Developing a student-led school mental health strategy

Although there is increasing interest in promoting mental health and wellbeing within education, to date, the voices of young people appear to have been almost completely overlooked in the development of school-based mental health practices. This is despite increasing focus on young people’s participation; and the fact that young people may be best positioned to understand the pressures of contemporary society. This paper, co-authored by educational psychologists (EPs), school students and the school vice-principal, documents the development of a student-led mental health initiative within a high-achieving girls’ grammar school, led by students aged 12–18. Following EP input, the students devised a whole-school, student-friendly mental health strategy with the support of the EPs and senior school staff. As the project progressed, it became evident that applying even carefully selected adult mental health models to school contexts might not be appropriate; instead the students advocated for young person-friendly, innovative, contemporary and creative ways of communicating information about mental health, which avoided stigma. The students involved were well-placed to identify environmental stressors and to disseminate their strategy. The authors conclude that mental health planning in schools should encourage greater student participation, show caution over applying adult mental health models and promote greater use of technology or visual resources.     

External quality assessment for the RIA of thyroid related hormones: Second phase

An external quality assessment was conducted to assess the performance of various laboratories for RIA of thhyroid related hormones in two phases. In the first phase thirty five laboratories participated. At the end of first phase a meeting cum workshop was organised to discuss the results of first phase, difficultires faced by the participants and pinpoint the short oming. A second phase was then initiated with an objective of improvement in the performance, if any, where twelve samples from four pools were distributed to twenty four laboratories who participated for the second phase. The overall return of the results increased significantly from 71.8% (1586/2208) for the first phase to 92.4% (732/792) for the second phase. The inter laboratory %CV for T₃, T₄ and TSH were lower during the second phase (30.6%, 19.0% and 31.6% respectively) as compared to those observed during first phase (36.3%, 22.7% and 52.8% respectively). Similarly, there was an improvement in reproducibility of ALTM as %CV for T₃, T₄ and TSH decreased from 6.0%, 9.8% and 13.4% respectively to 4.5%, 4.6% and 8.5% respectively. The individual performances of the participating laboratories viz. bias, variability of bias and imprecision also showed a trend towards improvement as percent laboratories having desirable or acceptable results for T₃, T₄ and TSH increased from 10.7%, 60.7% and 0.0% respectively to 20.8%, 66.7% and 22.2% respectively. External quality assessment thus appears to be beneficial in assessing the performane of a laboratory in comfparison with other laboratories and indeed helps in improving the performance.     

A Narrative Review of Potential Future Antidiabetic Drugs: Should We Expect More?

Prevalence of diabetes mellitus, a chronic metabolic disease characterized by hyperglycemia, is growing worldwide. The majority of the cases belong to type 2 diabetes mellitus (T2DM). Globally, India ranks second in terms of diabetes prevalence among adults. Currently available classes of therapeutic agents are used alone or in combinations but seldom achieve treatment targets. Diverse pathophysiology and the need of therapeutic agents with more favourable pharmacokinetic-pharmacodynamics profile make newer drug discoveries in the field of T2DM essential. A large number of molecules, some with novel mechanisms, are in pipeline. The essence of this review is to track and discuss these potential agents, based on their developmental stages, especially those in phase 3 or phase 2. Unique molecules are being developed for existing drug classes like insulins, DPP-4 inhibitors, GLP-1 analogues; and under newer classes like dual/pan PPAR agonists, dual SGLT1/SGLT2 inhibitors, glimins, anti-inflammatory agents, glucokinase activators, G-protein coupled receptor agonists, hybrid peptide agonists, apical sodium-dependent bile acid transporter (ASBT) inhibitors, glucagon receptor antagonists etc. The heterogeneous clinical presentation and therapeutic outcomes in phenotypically similar patients is a clue to think beyond the standard treatment strategy.     

Evaluation of urinary abnormalities in urolithiasis patients: A study from North India

Metabolic abnormalities were investigated in 44 stone patients with first time (group 1) and 56 with 2 times stone formation (group 2), and in 25 normal individuals. 24hr urine was analysed spectrophotometrically for oxalate, calcium, magnesium, citrate, uric acid, phosphate and creatinine. Hypocitraturia and hyperoxaluria were the common abnormalities in the stone formers. Stone patients had significantly higher urinary oxalate, calcium and uric acid and lower phosphate than normal individuals. Citrate/calcium and magnesium/calcium ratio were significantly high in normal individuals than stone formers. Patients in group 2 excreted significantly higher urinary calcium and lower citrate that patients in group 1. Citrate/calcium ratio was higher in group 1 than group 2. Hypocitraturia, hyperoxaluria, hypercalciuria and increased citrate/calcium and magnesium/calcium ratio seem to be an essential risk factor for stone formation. Patients with recurrent stone formation could be distinguished from patients with first time stone formation on the basis of urinary calcium and citrate.     

Status and Interrelationship of Zinc,Copper, Iron,Calcium and Selenium in Prostate Cancer

Deficiency or excess of certain trace elements has been considered as risk factor for prostate cancer. This study was aimed to detect differential changes and mutual correlations of selected trace elements in prostate cancer tissue versus benign prostatic hyperplasia tissue. Zinc, copper, iron, calcium and selenium were analysed in histologically proven 15 prostate cancer tissues and 15 benign prostatic hyperplasia tissues using atomic absorption spectrophotometer. Unpaired two tailed t test/Mann–Whitney U test and Pearson correlation coefficient were used to compare the level of trace elements, elemental ratios and their interrelations. As compared to benign prostatic tissue, malignant prostatic tissue had significantly lower selenium (p = 0.038) and zinc (p = 0.043) concentrations, a lower zinc/iron ratio (p = 0.04) and positive correlation of selenium with zinc (r = 0.71, p = 0.02) and iron (r = 0.76, p = 0.009). Considerably divergent interrelationship of elements and elemental ratios in prostate cancer versus benign prostatic hyperplasia was noted. Understanding of differential elemental changes and their interdependence may be useful in defining the complex metabolic alterations in prostate carcinogenesis with potential for development of element based newer diagnostic, preventive and therapeutic strategies. Further studies may be needed to elucidate this complex relationship between trace elements and prostate carcinogenesis.     

Study of adenosine deaminase activity in various arthritic conditions

Aim of present study was to compare the adenosine deaminase (ADA) activity in various types of arthritis conditions with synovial effusion. No. significant difference was observed in ADA activity in serum of control and study groups but results have shown a definite pattern of ADA activity in synovial fluid in various arthritic conditions. The highest value of ADA activity was observed in synovial fluid of patients with tubercular arthritis followed by rheumatoid, septic, osteo and post traumatic arthritis. Thus measurement of ADA activity in synovial fluid can be used as a parameter of differential diagnosis of arthritis specially tubercular in initial stages.     

Effects of roller burnishing process parameters on surface roughness of A356/5%SIC composite using response surface methodology

In this study, a simple roller burnishing tool was made to operate burnishing processes on A356/5%SIC metal matrix composite fabricated by electromagnetic stir casting under different parameters. The effects of burnishing speed, burnishing force and number of burnishing passes on the surface roughness and tribological properties were measured. Scanning electron microscopy （SEM） graphs of the machined surface with PCD （insert-10） tool and roller burnished surface with tungsten carbide （WC） roller were taken into consider- ation to observe the surface finish of metal matrix composites. The mechanical properties （tensile strength, hardness, duc- tility） of A356/5%SIC metal matrix composites were studied for both unburnished samples and burnished samples. The results revealed that the roller burnished samples of A356/ 5%SIC led to the improvement in tensile strength, hardness and ductility. In order to find out the effects of roller bur- nishing process parameters on the surface roughness of A356/ 5%SIC metal matrix composite, response surface methodol- ogy （RSM） （Box-Behnken design） was used and a prediction model was developed relevant to average surface roughness using experimental data. In the range of process parameters, the result shows that roller burnishing speed increases, and surface roughness decreases, but on the other hand roller burnishing force and number of passes increase, and surface roughness increases. Optimum values of burnishing speed （1.5 m/s）, burnishing force （50 N） and number of passes （2） during roller burnishing of A356/5%SIC metal matrix com- posite to minimize the surface roughness （predicted 1.232 μm） have been found out. There was only 5.03% error in the experimental and modeled results of surface roughness.     

I CARE: Development and Evaluation of a Campus Gatekeeper Training Program for Mental Health Promotion and Suicide Prevention

Addressing the need for suicide prevention on campus, I CARE training, developed and facilitated by counseling center clinicians, trains students, staff, and faculty to provide support to students experiencing distress or mental health problems. We assessed its impact using a mixed-methods approach. Quantitative analyses demonstrated significant increases in knowledge of intervention skills and readiness to intervene from pretraining to posttraining. Knowledge and readiness remained significantly higher than preworkshop for the entire follow-up evaluation period, extending 15 months posttraining. Qualitative analyses revealed the value of experiential activities and emotional processing in increasing participants’ comfort and preparedness to intervene in challenging situations.     

Serum oestradiol in women with carcinomas of the breast and uterine cervix

Endogenous oestrogens are thought to be involved in breast cancer, but few studies could show the direct relationship between hormones and pathological process of the disease. In the present study, oestradiol was estimated in the serum of pre-and postmenopausal breast cancer patients along with normal healthy controls and patients with carcinoma of the uterine cervix which is not dependent on oestrogens. Premenopausal patients with breast cancer showed higher levels of oestradiol as compared to premenopausal control women as well as cervical cancer patients. Whereas, no statistically significant differences were observed in serum oestradiol levels amongst postmenopausal groups of breast cancer, cervical cancer and normal women. The result of the study reflects the association of oestradiol as well as its difference in the pathological events of pre and postmenopausal breast cancer.     

Are we using Thyroid Function Tests Appropriately?

Thyroid function tests are very important for the diagnosis and monitoring of patients with thyroid dysfunction. The guidelines recommend serum thyroid stimulating hormone (TSH) as the single most reliable test to diagnose all common forms of hypothyroidism and hyperthyroidism. The aim of this study was to analyze the ordering pattern for thyroid function tests by physicians and the analysis of results based on the clinical history. The mean age of the patients was 32.5 ± 6.5 years. Majority of samples (87.7% of total) were received from the departments of Medicine and Gynae. Thyroid profiles (47.5%) were ordered more frequently as compared to TSH only (46%). There was no significant difference in the percentage of normal reports for both types of tests. 77.8% of TFT and 76.6% of TSH samples had results within the reference range. The percentage of abnormal results was 13.7% in the patients who were screened for thyroid disorders. There is a need to redefine the case definition for thyroid dysfunction and order the appropriate test in a rational and cost effective manner.