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This systematic review compiled evidence on interventions to reduce mental health-related stigma among medical and nursing students in low- and middle-income countries (LMICs). Primary outcomes were stigmatising attitudes and discriminatory behaviours.
Methods
Data collection included two strategies. First, previous systematic reviews were searched for studies that met the inclusion criteria of the current review. Second, a new search was done, covering the time since the previous reviews, i.e. January 2013 to May 2017. Five search concepts were combined in order to capture relevant literature: stigma, mental health, intervention, professional students in medicine and nursing, and LMICs. A qualitative analysis of all included full texts was done with the software MAXQDA. Full texts were analysed with regard to the content of interventions, didactic methods, mental disorders, cultural adaptation, type of outcome measure and primary outcomes. Furthermore, a methodological quality assessment was undertaken.
Results
A total of nine studies from six countries (Brazil, China, Malaysia, Nigeria, Somaliland and Turkey) were included. All studies reported significant results in at least one outcome measure. However, from the available literature, it is difficult to draw conclusions on the most effective interventions. No meta-analysis could be calculated due to the large heterogeneity of intervention content, evaluation design and outcome measures. Studies with contact interventions (either face-to-face or video) demonstrated attitudinal change. There was a clear lack of studies focusing on discriminatory behaviours. Accordingly, training of specific communication and clinical skills was lacking in most studies, with the exception of one study that showed a positive effect of training interview skills on attitudes. Methods for cultural adaptation of interventions were rarely documented. The methodological quality of most studies was relatively low, with the exception of two studies.
Conclusions
There is an increase in studies on anti-stigma interventions among professional students in LMICs. Some of these studies used contact interventions and showed positive effects. A stronger focus on clinical and communication skills and behaviour-related outcomes is needed in future studies.
Leucites are silicate framework structures with some of the silicon framework cations partially replaced by divalent or trivalent cations. A monovalent extraframework alkali metal cation is also incorporated to balance the charges. We have previously reported Pbca leucite structures with the stoichiometries Cs2X2+Si5O12 (X = Mg, Mn, Co, Ni, Cu, Zn, Cd) and Rb2X2+Si5O12 (X = Mg, Mn, Ni, Cd). These orthorhombic leucite structures have all the silicon and non-silicon framework cations completely ordered onto separate crystallographic sites. This structure has five distinct Si sites and 1 X site; there are also two distinct sites for the extra-framework Cs or Rb. We have recently synthesised leucite analogues with two different extra-framework cations, these have the stoichiometry RbCsX2+Si5O12 (X = Mg, Ni, Cd). The initial Rietveld refinements assumed 50% Cs and 50% Rb on each of the two extra-framework cation sites. The refined structures for X = Ni and Cd have (within error limits) complete extra-framework cation site disorder. However, for X = Mg there is partial ordering of the extra-framework cation sites, the site occupancies are:- Cs1 0.37(3), Rb1 0.63(3), Cs2 0.63(3), Rb2 0.37(3).
Background:ATP8A2 mutations have only recently been associated with human disease. We present the clinical features from the largest cohort of patients with this disorder reported to date. Methods: An observational study of 9 unreported and 2 previously reported patients with biallelic ATP8A2 mutations was carried out at multiple centres. Results: The mean age of the cohort was 9.4 years old (range: 2.5-28 yrs). All patients demonstrated developmental delay, severe hypotonia and movement disorders: chorea/choreoathetosis (100%), dystonia (27%) or facial dyskinesia (18%). Hypotonia was apparent at birth (70%) or before 6 months old (100%). Optic atrophy was observed in 75% of patients who had a funduscopic examination. MRI of the brain was normal for most patients with a small proportion showing mild cortical atrophy (30%), delayed myelination (20%) and/or hypoplastic optic nerves (20%). Epilepsy was seen in two older patients. Conclusions:ATP8A2 gene mutations have emerged as a cause of a novel phenotype characterized by developmental delay, severe hypotonia and hyperkinetic movement disorders. Optic atrophy is common and may only become apparent in the first few years of life, necessitating repeat ophthalmologic evaluation. Early recognition of the cardinal features of this condition will facilitate diagnosis of this disorder.
The livestock sector is one of the fastest growing subsectors of the agricultural economy and, while it makes a major contribution to global food supply and economic development, it also consumes significant amounts of natural resources and alters the environment. In order to improve our understanding of the global environmental impact of livestock supply chains, the Food and Agriculture Organization of the United Nations has developed the Global Livestock Environmental Assessment Model (GLEAM). The purpose of this paper is to provide a review of GLEAM. Specifically, it explains the model architecture, methods and functionality, that is the types of analysis that the model can perform. The model focuses primarily on the quantification of greenhouse gases emissions arising from the production of the 11 main livestock commodities. The model inputs and outputs are managed and produced as raster data sets, with spatial resolution of 0.05 decimal degrees. The Global Livestock Environmental Assessment Model v1.0 consists of five distinct modules: (a) the Herd Module; (b) the Manure Module; (c) the Feed Module; (d) the System Module; (e) the Allocation Module. In terms of the modelling approach, GLEAM has several advantages. For example spatial information on livestock distributions and crops yields enables rations to be derived that reflect the local availability of feed resources in developing countries. The Global Livestock Environmental Assessment Model also contains a herd model that enables livestock statistics to be disaggregated and variation in livestock performance and management to be captured. Priorities for future development of GLEAM include: improving data quality and the methods used to perform emissions calculations; extending the scope of the model to include selected additional environmental impacts and to enable predictive modelling; and improving the utility of GLEAM output.
A new protocol for the quantitative determination of zeolite-group mineral compositions by electron probe microanalysis (wavelength-dispersive spectrometry) under ambient conditions, is presented. The method overcomes the most serious challenges for this mineral group, including new confidence in the fundamentally important Si-Al ratio. Development tests were undertaken on a set of natural zeolite candidate reference samples, representing the compositional extremes of Na, K, Cs, Mg, Ca, Sr and Ba zeolites, to demonstrate and assess the extent of beam interaction effects on each oxide component for each mineral. These tests highlight the variability and impact of component mobility due to beam interaction, and show that it can be minimized with recommended operating conditions of 15 kV, 2 nA, a defocused, 20 μm spot size, and element prioritizing with the spectrometer configuration. The protocol represents a pragmatic solution that works, but provides scope for additional optimization where required. Vital to the determination of high-quality results is the attention to careful preparations and the employment of strict criteria for data reduction and quality control, including the monitoring and removal of non-zeolitic contaminants from the data (mainly Fe and clay phases). Essential quality criteria include the zeolite-specific parameters of R value (Si/(Si + Al + Fe3+), the 'E%' charge-balance calculation, and the weight percent of non-hydrous total oxides. When these criteria are applied in conjunction with the recommended analytical operating conditions, excellent inter-batch reproducibility is demonstrated. Application of the method to zeolites with complex solid-solution compositions is effective, enabling more precise geochemical discrimination for occurrence-composition studies. Phase validation for the reference set was conducted satisfactorily with the use of X-ray diffraction and laser-ablation inductively-coupled plasma mass spectroscopy.
Geological disposal facilities (GDF) are intended to isolate and contain radioactive waste within multiple protective barriers, deep underground, to ensure that no harmful quantities of radioactivity reach the surface environment. The last line of defense in a multi-barrier GDF is the geosphere, where iron is present in the host rock mineralogy as either Fe(II) or Fe(III), and in groundwater as Fe(II) under reducing conditions. The mobility of risk-driving radionuclides, including uranium and technetium, in the environment is affected significantly by their valence state. Due to its low redox potential, Fe(II) can mediate reduction of these radionuclides from their oxidized, highly mobile, soluble state to their reduced, insoluble state, preventing them from reaching the biosphere. Here a study of five types of potential host rocks, two granitoids, an andesite, a mudstone and a clay-rich carbonate, is reported. The bulk rocks and their minerals were analysed for iron content, Fe(II/III) ratio, and for the speciation and fine-grained nature of alteration product minerals that might have important controls on groundwater interaction. Total iron content varies between 0.9% in clays to 5.6% in the andesite. X-ray absorption spectroscopy reveals that Fe in the granitoids and andesite is predominantly Fe(II), and in mudstones, argillaceous limestone and terrestrial sandstone is predominantly Fe(III). The redox reactivity of the potential host rocks both in the presence and absence of Fe(II)-containing 'model' groundwater was investigated using an azo dye as a probe molecule. Reduction rates as determined by reactivity with the azo dye were correlated with the ability of the rocks to uptake Fe(II) from groundwater rather than with initial Fe(II) content. Potential GDF host rocks must be characterized in terms of mineralogy, texture, grain size and bulk geochemistry to assess how they might interact with groundwater. This study highlights the importance of redox reactivity, not just total iron and Fe(II)/(III) ratio, when considering the host rock performance as a barrier material to limit transport of radionuclides from the GDF.
Experiments in the system NaAlSiO4(Ne)−KAlSiO4(Ks)−SiO2(Qz)−H2O at 100 MPa show that the maximum content of NaAlSi2O6 in leucite is ∼4 wt.% and that analcime is close to the stoichiometric composition (NaAlSi2O6.H2O). Analcime forms metastably on quenching the higher-temperature experiments; it is secondary after leucite in experiments quenched from 780°C, while from 850°C it forms by alteration of leucite, and by devitrification of water-saturated glass. Both processes involve reaction with Na-rich aqueous fluids. Stable analcime forms at 500°C, well below the solidus, and cannot form as phenocrysts in shallow volcanic systems. New data for natural analcime macrocrysts in blairmorites are presented for the Crowsnest volcanics, Alberta, Canada. Other researchers have suggested that primary analcime occurs as yellow-brown, glassy, analcime phenocrysts. Our microprobe analyses show that such primary analcime is close to stoichiometric, with very low K2O (<0.1 wt.%), minor Fe2O3 (0.5−0.8 wt.%) and CaO (∼0.5 wt.%). An extrapolation of published experimental data for Ne−Ks−Qz at >500 MPa PH2O, where Anl + melt coexist, suggests that at >800 MPa two invariant points are present: (1) a reaction point involving Kf + Ab + Anl + melt + vapour; and (2) a eutectic with Kf + Anl + Ne + melt + vapour. We suggest that the nepheline-free equilibrium mineral assemblage for Crowsnest samples is controlled by reaction point (1). In contrast, blairmorites from Lupata Gorge, Mozambique, form at eutectic (2), consistent with the presence of nepheline phenocrysts. Our conclusions, based on high- vs. low-pressure experiments, confirm the suggestion made by other authors, that Crowsnest volcanic rocks must have been erupted explosively to preserve glassy analcime phenocrysts during very rapid, upward transport from deep in the crust (H2O pressures ≫500 MPa). Only rare examples survived the deuteric and hydrothermal alteration that occurred during and after eruption.
Although livestock production accounts for a sizeable share of global greenhouse gas emissions, numerous technical options have been identified to mitigate these emissions. In this review, a subset of these options, which have proven to be effective, are discussed. These include measures to reduce CH4 emissions from enteric fermentation by ruminants, the largest single emission source from the global livestock sector, and for reducing CH4 and N2O emissions from manure. A unique feature of this review is the high level of attention given to interactions between mitigation options and productivity. Among the feed supplement options for lowering enteric emissions, dietary lipids, nitrates and ionophores are identified as the most effective. Forage quality, feed processing and precision feeding have the best prospects among the various available feed and feed management measures. With regard to manure, dietary measures that reduce the amount of N excreted (e.g. better matching of dietary protein to animal needs), shift N excretion from urine to faeces (e.g. tannin inclusion at low levels) and reduce the amount of fermentable organic matter excreted are recommended. Among the many ‘end-of-pipe’ measures available for manure management, approaches that capture and/or process CH4 emissions during storage (e.g. anaerobic digestion, biofiltration, composting), as well as subsurface injection of manure, are among the most encouraging options flagged in this section of the review. The importance of a multiple gas perspective is critical when assessing mitigation potentials, because most of the options reviewed show strong interactions among sources of greenhouse gas (GHG) emissions. The paper reviews current knowledge on potential pollution swapping, whereby the reduction of one GHG or emission source leads to unintended increases in another.
Synchrotron X-ray powder diffraction data have been collected on three synthetic leucite analogues with the general formula Cs2XSi5O12(X = Cd, Cu, Zn) between 295 and 1173 K. All three samples have the orthorhombic Pbca leucite structure at room temperature with ordered framework T-site cations. The sample with X = Cd retains the Pbca structure over the whole of the investigated temperature range. The sample with X = Cu also retains the Pbca structure, but there is a transition to a less distorted structure with a larger unit-cell volume at ∼333 K. The sample with X = Zn shows evidence for a transition to a previously unknown Pa cubic structure, with some T-site cation disorder, at 566 K, on heating. This transition is reversible on cooling to 633 K.
Potassium-rich mafic dykes and lavas from the Highwood Mountains Igneous Province, USA were studied by electron-microprobe and bulk-rock analysis. For the mafic phonolites, compositional trends for olivine and augite phenocrysts and groundmass biotite, alkali feldspar and titanomagnetites are presented and substitution mechanisms discussed. Phenocrysts of biotite and augite in the minettes are also characterized, together with groundmass alkali feldspar and titanomagnetite. The alkali feldspars and biotites are commonly enriched in Ba. Olivine, clinopyroxene and biotite phenocrysts are generally quite magnesium-rich, which is consistent with the primitive natures of the least evolved rocks.
Bulk-rock major-element compositions are combined with modal and microprobe data for the principal phenocrysts to calculate model residual liquid compositions for mafic phonolites, minettes and a syenitic rock. On the basis of phase-equilibria, it is suggested that the main controls of differentiation are polybaric involving crystallization during transport of primary magmas from the mantle for the minettes, and low-pressure differentiation for the mafic phonolites. Whereas magma mixing might have contributed to petrogenesis, many of the disequilibrium features exhibited by clinopyroxene and biotite phenocrysts can also be attributed to pre-existing phenocrysts undergoing decompression melting during magma uprise from its mantle source, followed by rapid crystal growth and episodic volatile loss in sub-volcanic magma chambers.
The partitioning of Sr, Ba and Rb between alkali feldspar and melt has been determined at 0.1 GPa water vapour pressure, mainly on one Na-rich series and one K-rich series within the system nepheline-kalsilite-quartz. Experiments were also carried out with small amounts of the anorthite molecule or peralkaline components (Na, K metasilicates). The compositions of the alkali feldspars and coexisting quenched glasses were determined by electron microprobe analysis. Except for some peralkaline compositions, the crystal/liquid partition coefficients for Sr and Ba are always >1; the crystal/liquid partition coefficient for Rb is always <1. For sodic alkali feldspars DSr > DBa and for potassic feldspars DSr < DBa. Partition coefficients for Sr and Ba increase: (1) with decreasing temperature; (2) with increasing Or content of feldspar; (3) with increasing silica-undersaturation of the melt; (4) with decreasing peralkalinity. The variation in the value of DRb is less clear, but it is higher for K-rich feldspars. Multiple linear regression equations are fitted to correlate ln(D) with independent compositional and physical variables. Where rock/groundmass major-element data are available for felsic natural rocks, equations are recommended for obtaining reliable alkali feldspar partition coefficients for modelling fractional crystallization processes. The structural properties of silicate melts and crystal chemical relations are used to rationalize trends in partition coefficients.
The temperature (T) and pressure (P) dependence of dielectric and conductivity properties of natural leucite were determined using complex impedance spectroscopy at frequencies from 103 to 106 Hz. Experiments were carried out in a Walker multi-anvil cell at 1 atm and P from 2.5 to 6 GPa and at T from 350 to 800°C. At pressure >6 GPa and temperature >790°C the leucite broke down to kalsilite+sanidine and dielectric properties for this phase assemblage are given at 6.0–7.0 GPa and T to 1050°C.
Leucite conductivity increases with increasing T and decreases with increasing P reflecting their different effects on migration of K cations within the channels in the leucite aluminosilicate framework. Activation energies for K+ migration in leucite increase with increasing pressure (0.74–0.97 eV; 70.0–93.2 kJ/mol) and activation volumes for leucite increase with increasing T (6.42–9.51 cm3/mol; 400–700°C). The latter data provide model K+ cation diameters increasing from 2.7 Å at 400°C to 3.2 Å at 700°C. These values are consistent with the earlier suggestion of Palmer and Salje that the ionic mobility mechanism consists of diffusion along <110> rather than along the main channels parallel to <111>.