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

Biot-Savart-like law in electrostatics

The Biot-Savart law is a well-known and powerful theoretical tool used to calculate magnetic fields due to currents in magnetostatics. We extend the range of applicability and the formal structure of the Biot-Savart law to electrostatics by deriving a Biot-Savart-like law suitable for calculating electric fields. We show that, under certain circumstances, the traditional Dirichlet problem can be mapped onto a much simpler Biot-Savart-like problem. We find an integral expression for the electric field due to an arbitrarily shaped, planar region kept at a fixed electric potential, in an otherwise grounded plane. As a by-product we present a very simple formula to compute the field produced in the plane defined by such a region. We illustrate the usefulness of our approach by calculating the electric field produced by planar regions of a few nontrivial shapes.Comment: 14 pages, 6 figures, RevTex, accepted for publication in the European Journal of Physic

The impact of free access to swimming pools on children's participation in swimming:A comparative regression discontinuity study

Objective: Investigating the extent to which providing children with free swimming access during school holidays increased participation in swimming and whether this effect differed according to the socioeconomic deprivation of the neighbourhoods in which children lived. Setting: A highly disadvantaged local authority (LA) in North West England. Intervention: Provision of children with free swimming during the summer holidays. Outcome measures: Number of children swimming, and the number of swims, per 100 population in 2014. Design: Comparative regression discontinuity investigating the extent to which participation rates amongst children aged 5-15 were greater in the intervention LA compared to a similar control LA. We estimated the differential effect of the intervention across five groups, defined by quintiles of area deprivation. Results: Free swimming during the summer holidays was associated with an additional 6% of children swimming (95% CI: 4-9%) and an additional 33 swims per 100 children per year (95% CI: 21-44). The effects were greatest in areas with intermediate levels of deprivation (quintiles 3 and 4) within this deprived LA. Conclusion: Providing free facilities for children in disadvantaged areas is likely to increase swimming participation and may help reduce inequalities in physical activity

Pregnancy and childbirth in English prisons : institutional ignominy and the pains of imprisonment

© 2020 The Authors. Sociology of Health & Illness published by John Wiley & Sons Ltd on behalf of Foundation for SHIL.With a prison population of approximately 9000 women in England, it is estimated that approximately 600 pregnancies and 100 births occur annually. Despite an extensive literature on the sociology of reproduction, pregnancy and childbirth among women prisoners is under‐researched. This article reports an ethnographic study in three English prisons undertaken in 2015‐2016, including interviews with 22 prisoners, six women released from prison and 10 staff members. Pregnant prisoners experience numerous additional difficulties in prison including the ambiguous status of a pregnant prisoner, physical aspects of pregnancy and the degradation of the handcuffed or chained prisoner during visits to the more public setting of hospital. This article draws on Erving Goffman's concepts of closed institutions, dramaturgy and mortification of self, Crewe et al.'s work on the gendered pains of imprisonment and Crawley's notion of ‘institutional thoughtlessness’, and proposes a new concept of institutional ignominy to understand the embodied situation of the pregnant prisoner.Peer reviewe

Using conceptual metaphor and functional grammar to explore how language used in physics affects student learning

This paper introduces a theory about the role of language in learning physics. The theory is developed in the context of physics students' and physicists' talking and writing about the subject of quantum mechanics. We found that physicists' language encodes different varieties of analogical models through the use of grammar and conceptual metaphor. We hypothesize that students categorize concepts into ontological categories based on the grammatical structure of physicists' language. We also hypothesize that students over-extend and misapply conceptual metaphors in physicists' speech and writing. Using our theory, we will show how, in some cases, we can explain student difficulties in quantum mechanics as difficulties with language.Comment: Accepted for publication in Phys. Rev. ST:PE

Epidemiology of Leptospirosis in Africa: A Systematic Review of a Neglected Zoonosis and a Paradigm for 'One Health' in Africa.

Leptospirosis is an important but neglected bacterial zoonosis that has been largely overlooked in Africa. In this systematic review, we aimed to summarise and compare current knowledge of: (1) the geographic distribution, prevalence, incidence and diversity of acute human leptospirosis in Africa; and (2) the geographic distribution, host range, prevalence and diversity of Leptospira spp. infection in animal hosts in Africa. Following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, we searched for studies that described (1) acute human leptospirosis and (2) pathogenic Leptospira spp. infection in animals. We performed a literature search using eight international and regional databases for English and non-English articles published between January 1930 to October 2014 that met out pre-defined inclusion criteria and strict case definitions. We identified 97 studies that described acute human leptospirosis (n = 46) or animal Leptospira infection (n = 51) in 26 African countries. The prevalence of acute human leptospirosis ranged from 2 3% to 19 8% (n = 11) in hospital patients with febrile illness. Incidence estimates were largely restricted to the Indian Ocean islands (3 to 101 cases per 100,000 per year (n = 6)). Data from Tanzania indicate that human disease incidence is also high in mainland Africa (75 to 102 cases per 100,000 per year). Three major species (Leptospira borgpetersenii, L. interrogans and L. kirschneri) are predominant in reports from Africa and isolates from a diverse range of serogroups have been reported in human and animal infections. Cattle appear to be important hosts of a large number of Leptospira serogroups in Africa, but few data are available to allow comparison of Leptospira infection in linked human and animal populations. We advocate a 'One Health' approach to promote multidisciplinary research efforts to improve understanding of the animal to human transmission of leptospirosis on the African continent

Convergence of the Optimized Delta Expansion for the Connected Vacuum Amplitude: Zero Dimensions

Recent proofs of the convergence of the linear delta expansion in zero and in one dimensions have been limited to the analogue of the vacuum generating functional in field theory. In zero dimensions it was shown that with an appropriate, $N$-dependent, choice of an optimizing parameter \l, which is an important feature of the method, the sequence of approximants $Z_N$ tends to $Z$ with an error proportional to ${\rm e}^{-cN}$. In the present paper we establish the convergence of the linear delta expansion for the connected vacuum function $W=\ln Z$. We show that with the same choice of \l the corresponding sequence $W_N$ tends to $W$ with an error proportional to ${\rm e}^{-c\sqrt N}$. The rate of convergence of the latter sequence is governed by the positions of the zeros of $Z_N$.Comment: 20 pages, LaTeX, Imperial/TP/92-93/5

On the Divergence of Perturbation Theory. Steps Towards a Convergent Series

The mechanism underlying the divergence of perturbation theory is exposed. This is done through a detailed study of the violation of the hypothesis of the Dominated Convergence Theorem of Lebesgue using familiar techniques of Quantum Field Theory. That theorem governs the validity (or lack of it) of the formal manipulations done to generate the perturbative series in the functional integral formalism. The aspects of the perturbative series that need to be modified to obtain a convergent series are presented. Useful tools for a practical implementation of these modifications are developed. Some resummation methods are analyzed in the light of the above mentioned mechanism.Comment: 42 pages, Latex, 4 figure

Rhythm in the speech of a person with right hemisphere damage: Applying the pairwise variability index

Although several aspects of prosody have been studied in speakers with right hemisphere damage (RHD), rhythm remains largely uninvestigated. This study compares the rhythm of an Australian English speaker with right hemisphere damage (due to a stroke, but with no concomitant dysarthria) to that of a neurologically unimpaired individual. The speakers' rhythm is compared using the pairwise variability index (PVI) which allows for an acoustic characterization of rhythm by comparing the duration of successive vocalic and intervocalic intervals. A sample of speech from a structured interview between a speech and language therapist and each participant was analysed. Previous research has shown that speakers with RHD may have difficulties with intonation production, and therefore it was hypothesized that there may also be rhythmic disturbance. Results show that the neurologically normal control uses a similar rhythm to that reported for British English (there are no previous studies available for Australian English), whilst the speaker with RHD produces speech with a less strongly stress-timed rhythm. This finding was statistically significant for the intervocalic intervals measured (t(8) = 4.7, p < .01), and suggests that some aspects of prosody may be right lateralized for this speaker. The findings are discussed in relation to previous findings of dysprosody in RHD populations, and in relation to syllable-timed speech of people with other neurological conditions

Closing in on the picture : analyzing interactions in video recordings

This paper provides a detailed account of the processing and analysing of data, obtained through video recording during reflective practitioner research. It sets out five stages in the analysis of video recordings of classroom interactions during a series of educational drama lessons: from decisions relating to the selection of data for close analysis, to the seeking of themes, and finally to the presentation of conclusions. The researcher adapted and synthesised several processes derived from discourse analysis (Wells, 2001; Spiers, 2004; Gee, 2005) to produce a range of instruments for use in transcription and analysis of verbal and non-verbal discourse. These include: a simple transcription key; classifications for verbal and non-verbal discourse; and a template for a transcription and analysis matrix