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What about lay counselors' experiences of task-shifting mental health interventions? Example from a family-based intervention in Kenya.
Background:A key focus of health systems strengthening in low- and middle-income countries is increasing reach and access through task-shifting. As such models become more common, it is critical to understand the experiences of lay providers because they are on the forefront for delivering care services. A greater understanding would improve lay provider support and help them provide high-quality care. This is especially the case for those providing mental health services, as providing psychological care may pose unique stressors. We sought to understand experiences of lay counselors, focusing on identity, motivation, self-efficacy, stress, and burnout. The goal was to understand how taking on a new provider role influences their lives beyond simply assuming a new task, which would in turn help identify actionable steps to improve interventions with task-shifting components. Methods:Semi-structured interviews (n = 20) and focus group discussions (n = 3) were conducted with three lay counselor groups with varying levels of experience delivering a community-based family therapy intervention in Eldoret, Kenya. Thematic analysis was conducted, including intercoder reliability checks. A Stress Map was created to visualize stress profiles using free-listing and pile-sorting data collected during interviews and focus group discussions. Results:Counselors described high intrinsic motivation to become counselors and high self-efficacy after training. They reported positive experiences in the counselor role, with new skills improving their counseling and personal lives. As challenges arose, including client engagement difficulties and balancing many responsibilities, stress and burnout increased, dampening motivation and self-efficacy. In response, counselors described coping strategies, including seeking peer and supervisor support, that restored their motivation to persevere. At case completion, they again experienced high self-efficacy and a desire to continue. Conclusions:Findings informed suggestions for ways to incorporate support for lay providers into task-shifting interventions at initiation, during training, and throughout implementation. These include acknowledging and preparing counselors for challenges during training, increasing explicit attention to counselor stress in supervision, fostering peer support among lay providers, and ensuring a fair balance between workload and compensation. Improving and building an evidence base around practices for supporting lay providers will improve the effectiveness and sustainability of lay provider-delivered interventions
A Framework for Evaluating Security in the Presence of Signal Injection Attacks
Sensors are embedded in security-critical applications from medical devices
to nuclear power plants, but their outputs can be spoofed through
electromagnetic and other types of signals transmitted by attackers at a
distance. To address the lack of a unifying framework for evaluating the
effects of such transmissions, we introduce a system and threat model for
signal injection attacks. We further define the concepts of existential,
selective, and universal security, which address attacker goals from mere
disruptions of the sensor readings to precise waveform injections. Moreover, we
introduce an algorithm which allows circuit designers to concretely calculate
the security level of real systems. Finally, we apply our definitions and
algorithm in practice using measurements of injections against a smartphone
microphone, and analyze the demodulation characteristics of commercial
Analog-to-Digital Converters (ADCs). Overall, our work highlights the
importance of evaluating the susceptibility of systems against signal injection
attacks, and introduces both the terminology and the methodology to do so.Comment: This article is the extended technical report version of the paper
presented at ESORICS 2019, 24th European Symposium on Research in Computer
Security (ESORICS), Luxembourg, Luxembourg, September 201
Selective medium for culture of Mycoplasma hyopneumoniae
The fastidious porcine respiratory pathogen Mycoplasma hyopneumoniae has proven difficult to culture since it was first isolated in 1965. A reliable solid medium has been particularly challenging. Moreover, clinical and pathological samples often contain the fast-growing M. hyorhinis which contaminates and overgrows M. hyopneumoniae in primary culture. The aim of this study was to optimise the culture medium for recovery of M. hyopneumoniae and to devise a medium for selection of M. hyopneumoniae from clinical samples also containing M. hyorhinis. The solid medium devised by Niels Friis was improved by use of Purified agar and incorporation of DEAE-dextran. Addition of glucose or neutralization of acidity in liquid medium with NaOH did not improve the final yield of viable organisms or alter the timing of peak viability. Analysis of the relative susceptibility of M. hyopneumoniae and M. hyorhinis strains to four antimicrobials showed that M. hyopneumoniae is less susceptible than M. hyorhinis to kanamycin. This was consistent in all UK and Danish strains tested. A concentration of 2 μg/ml of kanamycin selectively inhibited the growth of all M. hyorhinis tested, while M. hyopneumoniae was able to grow. This forms the basis of an effective selective culture medium for M. hyopneumoniae.(Résumé d'auteur
Dissolution of calcium carbonate: observations and model results in the subpolar North Atlantic
We investigate the significance of in situ dissolution of calcium carbonate above its saturation horizons using observations from the open subpolar North Atlantic [sNA] and to a lesser extent a 3-D biogeochemical model. The sNA is particularly well suited for observation-based detections of in situ, i.e. shallow-depth CaCO3 dissolution [SDCCD] as it is a region of high CaCO3 production, deep CaCO3 saturation horizons, and precisely-defined pre-formed alkalinity. Based on the analysis of a comprehensive alkalinity data set we find that SDCCD does not appear to be a significant process in the open sNA. The results from the model support the observational findings by indicating that there is not a significant need of SDCCD to explain observed patterns of alkalinity in the North Atlantic. Instead our investigation points to the importance of mixing processes for the redistribution of alkalinity from dissolution of CaCO3 from below its saturation horizons. However, mixing has recently been neglected for a number of studies that called for SDCCD in the sNA and on global scale
Topology and Phases in Fermionic Systems
There can exist topological obstructions to continuously deforming a gapped
Hamiltonian for free fermions into a trivial form without closing the gap.
These topological obstructions are closely related to obstructions to the
existence of exponentially localized Wannier functions. We show that by taking
two copies of a gapped, free fermionic system with complex conjugate
Hamiltonians, it is always possible to overcome these obstructions. This allows
us to write the ground state in matrix product form using Grassman-valued bond
variables, and show insensitivity of the ground state density matrix to
boundary conditions.Comment: 4 pages, see also arxiv:0710.329
Relativistic entanglement of two massive particles
We describe the spin and momentum degrees of freedom of a system of two
massive spin-- particles as a 4 qubit system. Then we explicitly
show how the entanglement changes between different partitions of the qubits,
when considered by different inertial observers. Although the two particle
entanglement corresponding to a partition into Alice's and Bob's subsystems is,
as often stated in the literature, invariant under Lorentz boosts, the
entanglement with respect to other partitions of the Hilbert space on the other
hand, is not. It certainly does depend on the chosen inertial frame and on the
initial state considered. The change of entanglement arises, because a Lorentz
boost on the momenta of the particles causes a Wigner rotation of the spin,
which in certain cases entangles the spin- with the momentum states. We
systematically investigate the situation for different classes of initial spin
states and different partitions of the 4 qubit space.
Furthermore, we study the behavior of Bell inequalities for different
observers and demonstrate how the maximally possible degree of violation, using
the Pauli-Lubanski spin observable, can be recovered by any inertial observer.Comment: 17 pages, 4 figure
Ticket Inspectors in Action:Body-Worn Camera Analysis of Aggressive and Nonaggressive Passenger Encounters
Objective: Workplace aggression is a harmful occupational hazard, which has been associated with individual- and organizational-level risk factors. By comparison, little is known about the face-to-face interactional dynamics that shape employee victimizations. To address this gap, we provide an interactional analysis of how ticket inspector actions are associated with the risk of passenger aggression. Method: Data were a video sample of 123 ticket fining events from public buses recorded by occupational body-worn cameras. We systematically coded the inspector and passenger actions in each fining event. The individual and interactional risk factors associated with passenger aggression were estimated with a logistic regression model. Results: Our empirical analysis suggests that aggressive fining events unfold as “character contests,” in which the actions of the inspectors are associated with the aggressive outcome. Conclusions: These findings are in line with situational approaches to violence highlighting that aggressive incidents often develop as an interplay between victim and offender actions. We propose focusing on the behavioral actions of employees for prevention measures of workplace aggression
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