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Integrating mental health care into HIV services is critical to addressing the high unmet treatment needs for people living with HIV and comorbid major depressive disorder. Introducing routine mental health screening at the primary health care level is a much needed diagonal approach to enhancing HIV care. In low-resource settings with a shortage of mental health care providers, eMental Health may provide a novel opportunity to attenuate this treatment gap and strengthen the health system.
To conduct formative health systems research on the implementation of routine depression screening using a digital tool – Mood in Retroviral Positive Individuals Application Monitoring (MIR + IAM) – in an HIV primary care setting in South Africa.
A Theory of Change (ToC) approach was utilised through individual and group session interviews to design an intervention that is embedded in the local context. Ten experts and local stakeholders were selected from the UK and South Africa. Data were analysed thematically using Atlas.ti to identify interventions, assumptions, barriers and facilitators of implementation.
The participants considered digital depression screening in HIV care services relevant for the improvement of mental health in this population. The six main themes identified from the ToC process were: (1) user experience including acceptability by patients, issues of patient privacy and digital literacy, and the need for a patient-centred tool; (2) benefits of the digital tool for data collection and health promotion; (3) availability of treatment after diagnosis; (4) human and physical resource capacity of primary health care; (5) training for lay health care workers; and (6) demonstration of the intervention's usefulness to generate interest from decision-makers.
Digital depression screening coupled with routine mental health data collection and analysis in HIV care is an applicable service that could improve the mental and physical health outcomes of this population. Careful consideration of the local health system capacity, including both workers and patients, is required. Future research to refine this intervention should focus on service users, government stakeholders and funders.
Individuals with a borderline personality disorder (BPD) suffer from a constellation of rapidly shifting emotional, interpersonal, and behavioral symptoms. The menstrual cycle may contribute to symptom instability among females with this disorder.
Fifteen healthy, unmedicated females with BPD and without dysmenorrhea reported daily symptoms across 35 days. Urine luteinizing hormone and salivary progesterone (P4) were used to confirm ovulation and cycle phase. Cyclical worsening of symptoms was evaluated using (1) phase contrasts in multilevel models and (2) the Carolina Premenstrual Assessment Scoring System (C-PASS), a protocol for evaluating clinically significant cycle effects on symptoms.
Most symptoms demonstrated midluteal worsening, a perimenstrual peak, and resolution of symptoms in the follicular or ovulatory phase. Post-hoc correlations with person-centered progesterone revealed negative correlations with most symptoms. Depressive symptoms showed an unexpected delayed pattern in which baseline levels of symptoms were observed in the ovulatory and midluteal phases, and exacerbations were observed during both the perimenstrual and follicular phases. The majority of participants met C-PASS criteria for clinically significant (⩾30%) symptom exacerbation. All participants met the emotional instability criterion of BPD, and no participant met DSM-5 criteria for premenstrual dysphoric disorder (PMDD).
Females with BPD may be at elevated risk for perimenstrual worsening of emotional symptoms. Longitudinal studies with fine-grained hormonal measurement as well as hormonal experiments are needed to determine the pathophysiology of perimenstrual exacerbation in BPD.
A significant portion of ruminant production in the tropics relies on the grazing of native grasses growing in acid, low-fertility soils. Under these conditions, animal production is generally limited by the low quality and availability of forage supply. The introduction of forage legumes into grazing systems is commonly accepted as a way to alleviate this problem. However, many of the tropical forage legumes adapted to acid soils and selected on the basis of good agronomic performance have limited feeding value. This could be associated with increased production of secondary metabolites such as condensed tannins (CT), which have the ability to bind and precipitate proteins, carbohydrates and other molecules (Mueller-Harvey and McAllan, 1992). High intake of CT by ruminants has been associated with depressed intake and reduced digestibilities of protein and cell wall of temperate (Barry and Duncan, 1984; Pritchard et al, 1988) and tropical (Carulla, 1994) forage legumes. However, more recent work showed that intake and digestibility of tropical legumes was not only influenced by CT concentration but also by cell wall content (Barahona et al, 1997). In the ongoing process of identifying legume germplasm for acid soils, the use of in vitro techniques has been of great benefit. Gas production methods have considerable appeal in this respect due to their ability to evaluate digestion kinetics and their potential to simulate digestion processes in the rumen. Pendong et al. (1996) using temperate forages, showed that the pressure transducer gas technique of Theodorou et al. (1994) could be used to assess digestible organic matter disappearance as well as fermentation kinetics. A similar assessment was undertaken in the current study in which the tannin contents and cell-wall characteristics of tanniniferous legumes from Colombia were determined and related using measurements made in laboratories in Colombia and the United Kingdom.
Sugar cane bagasse is produced in large quantities in Brazil. The cultivated area of sugar cane in recent years has been around 4.2 X 106 ha/year, with a production of about 270 X 106 t/year of cane. As each tonne of cane produces around 300 kg of bagasse by-product, a large quantity of bagasse is generated.
Bagasse is of low dry matter (DM) digestibility (about 250 g/kg), because of lignification. Efforts have been made to improve the digestibility of bagasse using treatment with chemicals (sodium hydroxide, ammonia) or steam (Abdalla et al., 1990). Although steam and pressure treatments have improved in situ degradability, intake and digestibility in cattle were disappointing (Mello et al, 1989). Recently treatment of bagasse with irradiation and ammonia have been investigated.
In the Central Kenyan Highlands, dairy cattle ownership is a crucial element in poverty alleviation. For example, in Kiambu district just north of Nairobi, out of the population of 744010, 48% of 189709 households stall feed dairy cattle. Farm sizes average 1.1 to 2.0 ha per household. Producing sufficient forage for dairy cattle is difficult and low dry matter intake constrains dairy production and there is a positive correlation between stover intake and milk yield.. Napier grass comprised 40% of the total dry matter fed to cattle and maize forage 24% according to the project’s Rapid Rural Appraisal, maize thinnings and stover being routinely fed to livestock. In another survey, dry maize stover accounted for nearly 65% of dry matter intake of dairy cattle during October.
Production from smallholder owned goats in the semi-arid tropics is constrained by dry season feed shortages. Kid mortality is high and low growth rate of kids weaned at the onset of the dry season delays slaughtering of males and breeding in females. Supplementation with purchased feed is unaffordable so only locally available, probably non-conventional feeds can be considered. In Southern Zimbabwe, the typical natural vegetation in communal grazing areas consists of annual and perennial grasses and trees and shrubs, many of which are Acacia species. In this project tree fruits, from Acacia and other available species were evaluated as dry season protein supplements for goats.
Transient storage and erosion of valley fills, or sediment buffering, is a fundamental but poorly quantified process that may significantly bias fluvial sediment budgets and marine archives used for paleoclimatic and tectonic reconstructions. Prolific sediment buffering is now recognized to occur within the mountainous upper Indus River headwaters and is quantified here for the first time using optically stimulated luminescence dating, petrography, detrital zircon U-Pb geochronology, and morphometric analysis to define the timing, provenance, and volumes of prominent valley fills. This study finds that climatically modulated sediment buffering occurs over 103–104 yr time scales and results in biases in sediment compositions and volumes. Increased sediment storage coincides with strong phases of summer monsoon and winter westerlies precipitation over the late Pleistocene (32–25 ka) and mid-Holocene (~8–6 ka), followed by incision and erosion with monsoon weakening. Glacial erosion and periglacial frost-cracking drive sediment production, and monsoonal precipitation mediates sediment evacuation, in contrast to the arid Transhimalaya and monsoonal frontal Himalaya. Plateau interior basins, although volumetrically large, lack transport capacity and are consequently isolated from the modern Indus River drainage. Marginal plateau catchments that both efficiently produce and evacuate sediment may regulate the overall compositions and volumes of exported sediment from the Himalayan rain shadow.
This paper is concerned with the distant radio galaxies in a sample of bright sources selected at 178 MHz by Laing, Riley & Longair (1982). This sample is 96% complete for sources with θ < 10′ and the bias of the 3CR catalogue against sources of large angular size has also been reduced. Deep optical searches have located many candidate identifications, but the probability of a chance coincidence with an unrelated object is appreciable, especially in the faintest cases, unless the area to be searched is small. We have therefore mapped the sources with candidate identifications having V > 20, using the VLA at a wavelength of 6 cm (Laing, Owen & Puschell, in preparation), in order to search for radio cores. We have so far located cores in 16/23 sources and set 5σ upper limits of 0.6 mJy for the remainder. None of the cores had been detected previously. In all cases, the cores coincide with optical objects, although one source (3C 340) had been misidentified. Several ambiguities have now been resolved.
To achieve their conservation goals individuals, communities and organizations need to acquire a diversity of skills, knowledge and information (i.e. capacity). Despite current efforts to build and maintain appropriate levels of conservation capacity, it has been recognized that there will need to be a significant scaling-up of these activities in sub-Saharan Africa. This is because of the rapid increase in the number and extent of environmental problems in the region. We present a range of socio-economic contexts relevant to four key areas of African conservation capacity building: protected area management, community engagement, effective leadership, and professional e-learning. Under these core themes, 39 specific recommendations are presented. These were derived from multi-stakeholder workshop discussions at an international conference held in Nairobi, Kenya, in 2015. At the meeting 185 delegates (practitioners, scientists, community groups and government agencies) represented 105 organizations from 24 African nations and eight non-African nations. The 39 recommendations constituted six broad types of suggested action: (1) the development of new methods, (2) the provision of capacity building resources (e.g. information or data), (3) the communication of ideas or examples of successful initiatives, (4) the implementation of new research or gap analyses, (5) the establishment of new structures within and between organizations, and (6) the development of new partnerships. A number of cross-cutting issues also emerged from the discussions: the need for a greater sense of urgency in developing capacity building activities; the need to develop novel capacity building methodologies; and the need to move away from one-size-fits-all approaches.
Objectives: This study examined whether children with distinct brain disorders show different profiles of strengths and weaknesses in executive functions, and differ from children without brain disorder. Methods: Participants were children with traumatic brain injury (N=82; 8–13 years of age), arterial ischemic stroke (N=36; 6–16 years of age), and brain tumor (N=74; 9–18 years of age), each with a corresponding matched comparison group consisting of children with orthopedic injury (N=61), asthma (N=15), and classmates without medical illness (N=68), respectively. Shifting, inhibition, and working memory were assessed, respectively, using three Test of Everyday Attention: Children’s Version (TEA-Ch) subtests: Creature Counting, Walk-Don’t-Walk, and Code Transmission. Comparison groups did not differ in TEA-Ch performance and were merged into a single control group. Profile analysis was used to examine group differences in TEA-Ch subtest scaled scores after controlling for maternal education and age. Results: As a whole, children with brain disorder performed more poorly than controls on measures of executive function. Relative to controls, the three brain injury groups showed significantly different profiles of executive functions. Importantly, post hoc tests revealed that performance on TEA-Ch subtests differed among the brain disorder groups. Conclusions: Results suggest that different childhood brain disorders result in distinct patterns of executive function deficits that differ from children without brain disorder. Implications for clinical practice and future research are discussed. (JINS, 2017, 23, 529–538)
Modern radio maps usually allow quasars to be recognized from their radio morphology alone. Most have strong central components, double lobed outer structure and one-sided jets connecting the inner and outer structures. The physics of the sources is poorly understood. The observed bending of the jets, the high minimum pressures observed, and the required energy supply to the lobes are major problems. However, the outstanding problem regarding the extended structure is whether or not this morphology is produced by special relativistic effects or the intrinsic activity level and physics of the radio sources.
In recent years a number of very steep spectrum, compact radio sources have been discovered (e.g. Cotton 1983, Cotton and Owen 1985, Ulvestad 1985) which have no optical counterpart to the limit of the Palomar Sky Survey. VLBI observations of a number of these have confirmed the very compact (<10 mas) nature of several of these sources. Analysis of the available data in terms of the standard synchrotron modal suggest that they contain very weak magnetic fields, large particle densities and may emit detectable infrared and optical emission by inverse Campton scattering in the compact radio source (Cotton 1983). This paper will report on an analysis including new VLBI observations, infrared and optical imaging at KPNO and low frequency radio observations at CLRO of a number of these objects.
Extended radio emission and its relation to parent galaxy properties is briefly reviewed. Our current understanding of the relation between absolute radio and optical luminosity, radio morphology and linear size is discussed. The impact of radio jets on dense cluster cores is discussed using M87 as an example. Finally, the relation of AGN's to star-bursting galaxies at high redshift is considered.
We have begun VLA observations of straight-angle tailed radio sources (SATs) at 1.5 and 4.8 GHz (L and C band) to achieve one arcsecond resolution at each frequency. This will provide a SAT data set similar to the O'Donoghue, Owen, and Eilek (1990) WAT data set with both total intensity and spectral index information. We will use these data to examine morphological and dynamical properties of straight-tailed radio sources in clusters of galaxies.