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There is a scarcity of specialist trainers and supervisors for psychosocial interventions in low- and middle-income countries. A cascaded model of training and supervision was developed to sustain delivery of an evidence-based peer-delivered intervention for perinatal depression (the Thinking Healthy Programme) in rural Pakistan. The study aimed to evaluate the model.
Mixed methods were employed as part of a randomised controlled trial of the intervention. Quantitative data consisted of the peers' competencies assessed during field training and over the implementation phase of the intervention, using a specially developed checklist. Qualitative data were collected from peers and their trainers through 11 focus groups during the second and third year of intervention rollout.
Following training, 43 peers out of 45 (95%) achieved at least a ‘satisfactory’ level of competency (scores of ⩾70% on the Quality and Competency Checklist). Of the cohort of 45 peers initially recruited 34 (75%) were retained over 3 years and showed sustained or improved competencies over time. Qualitatively, the key factors contributing to peers' competency were use of interactive training and supervision techniques, the trainer–peer relationship, and their cultural similarity. The partnership with community health workers and use of primary health care facilities for training and supervision gave credibility to the peers in the community.
The study demonstrates that lay-workers such as peers can be trained and supervised to deliver a psychological intervention using a cascaded model, thus addressing the barrier of scarcity of specialist trainers and supervisors.
Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88) presented a critique of our recently published paper in Cell Reports entitled ‘Large-Scale Cognitive GWAS Meta-Analysis Reveals Tissue-Specific Neural Expression and Potential Nootropic Drug Targets’ (Lam et al., Cell Reports, Vol. 21, 2017, 2597–2613). Specifically, Hill offered several interrelated comments suggesting potential problems with our use of a new analytic method called Multi-Trait Analysis of GWAS (MTAG) (Turley et al., Nature Genetics, Vol. 50, 2018, 229–237). In this brief article, we respond to each of these concerns. Using empirical data, we conclude that our MTAG results do not suffer from ‘inflation in the FDR [false discovery rate]’, as suggested by Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88), and are not ‘more relevant to the genetic contributions to education than they are to the genetic contributions to intelligence’.
UK guidelines recommend routine HIV testing in high prevalence emergency departments (ED) and targeted testing for HBV and HCV. The ‘Going Viral’ campaign implemented opt-out blood-borne virus (BBV) testing in adults in a high prevalence ED, to assess seroprevalence, uptake, linkage to care (LTC) rates and staff time taken to achieve LTC. Diagnosis status (new/known/unknown), current engagement in care, and severity of disease was established. LTC was defined as patient informed plus ⩾1 clinic visit. A total of 6211/24 981 ED attendees were tested (uptake 25%); 257 (4.1%) were BBV positive (15 co-infected), 84 (33%) required LTC. 100/147 (68%) HCV positives were viraemic; 44 (30%) required LTC (13 new, 16 disengaged). 26/54 (48%) HBV required LTC (seven new, 11 disengaged). 16/71 (23%) HIV required LTC (10 new, five disengaged). 26/84 (31%) patients requiring LTC had advanced disease (CD4 <350, APRI (AST-to-Platelet Ratio Index) >1, Fibroscan F3/F4 or liver cancer), including five with AIDS-defining conditions and three hepatocellular carcinomas. There were five BBV-related deaths. BBV prevalence was high (4.1%); most were HCV (2.4%). HIV patients were more successfully and quickly LTC than HBV or HCV patients. ED testing was valuable as one-third of those requiring LTC (new, disengaged or unknown status patients) had advanced disease.
The purpose of this study was to investigate the 10-year impact of Hurricane Katrina on the incidence of acute myocardial infarction (AMI) along with contributing risk factors and any alteration in chronobiology of AMI.
A single-center, retrospective, comparison study of AMI incidence was performed at Tulane University Health Sciences Center from 2 years before Hurricane Katrina to 10 years after Hurricane Katrina. A 6-year, pre-Katrina and 10-year, post-Katrina cohort were also compared according to pre-specified demographic, clinical, and chronobiological data.
AMI incidence increased from 0.7% (150/21,079) to 2.8% (2,341/84,751) post-Katrina (P<0.001). The post-Katrina cohort had higher rates of coronary artery disease (36.4% vs. 47.9%, P=0.01), diabetes mellitus (31.3% vs. 39.9%, P=0.04), hyperlipidemia (45.4% vs. 59.3%, P=0.005), smoking (34.4% vs. 53.8%, P<0.001), drug abuse (10.2% vs. 15.4%, P=0.02), psychiatric illness (6.7% vs. 14.9%, P<0.001), medication non-adherence (7.3% vs. 15.3%, P<0.001), and lack of employment (7.2% vs. 16.4%, P<0.001). The post-Katrina group had increased rates of AMI during nights (29.8% vs. 47.8%, P<0.001) and weekends (16.1% vs. 29.1%, P<0.001).
Even 10 years after the storm, Hurricane Katrina continues to be associated with increased incidence of AMI, higher prevalence of traditional cardiovascular and psychosocial risk factors, and an altered chronobiology of AMI toward nights and weekends. (Disaster Med Public Health Preparedness. 2019;13:217–222)
For this study, we adapted the Montgomery Borgatta Caregiver Burden Scale, used widely in the United States, to the Saudi Arabian context. To produce an Arabic, culturally sensitive version of the scale, we conducted semi-structured interviews with 20 Saudi family caregivers. The Arabic version of the scale was tested, and participants were asked to comment on the appropriateness of items for the construct of “caregiver burden” using the repertory grid technique and laddering procedure – two constructivist methods derived from personal construct theory. From interview findings, we examined the content of the items and the caregiver burden construct itself. Our findings suggest that the use of constructivist methods to refine constructs and quantitative instruments is highly informative. This strategy is feasible even when little is known about the investigated constructs in the target culture and further elucidates our understanding of cross-cultural variations or invariance of different versions of the scale.
The Pindari Glacier is situated in the heart of the Kumaon Hills in lat. 30° 17′ N. and long. 80° 0′ E. This glacier was visited by the authors in October 1959 when morphological and other observations were made. On the basis of these observations, it appears that during the last hundred years the rate of retreat of this glacier has been phenomenal, and it may be as much as 132 ft. (40.2 m.)/yr. There is also evidence that in the past the Pindari valley suffered at least two glacial advances.
Kolahoi Glacier is one of the longest glaciers in Kashmir and in the past it extended for at least 35 km. In the Pleistocene there were three advances of Kolahoi Glacier and the last one of them was a major advance when the glacier extended as far as Pahalgam.
A paraxial ray formalism is developed to study the evolution of an on axis intensity spike on a Gaussian laser beam in a plasma dominated by relativistic and ponderomotive non-linearities. Ion motion is taken to be frozen. A single beam width parameter characterizes the evolution of the spike. The spike introduces two competing influences: diffraction divergence and self-convergence. The former grows with the reduction in spot size of the spike, while the latter depends on the gradient in non-linear permittivity. Parameter δ = (ωpr00/c) a00/(3.5 r00/r01) characterizes the relative importance of the two, where r01 and r00 are the spike and main beam radii, ωp is the plasma frequency, and a00 is the normalized laser amplitude. For δ > 1, the intensity ripple causes faster self-focusing of the beam; higher the ripple amplitude stronger the focusing. In the opposite limit, diffraction divergence increases more rapidly, slowing down the self-focusing of the beam. As the beam intensity rises due to self-focusing, it causes stronger generation of the third harmonic.
Spectral analysis of time series of a c. 17 ± 0.3 year core, calibrated for total ß activity recovered from Sentik Glacier (4908m) Ladakh, Himalaya, yields several recognizable periodicities including subannual, annual, and multi-annual. The time-series, include both chemical data (chloride, sodium, reactive iron, reactive silicate, reactive phosphate, ammonium, δD, δ(18O) and pH) and physical data (density, debris and ice-band locations, and microparticles in size grades 0.50 to 12.70 μm). Source areas for chemical species investigated and general air-mass circulation defined from chemical and physical time-series are discussed to demonstrate the potential of such studies in the development of paleometeorological data sets from remote high-alpine glacierized sites such as the Himalaya.
Stimulated Brillouin backscattering of an intense hollow Gaussian laser beam (HGLB) from collisionless plasma has been investigated under relativistic–ponderomotive regime. The main feature of considered hollow Gaussian laser beam is having the same power at different beam orders with null intensity at the center. Backscattered radiation is generated due to nonlinear interaction between main beam (pump beam) with pre-excited ion acoustic wave (IAW). Modified coupled equations has been set up for the beam width parameters of the main beam, ion-acoustic wave, back-scattered wave, and back reflectivity of stimulated Brillouin scattering (SBS) with the help of the Wentzel–Kramers–Brillouin approximation, fluid equations and paraxial theory approach. These coupled equations are solved analytically and numerically to study the laser intensity in the plasma, the variation of amplitude of the excited IAW and back reflectivity of SBS. The back reflectivity of SBS is found to be highly sensitive to the order of the HGLB, intensity of main laser beam, and plasma density for typical laser and plasma parameters. The focusing of main laser beam (hollow Gaussian) and IAW significantly affected the back reflectivity of SBS. The results show that the self-focusing and back reflectivity is enhanced for higher order modes of HGLB.
Identification of new effective strategies for improving crop yields under environmental stresses such as drought represent key priorities for researchers around the globe. In the present study, the effects of different methods of exogenous selenium (Se) supply viz. Se seed priming, Se fertigation and Se foliar spray on yield of spring wheat under normal and water deficit conditions were investigated. Two field experiments were conducted using one indigenous drought-tolerant genotype (Kohistan-97) and a sensitive genotype (Pasban-90) to understand the role of Se in improving wheat yield. The experiments were laid out in a split-split plot design with three replications during consecutive years (2011/12 and 2012/13) and the plants were exposed to water stress by withholding irrigation at two different wheat growth stages, viz. tillering and anthesis. It was noted that drought stress significantly affected the yield attributes of wheat; however, exogenous Se supply was observed to be helpful in improving the drought tolerance potential and yield of water-stressed wheat plants through maintenance of plant water status. A significant increase in wheat yield by Se supply was also noted under normal conditions. The normal plants fertigated with Se maintained the highest values for number of productive tillers, spike length, number of grains per spike, thousand-grain weight, biological and grain yield with no significant difference from Se foliar spray at the tillering stage, which was found to be the most effective method of exogenous Se supply for improving wheat yield under water deficit conditions. Moreover, Se fertigation and foliar spray resulted in the maximum accumulation of Se in shoots and gave the highest net return and cost-benefit ratio under drought stress conditions. The present study is one of the few reports on the role of Se in alleviating water stress for obtaining maximum profit in field grown spring wheat.
The consumption of n-3 PUFAs is low, particularly the long chain (>18 carbon atoms) fatty acids that are most commonly found in fish oils. These dietary fatty acids have been shown to have a great effect on the health and immune status of different species including humans, rats and poultry. The current paper reviews studies on the effect of dietary polyunsaturated fatty acids on B- and T-cell subpopulations in peripheral blood, spleen, and thymus of poultry.
Zinc (Zn) is an important nutrient in poultry and its deficiency has been linked with various disorders, in addition to depressed growth and performance. It is now recognised that Zn has a major role in antioxidation, growth and development, production, immunity and stress related issues. Supplementation of Zn can improve growth, augment immunity, enhance antioxidant capacity, increase endocrine secretion and interact with other minerals in the gut. In this review, some of the basic information regarding the importance and activity of Zn within the body and the addition of Zn in poultry diets is discussed.