Treatment-seeking rates in malaria endemic countries

BACKGROUND: The proportion of individuals who seek treatment for fever is an important quantity in understanding access to and use of health systems, as well as for interpreting data on disease incidence from routine surveillance systems. For many malaria endemic countries (MECs), treatment-seeking information is available from national household surveys. The aim of this paper was to assemble sub-national estimates of treatment-seeking behaviours and to predict national treatment-seeking measures for all MECs lacking household survey data. METHODS: Data on treatment seeking for fever were obtained from Demographic and Health Surveys, Malaria Indicator Surveys and Multiple Cluster Indicator Surveys for every MEC and year that data were available. National-level social, economic and health-related variables were gathered from the World Bank as putative covariates of treatment-seeking rates. A generalized additive mixed model (GAMM) was used to estimate treatment-seeking behaviours for countries where survey data were unavailable. Two separate models were developed to predict the proportion of fever cases that would seek treatment at (1) a public health facility or (2) from any kind of treatment provider. RESULTS: Treatment-seeking data were available for 74 MECs and modelled for the remaining 24. GAMMs found that the percentage of pregnant women receiving prenatal care, vaccination rates, education level, government health expenditure, and GDP growth were important predictors for both categories of treatment-seeking outcomes. Treatment-seeking rates, which varied both within and among regions, revealed that public facilities were not always the primary facility type used. CONCLUSIONS: Estimates of treatment-seeking rates show how health services are utilized and help correct reported malaria case numbers to obtain more accurate measures of disease burden. The assembled and modelled data demonstrated that while treatment-seeking rates have overall increased over time, access remains low in some malaria endemic regions and utilization of government services is in some areas limited

Age of the Peach Springs Tuff, Southeastern California and Western Arizona

Sanidine separates from pumice of the early Miocene Peach Springs Tuff are concordantly dated at 18.5 ± 0.2 Ma by two isotopic techniques. The Peach Springs Tuff is the only known unit that can be correlated between isolated outcrops of Miocene strata from the central Mojave Desert of southeastern California to the western Colorado Plateau in Arizona, across five structural provinces, a distance of 350 km. Thus the age of the Peach Springs Tuff is important to structural and paleogeographic reconstructions of a large region. Biotite and sanidine separates from bulk samples of the Peach Springs Tuff from zones of welding and vapor-phase alteration have not produced consistent ages by the K-Ar method. Published ages of mineral separates from 17 localities ranged from 16.2 to 20.5 Ma. Discordant 40Ar/39Ar incremental release spectra were obtained for one biotite and two of the sanidine separates. Ages that correspond to the last gas increments are as old as 27 Ma. The 40Ar/39Ar incremental release determinations on sanidine separated from blocks of Peach Springs Tuff pumice yield ages of 18.3 ± 0.3 and 18.6 ± 0.4 Ma. Laser fusion measurements yield a mean age of 18.51 ± 0.10. The results suggest that sanidine and biotite K-Ar ages older than about 18.5 Ma are due to inherited Ar from pre-Tertiary contaminants, which likely were incorporated into the tuff during deposition. Sanidine K-Ar ages younger than 18 Ma probably indicate incomplete extraction of radiogenic 40Ar, whereas laser fusion dates of biotite and hornblende younger than 18 Ma likely are due to postdepositional alteration. Laser fusion ages as high as 19.01 Ma on biotite grains from pumice suggest that minerals from pre-Tertiary country rocks also were incorporated in the magma chamber

Seismic Structure, Gravity Anomalies and Flexure Along the Emperor Seamount Chain

The Hawaiian-Emperor seamount chain in the Pacific Ocean has provided fundamental insights into hotspot generated intraplate volcanism and the long-term strength of oceanic lithosphere. However, only a few seismic experiments to determine crustal and upper mantle structure have been carried out on the Hawaiian Ridge, and no deep imaging has ever been carried out along the Emperor seamounts. Here, we present the results of an active source seismic experiment using 29 Ocean-Bottom Seismometers (OBS) carried out along a strike profile of the seamounts in the region of Jimmu and Suiko guyots. Joint reflection and refraction tomographic inversion of the OBS data show the upper crust is highly heterogeneous with P wave velocities <4–5 km s−1, which are attributed to extrusive lavas and clastics. In contrast, the lower crust is remarkably homogeneous with velocities of 6.5–7.2 km s−1, which we attribute to oceanic crust and mafic intrusions. Moho is identified by a strong PmP arrival at offsets of 20–80 km, yielding depths of 13–16 km. The underlying mantle is generally homogeneous with velocities in the range 7.9–8.0 km s−1. The crust and mantle velocity structure has been verified by gravity modeling. While top of oceanic crust prior to volcano loading is not recognized as a seismic or gravity discontinuity, flexural modeling reveals a ∼5.0–5.5 km thick preexisting oceanic crust that is overlain by a ∼8 km thick volcanic edifice. Unlike at the Hawaiian Ridge, we find no evidence of magmatic underplating

Identifying Hallmark Symptoms of Developmental Prosopagnosia for Non-Experts

Developmental prosopagnosia (DP) is characterised by a severe and relatively selective deficit in face recognition, in the absence of neurological injury. Because public and professional awareness of DP is low, many adults and children are not identified for formal testing. This may partly result from the lack of appropriate screening tools that can be used by non-experts in either professional or personal settings. To address this issue, the current study sought to (a) explore when DP can first be detected in oneself and another, and (b) identify a list of the condition’s everyday behavioural manifestations. Questionnaires and interviews were administered to large samples of adult DPs, their unaffected significant others, and parents of children with the condition; and data were analysed using inductive content analysis. It was found that DPs have limited insight into their difficulties, with most only achieving realisation in adulthood. Nevertheless, the DPs’ reflections on their childhood experiences, together with the parental responses, revealed specific indicators that can potentially be used to spot the condition in early childhood. These everyday hallmark symptoms may aid the detection of individuals who would benefit from objective testing, in oneself (in adults) or another person (for both adults and children)

Age of the Peach Springs Tuff, southeastern California and western Arizona

Sanidine separates from pumice of the early Miocene Peach Springs Tuff (PST) are concordantly dated at 18.5 {plus minus} 0.2 Ma by two isotopic techniques. The PST is the only known unit that can be correlated between isolated outcrops of Miocene strata from the central Mojave Desert of southeastern California to the western Colorado Plateau in Arizona, across five structural provinces, a distance of 350 km. Thus the age of the PST is important to structural and paleogeographic reconstructions of a large region. Biotite and sanidine separates from bulk samples of the PST from zones of welding and vapor-phase alteration have not produced consistent ages by the K-Ar method. Published ages of mineral separates from 17 localities ranged from 16.2 to 20.5 Ma. Discordant {sup 40}Ar/{sup 39}Ar incremental release spectra were obtained for one biotite and two of the sanidine separates. Ages that correspond to the last gas increments are old as 27 Ma. The {sup 40}Ar/{sup 39}Ar incremental release determinations on sanidine separated from blocks of PST pumice yield ages of 18.3 {plus minus} 0.3 and 18.6 {plus minus} 0.4 Ma. Laser fusion measurements yield a mean age of 18.51 {plus minus} 0.10. The results suggest that sanidine andmore » biotite K-Ar ages older than about 18.5 Ma are due to inherited Ar from pre-Tertiary contaminants, which likely were incorporated into the tuff during deposition. Sanidine K-Ar ages younger than 18 Ma probably indicate incomplete extraction of radiogenic {sup 40}Ar, whereas laser fusion dates of biotite and hornblende younger than 18 Ma likely are due to postdepositional alteration.« les

'A greatest hits compilation of mental health support': A qualitative study of health professionals' perspectives of modular CBT in paediatric epilepsy services

OBJECTIVES: The primary aim of this qualitative study was to explore the views of health professionals, with little previous clinical mental health training, of an adapted modular cognitive-behavioral intervention (MATCH-ADTC) for common mental health problems in children and young people with epilepsy. METHODS: Healthcare Professionals (HCPs) and their supervisors were interviewed at the start (n = 23) and end (n = 15) of the six-month training period. The interviews were transcribed verbatim and analyzed using thematic analysis. RESULTS: Three higher order themes with sub-themes were identified: (1) strengths of the MATCH-ADTC content and manual; (2) expectations of the treatment; and (3) improving practice with MATCH-ADTC. Overall impressions of the training and treatment were largely positive, with HCPs viewing MATCH-ADTC as an acceptable treatment for the families that they worked with. HCPs highlighted some challenges in delivering an integrated service, particularly relating to the time commitment involved and their own confidence in delivering the intervention, as many participants did not have a mental health background. CONCLUSIONS: The findings suggested that the intervention and training was acceptable to HCPs working in pediatric epilepsy services, and confidence grew over the six-month training period. Further research is needed to understand how to best train, supervise, and support HCPs in pediatric epilepsy services to deliver mental health treatments

Feasibility of telephone-delivered therapy for common mental health difficulties embedded in paediatric epilepsy clinics

Background: Mental and physical health treatment should be delivered together for children and young people with epilepsy. Training healthcare professionals (HCPs) in epilepsy services to deliver mental health interventions is an important way to facilitate integrated care. Objective: To determine the feasibility of remotely delivered assessment and psychological treatment for mental health difficulties delivered by HCPs in pediatric epilepsy clinics with limited formal training in psychological interventions. We hypothesized that it would be (i) feasible to train HCPs to deliver the psychological intervention and (ii) that participants receiving the psychological therapy would report reductions in symptoms of mental health difficulties including anxiety, depression, and behavior difficulties and improve quality of life. Methods: Thirty-four children and young people with epilepsy who had impairing symptoms of a common mental health difficulty (anxiety, depression, disruptive behavior, and/or trauma) were allocated to receive 6 months of a modular cognitive behavioral intervention delivered by a HCP with limited formal psychological therapy experience. Thirteen HCPs were trained in delivery of the intervention. Healthcare professional competence was assessed in a two-stage process. Parent-reported measures of mental health symptoms and quality of life were completed at baseline and following the intervention. Paired t-tests were used to analyze changes in symptoms over time. Results: All thirteen HCPs who participated in the training were considered competent in therapeutic delivery by the end of the training period. Twenty-three patients completed pre- and post-intervention measures and were included in the analysis. There were statistically significant improvements in: symptoms of mental health problems (p = 0.01; Cohen’s d = 0.62), total impact of mental health problems (p = 0.03; Cohen’s d = 0.52), anxiety and depression symptoms (p = 0.02; Cohen’s d = 0.57) and quality of life (p = 0.01; Cohen’s d = 0.57). Conclusion: A modular cognitive behavioral treatment delivered over the telephone by HCPs with limited experience of psychological therapy was feasible and effective in treating mental health problems in children and young people with epilepsy. Health-related Quality of Life also improved over the duration of treatment. A randomized controlled trial (RCT) is needed to demonstrate efficacy of the intervention

Agricultural R&D, technology and productivity.

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Racism, anti-racist practice and social work: articulating the teaching and learning experiences of Black social workers

In the mid 1990s a Black practice teacher programme was established in Manchester and Merseyside with the primary aim to increase the number of Black practice teachers in social work organisations, and in turn provide a supportive and encouraging learning environment for Black student social workers whilst on placement. In the north‐west of England research has been undertaken, to establish the quality of the practice teaching and student learning taking place with Black practice teachers and students. This paper is an exploration of the ideas generated within the placement process that particularly focused on the discourse of racism and ant‐racist practice. Black students and practice teachers explain their understanding of racism and anti‐racist practice within social work. From the research, the paper will critique some of the ideas concerning anti‐racism. In particular, it will question whether anti‐racist social work practice needs to be re‐evaluated in the light of a context with new migrants, asylum seekers and refugees. It will concluded, by arguing that whilst the terms anti‐racism, Black and Minority Ethnic have resonance as a form of political strategic essentialism, it is important to develop more positive representations in the future