How Do Adolescent Smoking Prevention Interventions Work in Different Contextual Settings? A Qualitative Comparative Study Between the UK and Colombia.

BACKGROUND: Adolescent smoking is associated with significant health and social risks. Previous research has demonstrated the effectiveness of interventions based on behavior change theories in preventing adolescent smoking uptake. However, evidence from the theory-based perspective of evaluation is limited, especially for how such complex interventions work, and how they work when implemented in different contextual settings. METHOD: A comparative qualitative analysis was conducted to explore various influences on behavior change among participants taking part in two smoking prevention interventions in Northern Ireland and Bogotá. Twenty-seven focus groups were conducted in 12 schools (6 in Northern Ireland and 6 in Bogota, n = 195 pupils participated; aged 11-15 years). The Theoretical Domains Framework guided a content analysis of the data. RESULTS: We found similarities across settings in terms of knowledge, skills, and beliefs related to smoking or vaping behavior change, as well as differences in contextual resources and social influence. Different environmental resources included availability to purchase tobacco products in the neighborhoods and previous information about tobacco risk. Participants in both interventions perceived behavioral change outcomes related to personal skills and intention to not smoke or vape. CONCLUSION: These findings have highlighted how both individual factors and contextual resources influence behavior change for smoking prevention in practice. Local contextual factors and social influences affecting pupils should be taken into account in the implementation and evaluation of health behavior change interventions. In particular, this study supports using social and contextual influence strategies in interventions to reduce the onset of adolescent smoking and vaping.

Novel cetacean morbillivirus in a rare Fraser's dolphin (Lagenodelphis hosei) stranding from Maui, Hawai'i.

Cetacean morbillivirus (CeMV) is a global threat to cetaceans. We report a novel morbillivirus from a Fraser's dolphin (Lagenodelphis hosei) that stranded in Maui, Hawaii in 2018 that is dissimilar to the beaked whale morbillivirus previously identified from Hawaii and to other CeMV strains. Histopathological findings included intranuclear inclusions in bile duct epithelium, lymphoid depletion, rare syncytial cells and non-suppurative meningitis. Cerebellum and lung tissue homogenates were inoculated onto Vero.DogSLAMtag cells for virus isolation and cytopathic effects were observed, resulting in the formation of multinucleated giant cells (i.e., syncytia). Transmission electron microscopy of infected cell cultures also revealed syncytial cells with intracytoplasmic and intranuclear inclusions of viral nucleocapsids, consistent with the ultrastructure of a morbillivirus. Samples of the cerebellum, lung, liver, spleen and lymph nodes were positive for morbillivirus using a reverse transcription-polymerase chain reaction. The resulting 559 bp L gene sequence had the highest nucleotide identity (77.3%) to porpoise morbillivirus from Northern Ireland and the Netherlands. The resulting 248 bp P gene had the highest nucleotide identity to porpoise morbillivirus in Northern Ireland and the Netherlands and to a stranded Guiana dolphin (Sotalia guianensis) in Brazil (66.9%). As Fraser's dolphins are a pelagic species that infrequently strand, a novel strain of CeMV may be circulating in the central Pacific that could have additional population impacts through transmission to other small island-associated cetacean species.

PTSD as a consequence of past conflict experience, recent exposure to violence and economic marginalization in post-conflict contexts: A study from Nepal, Guatemala and Northern Ireland.

BACKGROUND: Exposure to war and conflict increases the risk of mental health problems. Poor living conditions are known to negatively impact mental health. HYPOTHESIS: It is hypothesized that exposure to negative events after armed conflict interacts with past negative experiences, socioeconomic factors and current mental health problems. METHODS: A cross-sectional survey was carried out in three contexts of previous internal armed conflict: Nepal, Guatemala and Northern Ireland. Three nationally representative samples were drawn, comprising a net sample of 3,229 respondents. RESULTS: Both recent negative events and past negative events linked to the previous conflicts were found to be associated with elevated risk of post-traumatic stress syndrome (PTSD). Economic marginalization and urban residency also contributed to current risk of PTSD. CONCLUSIONS: The results support the study hypothesis that both past and recent negative events in combination with economic marginalization contribute to explain current risk of PTSD. It is necessary both to improve living conditions more broadly and to establish and develop health services that have the capacity to screen, prevent and treat mental health problems also in poor contexts, in particular against a background of previous armed conflict.

Concordance between the diagnostic guidelines for alcohol and cannabis use disorders in the draft ICD-11 and other classification systems: analysis of data from the WHO's World Mental Health Surveys.

BACKGROUND AND AIMS: The World Health Organization's (WHO's) proposed International Classification of Diseases, 11th edition (ICD-11) includes several major revisions to substance use disorder (SUD) diagnoses. It is essential to ensure the consistency of within-subject diagnostic findings throughout countries, languages and cultures. To date, agreement analyses between different SUD diagnostic systems have largely been based in high-income countries and clinical samples rather than general population samples. We aimed to evaluate the prevalence of, and concordance between diagnoses using the ICD-11, The WHO's ICD 10th edition (ICD-10) and the Diagnostic and Statistical Manual of Mental Disorders, 4th and 5th editions (DSM-IV, DSM-5); the prevalence of disaggregated ICD-10 and ICD-11 symptoms; and variation in clinical features across diagnostic groups. DESIGN: Cross-sectional household surveys. SETTING: Representative surveys of the general population in 10 countries (Argentina, Australia, Brazil, Colombia, Iraq, Northern Ireland, Poland, Portugal, Romania and Spain) of the World Mental Health Survey Initiative. PARTICIPANTS: Questions about SUDs were asked of 12 182 regular alcohol users and 1788 cannabis users. MEASUREMENTS: Each survey used the World Mental Health Survey Initiative version of the WHO Composite International Diagnostic Interview version 3.0 (WMH-CIDI). FINDINGS: Among regular alcohol users, prevalence (95% confidence interval) of life-time ICD-11 alcohol harmful use and dependence were 21.6% (20.5-22.6%) and 7.0% (6.4-7.7%), respectively. Among cannabis users, 9.3% (7.4-11.1%) met criteria for ICD-11 harmful use and 3.2% (2.3-4.0%) for dependence. For both substances, all comparisons of ICD-11 with ICD-10 and DSM-IV showed excellent concordance (all κ ≥ 0.9). Concordance between ICD-11 and DSM-5 ranged from good (for SUD and comparisons of dependence and severe SUD) to poor (for comparisons of harmful use and mild SUD). Very low endorsement rates were observed for new ICD-11 feature for harmful use ('harm to others'). Minimal variation in clinical features was observed across diagnostic systems. CONCLUSIONS: The World Health Organization's proposed International Classification of Diseases, 11th edition (ICD-11) classifications for substance use disorder diagnoses are highly consistent with the ICD 10th edition and the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV). Concordance between ICD-11 and the DSM 5th edition (DSM-5) varies, due largely to low levels of agreement for the ICD harmful use and DSM-5 mild use disorder. Diagnostic validity of self-reported 'harm to others' is questionable.

Prevalence survey of healthcare-associated infections in Argentina; comparison with England, Wales, Northern Ireland and South Africa.

BACKGROUND: Prevalence surveillance methodology is the systematic observation of the occurrence and distribution of healthcare-associated infections (HCAIs) so that appropriate actions can be taken. AIM: The objectives of a prevalence survey with an international validated methodology were to determine the prevalence of HCAIs for the first time in Argentina, and to provide data which could be used for international benchmarking. METHODS: In 2008, an HCAI prevalence survey was carried out in 39 hospitals in seven of 23 provinces in Argentina, with methodology identical to that employed by the Hospital Infection Society in the third prevalence survey of HCAIs in acute hospitals in the British Isles. Data collected were processed and analysed at the Northern Ireland Healthcare-Associated Infection Surveillance Centre at Belfast. FINDINGS: A total of 4249 patients were surveyed; 480 of these had at least one HCAI, resulting in a prevalence of 11.3% of patients. Male prevalence was 13.6% and female 9.0%. The most common HCAIs were pneumonia (3.3%), urinary tract infection (3.1%), surgical site infection (2.9%), primary bloodstream infection (1.5%), and soft tissue infections (1.2%). Among the 1027 patients who underwent surgery, the prevalence of surgical site infection was 10.2%. The prevalence of meticillin-resistant Staphylococcus aureus was 1.1%, accounting for 10.0% of all HCAI isolates. The results for Argentina show higher HCAI rates compared with corresponding findings for England, Wales, Northern Ireland and South Africa. CONCLUSION: This survey will contribute to the prioritization of resources and help to inform Departments of Health and hospitals in the continuing effort to reduce HCAIs.

Cross-cultural patterns in dynamic ratings of positive and negative natural emotional behaviour.

BACKGROUND: Studies of cross-cultural variations in the perception of emotion have typically compared rates of recognition of static posed stimulus photographs. That research has provided evidence for universality in the recognition of a range of emotions but also for some systematic cross-cultural variation in the interpretation of emotional expression. However, questions remain about how widely such findings can be generalised to real life emotional situations. The present study provides the first evidence that the previously reported interplay between universal and cultural influences extends to ratings of natural, dynamic emotional stimuli. METHODOLOGY/PRINCIPAL FINDINGS: Participants from Northern Ireland, Serbia, Guatemala and Peru used a computer based tool to continuously rate the strength of positive and negative emotion being displayed in twelve short video sequences by people from the United Kingdom engaged in emotional conversations. Generalized additive mixed models were developed to assess the differences in perception of emotion between countries and sexes. Our results indicate that the temporal pattern of ratings is similar across cultures for a range of emotions and social contexts. However, there are systematic differences in intensity ratings between the countries, with participants from Northern Ireland making the most extreme ratings in the majority of the clips. CONCLUSIONS/SIGNIFICANCE: The results indicate that there is strong agreement across cultures in the valence and patterns of ratings of natural emotional situations but that participants from different cultures show systematic variation in the intensity with which they rate emotion. Results are discussed in terms of both 'in-group advantage' and 'display rules' approaches. This study indicates that examples of natural spontaneous emotional behaviour can be used to study cross-cultural variations in the perception of emotion.

Detection of bovine tuberculosis in herds with different disease prevalence and influence of paratuberculosis infection on PPDB and ESAT-6/CFP10 specificity.

Bovine tuberculosis (BTB) is a major animal health problem with zoonotic implications. Current control programs are based on test and slaughter strategies utilizing skin tests with tuberculins as antigens. The low specificity and associated operative difficulties of these tests have driven the search for new antigens and diagnostic assays. In this multicenter study, using herds from Argentina, Mexico and Northern Ireland, we selected skin test positive and negative animals from herds with different prevalence's of BTB and compared tuberculin (PPDB) and ESAT-6+CFP10 as antigens ex vivo. In low prevalence herds, crossreactivity of PPDB was apparent since up to 60% of the PPDB skin test and ex vivo positive animals did not responded to ESAT-6+CFP10 ex vivo. The superior specificity of ESAT-6+CFP10 was confirmed in a Mycobacterium avium sp. paratuberculosis infected herd where several of the animals had strong crossreactivity to PPDB and PPDA but not to ESAT-6+CFP10. In high prevalence herds 85% of the skin test-positive animals, were confirmed ex vivo using either PPDB or ESAT-6+CFP10 as antigen. However, within this group 60% of the skin test negative animals were PPDB and ESAT-6+CFP10 positive ex vivo indicating that the skin test can in some herds yield a significant number of false negative results. In conclusion, the ex vivo test is recommended as an ancillary test to accelerate BTB eradication. In high prevalence herds, PPDB or ESAT-6+CFP10 can be used as antigen whereas in low and medium prevalence herds ESAT-6+CFP10 is the preferred choice.

On positive psychological outcomes: what helps groups with a history of conflict to forgive and reconcile with each other?

Three studies examined the roles of traditional and novel social psychological variables involved in intergroup forgiveness. Study 1 (N = 480) revealed that among the pro-Pinochet and the anti-Pinochet groups in Chile, forgiveness was predicted by ingroup identity (negatively), common ingroup identity (positively), empathy and trust (positively), and competitive victimhood (the subjective sense of having suffered more than the outgroup, negatively). Political ideology (Right vs. Left) moderated the relationship between empathy and forgiveness, trust and forgiveness, and between the latter and competitive victimhood. Study 2 (N = 309), set in the Northern Irish conflict between Protestants and Catholics, provided a replication and extension of Study 1. Finally, Study 3 (N = 155/108) examined the longitudinal relationship between forgiveness and reconciliation in Northern Ireland, revealing that forgiveness predicted reconciliation intentions. The reverse direction of this relationship was also marginally significant. Results are discussed in terms of their theoretical and practical implications.

Achieving transparency in implementing abortion laws.

National and international courts and tribunals are increasingly ruling that although states may aim to deter unlawful abortion by criminal penalties, they bear a parallel duty to inform physicians and patients of when abortion is lawful. The fear is that women are unjustly denied safe medical procedures to which they are legally entitled, because without such information physicians are deterred from involvement. With particular attention to the European Court of Human Rights, the UN Human Rights Committee, the Constitutional Court of Colombia, the Northern Ireland Court of Appeal, and the US Supreme Court, decisions are explained that show the responsibility of states to make rights to legal abortion transparent. Litigants are persuading judges to apply rights to reproductive health and human rights to require states' explanations of when abortion is lawful, and governments are increasingly inspired to publicize regulations or guidelines on when abortion will attract neither police nor prosecutors' scrutiny.

The individual, the group and the psychology of terrorism.

Northern Ireland lived through a campaign of terrorism for thirty years. This has now ended and substantial progress has been made towards political stability through a long-term peace process. Using his experience as a psychiatrist and psychotherapist, but also as leader of a political party, negotiator in the peace process and subsequently Speaker of the Northern Ireland Assembly, Lord Alderdice explores the psychology of political terrorism. He examines the role of individual and group psychology, the evolution and dissolution of a 'group mind', splitting, and the factors that contribute to division and violence. He describes the frustration of healthy pathways for change, and humiliation, shame and rage as key factors in triggering regression into political violence. Containment, respect and a group psychological process are identified as necessary for evolution towards a more healthy state. It is suggested that application of these Northern Irish insights to the issue of terrorism in other places and especially in the Middle East, may open new and more psychologically sophisticated ways of addressing the problem of terrorism.

Optimizing antigen cocktails for detection of Mycobacterium bovis in herds with different prevalences of bovine tuberculosis: ESAT6-CFP10 mixture shows optimal sensitivity and specificity.

Bovine tuberculosis is a major problem in many countries; hence, new and better diagnostic tools are urgently needed. In this work, we have tested ESAT6, CFP10, PE13, PE5, MPB70, TB10.4, and TB27.4 for their potentials as diagnostic markers in field animals from Northern Ireland, Mexico, and Argentina, regions with low, medium, and high prevalences of bovine tuberculosis, respectively. At all three sites, ESAT6 and CFP10 were superior diagnostic antigens, while their combination performed even better at the two sites where the combination was tested, providing the best coverage for the detection of diseased populations. The high sensitivity in the skin test reactor groups, combined with the high specificity in the tuberculosis-free groups, indicated that a diagnosis could correctly be made for 85% of the infected animals, based on their responses to these two antigens. Furthermore, TB10.4, PE13, and PE5 have the potential to supplement ESAT6 and CFP10 in a future five-component diagnostic cocktail.

Detection of phosphonoacetate degradation and phnA genes in soil bacteria from distinct geographical origins suggest its possible biogenic origin.

Phosphonoacetate is regarded as an antiviral xenobiotic whose mineralization can be catalysed by an enzyme, phosphonoacetate hydrolase, encoded by the phnA gene. To date the enzyme's activity has been detected in only a limited number of bacteria. Its expression has been shown to occur in a manner independent of the phosphate status of the cell, in direct contrast to the general rule of organophosphonate metabolism being under the control of the pho regulon. In this study the environmental occurrence of the phnA gene was evaluated by polymerase chain reaction amplification of DNA extracts obtained directly from various soil environments. Sensitivity of this method was improved such that a positive result was routinely obtained with soil spiked with as few as 6 colony-forming units (cfu) per gram of soil of Pseudomonas fluorescens 23F (phnA(+)). When total DNA from a variety of Northern Irish, Greek and Bolivian soils was tested, all were positive for phnA. Bacteria capable of utilizing phosphonoacetate as sole carbon, energy and phosphorus source, with the release of essentially equimolar concentrations of phosphate to the culture supernatant, were isolated from all soil samples tested. Analysis of three such isolates revealed all to be species of Pseudomonas sensu stricto, possessing phosphonoacetate hydrolase activity in cell-free extracts. Sequence determination of the phnA gene revealed a similarity of the putative protein sequences at levels of 98.3-99.3% between the Pseudomonas strains. This is the first study to use molecular methods to investigate the distribution of a gene encoding organophosphonate metabolism, and indicates that the phnA gene is ubiquitous within soils from geographically distinct regions. Such an observation supports the proposition that phosphonoacetate is a compound that may also have a biogenic origin.

Investigating variations in infant mortality in England and Wales by mother's country of birth, 1983-2001.

The aim of this study was to investigate variations in infant mortality from 1983 to 2001 by birthweight, registration status, father's social class, age of mother at birth and cause of death, among babies of mothers born in countries that represent the largest ethnic minority groups in England and Wales. A total of 70,208 infant death registration records linked to their corresponding birth registration records were used. The study focused on infant deaths of babies of mothers born in the UK, Republic of Ireland, Caribbean, West Africa, East Africa, India, Pakistan and Bangladesh. From 1983 to 2001 infant mortality rates decreased overall, and this was also apparent in the rates by mother's country of birth. Overall, babies of mothers born in Pakistan consistently had the highest infant mortality rates. Low-birthweight babies of mothers born in West Africa had the highest infant, neonatal and postneonatal death rates. Differences were also seen by registration status, mother's age and between manual and non-manual occupations for all countries from 1983 to 2001. For babies of mothers born in the UK, Caribbean and West Africa, immaturity-related conditions were the most common cause of infant deaths. The leading cause of infant death among babies of mothers born in Pakistan and Bangladesh was congenital anomalies.

Investigation of killer cell immunoglobulinlike receptor gene diversity: I. KIR2DL4.

Polymerase chain reaction-sequence-specific oligonucleotide probes typing procedures identifying alleles of the killer immunoglobulin-like gene (KIR2DL4) have been established. The methods, designed around the specific amplification of the D0 and D2 domains of this gene, produce discrimination of KIR2DL4 alleles. The methods have been applied to a healthy Northern Irish control group, establishing frequencies for this Caucasian population. Additionally, the KIR2DL4 allele status of cell line DNA and CEPH families, from the 13th International Histocompatibility Workshop and local families, have also been investigated.

Alternativa para remediar zonas complejas

A raiz de una averia mecanica en un oleoducto se produjo un derrame de fueloil en la zona central termoelectrica de Ballylumford,cerca de Belfast,en Irlanda del Norte.La accion de los vientos y mareas desplazaron una parte de esta contaminacion a la zona costera.Las autoridades tomaron la decision de implementar un tratamiento in situ,el cual tuvo un excelente resultado sin consecuencia negativas de ninguna especie.Despues de 29 dias de aplicacion bacteriana,la mayor parte del hidrocarburo habia sido eliminado.Dicha decision mostro un gran espiritu innovador,al adoptar una tecnologia que nunca habia sido adoptada en dicho pais

Alternativa para remediar zonas complejas

A raiz de una averia mecanica en un oleoducto se produjo un derrame de fueloil en la zona central termoelectrica de Ballylumford,cerca de Belfast,en Irlanda del Norte.La accion de los vientos y mareas desplazaron una parte de esta contaminacion a la zona costera.Las autoridades tomaron la decision de implementar un tratamiento in situ,el cual tuvo un excelente resultado sin consecuencia negativas de ninguna especie.Despues de 29 dias de aplicacion bacteriana,la mayor parte del hidrocarburo habia sido eliminado.Dicha decision mostro un gran espiritu innovador,al adoptar una tecnologia que nunca habia sido adoptada en dicho pais

Absence of PAX6 gene mutations in Gillespie syndrome (partial aniridia, cerebellar ataxia, and mental retardation).

The PAX6 gene is expressed at high levels in the developing eye and cerebellum and is mutated in patients with autosomal dominant aniridia. We have tested the role of PAX6 mutations in three families with Gillespie syndrome, a rare autosomal recessive condition consisting of partial aniridia, cerebellar ataxia, and mental retardation. Single-strand conformational polymorphism analysis of affected individuals revealed no alteration of PAX6 sequences. In two families, the disease trait segregates independently from chromosome 11p markers flanking PAX6. We conclude that Gillespie syndrome is genetically distinct from autosomal dominant aniridia.

Unemployment and suicide in Northern Ireland.

For Northern Ireland, yearly mean percentages of unemployment and suicide rates (per 100,000 population) for specific age groups and by sex were compared over a 19-year period. Significant results were obtained for only two age groups of males (15-24 yr. and 45-54 yr.) and none for females.

Women as mothers in northern Ireland and Jamaica: a critique of the transcultural nursing movement.

Participant observation and structured interviews with selected groups of mothers in Northern Ireland and Jamaica revealed a variety of individual experiences that highlighted contrasts between the two cultures, and differences within each culture. The findings are used to illustrate the danger of cultural stereotyping, and the implications for the transcultural nursing movement are discussed.