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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
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
Morbidity in patients with clinically localized prostate cancer managed with non-curative intent. A population-based case-control study
Not Quite Equal Odds: Openness to Experience Moderates the Relation Between Quantity and Quality of Ideas in Divergent Production
Since brainstorming was introduced as a technique in 1953 it has been assumed that the best way to produce good ideas is through the production of many ideas, which has later been named the equal-odds rule. However, this finding that productivity often leads to creative quality has rarely been examined in psychometric studies of creative cognition. To close this knowledge gap, we examined the relationship between individual differences in creative personality, as assessed by the personality trait openness to experience, and both the quantity and quality of ideas produced in a divergent thinking task. Across 154 graduate students we found a positive and significant relationship between creative personality and the number of ideas produced, as well as their creative value. The present results indicate that while quantity does breed quality in creative production, the effect is moderated by individual differences, specifically the personality trait Openness to Experience. As the level of Openness to Experience increases, the relation of quantity of ideas to average Creative value gradually becomes positive and significant. We discuss the possible reasons for and implications of our findings
Potential toxicity of some traditional leafy vegetables consumed in Nyang’oma division, western Kenya
Traditional leafy vegetables are those plants whose leaves or aerial parts have been integrated in a community’s culture for use as food over a long span of time. These vegetables are highly recommended due to their relatively high nutritional value compared to the introduced varieties, and are also important in food security. Qualitative phytochemical screening, using standard laboratory procedure, was carried out for alkaloids, saponins, cardenolides, flavonoids and polyphenols on traditional leafy vegetables consumed amongst the Luo, an agro-pastoral community living along the shores of lake Victoria, Western Kenya. The vegetables were: Amaranthus hybridus L. (subsp.hybridus), Asystasia mysorensis T. Anderson, Coccinia grandis (L) Voigt, Crotalaria ochroleuca (Kotschy) Polhill, Cucurbita maxima Duchesne ex Lam, Portulaca quadrifida L., Sesamum calycimum Welw. var. angustifolium (Oliv.) Ihlenf. and Siedenst., Senna occidentalis L. and Sida acuta Burm. F. All the vegetables were found to contain polyphenols and flavanoids while other classes of phytochemicals varied from species to species Brine shrimp lethality tests revealed that S. calycimum var. angustifolium (LC50 84.8 μg/ml), S. occidentalis (LC5099.5 μg/ml), S. acuta (LC50 99.4 μg/ml), C. grandis (LC50 100.6 μg/ml) and A. mysorensis (LC50 207.7 μg/ml) exhibited marked levels of toxicity. C. ochroleuca (Sunnhemp) contained all the five classes of phytochemicals, but proved less toxic (LC50 4511.3 μg/ml). This vegetable is highly utilized in Nyang’oma, and seventy per cent of the respondents consume this species. A. hybridus (African spinach, or Amaranth) was found to be the least toxic (LC50 6233.6 μg/ml) and this vegetable is recommended for consumption. From the results, five vegetables contain possible agents that can cause acute or chronic toxicities when consumed in large quantities or over a long period of time. Hence some vegetables should be consumed with great care. Though further studies are required to determine which of the phytochemicals are lethal to mammals.Key words: Traditional vegetables, phytochemicals, toxicity, Luo, Nyang’om
Relativistic quantum clocks
The conflict between quantum theory and the theory of relativity is
exemplified in their treatment of time. We examine the ways in which their
conceptions differ, and describe a semiclassical clock model combining elements
of both theories. The results obtained with this clock model in flat spacetime
are reviewed, and the problem of generalizing the model to curved spacetime is
discussed, before briefly describing an experimental setup which could be used
to test of the model. Taking an operationalist view, where time is that which
is measured by a clock, we discuss the conclusions that can be drawn from these
results, and what clues they contain for a full quantum relativistic theory of
time.Comment: 12 pages, 4 figures. Invited contribution for the proceedings for
"Workshop on Time in Physics" Zurich 201
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