A systematic review and meta-analysis of the prevalence of common mental disorders in people with non-communicable diseases in Bangladesh, India, and Pakistan

Background: The prevalence of mental and physical comorbidities is unknown in South Asia, as estimates of mental ill health in patients with non-communicable diseases (NCDs) have predominantly come from studies based in the United States, Europe and Australasia. This systematic review and meta-analysis summarises evidence and provides pooled estimates of the prevalence of common mental disorders in adults with non-communicable diseases in South Asia. Methods: We included prevalence studies of depression and anxiety in adults with diabetes, cancer, cardiovascular disease, and chronic respiratory conditions in Bangladesh, India, and Pakistan, published from 1990 onwards in international and country-specific databases. Results: Out of 96 included studies, 83 provided data for random effects meta-analyses. The pooled prevalence of depression was 44% (95% confidence interval (CI) = 26 to 62) for patients with COPD, 40% (95% CI = 34 to 45) for diabetes, 39% (95% CI = 23 to 56) for stroke, 38% (95% CI = 32 to 45) for hypertension, and 37% (95% CI = 30 to 45) for cancer. The pooled prevalence of anxiety based on 28 studies was 29% (95% CI = 22 to 36). Many quality issues were identified in a critical appraisal of included studies, mostly relating to the sampling frame and selection process, the description of the methods and basic data, and the description of non-responders. Conclusions: Depression and anxiety are prevalent and underdiagnosed in people with physical comorbidities in Bangladesh, India, and Pakistan

The Australian Research Quality Framework: A live experiment in capturing the social, economic, environmental, and cultural returns of publicly funded research

Copyright @ 2008 Wiley Periodicals Inc. This is the accepted version of the following article: Donovan, C. (2008), The Australian Research Quality Framework: A live experiment in capturing the social, economic, environmental, and cultural returns of publicly funded research. New Directions for Evaluation, 2008: 47–60, which has been published in final form at http://onlinelibrary.wiley.com/doi/10.1002/ev.260/abstract.The author regards development of Australia's ill-fated Research Quality Framework (RQF) as a “live experiment” in determining the most appropriate approach to evaluating the extra-academic returns, or “impact,” of a nation's publicly funded research. The RQF was at the forefront of an international movement toward richer qualitative, contextual approaches that aimed to gauge the wider economic, social, environmental, and cultural benefits of research. Its construction and implementation sent mixed messages and created confusion about what impact is, and how it is best measured, to the extent that this bold live experiment did not come to fruition

‘You can't walk through water without getting wet’ UK nurses’ distress and psychological health needs during the Covid-19 pandemic: A longitudinal interview study

Background: Pre-COVID-19 research highlighted the nursing profession worldwide as being at high risk from symptoms of burnout, post-traumatic stress disorder (PTSD) and suicide. The World Health Organization declared a pandemic on 11th March 2020 due to the sustained risk of further global spread of COVID-19. The high healthcare burden associated with COVID-19 has increased nurses’ trauma and workload, thereby exacerbating pressure on an already strained workforce and causing additional psychological distress for staff. Objectives: The Impact of COVID-19 on Nurses (ICON) interview study examined the impacts of the pandemic on frontline nursing staff's psychosocial and emotional wellbeing. Design: Longitudinal qualitative interview study. Settings: Nurses who had completed time 1 and 2 of the ICON survey were sampled to include a range of UK work settings including acute, primary and community care and care homes. Interviewees were purposively sampled for maximum variation to cover a broad range of personal and professional factors, and experiences during the COVID-19 pandemic, including redeployment. Methods: Nurses participated in qualitative in-depth narrative interviews after the first wave of COVID-19 in July 2020 (n = 27) and again at the beginning of the second wave in December 2020 (n = 25) via video and audio platform software. Rigorous qualitative narrative analysis was undertaken both cross-sectionally (within wave) and longitudinally (cross wave) to explore issues of consistency and change. Results: The terms moral distress, compassion fatigue, burnout and PTSD describe the emotional states reported by the majority of interviewees leading many to consider leaving the profession. Causes of this identified included care delivery challenges; insufficient staff and training; PPE challenges and frustrations. Four themes were identified: (1) ‘Deathscapes’ and impoverished care (2) Systemic challenges and self-preservation (3) Emotional exhaustion and (4) (Un)helpful support. Conclusions: Nurses have been deeply affected by what they have experienced and report being forever altered with the impacts of COVID-19 persisting and deeply felt. There is an urgent need to tackle stigma to create a psychologically safe working environment and for a national COVID-19 nursing workforce recovery strategy to help restore nurse's well-being and demonstrate a valuing of the nursing workforce and therefore support retention

Folate during reproduction: the Canadian experience with folic acid fortification

Folate has received international attention regarding its role in the risk-reduction of birth defects, specifically neural tube defects (NTDs). In 1998, health officials in Canada, like the United States, mandated the addition of folic acid to white flour and select grain products to increase the folate intake of reproductive-aged women. Subsequent to this initiative there has been an increase in blood folate concentrations in Canada and a 50% reduction in NTDs. Many countries, including Korea, have not mandated folic acid fortification of their food supply. Reasons vary but often include concern over the masking of vitamin B12 deficiency, a belief that folate intakes among womenare adequate, low priority relative to other domestic issues, and the philosophy that individuals have the right not to consume supplemental folic acid if they so choose. Prior to folic acid fortification of the food supply in Canada, the folate intakes of women were low, and their blood folate concentrations while not sufficiently low to produce overt signs of folate deficiency (eg. anemia) were inconsistent with a level known to reduce the risk of an NTD-affected pregnancy. The purpose of this article is to describe the role of folate during the periconceptional period, pregnancy, and during lactation. The rationale for, and history of recommending folic acid-containing supplements during the periconceptional period and pregnancy is described as is folic acid fortification of the food supply. The impact of folic acid fortification in Canada is discussed, and unresolved issues associated with this policy described. While the incidence of NTDs in Canada pre-folic acid fortification were seemingly higherthan that of Korea today, blood folate levels of Korean women are strikingly similar. We will briefly explore these parallels in an attempt to understand whether folic acid fortification of the food supply in Korea might be worth consideratio

Choosing best practices for managing impacts of trawl fishing on seabed habitats and biota

Bottom trawling accounts for almost one quarter of global fish landings but may also have significant and unwanted impacts on seabed habitats and biota. Management measures and voluntary industry actions can reduce these impacts, helping to meet sustainability objectives for fisheries, conservation and environmental management. These include changes in gear design and operation of trawls, spatial controls, impact quotas and effort controls. We review nine different measures and actions and use published studies anda simple conceptual model to evaluate and compare their performance. The risks and benefits of these management measures depend on the extent to which the fishery is already achieving management objectives for target stocks and the characteristics of the management system that is already in place. We offer guidance on identifying best practices for trawl-fisheries management and show that best practices and their likelihood of reducing trawling impacts depend on local, national and regional management objectives and priorities, societal values and resources for implementation. There is no universalbest practice, and multiple management measures and industry actions are required to meet sustainability objectives and improve trade-offs between food production and environmental protection

Environmental impact assessments of the Three Gorges Project in China: issues and interventions

The paper takes China's authoritative Environmental Impact Statement for the Yangzi (Yangtze) Three Gorges Project (TGP) in 1992 as a benchmark against which to evaluate emerging major environmental outcomes since the initial impoundment of the Three Gorges reservoir in 2003. The paper particularly examines five crucial environmental aspects and associated causal factors. The five domains include human resettlement and the carrying capacity of local environments (especially land), water quality, reservoir sedimentation and downstream riverbed erosion, soil erosion, and seismic activity and geological hazards. Lessons from the environmental impact assessments of the TGP are: (1) hydro project planning needs to take place at a broader scale, and a strategic environmental assessment at a broader scale is necessary in advance of individual environmental impact assessments; (2) national policy and planning adjustments need to react quickly to the impact changes of large projects; (3) long-term environmental monitoring systems and joint operations with other large projects in the upstream areas of a river basin should be established, and the cross-impacts of climate change on projects and possible impacts of projects on regional or local climate considered. © 2013 Elsevier B.V.Xibao Xu, Yan Tan, Guishan Yan

Evaluation of a Citizens Advice Bureau (CAB) Mental Health Welfare Rights Project

This report presents the findings from the first year of a welfare rights project in an in-patient hospital unit. The study, carried out by a group of service users and carers, found that a considerable amount of time was spent by nursing staff on welfare benefits prior to the introduction of a specialist welfare rights worker. The welfare rights project freed up staff time, reduced patient anxiety about benefits and related problems, and helped patients obtain extra benefit entitlement. Someone with knowledge and dedicated time can be beneficial for patients, their families and carers, and nursing staff and provides a point of contact with the various agencies. However, it became clear that welfare benefit problems can take time to resolve and the projects existence in in-patient units did not fully meet the needs of patients returning to the community or those being treated in the community