STUDY AND DESIGN OF PORTABLE ANTIMICROBIAL WATER FILTER

  Objective: This study was conducted to design a portable antimicrobial water filter which is both economic and easy to use.Methods: A prototype following the designing of the water filter was constructed. Layers of sand, cloth, activated charcoal, and cotton containing compartments were built for carrying out water analysis.Results: Most probable number index of Vellore Institute of Technology lake water was compared with that of filtered water. Complete water analysis was done, and the sand filter layer was observed to be responsible for a maximum of the antimicrobial action of the filter.Conclusion: The study demonstrated that the proposed design of water filter is efficient in removal of turbidity, odor, and microbial content of lake water along with decreasing the acidity of water

What are young Indians saying about mental health? A content analysis of blogs on the It’s Ok To Talk website

Objectives: This study used thematic content analysis to examine submissions to a youth mental health website, www.itsoktotalk.in, in India. Setting: We considered submissions made to the It’s OK to Talk web platform during the first year of its operation (April 2017 - March 2018), focusing specifically on website users based in India. Participants: We analysed 37 submissions by 33 authors aged 19-31 years (mean age 22 years) from 7 Indian cities (New Delhi, Lucknow, Bengaluru, Mumbai, Pune, Hyderabad and Haryana). Eligible submissions were English-language first-person accounts of self-identified mental health problems, submitted in any media format for online publication by authors aged 18 years or older and who were based in India. Eight study participants were additionally involved in a focus group that contributed to the coding process and preparation of the final manuscript. Results: Four themes were identified:1) Living through difficulties; 2) Mental health in context; 3) Managing one's mental health; and 4) Breaking stigma and sharing hope. Overall, the participants expressed significant feelings of distress and hopelessness as a result of their mental health problems; many described the context of their difficulties as resulting from personal histories or wider societal factors; a general lack of understanding about mental health; and widespread stigma and other negative attitudes. Most participants expressed a desire to overcome mental health prejudice and discrimination. Conclusions: Personal narratives offer a window into young people’s self-identified priorities and challenges related to mental health problems and recovery. Such insights can inform anti-stigma initiatives and other public awareness activities around youth mental health

Frailty and chronic kidney disease: associations and implications

ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1–4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried’s frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients

App-based guided problem-solving intervention for adolescent mental health: a pilot cohort study in Indian schools

Background This paper describes the pilot evaluation of ‘POD Adventures’, a lay counsellor-guided problem-solving intervention delivered via a smartphone app in Indian secondary schools. Objective To test the feasibility and acceptability of POD Adventures for adolescents with a felt need for psychological support, and to explore the intervention’s effects on self-reported mental health symptoms, prioritised problems, stress and well-being. Methods We used a mixed-methods pre-post cohort design. Participants were self-referred from grades 9–12 in two coeducational government-aided secondary schools in Goa, India. The intervention was delivered in two formats, ‘mixed’ (comprising individual and small group sessions) and ‘group’ (small group sessions only). Findings 248 participants enrolled in the study and 230 (92.7%) completed the intervention. Outcomes at 4 weeks showed significant improvements on all measures that were maintained at 12 weeks. Large effects were observed on problem severity scores (4 weeks, d=1.47; 12 weeks, d=1.53) while small to moderate effects were seen on mental health symptoms, stress and well-being. 22 students completed qualitative interviews about their experience of the intervention. Participants found POD Adventures easy to use, engaging and helpful in solving their problems. They were satisfied with the guidance provided by the counsellor irrespective of delivery format. Conclusions POD Adventures was feasible to deliver with guidance from lay counsellors in Indian schools, acceptable to participants and associated with large improvements in problem severity and mental health symptom severity. Clinical implications POD Adventures has promise as an early intervention for adolescents with a felt need for psychological support in low-resource settings

Increasing demand for school counselling through a lay counsellor-delivered classroom sensitisation intervention: a stepped-wedge cluster randomised controlled trial in New Delhi, India

Introduction: We evaluated a classroom-based sensitisation intervention that was designed to reduce demand-side barriers affecting referrals to a school counselling programme. The sensitisation intervention was offered in the context of a host trial evaluating a low-intensity problem-solving treatment for common adolescent mental health problems. Methods: We conducted a stepped-wedge, cluster randomized controlled trial with 70 classes in six secondary schools serving low-income communities in New Delhi, India.The classes were randomized to receive a classroom sensitisation session involving a brief video presentation and group discussion, delivered by a lay counsellor over one class period (intervention condition, IC), in two steps of 4 weeks each. The control condition (CC) was whole-school sensitisation (teacher-meetings and whole-school activities such as poster displays). The primary outcome was the proportion of students referred into the host trial. Secondary outcomes were the proportion of students who met mental health caseness criteria and the proportion of self-referred adolescents. Results: Between 20th August 2018 and 9th December 2018, 835 students (23.3% of all students) were referred into the host trial. The referred sample included 591 boys (70.8%), and had a mean age of 15.8 years, SD=0.06; 194 students (31.8% of 610 with complete data) met mental health caseness criteria. Referral rates were substantially higher in the IC (IC=21.7%,CC=1.5%, OR=111.36, 95%CI=35.56-348.77,p<0.001). The proportion of self-referred participants was also higher in the IC (IC=98.1%,CC=89.1%, Pearson chi2(1)=16.92,p<0.001). Although the proportion of referred students meeting caseness criteria was similar in both conditions (IC=32.0% vs CC=28.1%), the proportion weighted for the total student population was substantially higher in the IC (IC=5.2%,CC=0.3%, OR=52.39, 95%CI=12.49-219.66,p<0.001), indicating that significantly more cases were referred in the IC. Conclusion: A single, lay counsellor-delivered, classroom sensitisation session increased psychological help-seeking for common mental health problems among secondary school pupils from urban, low-income communities in India

A guided internet-based problem-solving intervention delivered through smartphones for secondary school pupils during the COVID-19 pandemic in India: protocol for a pilot randomized controlled trial

Background: “POD Adventures” is a gamified mental health intervention delivered via a smartphone app and supported by counsellors for a target population of secondary school students in India. This paper describes the protocol for a pilot randomized controlled trial of a remotely delivered version of the intervention in the context of COVID-19 restrictions. Objective: Our objectives are to assess the feasibility of research procedures and intervention delivery and to generate preliminary estimates of the effectiveness of the intervention to inform the sample size calculation of a full-scale trial. Methods: We will conduct a parallel, 2-arm, individually randomized pilot controlled trial in 11 secondary schools in Goa, India. This pilot trial aims to recruit 70 participants with a felt need for psychological support. Participants will receive either the POD Adventures intervention delivered over 4 weeks or usual care comprising information about local mental health services and national helplines. Outcomes will be assessed at two timepoints: baseline and 6 weeks post randomization. Results: The first participant was enrolled on January 28, 2021, and 6-week assessment completed on April 4, 2021. Owing to a second wave of the COVID-19 pandemic in India, schools in Goa were closed on April 22, 2021. Trial participants are currently receiving the intervention or completing follow-up assessments. Conclusions: This pilot trial will help understand the feasibility of implementing and evaluating a remotely delivered digital mental health intervention in a low-resource setting. Our findings will be used to design future trials that can address difficulties of accessing psychosocial support in-person and support wider efforts to scale up evidence-based mental health interventions for young people. Trial Registration: ClinicalTrials.gov NCT04672486; https://clinicaltrials.gov/ct2/show/NCT04672486 International Registered Report Identifier (IRRID): DERR1-10.2196/3033

The MAGPI Survey: impact of environment on the total internal mass distribution of galaxies in the last 5 Gyr

We investigate the impact of environment on the internal mass distribution of galaxies using the Middle Ages Galaxy Properties with Integral field spectroscopy (MAGPI) survey. We use 2D resolved stellar kinematics to construct Jeans dynamical models for galaxies at mean redshift z ∼ 0.3, corresponding to a lookback time of 3–4 Gyr. The internal mass distribution for each galaxy is parametrized by the combined mass density slope γ (baryons + dark matter), which is the logarithmic change of density with radius. We use a MAGPI sample of 28 galaxies from low-to-mid density environments and compare to density slopes derived from galaxies in the high density Frontier Fields clusters in the redshift range 0.29 < z < 0.55, corresponding to a lookback time of ∼5 Gyr. We find a median density slope of γ = −2.22 ± 0.05 for the MAGPI sample, which is significantly steeper than the Frontier Fields median slope (γ = −2.00 ± 0.04), implying the cluster galaxies are less centrally concentrated in their mass distribution than MAGPI galaxies. We also compare to the distribution of density slopes from galaxies in ATLAS3D at z ∼ 0, because the sample probes a similar environmental range as MAGPI. The ATLAS3D median total slope is γ = −2.25 ± 0.02, consistent with the MAGPI median. Our results indicate environment plays a role in the internal mass distribution of galaxies, with no evolution of the slope in the last 3–4 Gyr. These results are in agreement with the predictions of cosmological simulations

Development of a transdiagnostic, low-intensity, psychological intervention for common adolescent mental health problems in Indian secondary schools

Background: The PRIDE programme aims to establish a suite of transdiagnostic psychological interventions organised around a stepped care system in Indian secondary schools. This paper describes the development of a low-intensity, first-line component of the PRIDE model. Method: Contextual and global evidence informed an intervention ‘blueprint’ with problem solving as the primary practice element. Successive iterations were tested and modified across two pilot cohort studies (N=45; N=39). Participants were aged 13–20 years and presenting with elevated mental health symptoms in New Delhi schools. Results: The first iteration of the intervention, based on a guided self-help modality, showed promising outcomes and user satisfaction when delivered by psychologists. However, delivery was not feasible within the intended 6-week schedule, and participants struggled to use materials outside ‘guidance’ sessions. In Pilot 2, a modified counsellor-led problem-solving intervention was implemented by less experienced counsellors over a 3–4 week schedule. Outcomes were maintained, with indications of enhanced feasibility and acceptability. High demand was observed across both pilots, leading to more stringent eligibility criteria and a modified sensitisation plan. Discussion: Findings have shaped a first-line intervention for common adolescent mental health problems in low-resource settings. A forthcoming randomised controlled trial will test its effectiveness

Effectiveness of a brief lay counsellor-delivered, problem-solving intervention for adolescent mental health problems in urban, low-income schools in India: a randomised controlled trial

Background Mental health problems are a leading cause of disability in adolescents worldwide. Problem solving is a well-tested mental health intervention in many populations. We aimed to investigate the effectiveness of a brief, transdiagnostic problem-solving intervention for common adolescent mental health problems when delivered by non-specialist school counsellors in New Delhi, India. Methods This randomised trial was done in six government-run schools (three all-boys schools, two all-girls schools, and one co-educational school) that serve low-income communities. We recruited participants from grades 9 to 12 (ages 12–20 years) by selecting students with persistently elevated mental health symptoms accompanied by distress or functional impairment. Clinical eligibility criteria were assessed by research assistants using the Hindi-language version of the Strengths and Difficulties Questionnaire (SDQ), with reference to locally validated borderline cutoff scores of 19 or greater for boys and 20 or greater for girls on the SDQ Total Difficulties scale, an abnormal score of 2 or more on the SDQ Impact scale, and persistence of more than 1 month on the SDQ Chronicity index. Participants were randomly allocated (1:1) to problem solving delivered through a brief (2–3 week) counsellor-led intervention with supporting printed materials (intervention group), or problem solving delivered via printed booklets alone (control group). Primary outcomes were adolescent-reported mental health symptoms (SDQ Total Difficulties scale) and idiographic psychosocial problems (Youth Top Problems [YTP]) at 6 weeks. Primary analyses were done on an intention-to-treat basis at the 6-week endpoint. The trial is registered with ClinicalTrials.gov, NCT03630471. Findings Participants were enrolled between Aug 20, and Dec 4, 2018. 283 eligible adolescents were referred to the trial, and 251 (89%) of these were enrolled (mean age 15·61 years; 174 [69%] boys). 125 participants were allocated to each group (after accounting for one participant in the intervention group who withdrew consent after randomisation). Primary outcome data were available for 245 (98%) participants. At 6 weeks, the mean YTP scores were 3·52 (SD 2·66) in the intervention group and 4·60 (2·75) in the control group (adjusted mean difference –1·01, 95% CI –1·63 to –0·38; adjusted effect size 0·36, 95% CI 0·11 to 0·61; p=0·0015). The mean SDQ Total Difficulties scores were 17·48 (5·45) in the intervention group and 18·33 (5·45) in the control group (–0·86, –2·14 to 0·41; 0·16, –0·09 to 0·41; p=0·18). We observed no adverse events. Interpretation A brief lay counsellor-delivered problem-solving intervention combined with printed booklets seemed to have a modest effect on psychosocial outcomes among adolescents with diverse mental health problems compared with problem-solving booklets alone. This counsellor-delivered intervention might be a suitable first-line intervention in a stepped care approach, which is being evaluated in ongoing studies

Microbial exposure during early human development primes fetal immune cells

Human fetal immune system begins to develop early during gestation, however factors responsible for fetal immune-priming remain elusive. We explored potential exposure to microbial agents in-utero and their contribution towards activation of memory T cells in fetal tissues. We profiled microbes across fetal organs using 16S-rRNA gene sequencing and detected low but consistent microbial signal in fetal gut, skin, placenta and lungs, in 2nd trimester of gestation. We identified several live bacterial strains including Staphylococcus and Lactobacillus in fetal tissues, which induced in vitro activation of memory T cells in fetal mesenteric lymph-node, supporting the role of microbial exposure in fetal immune-priming. Finally, using SEM and RNA-ISH, we visualised discrete localisation of bacteria-like structures and eubacterial-RNA within 14th week fetal gut lumen. These findings indicate selective presence of live-microbes in fetal organs during 2nd trimester of gestation and have broader implications towards establishment of immune competency and priming before birt