Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal

Background: Mental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation. Partnerships network We describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community. Conclusions: We propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal

Rhombohedral superlattice structure and relaxor ferroelectric behavior of (Pb<SUB>0.70</SUB>Ba<SUB>0.30</SUB>)ZrO<SUB>3</SUB> ceramics

Superlattice reflections observed in the neutron powder-diffraction patterns of (Pb<SUP>0.80</SUP>Ba<SUB>0.20</SUB>)ZrO<SUB>3</SUB> (PBZ20) and (Pb<SUB>0.70</SUB>Ba<SUB>0.30</SUB>)ZrO<SUB>3</SUB> (PBZ30) are explained in terms of doubled rhombohedral cell (R3c). A Rietveld analysis of the neutron data reveals that the displacements of Pb<SUP>2+</SUP>/Ba<SUP>2+</SUP> and Zr<SUP>4+</SUP> decrease with increasing Ba<SUP>2+</SUP> content while the thermal parameter for Pb<SUP>2+</SUP>/Ba<SUP>2+</SUP> increases and becomes similar to ferroelectric relaxors. Dielectric studies indeed confirm relaxor behavior in PBZ30 with Vogel-Fulcher type relaxational freezing

Translating mental health diagnostic and symptom terminology to train health workers and engage patients in cross-cultural, non-English speaking populations

Abstract Although there are guidelines for transcultural adaptation and validation of psychometric tools, similar resources do not exist for translation of diagnostic and symptom terminology used by health professionals to communicate with one another, their patients, and the public. The issue of translation is particularly salient when working with underserved, non-English speaking populations in high-income countries and low- and middle-income countries. As clinicians, researchers, and educators working in cross-cultural settings, we present four recommendations to avoid common pitfalls in these settings. We demonstrate the need for: (1) harmonization of terminology among clinicians, educators of health professionals, and health policymakers; (2) distinction in terminology used among health professionals and that used for communication with patients, families, and the lay public; (3) linkage of symptom assessment with functional assessment; and (4) establishment of a culture of evaluating communication and terminology for continued improvement

Partnerships in mental healthcare service delivery in low-resource settings: developing an innovative network in rural Nepal.

BackgroundMental illnesses are the largest contributors to the global burden of non-communicable diseases. However, there is extremely limited access to high quality, culturally-sensitive, and contextually-appropriate mental healthcare services. This situation persists despite the availability of interventions with proven efficacy to improve patient outcomes. A partnerships network is necessary for successful program adaptation and implementation.Partnerships networkWe describe our partnerships network as a case example that addresses challenges in delivering mental healthcare and which can serve as a model for similar settings. Our perspectives are informed from integrating mental healthcare services within a rural public hospital in Nepal. Our approach includes training and supervising generalist health workers by off-site psychiatrists. This is made possible by complementing the strengths and weaknesses of the various groups involved: the public sector, a non-profit organization that provides general healthcare services and one that specializes in mental health, a community advisory board, academic centers in high- and low-income countries, and bicultural professionals from the diaspora community.ConclusionsWe propose a partnerships model to assist implementation of promising programs to expand access to mental healthcare in low- resource settings. We describe the success and limitations of our current partners in a mental health program in rural Nepal

Perception towards vaccine effectiveness in controlling COVID-19 spread in rural and urban communities:a global survey

INTRODUCTION: Several studies exhibited varying reports of perception toward vaccine effectiveness, vaccine hesitancy, and acceptance of COVID-19 vaccines. As this fluctuated with evidence generation, this study explored the perception toward vaccine effectiveness in rural and urban communities among various countries. METHODS: A cross-sectional study was conducted online from April to August 2021 using convenience sampling among people from different countries approved by the Asia Metropolitan University Medical Research and Ethics. We adapted the questionnaire from the World Health Organization's (WHO) survey tool and guidance on COVID-19. The logistic regression models were performed to show perception toward vaccine effectiveness. RESULTS: A total of 5,673 participants responded to the online survey. Overall, 64% of participants agreed that the vaccine effectively controlled viral spread, and 23% agreed that there was no need for vaccination if others were vaccinated. Males had 14% higher odds of believing that there was no need for vaccination. Less social media users had 39% higher odds of developing the belief that there is no need for vaccination than all other people vaccinated. CONCLUSION: People's perceptions toward vaccine acceptance have fluctuated with the information flow in various social media and the severity of COVID-19 cases. Therefore, it is important that the current scenario of peoples' perception toward vaccine acceptance and determinants affecting the acceptance are explored to promote the vaccination approach against COVID-19 prevention and transmission effectively

Safety of Bariatric Surgery in ≥ 65-Year-Old Patients During the COVID-19 Pandemic

Background Age &gt;= 65 years is regarded as a relative contraindication for bariatric surgery. Advanced age is also a recognised risk factor for adverse outcomes with Coronavirus Disease-2019 (COVID-19) which continues to wreak havoc on global populations. This study aimed to assess the safety of bariatric surgery (BS) in this particular age group during the COVID-19 pandemic in comparison with the younger cohort.Methods We conducted a prospective international study of patients who underwent BS between 1/05/2020 and 31/10/2020. Patients were divided into two groups - patients &gt;= 65-years-old (Group I) and patients &lt; 65-years-old (Group II). The two groups were compared for 30-day morbidity and mortality.Results There were 149 patients in Group 1 and 6923 patients in Group II. The mean age, preoperative weight, and BMI were 67.6 +/- 2.5 years, 119.5 +/- 24.5 kg, and 43 +/- 7 in Group I and 39.8 +/- 11.3 years, 117.7 +/- 20.4 kg, and 43.7 +/- 7 in Group II, respectively. Approximately, 95% of patients in Group 1 had at least one co-morbidity compared to 68% of patients in Group 2 (p = &lt; 0.001). The 30-day morbidity was significantly higher in Group I ( 11.4%) compared to Group II (6.6%) (p = 0.022). However, the 30-day mortality and COVID-19 infection rates were not significantly different between the two groups.Conclusions Bariatric surgery during the COVID-19 pandemic is associated with a higher complication rate in those &gt;= 65 years of age compared to those &lt; 65 years old. However, the mortality and postoperative COVID-19 infection rates are not significantly different between the two groups