Publications by authors named "Alan Stein"

Background: Many adolescents in Uganda are affected by common mental disorders, but only a few affordable treatment options are available. Digital mental health interventions offer promising opportunities to reduce these large treatment gaps, but interventions specifically tailored for Ugandan adolescents are limited.

Objective: This study aimed to determine the feasibility and acceptability of the Kuamsha program, an intervention delivered through a gamified app with low-intensity telephonic guidance, as a way to promote mental health among adolescents from the general population in Uganda.

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Introduction: Low- and middle-income countries (LMICs) often dedicate limited domestic funds to expand quality early childhood care and education (ECCE), making complementary international donor support potentially important. However, research on the allocation of international development assistance for ECCE has been limited.

Methods: We analysed data from the Creditor Reporting System on aid projects to assess global development assistance for ECCE in 134 LMICs from 2007 to 2021.

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Perinatal depression (PND) affects up to 20% of women and is associated with significant impairment and disability in affected women. In addition, perinatal depression is associated with broader public health and multigenerational consequences. Innovative approaches are needed to reduce the burden of perinatal depression through identification, tracking, and treatment of depressive symptoms during the perinatal period.

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Article Synopsis
  • The text discusses how poverty, HIV, and perinatal depression in sub-Saharan Africa negatively impact parenting and child development, leading to public health concerns.
  • It highlights a proposed intervention that combines mental health support and parenting assistance, delivered by lay counselors, to help depressed, HIV-positive pregnant women while optimizing healthcare resources.
  • A cost-effectiveness analysis will evaluate this intervention's economic viability compared to standard care, measuring costs against improvements in maternal depression and child cognitive development over set timeframes.
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  • Spinal cord injury (SCI) causes significant health issues and financial strain, focusing management on minimizing secondary damage from ischemia and inflammation.* -
  • Emerging treatments like neuroprotective agents and neuromodulation techniques show promise but need more research, while timely surgical intervention within 24 hours is crucial for better outcomes.* -
  • Maintaining specific blood pressure targets after injury and providing comprehensive care can help reduce complications, with corticosteroids showing potential for improving motor recovery when given soon after the injury.*
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Introduction: Adolescents living with HIV (ALHIV) are an extremely vulnerable population, with the burden of mental health problems carefully documented together with the constraints for receiving timely and adequate management of the problems, especially in rural settings. Problem Management Plus (PM+) is a scalable psychological intervention for individuals impaired by distress in communities exposed to adversity. Initially developed for adult populations, few studies have assessed its potential to address adolescent distress.

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Background: Atlantoaxial subluxation (AAS) is a diagnosis describing misalignment of the C1 vertebra relative to C2. Excessive translation of this joint, located adjacent to the medullary brain stem, can lead to devastating neurological consequences. A higher prevalence of AAS within the Down syndrome (DS) population has been well-established.

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Background: Posttraumatic stress (PTS) and anxiety are common mental health problems among parents of babies admitted to a neonatal unit (NNU). This review aimed to identify sociodemographic, pregnancy and birth, and psychological factors associated with PTS and anxiety in this population.

Method: Studies published up to December 2022 were retrieved by searching Medline, Embase, PsychoINFO, Cumulative Index to Nursing and Allied Health electronic databases.

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Study Design: Bibliometric analysis.

Objective: Cervical disc arthroplasty (CDA) has emerged as an effective surgical intervention for degenerative cervical disc disease with potential advantages over traditional cervical fusion. This bibliometric analysis aimed to assess the current state of research on CDA by analyzing the relevant literature using bibliometric indicators.

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Study Design: Retrospective cohort study.

Objective: To evaluate the outcomes and reoperation rates in patients with adolescent idiopathic scoliosis undergoing lumbar anterior vertebral body tethering (AVBT).

Background: AVBT is a viable option for growing children.

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Background: There is an urgent need for scalable psychological treatments to address adolescent depression in low-resource settings. Digital mental health interventions have many potential advantages, but few have been specifically designed for or rigorously evaluated with adolescents in sub-Saharan Africa.

Objective: This study had 2 main objectives.

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Article Synopsis
  • Anterior vertebral body tethering (AVBT) and posterior spinal fusion (PSF) are surgical options for treating idiopathic scoliosis, often combined to maximize curve correction while preserving motion in the lumbar spine.
  • A study involving 20 patients showed significant improvements in spinal curve angles after a hybrid treatment involving both AVBT and PSF, with acceptable surgery times and blood loss.
  • The combined approach of PSF and AVBT is safe, effective, and aims to maintain mobility in the lumbar region while achieving optimal correction of the thoracic curve in scoliosis patients.
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Maturation of the human fetal brain should follow precisely scheduled structural growth and folding of the cerebral cortex for optimal postnatal function. We present a normative digital atlas of fetal brain maturation based on a prospective international cohort of healthy pregnant women, selected using World Health Organization recommendations for growth standards. Their fetuses were accurately dated in the first trimester, with satisfactory growth and neurodevelopment from early pregnancy to 2 years of age.

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Objective: Cervical spondylotic myelopathy (CSM) is a common clinical degenerative disease treated with anterior cervical discectomy and fusion (ACDF), which seriously impacts quality of life and causes severe disability. The objective of the study was to determine the effect of different characteristics of the neurological deficit found in myelopathic patients undergoing ACDFs on hospital cost, length of stay (LOS), and discharge location.

Methods: This is a retrospective review of ACDF cases performed at a single institution by multiple surgeons from 2011 to 2017.

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Executive functions (EF) can be measured by tests assessing accuracy, reaction times and by computing scores which combine these two components. Interpretation issues can arise from the use of different scoring methods across studies. Given that EF measures and their scoring methods are predominantly developed and validated in high income countries, little is known about the generalisability of such methods cross- culturally.

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Background: Intimate partner violence (IPV) is highly prevalent in low-income and middle-income countries and has been a major obstacle towards reaching global health targets for women and children. We aimed to investigate cross-sectional and longitudinal associations between IPV victimisation and maternal parenting practices of young children in a population-based birth cohort study in Brazil.

Methods: The 2015 Pelotas Birth Cohort is an ongoing, prospective cohort, including all hospital births occurring between Jan 1 and Dec 31, 2015, in the city of Pelotas, Brazil.

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Background: Providing young children with universal access to preprimary education (PPE) is considered a powerful tool for human capital development and eliminating the intergenerational transmission of poverty. To remove household financial barrier for achieving universal PPE, this study proposed a measure to identify households incurring 'heavy financial burdens from paying for PPE' (HBPPE) and conducted a case study in China.

Methods: Using nationally representative data in 2019, we estimated the percentage of households with HBPPE (spent 7% or more of their total annual expenditure) and associated socioeconomic inequalities.

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Background: Few studies have evaluated postnatal depression before and during the Covid-19 pandemic using comparable data across time. We used data from three national maternity surveys in England to compare prevalence and risk factors for postnatal depression before and during the pandemic.

Methods: Analysis was conducted using population-based surveys carried out in 2014 (n = 4571), 2018 (n = 4509), and 2020 (n = 4611).

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Article Synopsis
  • A study found that mothers whose infants were admitted to neonatal units have higher rates of mental health issues, including postnatal depression, anxiety, and post-traumatic stress six months after childbirth.
  • The research analyzed data from nearly 8,600 women and highlighted the prevalence of mental health issues among mothers of NNU infants, with significant rates for depression (23.7%) and anxiety (16.0%).
  • Key risk factors for experiencing these issues included having a history of long-term mental health problems and experiencing anxiety during pregnancy.
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Background: Disparities in neurosurgical care have emerged as an area of interest when considering the impact of social determinants on access to health care. Decompression via anterior cervical discectomy and fusion (ACDF) for cervical stenosis (CS) may prevent progression towards debilitating complications that may severely compromise one's quality of life. This retrospective database analysis aims to elucidate demographic and socioeconomic trends in ACDF provision and outcomes of CS-related pathologies.

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This paper used longitudinal data from five studies conducted in Bangladesh, Bhutan, Cambodia, Ethiopia, and Rwanda to examine the links between family stimulation and early childhood development outcomes (N = 4904; M = 51.5; 49% girls). Results from random-effects and more conservative child-fixed effects models indicate that across these studies, family stimulation, measured by caregivers' engagement in nine activities (e.

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Article Synopsis
  • - The AHEAD feasibility trial tested an 8-session group drumming program to improve mental health and social support among adolescents living with HIV in rural South Africa, with 68 participants randomly assigned to either the drumming intervention or a control group.
  • - Results showed high enrollment, retention, and acceptability rates for the program, along with positive effects on mood and potential improvements in working memory, but no significant changes in executive function or socio-emotional measures.
  • - Qualitative feedback indicated benefits like feeling a sense of belonging, reduced stigma, and decreased anxiety, supporting the recommendation for a full-scale trial of the drumming intervention.
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Partnerships between school staff and mental health professionals have the potential to improve access to mental health support for students, but uncertainty remains regarding whether and how they work in practice. We report on two pilot projects aimed at understanding the implementation drivers of tailored strategies for supporting and engaging front-line school staff in student mental health. The first project provided regular, accessible mental health professionals with whom school staff could meet and discuss individual or systemic mental health concerns (a school 'InReach' service), and the other offered a short skills training programme on commonly used psychotherapeutic techniques (the School Mental Health Toolbox; SMHT).

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Friendships are crucial in adolescent development. This paper presents a scoping review, followed by a systematic review, to assess friendship interventions and their impacts on the mental health outcomes of adolescents aged 12-24 years. Studies were included if they incorporated a friend or authentic social group in an intervention dedicated to improving mental health outcomes and well-being.

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Background: Given that common mental disorders are one of the leading causes of disease burden worldwide, it is likely that many children are growing up with a parent or other adult within their family who has anxiety or depression. Parents with a mental illness may not consider it appropriate to discuss their illness with their child, and consequently an absence of communication may lead to stigmatization, shame, misunderstanding their parents' symptoms, and even blaming themselves. There is a scarcity of research exploring the experiences and perceptions of healthcare professionals about communication with children of parents with mental illness in low-resource and African contexts.

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