Low-level Support Research Articles

Mental Health Effects in Primary Care Patients 18 Months After a Major Wildfire in Fort McMurray: Risk Increased by Social Demographic Issues, Clinical Antecedents, and Degree of Fire Exposure.

Objectives: To assess prevalence of likely posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) in patients attending the only out-of-hours primary care clinic in Fort McMurray some 18 months following a major fire. Methods: A quantitative cross-sectional survey was used to collect data through self-administered paper-based questionnaires to determine likely PTSD, MDD, and GAD using the PTSD Checklists for Diagnostic and Statistical Manual (DSM) 5, Patient Health Questionnaire (PHQ) 9, and GAD-7, respectively, from residents of Fort McMurray who were impacted by the wildfires. This was carried out eighteen (18) months after a major wildfire, which required the rapid evacuation of the entire city population (approximately 90,000 individuals). Results: We achieved a response rate of 48% and results from the 290 respondents showed the 1 month prevalence rate for likely PTSD was 13.6%, likely MDD was 24.8%, and likely GAD was 18.0%. Compared to self-reported prevalence rates before the wildfire (0%, 15.2%, and 14.5% respectively), these were increased for all diagnoses. After controlling for other factors in a logistic regression model, there were statistically significant associations between individuals who had likely PTSD, MDD, and GAD diagnoses and multiple socio-demographic, clinical, and exposure-related variables as follows: PTSD: History of anxiety disorder and received counselling had odds ratios (ORs) of 5.80 and 7.14, respectively. MDD: Age, witnessed the burning of homes, history of depressive disorder, and receiving low level support from friends and family had ORs of 2.08, 2.29, 4.63, and 2.5, respectively. GAD: Fearful for their lives or the lives of friends/family, history of depressive disorder, and history of anxiety disorder had ORs of 3.52, 3.04, and 2.68, respectively. There were also associations between individuals with a likely psychiatric diagnosis and those who also had likely alcohol or drug abuse/dependence. Conclusion: Our study suggests there are high prevalence rates for mental health and addiction conditions in patients attending the out-of-hours clinic 18 months after the wildfires, with significant associations between multiple variables and likely PTSD, MDD, and GAD. Further studies are needed to explore the impact of population-based mental health interventions on the long-term mental health effects of the wildfires.

To teach writing: Teachers' perspectives on how to promote children’s writing development in the Swedish preschool class

This study focuses on how teachers in Swedish preschool classes describe their work to promote children’s early writing. The research questions are the following: According to teachers, in what daily activities are children given the opportunity to write? How do teachers describe their support for children’s writing processes? The empirical data was collected from interviews with twelve teachers working in preschool classes in seven different Swedish municipalities. The result shows that preschool class teachers express how they work to promote both individual and group writing. It reveals two different approaches regarding guiding children to develop their writing skills. First approach puts emphasis on working to develop creative and functional writing based on the child’s own interests, life experiences and level of knowledge. The second approach is primarily characterised by working on technical abilities; forming letters of the alphabet and developing the child’s phonological awareness. It was also found that there are teachers who use both approaches in their teaching. Teachers utilise various support strategies to develop children’s writing skills. These encompass everything from individual and group activities to the use of various artefacts in the teaching environment. The support that teachers offer children might be divided into high-level and low-level support.

PRISM revisited: Declarative implementation of a probabilistic programming language using multi-prompt delimited control

PRISM is a probabilistic programming language based on Prolog, augmented with primitives to represent probabilistic choice. It is implemented using a combination of low level support from a modified version of B-Prolog, source level program transformation, and libraries for inference and learning implemented in C. More recently, developers working with functional programming languages have taken the approach of embedding probabilistic primitives into an existing language, with little or no modification to the host language, often by using delimited continuations. Captured continuations represent pieces of the probabilistic program which can be manipulated to achieve a great variety of computational effects useful for inference. In this paper, I will describe an approach based on delimited control operators recently introduced into SWI Prolog. These are used to create a system of nested effect handlers which together implement a core functionality of PRISM—the building of explanation graphs—entirely in Prolog and using an order of magnitude less code. Other declarative programming tools, such as constraint logic programming, are used to implement tools for inference, such as the inside-outside and EM algorithms, lazy best-first explanation search, and MCMC samplers. By embedding the functionality of PRISM into SWI Prolog, users gain access to its rich libraries and development environment. By expressing the functionality of PRISM in a small amount of pure, high-level Prolog, this implementation facilitates further experimentation with the mechanisms of probabilistic logic programming, including new probabilistic modelling features and inference algorithms, such as variational inference in models with real-valued variables.

The work\u2013life balance and psychosocial well-being of South Korean workers

BackgroundIt is challenging to balance work and life, and little attention has been paid to the work–life balance and psychosocial well-being of South Koreans. We assessed the association between work–life balance and psychosocial well-being among paid Korean workers.MethodsThis study was based on data from the fourth Korean Working Conditions Survey. We evaluated only paid workers, which constituted 30,649 of the total of 50,007 subjects surveyed. Poor work–life balance was defined based on the goodness of fit between working hours and social commitments. Well-being was measured using the World Health Organization WHO-5 index. Poisson regression with robust variances was used to calculate the estimated prevalence ratios (PRs) with confidence intervals.ResultsPoor work–life balance was associated with poor psychosocial well-being (PR = 1.25; 95% CI 1.21 to 1.28) even after adjusting for work-related and individual characteristics. Poor well-being was associated with low-level job autonomy (PR = 1.06; 95% CI 1.03 to 1.09), working for ≥53 h per week (PR = 1.10; 95% CI 1.06 to 1.14), blue-collar status (PR = 1.16; 95% CI 1.11 to 1.21), low-level support at work (PR = 1.32; 95% CI 1.29 to 1.36), age ≥ 50 years (PR = 1.21; 95% CI 1.15 to 1.26), the female gender (95% CI PR = 1.04; 95% CI 1.01 to 1.07), and cohabitation (living with somebody) (PR = 1.08; 95% CI 1.04 to 1.12). Good well-being was associated with high-intensity work (PR = 0.96; 95% CI 0.94 to 0.99), being the secondary earner in a household (PR = 0.82; 95% CI 0.79 to 0.85), and higher income (PR = 0.75; 95% CI 0.71 to 0.79).ConclusionWork–life balance was associated with psychosocial well-being after adjusting for both work-related and individual characteristics.

Materialities of mundane care and the art of holding one's own

The focus of this special issue is on how everyday or mundane materialities actively mediate health and care practices. This article extends this concern with the mundane to care itself and explores how specific materialities, such as shared spaces and everyday objects, not only mediate mundane care but enable it to happen. Our focus is on mundane help in the context of ill health, between people who are not immediate family, such as neighbours, acquaintances and others with whom we interact in our daily lives. Drawing on recent empirical studies of low-level support in two different parts of the UK, we show how the materialities of care can mediate the affective risks associated with receiving such help. Specifically, we investigate how materialities help people to balance the expression of their vulnerability with a need to retain their dignity, a practice referred to as 'holding one's own'. In doing so, we argue that materialities are not just the conduits for care - what care passes through - or things that mediate care. We suggest instead that materialities are part of how relationships of mundane care are constituted and maintained.

Information, Advocacy and Signposting as a Low-Level Support for Adults with High-Functioning Autism Spectrum Disorder: An Example from the UK

‘Low-level’ support is championed to support adults with high functioning autism spectrum disorder (HFASD) to achieve good quality health and social care, yet research in the area is sparse. Drawing on semi-structured interview data, this paper considers the efficacy of an intervention to provide low-level support to adults with HFASD with little or no funded support. The intervention led to a number of perceived positive outcomes for adults with HFASD, their families, and service providers in the city, including increased access to education, volunteering, support and information, socialising, improved health and wellbeing, and managing day-to-day. Although many of life’s difficulties still persisted, the intervention helped service users overcome barriers to availing further support, possibly leading to beneficial outcomes down the line.

Audio Identification by Sampling Sub-fingerprints and Counting Matches

It is challenging to retrieve audio clips from large audio datasets not only due to the high dimensionality of audio but also due to the large number of audios. Fingerprinting methods primarily focus on the use of semantic-level techniques to speed up retrieval and neglect low-level support. This paper shows that the performance of audio retrieval can be exploited by properly organizing and manipulating audio fingerprint data. The proposed sampling and counting method markedly improves the retrieval speed while maintaining a high recall rate and high precision for short audio clips. The proposed inverted index structure for fingerprints quickly shrinks the scope of the candidate set while requiring considerably less memory. The experiments show that the proposed method is faster and yields more consistent performance in terms of recall rate and precision than do the state-of-the-art methods. The proposed method is scalable for big audio data and is robust to background noise, resampling, MP3 conversion, white noise addition, bandpass filtering, chorus, echo, flanger, gsm compression, and tremolo. The average precision and recall rates are 99.995% and 99.78%, respectively, for dataset 1 and average 98.97% and 95.15%, respectively, for dataset 2. Specifically, the precision and recall rates for query audio clips of 3 s in length in the targeted dataset 1 are 99.94% and 99.64%, respectively.

Integrating emotional and psychological support into the end-stage renal disease pathway: a protocol for mixed methods research to identify patients' lower-level support needs and how these can most effectively be addressed.

BackgroundAs a result of difficulties related to their illness, diagnosis and treatment, patients with end-stage renal disease experience significant emotional and psychological problems, which untreated can have considerable negative impact on their health and wellbeing. Despite evidence that patients desire improved support, management of their psychosocial problems, particularly at the lower-level, remains sub-optimal. There is limited understanding of the specific support that patients need and want, from whom, and when, and also a lack of data on what helps and hinders renal staff in identifying and responding to their patients’ support needs, and how barriers to doing so might be overcome. Through this research we therefore seek to determine what, when, and how, support for patients with lower-level emotional and psychological problems should be integrated into the end-stage renal disease pathway.Methods/DesignThe research will involve two linked, multicentre studies, designed to identify and consider the perspectives of patients at five different stages of the end-stage renal disease pathway (Study 1), and renal staff working with them (Study 2). A convergent, parallel mixed methods design will be employed for both studies, with quantitative and qualitative data collected separately. For each study, the data sets will be analysed separately and the results then compared or combined using interpretive analysis. A further stage of synthesis will employ data-driven thematic analysis to identify: triangulation and frequency of themes across pathway stages; patterns and plausible explanations of effects.DiscussionThere is an important need for this research given the high frequency of lower-level distress experienced by end-stage renal disease patients and lack of progress to date in integrating support for their lower-level psychosocial needs into the care pathway. Use of a mixed methods design across the two studies will generate a holistic patient and healthcare professional perspective that is more likely to identify viable solutions to enable implementation of timely and integrated care. Based on the research outputs, appropriate support interventions will be developed, implemented and evaluated in a linked follow-on study.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-016-0327-2) contains supplementary material, which is available to authorized users.

Family close but friends closer: exploring social support and resilience in older spousal dementia carers

ABSTRACTObjectives: Spousal dementia carers have unique support needs; they are likely to disengage from their existing social networks as they need to devote more time to caring as the disease progresses. Previously we showed that support resources can facilitate resilience in carers, but the relationship is complex and varies by relationship type. The current paper aims to explore social support as a key component of resilience to identify the availability, function and perceived functional aspects of support provided to older spousal dementia carers.Method: We conducted 23 in-depth qualitative interviews with spousal carers from two carer support groups and a care home in North West England.Results: Family and friends served a wide range of functions but were equally available to resilient and non-resilient participants. Family support was perceived as unhelpful if it created feelings of over-dependence. Participants were less likely to resist involvement of grandchildren due to their relatively narrow and low-level support functions. Friend support was perceived as most helpful when it derived from those in similar circumstances. Neighbours played a functionally unique role of crisis management. These perceptions may moderate the effect of support on resilience.Conclusion: Family and friend support is not always sufficient to facilitate resilience. Support functions facilitate resilience only if they are perceived to match need. Implications of these findings are discussed.

The Paradox of Middle-Class Attitudes in China: Democracy, Social Stability, and Reform

This article explores the seemingly paradoxical attitudes of the Chinese middle class towards democracy, social stability, and reform. Using fieldwork data from Ningbo, this article shows that a group of objective, middle-class individuals can concurrently display high levels of support for democratic principles and low levels of participation in real-life socio-political events. Being generally confident in China's social stability, these individuals have little to no desire for significant democratic reform, or indeed any reform that occurs outside the purview of the state, as it is considered destabilising. By highlighting the distinction between how these members of the middle class respond to generic democratic concepts, real-life sociopolitical affairs, and the idea of democratic reform, this article argues that the Chinese middle class are aware of what “should be,” what “could be,” and what “is,” which lends their socio-political attitudes a paradoxical appearance.

A Quality Based Power-Hump Mechanism for High Speed Network Connectivity of Mobile Devices in Digital Living Network Alliance Networks

Mobile devices are increasingly assuming an important role in “smart home” network environments. Although their computing, storage and networking capabilities have evolved significantly, these devices remain power-constrained and, therefore, there is need to actively take measures to minimize their power consumption. In this paper, we propose a Power Saving (PS) mechanism for mobile devices in Digital Living Network Alliance (DLNA) home networks, which allows them to conserve power without compromising their higher-layer functionality. The proposed mechanism introduces a level of indirection that abstracts the low-level low-power support of different wireless bearers and exposes a uniform interface to higher-layer entities, such as applications and Universal–Plugand-Play (UPP) agents. We define four abstract NC-PS modes and describe their mapping in the case of Bluetooth, a common wireless bearer for mobile devices, now supported in DLNA. Battery power is an important resource in Ad-hoc networks. It has been observed that in Ad-hoc networks, routing control messages and data transmission, these timers are set and refreshed on-demand. Nodes that are not involved in energy consumption do not reflect the communication activities in the network.

Coparental Affect, Children's Emotion Dysregulation, and Parent and Child Depressive Symptoms.

Children's emotion dysregulation and depressive symptoms are known to be affected by a range of individual (parent, child) and systemic (parent-child, marital, and family) characteristics. The current study builds on this literature by examining the unique role of coparental affect in children's emotion dysregulation, and whether this association mediates the link between parent and child depressive symptoms. Participants were 51 mother-father-child triads with children aged 7 to 12 (M age=9.24years). Triads discussed a time when the child felt sad and a time when the child felt happy. Maternal and paternal displays of positive affect were coded, and sequential analyses examined the extent to which parents were congruent in their displays of positive affect during the emotion discussions. Results indicated that interparental positive affect congruity (IPAC) during the sadness discussion, but not the happiness discussion, uniquely predicted parent-reported child emotion dysregulation, above and beyond the contributions of child negative affect and parental punitive reactions. The degree of IPAC during the sadness discussion and child emotion dysregulation mediated the association between maternal, but not paternal, depressive symptoms and child depressive symptoms. Findings highlight the unique role of coparental affect in the socialization of sadness in youth and offer initial support for low levels of IPAC as a risk factor for the transmission of depressive symptoms in youth.

Spatial Topological Relationship for Remote Sensing Image Analysis

For remote sensing imagery, spatial relationships are extracted by segmentation and classification. Unlike traditional vector relationships, spatial relationship reasoning is equivalent to constraint satisfaction problems in the image process. Based on 9-intersect model, the paper discuss spatial topological relationship between image objects to provide a theoretical and technical support for low levels of image segmentation, high-level analysis.

Spatial Topological Relationship for Remote Sensing Image Analysis

For remote sensing imagery, spatial relationships are extracted by segmentation and classification. Unlike traditional vector relationships, spatial relationship reasoning is equivalent to constraint satisfaction problems in the image process. Based on 9-intersect model, the paper discuss spatial topological relationship between image objects to provide a theoretical and technical support for low levels of image segmentation, high-level analysis.

Reducing duplication and redundancy in declarative model specifications

Event Abstract Back to Event Reducing duplication and redundancy in declarative model specifications Robert Cannon1*, Padraig Gleeson2, Sharon Crook3 and Angus Silver2 1 Textensor Limited, UK 2 University College London, United Kingdom 3 Arizona State University, United States Methods for storing and sharing biological models, whether by scripts, or with declarative languages such as SBML or CellML, tend to focus on directly encoding a model and its equations. However, many models share essentially the same equations, except for differences in parameter values or the number of instances of particular processes. We have therefore developed a mechanism within NeuroML[1] whereby the common structural and mathematical features of a family of models can be expressed separately from the parameter values that make up a particular member of the family. Specifications in this form correspond closely to the conceptual understanding that modelers have of the systems they work on. Supporting this style of description allows models to be expressed more concisely than if flatter structures are used since it avoids repeating common elements. It also enables a wide range of model related processing beyond simply executing them, including systematic comparisons, archiving, model composition, and sensitivity analysis. The resulting system, known as LEMS (Low Entropy Model Specification), has been developed to meet the needs of NeuroML but can also be applied to other declarative model specifications. It makes it possible to retro-fit most of the existing high level concepts ion NeuroML version 1 with domain independent definitions built out of the LEMS elements. This preserves the benefits of the existing semantically rich high-level concepts while adding the ability to extend it with new concepts at the user-level rather than requiring changes to the language. Simulator developers have a choice between directly supporting the library of core types in NeuroML or supporting the underlying LEMS definitions. Libraries are available in both Java and Python to allow simulator developers to work with LEMS models without having to implement the low level support themselves. These include options for flattening models into sets of simultaneous differential equations, and for code generation to create standalone executable units.

What Do Service Users with Bipolar Disorder Want from a Web‐Based Self‐Management Intervention? A Qualitative Focus Group Study

Bipolar disorder (BD) is a chronic and recurrent severe mental health problem. A web-based self-management intervention provides the opportunity to widen access to psychological interventions. This qualitative study aims to identify what an ideal web-based intervention would look like for service users with BD. Twelve service users with BD were recruited in the UK and took part in a series of focus groups to inform and refine the development of a web-based self-management intervention. Reported here is a subset analysis of data gathered with the primary aim of identifying the needs and desires of service users for such an intervention for BD. We analysed service users' responses to questions about content, outcomes, format, barriers and support. Focus groups were transcribed verbatim, and thematic analysis was employed. The data were ordered into four key themes: (1) gaining an awareness of and managing mood swings; (2) not just about managing mood swings: the importance of practical and interpersonal issues; (3) managing living within mood swings without losing the experience; (4) internet is the only format: freely accessible, instant and interactive; (5) professional and peer support to overcome low motivation and procrastination difficulties. The small group of participants are not representative of those living with BD. These findings have significantly enhanced our understanding of what service users with BD want from a web-based self-management intervention and have clear implications for the future development of such approaches. Service users desire a web-based self-management approach that gives them the techniques they need to not only manage their moods but also manage their lives alongside the disorder, including interpersonal and practical issues. Service users describe their primary outcome, not as a cure or reduction in their symptoms, but instead being able to live a fulfilling life alongside their condition. Service users see the internet as their preferred format because of the increased accessibility to evidence-based intervention. Service users discussed the potential barriers to web-based interventions including motivation and procrastination. Effective and acceptable content and low-level support provide potential solutions to these issues.

The use of telephone befriending in low level support for socially isolated older people – an evaluation

The use of telephone befriending in low level support for socially isolated older people – an evaluation

Evaluating Domain-Specific Languages for the Development of OPC UA Based Applications

AbstractThe OPC Unified Architecture (OPC UA) is becoming more and more important for industrial automation products. The development of OPC UA components is currently supported by the use of special SDKs for OPC UA. However, these SDKs provide only low level support for creating OPC UA based applications. This leads to higher efforts in developing such applications. The domain-specific metamodel that OPC UA defines could serve as a good basis for creating domain-specific languages on a higher abstraction level. This has the potential of significantly reducing development efforts. In this paper, we analyse the various use cases within the development of OPC UA applications for their potential to be supported by a domain-specific language.

Low level communication management for e-health systems

The heterogeneity of e-health systems encourages the use of standards such as Health Level 7 (HL7v3) to ensure interoperability. Many actual implementations address this problem by unoptimized high level programming of top-range portable computing platforms. However, this approach could pose excessive demands on battery-powered mid-range terminals. In this work, we propose low-level support for portable HL7v3-compatible embedded systems in order to better exploit their limited processing and communications capabilities. In particular, we present our experience in mobile communication management through two different approaches, which proves the feasibility of this proposal.

Observational Learning of New Movement Sequences Is Reflected in Fronto-Parietal Coherence

Mankind is unique in her ability for observational learning, i.e. the transmission of acquired knowledge and behavioral repertoire through observation of others' actions. In the present study we used electrophysiological measures to investigate brain mechanisms of observational learning. Analysis investigated the possible functional coupling between occipital (alpha) and motor (mu) rhythms operating in the 10Hz frequency range for translating “seeing” into “doing”. Subjects observed movement sequences consisting of six consecutive left or right hand button presses directed at one of two target-buttons for subsequent imitation. Each movement sequence was presented four times, intervened by short pause intervals for sequence rehearsal. During a control task subjects observed the same movement sequences without a requirement for subsequent reproduction. Although both alpha and mu rhythms desynchronized during the imitation task relative to the control task, modulations in alpha and mu power were found to be largely independent from each other over time, arguing against a functional coupling of alpha and mu generators during observational learning. This independence was furthermore reflected in the absence of coherence between occipital and motor electrodes overlaying alpha and mu generators. Instead, coherence analysis revealed a pair of symmetric fronto-parietal networks, one over the left and one over the right hemisphere, reflecting stronger coherence during observation of movements than during pauses. Individual differences in fronto-parietal coherence were furthermore found to predict imitation accuracy. The properties of these networks, i.e. their fronto-parietal distribution, their ipsilateral organization and their sensitivity to the observation of movements, match closely with the known properties of the mirror neuron system (MNS) as studied in the macaque brain. These results indicate a functional dissociation between higher order areas for observational learning (i.e. parts of the MNS as reflected in 10Hz coherence measures) and peripheral structures (i.e. lateral occipital gyrus for alpha; central sulcus for mu) that provide low-level support for observation and motor imagery of action sequences.