HESPER web - development and reliability evaluation of a web-based version of the humanitarian emergency settings perceived needs scale

Background: The Humanitarian Emergency Settings Perceived Needs Scale (HESPER) assesses a wide range of physical, psychological and social perceived needs across 26 questions, and can be used in humanitarian emergencies and disasters for needs assessment or research studies. The original HESPER collects data through individual interviews. Today, a large number of people have access to the internet, including in humanitarian emergencies and disasters. Therefore, this paper aimed to report the development, reliability evaluation and feasibility evaluation of the HESPER Web. Methods: First, the original HESPER was developed into a web based survey. Thereafter, alternate forms reliability between the HESPER and HESPER Web, and test-retest reliability for the HESPER Web, was evaluated using a study sample of 85 asylum seekers in Sweden in total. Results: The alternate forms reliability evaluation showed that the HESPER Web was a reliable instrument to assess perceived needs. Intraclass correlation coefficient (ICC) for total number of serious needs was 0.96 (CI 0.93–09.98, p <0.001). Cohen’s κ was used to analyse the alternate forms reliability between the HESPER and HESPER Web item per item; the correspondence between HESPER and HESPER Web varied between 0.54 and 1.0 for the 26 questions. There was a strong nominal association in first priority need between the HESPER and HESPER Web (Cramer’sV 0.845, p <0.001). In the test-retest reliability evaluation of HESPER Web, ICC was 0.98 (CI 0.97–0.99, p <0.001), and Cohen’s κ varied between 0.53 and 1.0. There was a strong nominal association in first priority need between test and re-test (Cramer’s V 0.93, p <0.001). The HESPER Web was experienced as easy and safe to use and was found less time consuming than the original HESPER interview, according to the study participants. Conclusion: The HESPER Web is a reliable and usable instrument to assess perceived needs. It can reduce a number of practical challenges both for needs assessment in disasters or humanitarian emergencies as well as in research

P02-07. High Concentrations of Interleukin-15 and Low Concentrations of CCL5 in Breast Milk are Associated with Protection against Postnatal HIV Transmission

Background: Natural variations in IL-15 concentration have not been investigated for an association with an immune-protection against HIV. Given IL-15's central role in anti-HIV immunity, we hypothesized that higher concentrations of IL-15 in breast milk may protect against postnatal mother-to-child HIV transmission. Methods: In a case-control study nested within a clinical trial in Zambia, we compared IL-15 concentrations in breast milk of 22 HIV-infected women who transmitted HIV to their infants through breastfeeding with those of 72 who did not, as well as 18 HIV-uninfected women. Breast milk HIV RNA quantity, sodium, CXCL12, CCL5, and IL-8 concentrations were measured as well as maternal plasma HIV RNA concentrations and CD4 cell count. We used logistic regression modeling to adjust for potential confounders. Results: Higher concentrations of IL-15 in breast milk (adjusted odds ratio [AOR]: 0.01 per log10 pg/ml increase, 95% confidence interval [CI]: <0.001 to 0.3) were associated with protection against postnatal HIV transmission in univariate analysis and after adjusting for maternal CD4 cell counts, breast milk HIV RNA, CCL5, CXCL12, and IL-8 concentrations. Breast milk IL-15 concentration correlated with breast milk sodium, the other cytokines and HIV RNA concentration. It was inversely correlated with infant birth weight and tended to be higher in 1 week than in 1 month post-partum samples. Breast milk CCL5 concentrations were associated with increased risk of HIV transmission (AOR: 12.7 95% CI: 1.6 to 102.0) in adjusted analysis. Breast milk CXCL12 and IL-8 concentrations were not independently associated with transmission. Conclusion: High concentration of IL-15 were associated with a protection against breastfeeding HIV transmission after adjusting for other pro-inflammatory cytokines, HIV RNA in breast milk, and maternal CD4 cell count. These results corroborate a protective role of IL-15-mediated cellular immunity against HIV transmission during breastfeeding. They are informative for vaccination studies using IL-15 as an adjuvant

Accurate determination of elastic parameters for multi-component membranes

Heterogeneities in the cell membrane due to coexisting lipid phases have been conjectured to play a major functional role in cell signaling and membrane trafficking. Thereby the material properties of multiphase systems, such as the line tension and the bending moduli, are crucially involved in the kinetics and the asymptotic behavior of phase separation. In this Letter we present a combined analytical and experimental approach to determine the properties of phase-separated vesicle systems. First we develop an analytical model for the vesicle shape of weakly budded biphasic vesicles. Subsequently experimental data on vesicle shape and membrane fluctuations are taken and compared to the model. The combined approach allows for a reproducible and reliable determination of the physical parameters of complex vesicle systems. The parameters obtained set limits for the size and stability of nanodomains in the plasma membrane of living cells.Comment: (*) authors contributed equally, 6 pages, 3 figures, 1 table; added insets to figure

Service user involvement in global mental health: what have we learned from recent research in low- and middle-income countries?

Purpose of Review The Lancet Commission on global mental health and sustainable development claims the field of global mental health is undergoing a “transformational shift” toward an ethic of “nothing about us without us”. Yet a systematic review published in 2016 identified few examples of meaningful participation by service users in mental health systems strengthening in low- and middle-income countries (LMICs). To investigate whether this is still the case, we conducted a rapid review of primary research published between June 2017 and December 2018. Recent Findings We identified 10 studies reporting on user involvement in LMICs, including three in mental health policy and planning, three in mental health services or capacity-building, and three in treatment decision-making. An additional study was identified as having involved users in data collection, although this was unclear from the original text. Included studies were mostly qualitative and conducted as part of a situation analysis, pilot study or other formative research. Few reported the results of efforts to improve involvement, suggesting this shift remains at an early stage. Summary While the number of studies published on user involvement is rapidly increasing, the potentially “transformational” effects of this shift in global mental health are not yet being felt by most users in LMICs

Investigation of bandwidth loading in optical fibre transmission using amplified spontaneous emission noise

The use of spectrally shaped amplified spontaneous emission noise (SS-ASE) as a method for emulating interfering channels in optical fibre transmission systems has been studied. It is shown that the use of SS-ASE leads to a slightly pessimistic performance relative to the use of conventionally modulated interfering channels in the nonlinear regime. The additional nonlinear interference noise (on the channel under test), due to the Gaussian nature of SS-ASE, has been calculated using a combination of the Gaussian noise (GN) and enhanced GN (EGN) models for the entire C-band (4.5 THz) and experimentally shown to provide a lower bound for transmission performance

A Qualitative Study of Georgian Youth Who Are on the Street or Institutionalized

Street children, or children who live and/or spend time on the streets, are a vulnerable group of considerable concern to the global public health community. This paper describes the results of two linked qualitative studies conducted with children living or spending time on the street and in orphanages in and around urban areas in the Republic of Georgia between 2005 and 2006. The studies examined perceived causes of children going to the street, as well as indicators of healthy functioning and psychosocial problems among these children. Results on causes indicated a range of “push” factors leading children to the street and “pull” factors that keep children living on the street. Findings also showed a range of internalizing and externalizing mental health symptoms among children on the street and within orphanages. Some differences in responses were found between children living on the street and in institutions. It is important to understand the perspectives of these vulnerable populations to guide decisions on appropriate interventions that address their primary problems

Oral vinorelbine and cisplatin with concomitant radiotherapy in stage III non-small cell lung cancer (NSCLC): A feasibility study

Background: Concurrent chemoradiotherapy has improved survival in inoperable stage III non-small cell lung cancer (NSCLC). This phase I trial was performed in order to establish a dose recommendation for oral vinorelbine in combination with cisplatin and simultaneous radiotherapy. Patients and Methods: Previously untreated patients with stage IIIB NSCLC received concurrent chemoradiotherapy with 66 Gy and 2 cycles of cisplatin and oral vinorelbine which was administered at 3 different levels (40, 50 and 60 mg/m(2)). This was to be followed by 2 cycles of cisplatin/vinorelbine oral consolidation chemotherapy. The study goal was to determine the maximal recommended dose of oral vinorelbine during concurrent treatment. Results: 11 stage IIIB patients were entered into the study. The median radiotherapy dose was 66 Gy. Grade 3-4 toxicity included neutropenia, esophagitis, gastritis and febrile neutropenia. The dose-limiting toxicity for concurrent chemoradiotherapy was esophagitis. 9 patients received consolidation chemotherapy, with neutropenia and anemia/thrombocytopenia grade 3 being the only toxicities. The overall response was 73%. Conclusion: Oral vinorelbine 50 mg/m(2) (days 1, 8, 15 over 4 weeks) in combination with cisplatin 20 mg/m2 (days 1-4) is the recommended dose in combination with radiotherapy (66 Gy) and will be used for concurrent chemoradiotherapy in a forthcoming phase III trial testing the efficacy of consolidation chemotherapy in patients not progressing after chemoradiotherapy

Investigation of phenolic defense properties in Acer rubrum

General EcologyIt is important that plants have the ability to increase levels of chemical defenses to deter herbivores. According to the carbon nutrient balance hypothesis a plant can favor allocation of energy toward growth or toward carbon based defenses depending on the metabolic needs of the plant. Because of this, levels of chemical defenses may fluctuate during a plants lifetime. Phenolic levels in plants are found at a constitutive level until after an attack, at which point the plant can induce the production of phenolics to increase the concentration. Chemical activity within a plant relies largely on the rate of photosynthesis, so accordingly we ask whether a resource such as sunlight could have an effect on the production rate of phenolics. Our experiment focuses on investigating the pre- and post-attack levels of phenolic compounds on Acer rubrum leaves receiving different levels of sunlight. We found that leaves from the north and south side both experienced induction, but that the amount of sunlight available to a leaf did not significantly affect the constitutive or induced phenolic concentrations.http://deepblue.lib.umich.edu/bitstream/2027.42/61465/1/Koch_Maiuri_Motalleb_Semrau_2008.pd

Validation of the UCLA Child Post traumatic stress disorder-reaction index in Zambia

<p>Abstract</p> <p>Background</p> <p>Sexual violence against children is a major global health and human rights problem. In order to address this issue there needs to be a better understanding of the issue and the consequences. One major challenge in accomplishing this goal has been a lack of validated child mental health assessments in low-resource countries where the prevalence of sexual violence is high. This paper presents results from a validation study of a trauma-focused mental health assessment tool - the UCLA Post-traumatic Stress Disorder - Reaction Index (PTSD-RI) in Zambia.</p> <p>Methods</p> <p>The PTSD-RI was adapted through the addition of locally relevant items and validated using local responses to three cross-cultural criterion validity questions. Reliability of the symptoms scale was assessed using Cronbach alpha analyses. Discriminant validity was assessed comparing mean scale scores of cases and non-cases. Concurrent validity was assessed comparing mean scale scores to a traumatic experience index. Sensitivity and specificity analyses were run using receiver operating curves.</p> <p>Results</p> <p>Analysis of data from 352 youth attending a clinic specializing in sexual abuse showed that this adapted PTSD-RI demonstrated good reliability, with Cronbach alpha scores greater than .90 on all the evaluated scales. The symptom scales were able to statistically significantly discriminate between locally identified cases and non-cases, and higher symptom scale scores were associated with increased numbers of trauma exposures which is an indication of concurrent validity. Sensitivity and specificity analyses resulted in an adequate area under the curve, indicating that this tool was appropriate for case definition.</p> <p>Conclusions</p> <p>This study has shown that validating mental health assessment tools in a low-resource country is feasible, and that by taking the time to adapt a measure to the local context, a useful and valid Zambian version of the PTSD-RI was developed to detect traumatic stress among youth. This valid tool can now be used to appropriately measure treatment effectiveness, and more effectively and efficiently triage youth to appropriate services.</p