Context Of Processes Research Articles

Local crime and substance use disorders: A comparison of midlife adults in the 1990s and 2000s

This study investigated how sociopolitical changes in the United States between the 1990s and 2000s may explain the increase in substance use disorders and reduced longevity in more recent cohorts of US midlife adults. The 2008 recession which drastically increased unemployment rates across the country may have had negative implications for downstream contextual and individual processes, including both local crime rates and substance use disorders. The Midlife in the United States Survey cohort (1995; n = 6148; 20–75 years) and the MIDUS Refresher cohort (2011; n = 3543; 23–76 years) reported on substance use disorders. These data were linked to Uniform Crime Reporting violent crime rates to determine whether associations between local crime and substance use disorders changed among two separate cohorts of US midlife adults assessed before or after the 2008 recession. In 1995, despite higher local crime rates, substance use disorders were not associated with local crime. The comparatively lower crime rates of 2011, however, associated with greater prevalence of substance use disorders. Considering unemployment rates from the Decennial Census and American Community Survey, which were substantially higher in 2011 relative to 1995, completely diminished the local crime rate-substance use disorder association. The increased prevalence of substance use disorders observed in the more recent cohort of midlife adults assessed in the current study may represent maladaptive coping to local crime after the 2008 recession.

The use of respiratory patient reported outcome measures (PROMs) in the management of COPD: Perceptions of Australian osteopaths

BackgroundPatient reported outcome measures (PROMs) are widely used to capture patients' perspectives of their health status and treatment outcomes and to enable practitioners to evaluate the effectiveness of interventions. The aim of this study was to explore Australian osteopaths’ perceptions of the use of respiratory PROMS in the management of chronic lung conditions. MethodsThis study drew on the social ecological model (SEM), which highlights the interdependence of contextual structures and processes. Osteopaths who were initially part of a larger mixed-methods study were invited to participate in semi-structured interviews. Transcripts were thematically analysed using the SEM. ResultsSeven of the original study osteopaths were interviewed. When presented with a patient who had a co-morbid respiratory condition, they focused on the musculoskeletal aspects of that condition (intrapersonal factors). Participants described sporadic use of musculoskeletal and quality of life PROMs in practice, and scarce use of respiratory PROMs (intrapersonal and organizational factors). Participants’ perceptions of their scope of practice strongly influenced their use of respiratory PROMs (environmental factors). ConclusionIntrapersonal and environmental factors were dominant drivers for participants’ scant use of respiratory PROMs. Further education on the scope and contribution of osteopaths to the management of chronic lung conditions and the use of respiratory PROMS is called for to promote multidisciplinary patient care.

Development of a communicative BIPA digital dictionary featuring Central Javanese cuisine for American students

This study aims to develop a communicative BIPA (Indonesian Language for Foreign Speakers) digital dictionary featuring traditional Central Javanese cuisine for students in the United States. The dictionary is expected to introduce Indonesian local culture through Indonesian language learning. The research method used is Research and Development (R&D) with the ADDIE development model (Analysis, Design, Development, Implementation, Evaluation). The data collection phase involved 32 BIPA students in the United States, using instruments such as open-ended questionnaires, validation sheets, and observations. The results of the study showed that 87.5% of students experienced a significant improvement in their culinary vocabulary mastery after using the developed digital dictionary. Expert validation indicated that the digital dictionary has a validity level of 93% in terms of content, 91% in terms of media, and 95% in terms of pedagogy. In conclusion, this communicative BIPA digital dictionary featuring traditional Central Javanese cuisine is effective in enhancing vocabulary mastery and understanding of local culture for BIPA students in the United States. The use of this dictionary can support a more interactive and contextual learning process and reduce cultural barriers for students who will interact with communities in Central Java.

Topography of Cholinergic Nerve Terminal Vulnerability and Balance Self-Efficacy in Parkinson's Disease.

Postural instability and gait disturbances (PIGD) represent a significant cause of disability in Parkinson's disease (PD). Cholinergic system dysfunction has been implicated in falls in PD. The occurrence of falls typically results in fear of falling (FoF) that in turn may lead to poorer balance self-efficacy. Balance self-efficacy refers to one's level of confidence in their ability to balance while completing activities of daily living like getting dressed, bathing, and walking. Lower self-efficacy, or greater FoF during these activities is a function of motor, cognitive, and emotional impairments and may impact quality of life in PD. Unlike known cholinergic reduction, especially in the right lateral geniculate and caudate nuclei, little is known about the role of cholinergic transporters in FoF or mobility self-efficacy in PD. [18F]fluoroethoxybenzovesamicol ([18F]FEOBV) positron emission tomography (PET) studies were conducted to assess vesicular acetylcholine transporter (VAChT) expression in 126 patients with PD (male (m) = 95, female (f) = 31). Participants had a mean age of 67.3 years (standard deviation (SD) = 7.1) and median Hoehn Yahr stage of 2.5. Patients also completed the Short Falls Efficacy Scale (sFES-I) as a survey measure of concerns about falling. [18F]FEOBV data were processed in Statistical Parametric Mapping (SPM) using a voxel-wise regression model with sFES-I scores as the outcome measure. Reduced [18F]FEOBV binding in tectum, metathalamic (lateral more than medial geniculate nuclei), thalamus proper, bilateral mesiotemporal (hippocampal, parahippocampal, fusiform gyri and fimbriae), and right cerebellar lobule VI significantly associated with higher sFES-I scores (p < 0.05, family-wise error (FWE) correction after Threshold-Free Cluster Enhancement (TFCE)). Unlike the more limited involvement of the brainstem-thalamic complex and caudate nuclei cholinergic topography associated with falls in PD, cholinergic reductions in the extended connectivity between the thalamic complex and the temporal limbic system via the fimbriae associates with FoF. Additional cholinergic changes were seen in the cerebellum. The temporal limbic system plays a role not only in episodic memory but also in spatial navigation, scene and contextual (e.g., emotional) processing. Findings may augur novel therapeutic approaches to treat poor mobility self-efficacy in PD. No: NCT02458430. Registered 18 March, 2015, https://www. gov/study/NCT02458430; No: NCT05459753. Registered 01 July, 2022, https://www. gov/study/NCT05459753.

DESIGN OF E-MODULE TEACHING MATERIALS BASED ON LOCAL WISDOM FOR BIPA LEARNING

This research aims to design teaching materials in e-modules that integrate local wisdom to increase the effectiveness of learning Indonesian for Foreign Speakers (BIPA). In the era of globalization, understanding local culture is important to support a more contextual and authentic language learning process. The e-module developed in this research focuses on introducing and understanding local Indonesian culture, such as customs, traditional arts, and social values. This development model uses the Borg &amp; Gall development model, namely preliminary study, research planning, design development, preliminary field test, revision of limited field test results, main field test, revision of wider field test results, feasibility test, final revision of feasibility test results, and dissemination and implementation of the final product. Data collection at the pre-development stage was carried out using a questionnaire validation instrument. The type of data in this research is qualitative data. Qualitative data was obtained from expert test questionnaire validation in the form of data resulting from comments, criticism, and suggestions in the form of nonverbal data at the pre-development stage.

Contribution of the Link with society in the training of doctors in the Medicine degree at the San Gregorio de Portoviejo University

Introduction: In Latin America, university extension, today called in Ecuador, connection with society, emerges irreverently with the movement of Córdova, Argentina; It constitutes the historical reason of the university, the engine that provides the basic inputs to Research and Teaching. It is recognized as an academic, dynamic, participatory, dialogic and contextual process that determines social and curricular relevance. It is a real challenge to train responsible professionals committed to solving the problems in their environment, and this is where the contribution of Linkage in the comprehensive training of man is shown, especially in the field of Health Sciences and Medicine particularly. Objective: To assess the contribution of the connection with society in the training of doctors in the Medicine degree at the San Gregorio de Portoviejo University (USGP). Methods: It was a qualitative research, analysis-synthesis, induction-deduction and systemic methods were used, bibliographic sources that regulate the policies of this function in Ecuador, in the USGP and in the Medicine career were also reviewed, and of other materials related to Linkage with society, its contribution to the training of professionals in the field of Health Sciences and specifically in Medicine. Results: It was identified that the policy of linkage with society contained in the training program for doctors in the Medicine career meets the external demands and the premises raised by the CES and the USGP. Conclusions: The Medicine degree implements in its links a comprehensive approach, which is exhibited from the dimension of curricular actions, goes through research and is brought together in university extension, for responsible, committed and highly qualified professionals.

Action Segmentation in the Brain: The Role of Object-Action Associations.

Motion information has been argued to be central to the subjective segmentation of observed actions. Concerning object-directed actions, object-associated action information might as well inform efficient action segmentation and prediction. The present study compared the segmentation and neural processing of object manipulations and equivalent dough ball manipulations to elucidate the effect of object-action associations. Behavioral data corroborated that objective relational changes in the form of (un-)touchings of objects, hand, and ground represent meaningful anchor points in subjective action segmentation rendering them objective marks of meaningful event boundaries. As expected, segmentation behavior became even more systematic for the weakly informative dough. fMRI data were modeled by critical subjective, and computer-vision-derived objective event boundaries. Whole-brain as well as planned ROI analyses showed that object information had significant effects on how the brain processes these boundaries. This was especially pronounced at untouchings, that is, events that announced the beginning of the upcoming action and might be the point where competing predictions are aligned with perceptual input to update the current action model. As expected, weak object-action associations at untouching events were accompanied by increased biological motion processing, whereas strong object-action associations came with an increased contextual associative information processing, as indicated by increased parahippocampal activity. Interestingly, anterior inferior parietal lobule activity increased for weak object-action associations at untouching events, presumably because of an unrestricted number of candidate actions for dough manipulation. Our findings offer new insights into the significance of objects for the segmentation of action.

Cellular and circuit features distinguish dentate gyrus semilunar granule cells and granule cells activated during contextual memory formation.

Evaluation of semilunar granule cell involvement in dentate gyrus contextual memory processing supports recruitment based on intrinsic and input characteristics while revealing limited contribution to ensemble refinement.

The awe-habitual model: exploring tourists’ pro-environmental behaviors in religious settings

This study proposes a novel comprehensive model integrating contextual, habitual, and psychological processes to address the multi-determination feature of tourists’ pro-environmental behavior (TPEB) intention. The model includes religious ambience as a contextual process, domestic pro-environmental behavior (DPEB) as a habitual process, and awe, along with Norm Activation Theory, as a psychological process. A questionnaire survey was administered at Guandi Temple, a popular religious site in Haizhou, China, collecting 363 valid datasets to test the model using the Structured Equation Modelling method. The results indicate that TPEB intention is directly associated with DPEB and religious ambience. This connection also reveals that when visitors immerse themselves in a strong religious ambience, the stimulated awe will induce a higher level of TPEB intention, with the Norm Activation Theory mediating this relationship. Furthermore, this theory also explains the indirect spillover effect from DPEB to TPEB intention. Conclusively, this study proposes the validated comprehensive Awe-Habitual Model for TPEB intention, particularly applicable in religious destinations, integrating psychological, contextual, and habitual processes. It also verifies the self-transcendence of awe and extends the application of Norm Activation Theory to measure pro-environmental behavior spillovers. Practical suggestions on encouraging TPEB and promoting sustainable tourism are offered.

Decision-making pathways for contraceptive use among refugee and host populations in Adjumani district, Uganda; an exploratory study

IntroductionContraceptive use is known to have a positive impact on maternal and child health outcomes; however, its use is still low in low-income countries, especially among people in humanitarian situations. This study explored decision-making processes towards the use of contraceptives by people in humanitarian situations to inform program design and uptake.MethodsA qualitative exploratory study was conducted among women of reproductive age (15–49 years) and men (15–60 years) living in three refugee settlements of Pagirinya, Nyumanzi, and Mirieyi and the surrounding host communities in Adjumani district, Uganda. Data were collected using 49 in-depth interviews (IDIs), 11 Key Informant Interviews (KIIs,) and 20 Focus Group Discussions (FGDs). Inductive thematic analysis was done with the aid of Atlas ti. Version 14.ResultsWe found that the decision-making processes entailed linear and nonlinear internalized cognitive and contextual processes involving four dynamic pathways. In the linear pathway, participants reported starting with 1) idea inception, 2) followed by cognitive processing, 3) consultation, and 4) decision-making for contraceptive use. The complex linear pathway happened when participants did not go through consultation but went straight to decision-making. However, participants who followed the non-linear pathway repeatedly went back to cognitive processing. Some women after consultation, or those already using and those not using contraceptives, decided to go back to cognitive processing to reconsider their current positions. This study found that some women who were not using contraceptives ended up using, while some who were using contraception ended up dropping out.ConclusionsThis study showed dynamic decision-making processes involving both internal and external environments as triggers to decision-making for contraceptive use. Interventions to increase contraceptive use should target both users and significant others who influence the decision to use particularly among refugees.Trial registrationThis study was registered by Makerere University School of Public Health Higher Degrees Research and Ethic Committee (HDREC) #188 and approved by Uganda National Council of Science and Technology on 15th/7/2021, Registration number—SS809ES.

Sex differences in discrimination behavior and orbitofrontal engagement during context-gated reward prediction.

Animals, including humans, rely on contextual information to interpret ambiguous stimuli. Impaired context processing is a hallmark of several neuropsychiatric disorders, including schizophrenia, autism spectrum disorders, post-traumatic stress disorder, and addiction. While sex differences in the prevalence and manifestations of these disorders are well established, potential sex differences in context processing remain uncertain. Here, we examined sex differences in the contextual control over cue-evoked reward seeking and its neural correlates, in rats. Male and female rats were trained in a bidirectional occasion-setting preparation in which the validity of two auditory reward-predictive cues was informed by the presence, or absence, of a visual contextual feature (LIGHT: X+/DARK: X-/LIGHT: Y-/DARK: Y+). Females were significantly slower to acquire contextual control over cue-evoked reward seeking. However, once established, the contextual control over behavior was more robust in female rats; it showed less within-session variability (less influence of prior reward) and greater resistance to acute stress. This superior contextual control achieved by females was accompanied by an increased activation of the orbitofrontal cortex (OFC) compared to males. Critically, these behavioral and neural sex differences were specific to the contextual modulation process and not observed in simple, context-independent, reward prediction tasks. These results indicate a sex-biased trade-off between the speed of acquisition and the robustness of performance in the contextual modulation of cued reward seeking. The different distribution of sexes along the fast learning ↔ steady performance continuum might reflect different levels of engagement of the OFC, and might have implications for our understanding of sex differences in psychiatric disorders.

Sex differences in discrimination behavior and orbitofrontal engagement during context-gated reward prediction

Animals, including humans, rely on contextual information to interpret ambiguous stimuli. Impaired context processing is a hallmark of several neuropsychiatric disorders, including schizophrenia, autism spectrum disorders, post-traumatic stress disorder, and addiction. While sex differences in the prevalence and manifestations of these disorders are well established, potential sex differences in context processing remain uncertain. Here, we examined sex differences in the contextual control over cue-evoked reward seeking and its neural correlates, in rats. Male and female rats were trained in a bidirectional occasion-setting preparation in which the validity of two auditory reward-predictive cues was informed by the presence, or absence, of a visual contextual feature (LIGHT: X+/DARK: X−/LIGHT: Y−/DARK: Y+). Females were significantly slower to acquire contextual control over cue-evoked reward seeking. However, once established, the contextual control over behavior was more robust in female rats; it showed less within-session variability (less influence of prior reward) and greater resistance to acute stress. This superior contextual control achieved by females was accompanied by an increased activation of the orbitofrontal cortex (OFC) compared to males. Critically, these behavioral and neural sex differences were specific to the contextual modulation process and not observed in simple, context-independent, reward prediction tasks. These results indicate a sex-biased trade-off between the speed of acquisition and the robustness of performance in the contextual modulation of cued reward seeking. The different distribution of sexes along the fast learning ↔ steady performance continuum might reflect different levels of engagement of the OFC, and might have implications for our understanding of sex differences in psychiatric disorders.

A SMARTR workflow for multi-ensemble atlas mapping and brain-wide network analysis.

In the last decade, activity-dependent strategies for labelling multiple immediate early gene (IEG) ensembles in mice have generated unprecedented insight into the mechanisms of memory encoding, storage, and retrieval. However, few strategies exist for brain-wide mapping of multiple ensembles, including their overlapping population, and none incorporate capabilities for downstream network analysis. Here, we introduce a scalable workflow to analyze traditionally coronally-sectioned datasets produced by activity-dependent tagging systems. Intrinsic to this pipeline is simple multi-ensemble atlas registration and statistical testing in R (SMARTR), an R package which wraps mapping capabilities with functions for statistical analysis and network visualization. We demonstrate the versatility of SMARTR by mapping the ensembles underlying the acquisition and expression of learned helplessness (LH), a robust stress model. Applying network analysis, we find that exposure to inescapable shock (IS), compared to context training (CT), results in decreased centrality of regions engaged in spatial and contextual processing and higher influence of regions involved in somatosensory and affective processing. During LH expression, the substantia nigra emerges as a highly influential region which shows a functional reversal following IS, indicating a possible regulatory function of motor activity during helplessness. We also report that IS results in a robust decrease in reactivation activity across a number of cortical, hippocampal, and amygdalar regions, indicating suppression of ensemble reactivation may be a neurobiological signature of LH. These results highlight the emergent insights uniquely garnered by applying our analysis approach to multiple ensemble datasets and demonstrate the strength of our workflow as a hypothesis-generating toolkit.

‘Brandsluts’: Instagram influencers and conspicuous consumption in post-apartheid South Africa

ABSTRACT Post-Apartheid South Africa shifted to a culture of consumption, originating with a transition to a neoliberal society [Sana, V. (2022). Bits of bytes and bites of bits: Instagram and the gendered performance of food production in the South African Indian community. Agenda, 36(1), 100–108), alongside access to a globalized world. During apartheid, consumption was strictly regulated, and racialized. This culture of consumption has been prevalent since the mid-1990s. As apartheid regulations lifted, the freedom of movement, choice and the ability to consume unreservedly, opened possibilities previously unimagined for much of the population. Consumption in South Africa is largely characterized by the unique contextual and symbolic processes that inform it. Consumption practices have impacted performances of identity and anxieties of belonging in turn [Sana, V. (2022). Bits of bytes and bites of bits: Instagram and the gendered performance of food production in the South African Indian community. Agenda, 36(1), 100–108]. This paper examines the visual representations of consumption practices on Instagram. Using critical consumption studies, an analysis of various Instagram influencers' consumption uncovers how South Africans affirm their place in the neoliberal global stage through acts of consumption. The article considers the consumption of products as a product itself to be consumed, and how this links to debates around conspicuous consumption in South Africa.

Predictors of the sustainability for an evidence-based eating disorder prevention program delivered by college peer educators

BackgroundDespite ongoing efforts to introduce evidence-based interventions (EBIs) into mental health care settings, little research has focused on the sustainability of EBIs in these settings. College campuses are a natural place to intervene with young adults who are at high risk for mental health disorders, including eating disorders. The current study tested the effect of three levels of implementation support on the sustainability of an evidence-based group eating disorder prevention program, the Body Project, delivered by peer educators. We also tested whether intervention, contextual, or implementation process factors predicted sustainability.MethodsWe recruited 63 colleges with peer educator programs and randomly assigned them to (a) receive a 2-day Train-the-Trainer (TTT) training in which peer educators were trained to implement the Body Project and supervisors were taught how to train future peer educators (TTT), (b) TTT training plus a technical assistance (TA) workshop (TTT + TA), or (c) TTT plus the TA workshop and quality assurance (QA) consultations over 1-year (TTT + TA + QA). We tested whether implementation support strategies, perceived characteristics of the intervention and attitudes towards evidence-based interventions at baseline and the proportion of completed implementation activities during the implementation year predicted three school-level dichotomous sustainability outcomes (offering Body Project groups, training peer educators, training supervisors) over the subsequent two-year sustainability period using logistic regression models.ResultsImplementation support strategies did not significantly predict any sustainability outcomes, although a trend suggested that colleges randomized to the TTT + TA + QA strategy were more likely to train new supervisors (OR = 5.46, 95% CI [0.89–33.38]). Colleges that completed a greater proportion of implementation activities were more likely to offer Body Project groups (OR = 1.53, 95% CI [1.19–1.98]) and train new peer educators during the sustainability phase (OR = 1.39, 95% CI [1.10–1.74]). Perceived positive characteristics of the Body Project predicted training new peer educators (OR = 18.42, 95% CI [1.48–299.66]), which may be critical for sustainability in routine settings with high provider turnover.ConclusionsHelping schools complete more implementation activities and increasing the perceived positive characteristics of a prevention program may result in greater sustainment of prevention program implementation.Trial RegistrationThis study was preregistered on 12/07/17 with ClinicalTrials.gov, ID NCT03409809, https://clinicaltrials.gov/ct2/show/NCT03409809.

Students' Difficulty in Understanding Problems in the Contextual Problem-Solving Process

The main procedure that students need to master in the problem-solving process is understanding the problem before proceeding to the next steps. This research aims to investigate students' difficulties and the factors causing these difficulties in understanding the problem. This research is qualitative in nature and is based on the philosophy of phenomenology. The research was conducted in an eighth-grade class at one of the Junior High Schools in Bandung, consisting of 28 students. Data collection techniques included tests, interviews, and think-aloud methods. The data collection instruments used were tests and interview guides. The tests used in this research had been previously validated for content, construct, and face validity by mathematics education experts. Data analysis in qualitative research involves data reduction, data presentation, and drawing conclusions. The findings of this research indicate that the difficulties faced by students in understanding the problem include difficulties in comprehending language, difficulties in grasping both explicit and implicit meanings, difficulties in identifying the necessary information, and difficulties in connecting meanings. The main factors causing students' difficulties in understanding the problem are a lack of careful reading skills and a lack of understanding of the concepts held by students.

Visual Question Answering Models for Zero-Shot Pedestrian Attribute Recognition: A Comparative Study

Pedestrian Attribute Recognition (PAR) poses a significant challenge in developing automatic systems that enhance visual surveillance and human interaction. In this study, we investigate using Visual Question Answering (VQA) models to address the zero-shot PAR problem. Inspired by the impressive results achieved by a zero-shot VQA strategy during the PAR Contest at the 20th International Conference on Computer Analysis of Images and Patterns in 2023, we conducted a comparative study across three state-of-the-art VQA models, two of them based on BLIP-2 and the third one based on the Plug-and-Play VQA framework. Our analysis focuses on performance, robustness, contextual question handling, processing time, and classification errors. Our findings demonstrate that both BLIP-2-based models are better suited for PAR, with nuances related to the adopted frozen Large Language Model. Specifically, the Open Pre-trained Transformers based model performs well in benchmark color estimation tasks, while FLANT5XL provides better results for the considered binary tasks. In summary, zero-shot PAR based on VQA models offers highly competitive results, with the advantage of avoiding training costs associated with multipurpose classifiers.

Parallel multi-criteria decision analysis for sub-national prioritization of zoonoses and animal diseases in Africa: The case of Cameroon.

The use of multi-criteria decision analysis (MCDA) for disease prioritization at the sub-national level in sub-Sahara Africa (SSA) is rare. In this research, we contextualized MCDA for parallel prioritization of endemic zoonoses and animal diseases in The Adamawa and North regions of Cameroon. MCDA was associated to categorical principal component analysis (CATPCA), and two-step cluster analysis. Six and seven domains made of 17 and 19 criteria (out of 70) respectively were selected by CATPCA for the prioritization of zoonoses and animal diseases, respectively. The most influencing domains were "public health" for zoonoses and "control and prevention" for animal diseases. Twenty-seven zoonoses and 40 animal diseases were ranked and grouped in three clusters. Sensitivity analysis resulted in high correlation between complete models and reduced models showing the robustness of the simplification processes. The tool used in this study can be applied to prioritize endemic zoonoses and transboundary animal diseases in SSA at the sub-national level and upscaled at the national and regional levels. The relevance of MCDA is high because of its contextualization process and participatory nature enabling better operationalization of disease prioritization outcomes in the context of African countries or other low and middle-income countries.

Strategies, processes, outcomes, and costs of implementing experience sampling-based monitoring in routine mental health care in four European countries: study protocol for the IMMERSE effectiveness-implementation study

BackgroundRecent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users’ daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia).MethodsIn this hybrid effectiveness-implementation study, a parallel-group, assessor-blind, multi-centre cluster randomized controlled trial (cRCT) will be conducted, combined with a process and economic evaluation. In the cRCT, 24 clinical units (as the cluster and unit of randomization) at eight sites in four European countries will be randomly allocated using an unbalanced 2:1 ratio to one of two conditions: (a) the experimental condition, in which participants receive a Digital Mobile Mental Health intervention (DMMH) and other implementation strategies in addition to treatment as usual (TAU) or (b) the control condition, in which service users are provided with TAU. Outcome data in service users and clinicians will be collected at four time points: at baseline (t0), 2-month post-baseline (t1), 6-month post-baseline (t2), and 12-month post-baseline (t3). The primary outcome will be patient-reported service engagement assessed with the service attachment questionnaire at 2-month post-baseline. The process and economic evaluation will provide in-depth insights into in-vivo context-mechanism-outcome configurations and economic costs of the DMMH and other implementation strategies in routine care, respectively.DiscussionIf this trial provides evidence on reach, effectiveness, adoption, implementation and maintenance of implementing ESM-based monitoring, reporting, and feedback, it will form the basis for establishing its public health impact and has significant potential to bridge the research-to-practice gap and contribute to swifter ecological translation of digital innovations to real-world delivery in routine mental health care.Trial registrationISRCTN15109760 (ISRCTN registry, date: 03/08/2022).

Dynamic Nonlinear Spatial Integrations on Encoding Contrasting Stimuli of Tectal Neurons.

Animals detect targets using a variety of visual cues, with the visual salience of these cues determining which environmental features receive priority attention and further processing. Surround modulation plays a crucial role in generating visual saliency, which has been extensively studied in avian tectal neurons. Recent work has reported that the suppression of tectal neurons induced by motion contrasting stimulus is stronger than that by luminance contrasting stimulus. However, the underlying mechanism remains poorly understood. In this study, we built a computational model (called Generalized Linear-Dynamic Modulation) which incorporates independent nonlinear tuning mechanisms for excitatory and inhibitory inputs. This model aims to describe how tectal neurons encode contrasting stimuli. The results showed that: (1) The dynamic nonlinear integration structure substantially improved the accuracy (significant difference (p < 0.001, paired t-test) in the goodness of fit between the two models) of the predicted responses to contrasting stimuli, verifying the nonlinear processing performed by tectal neurons. (2) The modulation difference between luminance and motion contrasting stimuli emerged from the predicted response by the full model but not by that with only excitatory synaptic input (spatial luminance: 89 ± 2.8% (GL_DM) vs. 87 ± 2.1% (GL_DMexc); motion contrasting stimuli: 87 ± 1.7% (GL_DM) vs. 83 ± 2.2% (GL_DMexc)). These results validate the proposed model and further suggest the role of dynamic nonlinear spatial integrations in contextual visual information processing, especially in spatial integration, which is important for object detection performed by birds.