Strengthening the Paediatricians Project 1: The need, content and process of a workshop to address the Priority Mental Health Disorders of adolescence in countries with low human resource for health

<p>Abstract</p> <p>Objective</p> <p>World Health Organization has identified <it>Priority Mental Health Disorders </it>(PMHD) of adolescence. To effectively address these disorders at the primary care level paediatricians have to be trained in the low-income countries, which often have paucity of mental health resources. We studied: (1) the need of psychiatric training required among paediatricians; (2) if the content and process of the model workshop suits them to identify and treat these disorders.</p> <p>Methods</p> <p>Forty-eight paediatricians completed evaluation questionnaire at the end of a 3-day workshop on adolescent psychiatry. They participated in a focused group discussion addressing the areas in psychiatry that needs to be strengthened in these workshops, the changes in the content and process of the workshop to bolster their learning. Qualitative and descriptive analyses were appropriately used.</p> <p>Results</p> <p>Training in adolescent psychiatry was considered necessary among the paediatricians at zonal level frequently to develop their private practice, treat psychiatric disorders confidently, make correct referrals, and learn about counselling. Prioritizing training from under and postgraduate training, integrate psychiatry training with conference, conducting special workshops or Continuing Medical Education were suggested as ways of inculcating adolescent psychiatry proficiency. Mental status examination, psychopathology and management of the PMHD were considered by the respondents as important content that need to be addressed in the program but aspects of behavioural problems and developmental disabilities were also identified as areas of focus to gain knowledge and skill. Appropriate group size, flexibility in management decisions to fit the diverse clinical practice- settings was appreciated. Lack of skills in giving clinical reasoning in relation to PMHD, time management and feedback to individuals were identified as required components in the collaborative effort of this manner. Providing delegates with basic information on adolescent psychiatry prior to the workshop was suggested to make the workshop more valuable.</p> <p>Conclusions</p> <p>There is a need to expand training for paediatricians from various backgrounds in adolescent psychiatry to strengthen their clinical skills to address the PMHD at the primary-care level. The evaluation suggests that the design and collaborative approach evident in this programme have merit as a model for training paediatricians in adolescent psychiatry in countries with low human resource for health.</p

Predictive factors for polypharmacy among child and adolescent psychiatry inpatients

BACKGROUND: Aim was to determine the predictive factors for polypharmacy among inpatient children and adolescents with psychiatric disorders. METHODS: Blinded, case-note review of children and adolescents with ICD 10 diagnosis of psychiatric disorders on psychotropic medication was conducted. Data on demography, illness, and treatment was analyzed with univariate and multivariate techniques. RESULTS: Proscribing non-pharmacological interventions (OR = 4.7) and pro re nata medication (OR = 3.3), increased the risk of polypharmacy. Prescribing physical restraint reduced the risk of receiving multiple medications (OR = 0.3). CONCLUSION: Proscribing non-pharmacological interventions, pro re nata medication and physical restraints increased polypharmacy

Bulk spectral function sum rule in QCD-like theories with a holographic dual

We derive the sum rule for the spectral function of the stress-energy tensor in the bulk (uniform dilatation) channel in a general class of strongly coupled field theories. This class includes theories holographically dual to a theory of gravity coupled to a single scalar field, representing the operator of the scale anomaly. In the limit when the operator becomes marginal, the sum rule coincides with that in QCD. Using the holographic model, we verify explicitly the cancellation between large and small frequency contributions to the spectral integral required to satisfy the sum rule in such QCD-like theories.Comment: 16 pages, 2 figure

Optimisation of a reduced volume PCR amplification for PowerPlex® Fusion kit using FTA™ cards and generation of population genetic data for Brunei population

The commercial PowerPlex® Fusion kit is an autosomal STR multiplex kit that has high discrimination power and is more informative in forensic, paternity and relationship‐testing cases. Key features of this multiplex system are the possibility to direct amplify FTA™ card punches as well as non‐FTA cards and commonly used swabs; optimised inhibitor tolerance and high sensitivity generating full profiles from as little as 100 pg of human DNA. This study focused on the optimization of performance variables such as FTA™ punch sizes, reduced reaction volumes, and FTA™ purification reagent aiming to increase the analytical sensitivity, decrease the sample consumption and cost effectiveness. LOD and LOQ values demonstrated high sensitivity of the PowerPlex® Fusion system. In addition, population databases of Brunei Malay and Chinese from the Brunei Darussalam were established, and parameters of forensic importance were calculated. Overall, the forensic parameters indicated an enhanced utility of the PowerPlex® Fusion kit for forensic evidence analysis and paternity testing in Brunei Malay and Chinese populations

Supercapacitor Degradation: Understanding Mechanisms of Cycling-Induced Deterioration and Failure of a Pseudocapacitor

Owing to a reputation for long lifetimes and excellent cycle stability, degradation in supercapacitors has largely been overlooked. In this work, we demonstrate that significant degradation in some commercial supercapacitors can in fact occur early in their life, leading to a rapid loss in capacitance, especially when utilized in full voltage range, high charge-discharge frequency applications. By using a commercial 300 F lithium-ion pseudocapacitor rated for 100,000 charge/discharge cycles as an example system, it is shown that a ∼96 % loss in capacitance over the first ∼2000 cycles is caused by significant structural and chemical change in the cathode active material (LiMn2O4, LMO). Multi-scale in-situ and ex-situ characterization, using a combination of X-ray computed tomography, Raman spectroscopy and X-ray photoelectron spectroscopy, shows that while minimal material loss (∼5.5 %), attributed to the dissolution of Mn2+, is observed, the primary mode of degradation is due to manganese charge disproportionation (Mn3+→Mn4++Mn2+) and its physical consequences (i. e. microstrain formation, particle fragmentation, loss of conductivity etc.). In contrast to prior understanding of LMO material degradation in battery systems, negligible contributions from cubic-to-tetragonal phase transitions are observed. Hence, as supercapacitors are becoming more widely utilized in real-world applications, this work demonstrates that it is vital to understand the mechanisms by which this family of devices change during their lifetimes, not just for lithium-ion pseudocapacitors, but for a wide range of commercial chemistries

Plausible Constraints on the Range of Bulk Terrestrial Exoplanet Compositions in the Solar Neighborhood

Rocky planet compositions regulate planetary evolution by affecting core sizes, mantle properties, and melting behaviors. Yet, quantitative treatments of this aspect of exoplanet studies remain generally underexplored. We attempt to constrain the range of potential bulk terrestrial exoplanet compositions in the solar neighborhood (<200 pc). We circumscribe probable rocky exoplanet compositions based on a population analysis of stellar chemical abundances from the Hypatia and GALAH catalogs. We apply a devolatilization model to simulate compositions of hypothetical, terrestrial-type exoplanets in the habitable zones around Sun-like stars, considering elements O, S, Na, Si, Mg, Fe, Ni, Ca, and Al. We further apply core-mantle differentiation by assuming constant oxygen fugacity, and model the consequent mantle mineralogy with a Gibbs energy minimization algorithm. We report statistics on several compositional parameters and propose a reference set of (21) representative planet compositions for use as end-member compositions in imminent modeling and experimental studies. We find a strong correlation between stellar Fe/Mg and metallic-core sizes, which can vary from 18 to 35 wt%. Furthermore, stellar Mg/Si gives a first-order indication of mantle mineralogy, with high-Mg/Si stars leading to weaker, ferropericlase-rich mantles, and low-Mg/Si stars leading to mechanically stronger mantles. The element Na, which modulates crustal buoyancy and mantle clinopyroxene fraction, is affected by devolatilization the most. While we find that planetary mantles mostly consist of Fe/Mg silicates, the core sizes and relative abundances of common minerals can nevertheless vary significantly among exoplanets. These differences likely lead to different evolutionary pathways among rocky exoplanets in the solar neighborhood

A RANDOMIZED CLINICAL ENDPOINT STUDY TO EVALUATE THE SAFETY AND EFFICACY OF CLEARLIV TABLETS IN PATIENTS WITH ALCOHOLIC LIVER DISEASE

Objective: The objective of this study was to evaluate and compare the hepatoprotective effect of clearliv tablets with silymarin in patients with alcoholic liver disease.Methods: This was a prospective, randomized, multicenter, open-label, parallel group interventional clinical endpoint study (Phase IIa). Patients attending general medicine outpatient department were screened for alcoholic liver disease using the serum biochemical liver function test and ultrasonogram abdomen and tested whether they satisfy the selection criteria, and 24 patients were then enrolled in the study. The study drug, namely clearliv tablets of Apex Laboratories Pvt. Ltd., was administered to Group A and tablet silymarin was administered to Group B from day 1 to day 56. Patients were reviewed once in 2 weeks. Liver function test was repeated, and patients were enquired of their well-being and any adverse events.Results: The demographic characters and body weight of the subjects showed no significant difference between the groups. There is a significant improvement (p&lt;0.05) in the aspartate transaminase (AST), alanine transaminase (ALT), and total bilirubin (TB) levels on 28th and 56th days in both silymarin and clearliv groups. Of the 2 groups, there is higher significance of improvement in clearliv group (p&lt;0.001), compared to silymarin group. Clearliv group started showing a significant reduction in AST and ALT levels in the first 14 days of the study period. On comparing the mean percentage reduction in the levels of AST (35.7% and 35%), ALT (26.7% and 24.3%), and TB (26.7% and 25%), it was found that clearliv is showing a better percentage of reduction of the above parameters compared to silymarin. There were reports of adverse effects such as loss of appetite and gastritis in both the groups.Conclusion: This clinical study proves that clearliv is functioning as a hepatoprotective drug. It is offering a better hepatoprotection compared to silymarin. Clearliv tablets can be indicated for the management of liver dysfunction, which occurs due to alcoholic liver damage. It may also be used in similar manner in cases of viral hepatitis, drug-induced liver damage, acute and chronic hepatitis