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The Democratic Republic of Congo (DRC) has been the subject of several armed conflicts for more than two decades, causing the displacement of millions of Congolese in and outside the country and impacting on their mental health and wellbeing. Mental healthcare interventions are a vital component for the displaced to holistically integrate into their new communities. This policy brief draws from a systematic review of various laws and policies as well as stakeholders' analysis to address the mental health issues of internally displaced persons (IDPs) in the DRC. In addition, we examine data from 32 interviews with various stakeholders at the national level and in 4 provinces of the DRC (Kasai Central, Tanganyika, South Kivu and Ituri). The findings show that while the DRC has committed to progressive policies and conventions the implementation of these policies and conventions, however, remains insufficient. There are also limited local and international stakeholders that provide forms of psychosocial support to IDPs and, effectively address mental health challenges in context. In addition, the provision of such care is limited by the scarcity of specialized and skilled staffs. These findings point to the need to strengthen mental health system governance. This should include scaling up of the integration of mental healthcare at the operational level, the training of community health workers in the screening of mental health issues and the sensitization of the IDPs and the host population to help them change their perception of mental ill-health.

This article explores the link between migration and alienation and its impact on the mental health and wellbeing of Congolese and Somali asylum seekers and refugees—two of the largest populations of displaced migrants in South Africa. Drawing on ethnographic research in Johannesburg, we highlight the various ways alienation is both imposed upon and experienced by migrants and argue that systemic disintegration, or acts of alienation, can be seen as deliberate and active policies and practices that are instrumental in excluding asylum seekers and refugees from everyday life. The experiences of marginalization and othering narrated by Congolese and Somali migrants highlight ways in which alienation and disintegration from critical social connections including family, community, and familiar contexts fundamentally impact wellbeing and mental health as well as strategies of care-seeking, and other forms of relational resilience. While conceptualizations and metrics of integration may in some ways capture the fallout of disintegration, such as access to livelihoods, housing, education, and healthcare, we suggest that this does not adequately assess the profound damage by acts of alienation on crucial relationships. The alienated psyche of innumerable migrants in South Africa results in the feeling that “when a bad thing happens…you are better only when you are home.” This pain, or feelings of alienation, we argue, are a crucial aspect to our understanding of alienation and in turn, highlight the importance of alienation as an apt analytical tool through which experiences of asylum-seeking in South Africa can be understood.

How mechanical forces drive fluid transport in the kidney remains unclear. Here, the authors use a microfluidic platform to show that kidney epithelial cells generate hydraulic pressure gradients across the epithelium, and that the fluid flux is from apical to basal for normal cells, and inverted in autosomal dominant polycystic kidney disease cells.

Background: Emergency medical services (EMS) are a critical but often overlooked component of essential public health care delivery in low- and middle-income countries (LMICs). Few countries in Africa have established EMS and there is scant literature to provide guidance for EMS growth. Objective: This study aimed to characterize EMS utilization in Harare, Zimbabwe in order to guide system strengthening efforts. Methods: We performed a retrospective chart review of patient care reports (PCR) generated by the City of Harare ambulance system for patients transported and/or treated in the prehospital setting over a 14-month period (February 2018 – March 2019). Findings: A total of 875 PCRs were reviewed representing approximately 8% of the calls to EMS. The majority of patients were age 15 to 49 (76%) and 61% were female patients. In general, trauma and pregnancy were the most common chief complaints, comprising 56% of all transports. More than half (51%) of transports were for inter-facility transfers (IFTs) and 52% of these IFTs were maternity-related. Transports for trauma were mostly for male patients (63%), and 75% of the trauma patients were age 15–49. EMTs assessed and documented pulse and blood pressure for 72% of patients. Conclusion: In this study, EMS cared primarily for obstetric and trauma emergencies, which mirrors the leading causes of premature death in LMICs. The predominance of requests for maternity-related IFTs emphasizes the role for EMS as an integral player in peripartum maternal health care. Targeted public health efforts and chief complaint-specific training for EMTs in these priority areas could improve quality of care and patient outcomes. Moreover, a focus on strengthening prehospital data collection and research is critical to advancing EMS development in Zimbabwe and the region through quality improvement and epidemiologic surveillance.

Alongside the rapid and broad uptake of online learning in higher education, fully online students report feeling isolated and disconnected from their institutions. Although formal course content may be expertly designed to engage online learners, much of the information provided to support higher education students’ orientation to the institution and to study is presented online in a written static form. Such presentations may not be accessible and engaging and may contribute to feelings of disconnection. Technologies such as virtual reality (VR) are being used in higher education to engage, motivate and connect students in their learning. This paper reports on the early design stages for a VR that aims to support initial teacher education students to connect and engage with key orienting information. The design of the VR was achieved by following a user-centred, iterative engineering design process and design principles of spatiality, interaction and narrative. The VR environment emulates the School of Education’s physical, on-campus reception area to provide an immersive experience where students have a choice in the types and format of key study information they receive. This experience was designed to be utilised in online orientation but also throughout students’ first year of study. Future research directions include collecting student responses to the VR to inform how students can be involved in enhancing the VR so that it supports their learning and sense of connection. Furthermore, future research can aim for the expansion of the VR inclusive of additional information, rooms and buildings and increased capabilities such as gamification and mobile access. This will enable the creation of a valuable teaching resource for online programs.

Background: Patients in low-income and middle-income countries (LMICs) have limited access to palliative care providers. In Myanmar, little is known about physician knowledge of or perceptions about palliative care. An assessment of physician practice and capacity to provide palliative care is needed. Objective: Our objective was to identify physician practice patterns, knowledge gaps, and confidence in providing palliative and end-of-life care in Myanmar. Design: This was a cross-sectional survey study. Setting/Subjects: Participants were physicians practicing in Myanmar who attended the Myanmar Emergency Medicine Updates Symposium on November 10 to 11, 2018 in Yangon, Myanmar (n?=?89). Measurements: The survey used modified Likert scales to explore four aspects of palliative care practice and training: frequency of patient encounters, confidence in skills, previous training, and perceived importance of formal training. Results: Study participants were young (median age 27 years old); 89% cared for terminally ill patients monthly, yet 94% reported less than two weeks of training in common palliative care domains. Lack of training significantly correlated with lack of confidence in providing care. Priorities for improving palliative care services in Myanmar include better provider training and medication access. Conclusions: Despite limited training and low confidence in providing palliative care, physicians in Myanmar are treating patients with palliative needs on a monthly basis. Future palliative care education and advocacy in Myanmar and other LMICs could focus on physician training to improve end-of-life care, increase physician confidence, and reduce barriers to medication access.

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Marine mammals are vulnerable to a variety of acute and chronic anthropogenic stressors, potentially experiencing these in isolation, successively and/or simultaneously. Formal assessment of the likely impact(s) of the cumulative effects of multiple stressors on a defined population is carried out through a Cumulative Effects Assessment (CEA), which is a mandatory component of the Environmental Impact Assessment (EIA) process in many countries. However, for marine mammals, the information required to feed into CEA, such as thresholds for disturbance, frequency of multiple (and simultaneous) exposures, interactions between stressors, and individual variation in response, is extremely limited, though our understanding is slowly improving. The gaps in knowledge make it challenging to effectively quantify and subsequently assess the risk of individual and population consequences of multiple disturbances in the form of a CEA. To assess the current state of practice for assessing cumulative effects on marine mammals within UK waters, 93 CEAs were reviewed across eleven maritime industries. An objective framework of thirteen evaluative criteria was used to score each assessment on a scale of 13-52 (weak - strong). Scores varied significantly by industry. On average, the aquaculture industry produced the lowest scoring CEAs, whilst the large offshore windfarm industry (≥ 20 turbines) scored highest, according to the scoring criteria used. There was a significant increase in scores over the sample period (2009-2019), though this was mostly attributed to five industries (cable, large and small offshore wind farms, tidal and wave energy). There was inconsistency in the language used to define and describe cumulative effects and a lack of routinely applied methodology. We use the findings presented here, along with a wider review of the literature, to provide recommendations and discussion points aimed at supporting the standardisation and improvement of CEA practice. Although this research focused on how marine mammals were considered within UK CEAs, recommendations made are broadly applicable to assessments conducted for other receptors, countries and/or environments. Adoption of these proposals would help to ensure a more consistent approach, and would aid decision-makers and practitioners in mitigating any potential impacts, to ensure conservation objectives of marine mammal populations are not compromised.

The twist-bend nematic (NTB) phase of bent-shaped molecules has recently attracted much attention due to the spontaneous bend of its director field and the doubly-degenerate chirality of its heliconical structure. Despite intensive experimental and theoretical investigation worldwide, the main structural characteristics (pitch and conical angle) and elastic properties of the phase are still barely understood. This is mainly due to the difficulty in growing large single domains of the NTB phase, which prevents the application of the powerful electro-optical techniques developed for the nematic (N) phase. Moreover, the twist and bend distortions of the optic axis are forbidden by the pseudo-layered structure of the NTB phase, which makes its response to the field smectic-like instead of nematic-like. Therefore, the only macroscopic electric effect that can be observed deep in the NTB phase is the smectic-like “electroclinic” effect (ECENTB). Here, we achieve large monochiral NTB domains which remain uniform over a wide temperature range (20–60 °C) in thin (1.5 µm) planar cells, thus avoiding the so-called stripe- and rope-like textural instabilities. This allowed us to experimentally determine, using electro-optical measurements, the temperature dependence of the ECENTB response in four different NTB materials: namely the dimers CB7CB, CB9CB, CB6OCB, and BNA76. For all compounds, the thermal dependences of conical angle and pitch in the vicinity of the N-NTB transition follow the theoretically predicted power law behaviour. However, the agreement between the measured and predicted power law exponents remains only qualitative, which calls for improvement of the theoretical models.

Recognition that schools should be responsive to children who are impacted by adversity and trauma is burgeoning internationally. However, consensus regarding the necessary components of a trauma-informed school is lacking. This research developed expert-informed and internationally relevant best-practice trauma-informed principles for schools. A four-phase methodology included (i) identification of school-relevant trauma-informed practice programs, (ii) inductive thematic analysis of the main concepts underlying programs, (iii) phrasing of draft Principles and (iv) Principle revision and finalisation via a two-round Delphi survey with international experts. Excellent agreement by experts on the importance of all Principles was achieved (round 1 [greater than or equal to] 86.4%, 2 [greater than or equal to] 92.3%). The final 'International Trauma-Informed Practice Principles for Schools' (ITIPPS) include four Overarching (A-D) and 10 Practice Principles (1-10). Summarised, these include that the school: (A) is student focussed; (B) models compassion and generosity; (C) is understanding and responsive; (D) incorporates recognition of their First Nations peoples in the school's ethos: (1) prioritises safety and wellbeing; (2) models positive relationships; (3) provides a positive culture and connects; (4) consults and collaborates; (5) supports vulnerable students; (6) teaches social and emotional learning; (7) provides trauma-informed practice training; (8) is predictable yet flexible; (9) identifies and nurtures strengths and (10) reflects, changes and grows. The ITIPPS provide clear guidance for education sectors, schools and other settings about appropriate learning environments for children and young people impacted by trauma. Research is now underway in Western Australian schools to pilot test the feasibility and impact of using the ITIPPS within a framework (thoughtfulschools.org.au) to establish trauma-informed schools.

Over recent years, much has been said about the quality of Australian initial teacher education. Concerns about the preparation of pre-service teachers and the capacity of graduates to meet the demands of the classroom have re-emphasised professional experience as a fundamental component of high-quality teacher preparation. Simultaneously, this focus on professional experience has emphasised the importance of partnerships. Through policy, the formalisation of partnerships between initial teacher education providers and early learning centres and schools has been linked to quality assurance and auditing cycles which report on the ways that providers prepare graduates for teaching. The employability of suitably-prepared graduates and their early career traction are of particular interest to policy makers, regulators and teacher educators alike. As a result, establishing an evidence base for quality in professional experience partnerships is paramount. This paper reports on the evolution of a strategic partnerships model between one provider and its growing network of partner schools. This model has been developed through a comprehensive evaluation process, examining the nature of formal partnerships and the outcomes associated with them. Data presented here highlights outcomes identified by stakeholders as influential and enacted through formal partnerships. Analysis of data also emphasises ongoing priorities for partnership development, implementation and evaluation, collectively understood to be closely connected to graduate employability.

It was previously shown that chiral structures can be formed from achiral bent-shaped mesogens. Here the authors observe hierarchical chiral structures with coupling of chirality at different levels in a system with achiral constituents.

In this review we consider the relationships between molecular structure and the tendency of liquid crystal dimers to exhibit smectic phases, and show how our application of these led to the recent discovery of the twist-bend, heliconical smectic phases. Liquid crystal dimers consist of molecules containing two mesogenic groups linked through a flexible spacer, and even- and odd-membered dimers differ in terms of their average molecular shapes. The former tend to be linear whereas the latter are bent, and this difference in shape drives very different smectic behaviour. For symmetric dimers, in which the two mesogenic groups are identical, smectic phase formation may be understood in terms of a microphase separation into distinct sublayers consisting of terminal chains, mesogenic units and spacers, and monolayer smectic phases are observed. By contrast, intercalated smectic phases were discovered for nonsymmetric dimers in which the two mesogenic units differ. In these phases, the ratio of the layer spacing to the molecular length is typically around 0.5 indicating that unlike segments of the molecules overlap. The formation of intercalated phases is driven by a favourable interaction between the different liquid crystal groups. If an odd-membered dimer possesses sufficient molecular curvature, then the twist-bend nematic phase may be seen in which spontaneous chirality is observed for a system consisting of achiral molecules. Combining the empirical relationships developed for smectogenic dimers, and more recently for twist-bend nematogenic dimers, we show how dimers were designed to show the new twist-bend, heliconical smectic phases. These have been designated SmCTB phases in which the director is tilted with respect to the layer plane, and the tilt direction describes a helix on passing between layers. We describe three variants of the SmCTB phase, and in each the origin of the symmetry breaking is attributed to the anomalously low-bend elastic constant arising from the bent molecular structures.