Developing a scalable training model in global mental health: pilot study of a video-assisted training Program for Generalist Clinicians in Rural Nepal.

BackgroundIn low- and middle-income countries, mental health training often includes sending few generalist clinicians to specialist-led programs for several weeks. Our objective is to develop and test a video-assisted training model addressing the shortcomings of traditional programs that affect scalability: failing to train all clinicians, disrupting clinical services, and depending on specialists.MethodsWe implemented the program -video lectures and on-site skills training- for all clinicians at a rural Nepali hospital. We used Wilcoxon signed-rank tests to evaluate pre- and post-test change in knowledge (diagnostic criteria, differential diagnosis, and appropriate treatment). We used a series of 'Yes' or 'No' questions to assess attitudes about mental illness, and utilized exact McNemar's test to analyze the proportions of participants who held a specific belief before and after the training. We assessed acceptability and feasibility through key informant interviews and structured feedback.ResultsFor each topic except depression, there was a statistically significant increase (Δ) in median scores on knowledge questionnaires: Acute Stress Reaction (Δ = 20, p = 0.03), Depression (Δ = 11, p = 0.12), Grief (Δ = 40, p < 0.01), Psychosis (Δ = 22, p = 0.01), and post-traumatic stress disorder (Δ = 20, p = 0.01). The training received high ratings; key informants shared examples and views about the training's positive impact and complementary nature of the program's components.ConclusionVideo lectures and on-site skills training can address the limitations of a conventional training model while being acceptable, feasible, and impactful toward improving knowledge and attitudes of the participants

Strategic and Managerial Decision-Making for Sustainable Management: Factors and Remedies for Information Overload

In the past century, the amount of information that is generated has increased at an exponential rate. As a result of this information saturation process or ‘information overload’, people cannot keep pace with the information flowing towards them. Organizations can take steps towards sustainability by improving the health conditions in their organizations and the products they offer. One way to do so is by trying to reduce information overload. Besides improving health conditions, decreasing information overload also positively affects the quality of organizational-level decision-making. This is a conceptual chapter in which propositions are built. The determinants of information overload and the effect on decision quality are described, and an extensive literature review is conducted. The chapter draws from decision theory and the theory of human information processing and focuses on the individual characteristics of decision-makers and the quality of the information provided by the information system. Seven propositions are formulated and several remedies for information overload are discussed. The chapter arrives at two determinants of an individual’s degree of information overload experienced (characteristics of the decision-maker and the information system), and it is argued that information overload has a negative influence on the quality of decisions. These concepts are combined in one model. The conceptual model is an attempt to provide a better theoretical understanding of the concept of information overload. Finally, contributions, limitations and areas for future research are discussed.Green Open Access added to TU Delft Institutional Repository ‘You share, we take care!’ – Taverne project https://www.openaccess.nl/en/you-share-we-take-care Otherwise as indicated in the copyright section: the publisher is the copyright holder of this work and the author uses the Dutch legislation to make this work public.Economics of Technology and Innovatio