró el papel moderador que desempeña la cobertura mediática de la pandemia para inducir estrés y exacerbar las dificultades relacionadas con el COVID-19 en el afrontamiento percibido entre los estudiantes.Método: Se recopilaron datos de 7.446 estudiantes de siete centros académicos en Israel a través de cuestionarios en línea entre cuatro y seis semanas después del estallido de la pandemia en Israel.Resultados: Los hallazgos mostraron asociaciones positivas entre las dificultades relacionadas con COVID-19, la exposición a los medios, el estrés relacionado con los medios y la disminución del nivel de afrontamiento percibido con la pandemia. Además, el estrés relacionado con los medios (pero no el nivel de exposición a los medios) moderó la relación entre las dificultades relacionadas con COVID-19 y el afrontamiento percibido: las asociaciones fueron significativamente más fuertes para los estudiantes que informaron un alto estrés relacionado con los medios en comparación con las personas que informaron un bajo nivel de estrés mediático relacionado.Conclusiones: Estos resultados destacan el papel específico del estrés relacionado con los medios y la necesidad de distinguir este factor de riesgo del impacto global de la exposición a la cobertura de los medios. La necesidad de autocontrol del nivel subjetivo de estrés asociado con la exposición a los medios debe ser parte de los esfuerzos de psicoeducación brindados por las autoridades de salud pública para promover el autocuidado durante la pandemia de COVID-19.

Mechanism and Timescales of Reversible p-Doping of Methylammonium Lead Triiodide by Oxygen.

Understanding and controlling the energy level alignment at interfaces with metal halide perovskites (MHPs) is essential for realizing the full potential of these materials for use in optoelectronic devices. To date, however, the basic electronic properties of MHPs are still under debate. Particularly, reported Fermi level positions in the energy gap vary from indicating strong n- to strong p-type character for nominally identical materials, raising serious questions about intrinsic and extrinsic defects as dopants. ​In this work, photoemission experiments demonstrate that thin films of the prototypical methylammonium lead triiodide (MAPbI3 ) behave like an intrinsic semiconductor in the absence of oxygen. Oxygen is then shown to be able to reversibly diffuse into and out of the MAPbI3 bulk, requiring rather long saturation timescales of ≈1 h (in: ambient air) and over 10 h (out: ultrahigh vacuum), for few 100 nm thick films. Oxygen in the bulk leads to pronounced p-doping, positioning the Fermi level universally ≈0.55 eV above the valence band maximum. The key doping mechanism is suggested to be molecular oxygen substitution of iodine vacancies, supported by density functional theory calculations. This insight rationalizes previous and future electronic property studies of MHPs and calls for meticulous oxygen exposure protocols.

Choice of Transport to Hospital in Nonurban Areas in Life-Threatening Situations: A Qualitative Research.

The time it takes to begin treatment in life-threatening situations is critical. Ambulance transport to the hospital in such situations ensures quick and effective treatment but is not always readily available in nonurban areas, or not preferred by the public, for various reasons. The purpose of this qualitative study was to examine the factors that deter or encourage ambulance use in life-threatening situations in the geographic periphery from clients' perspectives. We conducted interviews with 71 patients in 3 medical centers who had arrived by ambulance or by private transport, and with the 3 emergency department directors. The findings revealed that awareness of the clinical situation and health literacy, accessibility of emergency services, geographical conditions, and social and economic factors are central in the decision to utilize this service. We detail research recommendations for strengthening public health literacy and access to services.

Breakdown of the Static Picture of Defect Energetics in Halide Perovskites: The Case of the Br Vacancy in CsPbBr3.

We consider the Br vacancy in CsPbBr3 as a prototype for the impact of structural dynamics on defect energetics in halide perovskites (HaPs). Using first-principles molecular dynamics based on density functional theory, we find that the static picture of defect energetics breaks down; the energy level associated with a Br vacancy is found to be intrinsically dynamic, oscillating by as much as 1 eV on the picosecond time scale at room temperature. These significant energy fluctuations are correlated with the distance between the neighboring Pb atoms across the vacancy and with the electrostatic potential at these Pb atomic sites. We expect this unusually strong coupling of structural dynamics and defect energetics to bear important implications for both experimental and theoretical analyses of defect characteristics in HaPs. It may also hold significant ramifications for carrier transport and defect tolerance in this class of photovoltaic materials.

The tolerance benefits of multicultural experiences depend on the perception of available mental resources.

[Correction Notice: An Erratum for this article was reported in Vol 115(3) of Journal of Personality and Social Psychology (see record 2018-40364-001). In the article, the legend labels for Figure 4 are missing. The correct labels are Regulated-writing for the black bar and Free-writing for the gray bar. All versions of this article have been corrected.] Multicultural experience has been shown to lead to greater intergroup tolerance via reduced need for cognitive closure (NFCC). However, the requisite metacognitive conditions that facilitate this effect have yet to be examined. In 6 studies, we systematically demonstrated that the ameliorative effects of multicultural experience on intergroup bias are achieved only when individuals perceived that they had sufficient mental resources. Mental resources were either (a) measured during the Hong Kong "Umbrella Revolution" (Study 1), (b) experimentally manipulated in the lab through a classic depletion task (Study 2), or (c) subjectively recalled (Studies 3, 4, 5, and 6). We further showed that the moderating effects of perceived resource availability on the tolerance benefits of multicultural experience were mediated by reduced levels of NFCC (Studies 1, 5, and 6). This effect was consistent across a variety of targeted outgroups (Mainland Chinese, Arabs, Russians, Blacks, Asian Americans, and homosexuals), regardless of whether multicultural experience was measured or manipulated, and across samples (Hong Kongers, Jewish Israelis, and U.S.-born Americans). Overall, by integrating the literature on multicultural experiences with that on perceived resource depletion, we demonstrate the state-dependent nature of the advantages of multicultural experiences as well as afford a more nuanced view of the downstream influence of perceived mental depletion. (PsycINFO Database Record

Central tendency and matched difference approaches for assessing interrater agreement.

In Study 1 of this two-part investigation, we present a "central tendency approach" and procedures for assessing overall interrater agreement across multiple groups. We define parameters for mean group agreement and construct bootstrapped confidence intervals around the mean population parameters for rWG, AD, and ICC(1). In Study 2, we extend assessments of overall interrater agreement by developing a "matched difference approach" and procedures for assessing real versus pseudo agreement in a sample of groups. Here, we use random group resampling and the matched difference between assessments of the respective rWG, AD, and ICC(1) values for actual and pseudo groups, with the establishment of bootstrapped confidence intervals around such differences. In both studies, we employ simulated and real data to demonstrate the accuracy and practical utility of the new procedures for assessing agreement with respect to groups. Notably, to generate simulated data for Studies 1 and 2, we developed a new underlying model for multilevel data and procedure for data generation, and we discuss its potential utility for enhancing research in group-level studies. Moreover, we discuss, relative to current practices, how and why the new inference procedures provide information about mean interrater agreement in the population, which can improve data aggregation decisions and interpretations of findings from group-level studies. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The Short-Term Placebo Response in Children With Attention-Deficit Hyperactivity Disorder (ADHD).

To assess short-term placebo response in 6- to 13-year-old children with ADHD, children who were administered a double-blind placebo-methylphenidate trial, 1 week each, were included in the analysis. Conners' parents and Teacher Rating scales, the Aggregate Neurobehavioral Student Health and Educational Review inventory, and the Matching Familiar Figure Test were employed. A reduction of 30% or more in one or more of the teachers report subscales was observed in 18.8% of the participants. Attention test performance resulted in 58% of children exhibiting reduction in error rates and 36.2% exhibited longer latency period. Significant correlations between placebo response and methylphenidate response in all of the teachers report subscales were found. Base line severity, learning problem and emotional status were found associated with placebo response. Short-term placebo response should be accounted for in children with ADHD.

De-freezing frozen patient management.

OBJECTIVE: To compare the effectiveness of two methods in encouraging the consideration of a leap from one patient management routine to another: (i) real-time review of the facts by an external medical team (ii) implementation of the 're-thinking-protocol' ('de-Freezing') by both treating and external medical teams. DESIGN: Students accompanied doctors, nurses and patients as non-interrupting observers. When an obvious gap between the expected and actual findings occurred, it was discussed four times: by two teams (treating team, external medical team) in two discussion modes (real-time review, de-Freezing-questionnaire). The students then recorded if a leap was considered for each discussion. SETTING: The study was conducted in the emergency department of the Baruch Padeh Medical Centre, Poriya, Israel. PARTICIPANTS: All patients were included during times when both medical teams (treating, external) were present. INTERVENTION(S): During 14 periods of 5-7 h each, 459 patients were sampled. In 183 patients, 200 gaps were discovered. RESULTS: The external team considered a leap 76 times, compared with 47 by the treating team (P < 0.001). Using the de-Freezing-protocol, the treating team considered a leap 133 times. Interestingly, even the external team benefited from the de-Freezing protocol and considered a leap 140 times (NS compared to the treating team). CONCLUSIONS: While the importance of timely leaping from one patient management routine to another is emphasized in the training of physicians, medical teams too often fail to do so. The de-Freezing-protocol inexpensively encourages the consideration of a leap beyond what is evoked by the involvement of an external team. The protocol is applicable to all medical processes and should be incorporated into medical practice and education.

Efficacy of oral methotrexate in paediatric Crohn's disease: a multicentre propensity score study.

BACKGROUND: Oral methotrexate (MTX) administration avoids weekly injections, reduces costs and may improve quality of life of patients with Crohn's disease (CD), especially children. Routes of administration have never been systematically compared in CD. We aimed to compare effectiveness and safety of orally (PO) versus subcutaneously (SC) administered MTX in paediatric CD. METHODS: 226 children with CD treated with oral or subcutaneous MTX were included in a multicentre, retrospective 1-year cohort study (62% boys, mean age 13.8±2.8 years, 88% previous thiopurines). 38 (17%) were initially commenced on oral, 98 (43%) started subcutaneous and switched to oral and 90 (40%) were treated with subcutaneous only. Matching and 'doubly robust' weighted regression models were based on the propensity score method, controlling for confounding-by-indication bias. 11/23 pretreatment variables were different between the groups, but the propensity score modelling successfully balanced the treatment groups. RESULTS: 76 children (34%) had sustained steroid-free remission with a difference that did not reach significance between the PO and the SC groups (weighted OR=1.72 (95% CI 0.5 to 5.9); p=0.52). There were no differences in need for treatment escalation (p=0.24), elevated liver enzymes (p=0.59) or nausea (p=0.85). Height velocity was lower in the PO group (p=0.006) and time to remission was delayed in the PO group (p=0.036; Fleming (0, 1) test). CONCLUSIONS: In this largest paediatric CD cohort to date, SC administered MTX was superior to PO, but only in some of the outcomes and with a modest effect size. Therefore, it may be reasonable to consider switching children in complete remission treated with subcutaneous MTX to the oral route with close monitoring of inflammatory markers and growth.

Dependence of the absorption and optical surface plasmon scattering of MoS2 nanoparticles on aspect ratio, size, and media.

The optical and electronic properties of suspensions of inorganic fullerene-like nanoparticles of MoS2 are studied through light absorption and zeta-potential measurements and compared to those of the corresponding microscopic platelets. The total extinction measurements show that, in addition to excitonic peaks and the indirect band gap transition, a new peak is observed at 700-800 nm. This spectral peak has not been reported previously for MoS2. Comparison of the total extinction and decoupled absorption spectrum indicates that this peak largely originates from scattering. Furthermore, the dependence of this peak on nanoparticle size, shape, and surface charge, as well as solvent refractive index, suggests that this transition arises from a plasmon resonance.

Statistical significance criteria for the rWG and average deviation interrater agreement indices.

Despite the widespread use of interrater agreement statistics for multilevel modeling and other types of research, the existing guidelines for inferring the statistical significance of interrater agreement are quite limited. They are largely relevant only under conditions that numerous researchers have argued rarely exist. Here we address this problem by generating guidelines for inferring statistical significance under a number of conditions via a computer simulation. As a set, these guidelines cover many of the conditions researchers commonly face. We discuss how researchers can use the guidelines presented to more reasonably infer the statistical significance of interrater agreement relative to using the limited guidelines available in the extant literature.

Detection of subclinical keratoconus using an automated decision tree classification.

PURPOSE: To develop a method for automatizing the detection of subclinical keratoconus based on a tree classification. DESIGN: Retrospective case-control study. METHODS: setting: University Hospital of Bordeaux. participants: A total of 372 eyes of 197 patients were enrolled: 177 normal eyes of 95 subjects, 47 eyes of 47 patients with forme fruste keratoconus, and 148 eyes of 102 patients with keratoconus. observation procedure: All eyes were imaged with a dual Scheimpflug analyzer. Fifty-five parameters derived from anterior and posterior corneal measurements were analyzed for each eye and a machine learning algorithm, the classification and regression tree, was used to classify the eyes into the 3 above-mentioned conditions. main outcome measures: The performance of the machine learning algorithm for classifying eye conditions was evaluated, and the curvature, elevation, pachymetric, and wavefront parameters were analyzed in each group and compared. RESULTS: The discriminating rules generated with the automated decision tree classifier allowed for discrimination between normal and keratoconus with 100% sensitivity and 99.5% specificity, and between normal and forme fruste keratoconus with 93.6% sensitivity and 97.2% specificity. The algorithm selected as the most discriminant variables parameters related to posterior surface asymmetry and thickness spatial distribution. CONCLUSION: The machine learning classifier showed very good performance for discriminating between normal corneas and forme fruste keratoconus and provided a tool that is closer to an automated medical reasoning. This might help in the surgical decision before refractive surgery by providing a good sensitivity in detecting ectasia-susceptible corneas.

Facilitation of left ventricular function recovery post percutaneous coronary intervention by levosimendan.

BACKGROUND: Efficiency of percutaneous revascularization and the utility of levosimendan for advanced ischemic heart failure (HF) is unclear. We examined the efficacy of revascularization and levosimendan on left ventricular ejection fraction (LVEF) and mortality of patients admitted with acute decompensated HF and severe left ventricular dysfunction. METHODS: A prospective case control study that enrolled 84 patients with ischemic decompensated HF with LVEF <35% and preserved LV wall thickness. Group A: 42 patients whose LVEF improved post percutaneous coronary intervention (PCI). Group B1: 22 patients whose LVEF did not improve post-PCI alone but improved after levosimendan. Group B2: 20 patients whose LVEF did not improve neither post-PCI nor post levosimendan. RESULTS: LVEF increased in group A from 22 ± 5 to 29 ± 5% post PCI and continued to improve at the 6 month follow-up (36 ± 4%). In group B1 LVEF did not improve after PCI, but increased after levosimendan from 23 ± 4% to 32 ± 4% and remained constant at 6 months. In group B2 LVEF 26 ± 4% did not change following both interventions. Reverse remodeling with a decrease in end-diastolic and end-systolic diameters was observed only in groups A and B1. Group B2 had a dismal prognosis with 36% in-hospital and 43% six month mortality. Groups A and B1 had a lower in hospital (4.7%, 4.5%) and mid term (11%, 11%) mortality. CONCLUSION: Improvement of LV size and function with better prognosis can be expected in the majority of patients undergoing PCI for decompensated ischemic HF. Levosimendan enhanced the recovery of LV function post PCI.