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Global inequity in access to and availability of essential mental health services is well recognized. The mental health treatment gap is approximately 50% in all countries, with up to 90% of people in the lowest-income countries lacking access to required mental health services. Increased investment in global mental health (GMH) has increased innovation in mental health service delivery in LMICs. Situational analyses in areas where mental health services and systems are poorly developed and resourced are essential when planning for research and implementation, however, little guidance is available to inform methodological approaches to conducting these types of studies. This scoping review provides an analysis of methodological approaches to situational analysis in GMH, including an assessment of the extent to which situational analyses include equity in study designs. It is intended as a resource that identifies current gaps and areas for future development in GMH. Formative research, including situational analysis, is an essential first step in conducting robust implementation research, an essential area of study in GMH that will help to promote improved availability of, access to and reach of mental health services for people living with mental illness in low- and middle-income countries (LMICs). While strong leadership in this field exists, there remain significant opportunities for enhanced research representing different LMICs and regions.
We report the utility of whole-genome sequencing (WGS) conducted in a clinically relevant time frame (ie, sufficient for guiding management decision), in managing a Streptococcus pyogenes outbreak, and present a comparison of its performance with emm typing.
A 2,000-bed tertiary-care psychiatric hospital.
Active surveillance was conducted to identify new cases of S. pyogenes. WGS guided targeted epidemiological investigations, and infection control measures were implemented. Single-nucleotide polymorphism (SNP)–based genome phylogeny, emm typing, and multilocus sequence typing (MLST) were performed. We compared the ability of WGS and emm typing to correctly identify person-to-person transmission and to guide the management of the outbreak.
The study included 204 patients and 152 staff. We identified 35 patients and 2 staff members with S. pyogenes. WGS revealed polyclonal S. pyogenes infections with 3 genetically distinct phylogenetic clusters (C1–C3). Cluster C1 isolates were all emm type 4, sequence type 915 and had pairwise SNP differences of 0–5, which suggested recent person-to-person transmissions. Epidemiological investigation revealed that cluster C1 was mediated by dermal colonization and transmission of S. pyogenes in a male residential ward. Clusters C2 and C3 were genomically diverse, with pairwise SNP differences of 21–45 and 26–58, and emm 11 and mostly emm120, respectively. Clusters C2 and C3, which may have been considered person-to-person transmissions by emm typing, were shown by WGS to be unlikely by integrating pairwise SNP differences with epidemiology.
WGS had higher resolution than emm typing in identifying clusters with recent and ongoing person-to-person transmissions, which allowed implementation of targeted intervention to control the outbreak.
Suicide-related behaviours are common in schizophrenia and are significantly associated with premature death. The objective of this meta-analysis study was to estimate the pooled prevalence of suicide-related behaviours in schizophrenia patients in China.
The relevant literature was searched systematically via the relevant electronic databases (PubMed, Embase, PsycINFO, Chinese National Knowledge Infrastructure, Wanfang Databases and Chinese Biological Medical Literature Database) from their inception until 14 September 2016. Only original studies that reported the prevalence of suicide-related behaviours including suicidal ideation (SI), suicide plan, suicide attempt (SA) and completed suicide were selected.
Nineteen articles met the inclusion criteria and were analysed. The pooled lifetime prevalence of SI and SA were 25.8% (95% CI 14.7–41.1%) and 14.6% (95% CI 9.1–22.8%), respectively. The 1-month prevalence of SI was 22.0% (95% CI 18.2–26.4%). Subgroup analyses of lifetime SI and SA showed that gender, sample size, survey year, study location and source of patients have no significant mediating effects on the results.
Suicide-related behaviours are common in Chinese schizophrenia patients. Due to the high mortality risk, regular screening and effective suicide prevention programmes are warranted.
We describe the performance of the Boolardy Engineering Test Array, the prototype for the Australian Square Kilometre Array Pathfinder telescope. Boolardy Engineering Test Array is the first aperture synthesis radio telescope to use phased array feed technology, giving it the ability to electronically form up to nine dual-polarisation beams. We report the methods developed for forming and measuring the beams, and the adaptations that have been made to the traditional calibration and imaging procedures in order to allow BETA to function as a multi-beam aperture synthesis telescope. We describe the commissioning of the instrument and present details of Boolardy Engineering Test Array’s performance: sensitivity, beam characteristics, polarimetric properties, and image quality. We summarise the astronomical science that it has produced and draw lessons from operating Boolardy Engineering Test Array that will be relevant to the commissioning and operation of the final Australian Square Kilometre Array Path telescope.
Carbapenem-resistant Acinetobacter baumannii (CRAB) with diverse multilocus sequence typing emerged among our nursing home residents (6.5%) with a high background rate of MRSA (32.2%). Rectal swabs yielded a higher rate of CRAB detection than axillary or nasal swabs. Bed-bound status, use of adult diapers, and nasogastric tube were risk factors for CRAB colonization.
It is unclear if the impact of psychoeducational family intervention for patients with schizophrenia can be sustained over 10 years. In this study, we explored the 14-year effect of psychoeducational family intervention for patients with schizophrenia in a Chinese rural area.
The data from a cluster randomized control trial (CRCT) study of psychoeducational family intervention in a 14-year follow-up was analyzed. All patients with schizophrenia (n = 326) who participated in the CRCT drawn from six townships in Xinjin County of Chengdu in 1994, of whom 238 (73.0%) who were still alive, and their informants were followed up in 2008. The Patients Follow-up Scale, the Positive and Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning were used in the follow-up study.
There were no significant differences of marital status, mean scores of PANSS positive symptoms, negative symptoms, general mental health, and total scores among the psychoeducational family intervention, medication, and control groups in 2008. The psychoeducational family intervention group had a significantly higher rate of antipsychotic medication and a higher level of work ability than other two groups. The control group had a significantly higher rate of never-treated (26.0%) than psychoeducational family intervention group (6.5%).
Psychoeducational family intervention might be still effective in the 14-year follow-up, especially in patients’ treatment adherence/compliance and social functioning. Psychoeducational family intervention might be more effective in places where family members frequently participated in patients’ care and had a lower level of knowledge on mental illness. Family intervention should be considered when making mental health policy and planning mental health services.
This paper describes the system architecture of a newly constructed radio telescope – the Boolardy engineering test array, which is a prototype of the Australian square kilometre array pathfinder telescope. Phased array feed technology is used to form multiple simultaneous beams per antenna, providing astronomers with unprecedented survey speed. The test array described here is a six-antenna interferometer, fitted with prototype signal processing hardware capable of forming at least nine dual-polarisation beams simultaneously, allowing several square degrees to be imaged in a single pointed observation. The main purpose of the test array is to develop beamforming and wide-field calibration methods for use with the full telescope, but it will also be capable of limited early science demonstrations.
As the remnant of Supernova (SN) 1987A has been getting brighter over time, new observations at high frequencies have allowed imaging of the radio emission at unprecedented detail. We present a new radio image at 44 GHz of the supernova remnant (SNR), derived from observations performed with the Australia Telescope Compact Array (ATCA) in 2011. The diffraction-limited image has a resolution of 349×225 mas, which is the highest achieved to date in high-dynamic range images of the SNR. We also present a new image at 18 GHz, also derived from ATCA observations performed in 2011, which is super-resolved to 0″.25. The new 44 and 18 GHz images yield the first high-resolution spectral index map of the remnant. The comparison of the 44 GHz image with contemporaneous X-ray and Hα observations allows further investigations of the nature of the remnant asymmetry and sheds more light into the progenitor hypotheses and SN explosion. In light of simple free-free absorption models, we discuss the likelihood of detecting at 44 GHz the possible emission originating from a pulsar wind nebula (PWN) or a compact source in the centre of the remnant.
Supernovae and their remnants are believed to be prodigious sources of Galactic cosmic rays and interstellar dust. Understanding the mechanisms behind their surprisingly high production rate is helped by the study of nearby young supernova remnants. There has been none better in modern times than SN1987A, for which radio observations have been made for over a quarter of a century. We review extensive observations made with the Australia Telescope Compact Array (ATCA) at centimetre wavelengths. Emission at frequencies from 1 to 100 GHz is dominated by synchrotron radiation from an outer shock front which has been growing exponentially in strength from day 3000, and is currently sweeping around the circumstellar ring at about 4000 km s−1. Three dimensional models of the propagation of the shock into the circumstellar medium are able to reproduce the main observational features of the remnant, and their evolution. We find that up to 4% of the electrons encountered by the shock are accelerated to relativistic energies. High-frequency ALMA observations will break new ground in the understanding of dust and molecule production.
Although usually thought of as external environmental stressors, a significant heritable component has been reported for measures of stressful life events (SLEs) in twin studies.
We examined the variance in SLEs captured by common genetic variants from a genome-wide association study (GWAS) of 2578 individuals. Genome-wide complex trait analysis (GCTA) was used to estimate the phenotypic variance tagged by single nucleotide polymorphisms (SNPs). We also performed a GWAS on the number of SLEs, and looked at correlations between siblings.
A significant proportion of variance in SLEs was captured by SNPs (30%, p = 0.04). When events were divided into those considered to be dependent or independent, an equal amount of variance was explained for both. This ‘heritability’ was in part confounded by personality measures of neuroticism and psychoticism. A GWAS for the total number of SLEs revealed one SNP that reached genome-wide significance (p = 4 × 10−8), although this association was not replicated in separate samples. Using available sibling data for 744 individuals, we also found a significant positive correlation of R2 = 0.08 in SLEs (p = 0.03).
These results provide independent validation from molecular data for the heritability of reporting environmental measures, and show that this heritability is in part due to both common variants and the confounding effect of personality.
Nanoscale superlattice-like (SLL) dielectric was employed to reduce the power consumption of the Phase-change random access memory (PCRAM) cells. In this study, we have simulated and found that the cells with the SLL dielectric have a higher peak temperature compared to that of the cells with the SiO2 dielectric after constant pulse activation, due to the interface scattering mechanism. Scaling of the SLL dielectric has resulted in higher peak temperatures, which can be even higher after material/structural modifications. Furthermore, the SLL dielectric has good material properties that enable the cells to have high endurance. This shows the effectiveness of the SLL dielectric for advanced memory applications.
This study was performed to determine the prevalence, distribution of specimen sources, and antimicrobial susceptibility of the Acinetobacter calcoaceticus–Acinetobacter baumannii (Acb) species complex in Singapore. One hundred and ninety-three non-replicate Acb species complex clinical isolates were collected from six hospitals over a 1-month period in 2006. Of these, 152 (78·7%) were identified as A. baumannii, 18 (9·3%) as ‘Acinetobacter pittii’ [genomic species (gen. sp.) 3], and 23 (11·9%) as ‘Acinetobacter nosocomialis’ (gen. sp. 13TU). Carbapenem resistance was highest in A. baumannii (72·4%), followed by A. pittii (38·9%), and A. nosocomialis (34·8%). Most carbapenem-resistant A. baumannii and A. nosocomialis possessed the blaOXA-23-like gene whereas carbapenem-resistant A. pittii possessed the blaOXA-58-like gene. Two imipenem-resistant strains (A. baumannii and A. pittii) had the blaIMP-like gene. Representatives of carbapenem-resistant A. baumannii were related to European clones I and II.
The interplay of melting equilibria and reaction kinetics is important during formation of the Ba2YCu3O6+x (Y-213) phase from starting materials in the quaternary reciprocal system Ba,Y,Cu//O,F. For experimental investigation of the process we used a combination of differential thermal analysis (DTA) for study of melting equilibria, and in-situ high-temperature x-ray diffraction (HTXRD) for study of the phase formation and reaction kinetics. DTA investigation of compositions spaced along compositional vectors extending from the oxide end to the fluoride end of the reciprocal system have given evidence of low melting liquids (∼600 °C) near the fluorine-rich end. Work is continuing to determine whether similar thermal events observed in the interior of the system also indicate low temperature liquids, and on the extent to which low-melting liquids could be involved in Y-213 phase formation. HTXRD investigations have been initiated on the conversion of 0.3 μm and 1.0 μm thick BaF2-Y-Cu precursor films to Y-213 in the presence of water vapor. Preliminary results indicated that the thickness of film has a strong influence on the texture of the Y-213 film: a 0.3 μm film showed mainly (001) texture, whereas a 1.0 μm film showed a greater volume fraction of (h00) texture. While the HTXRD method cannot directly reveal the presence of liquid, we are working to combine DTA and HTXRD data for a unified picture of Y-213 phase formation during the “BaF2 ex-situ” process for coated-conductor fabrication.
The device on Si substrates behaves as an MIS capacitor and the response to hydrogen is given by a shift of the capacitance vs. bias profile along the bias voltage axis, whereas the device on SiC behaves as a rectifying diode and the presence of hydrogen causes a shift of the forward current vs. voltage plot. The relatively large forward current, in both cases, indicates that there is measurable electrical transport across the AlN layer, but at the same temperature the turn on bias is different. Either structure contains two rectifying contacts in series, namely a Schottky contact between Pd and AlN and a heterojunction between AlN and the substrate.
A Pd/AlN/SiC device was fabricated with a 550 Å thick AlN layer in between the SiC substrate and Pd gate. At fixed flow rate, the response to Hydrogen initially increases roughly linearly with concentration, but eventually becomes saturated. The magnitude of the response as well as the saturating concentration increase with temperature. At 120° C the response saturates around 60 ppm of H2 whereas at 250° C, the onset of saturation occurs at higher ppm. The magnitude of the response also increases with the total flow rate, up to a flow rate of 250 sccm beyond which it remains constant. In the linear region, the magnitude of the response increases by a factor of 4 between 120° and 250° C, at a flow rate of 250 sccm.
A combined structural and optical assessment of cubic (3C-) SiC thin films grown on Si (100) substrates by chemical vapor epitaxy (CVD) is presented. The CVD growth was performed at both atmospheric and low (100 Torr) pressure, using a vertical reactor. The CVD-grown 3C-SiC films with different growth time were characterized by X-ray diffraction, Raman scattering and Fourier transform infrared (FTIR) spectroscopy to be single crystalline with a high degree of crystal perfection. The film thickness was determined from FTIR spectra. Variations of X-ray, FTIR and Raman spectra with different growth conditions and film thicknesses are studied comparatively. Related problems are discussed.