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Developing a scalable training model in global mental health: pilot study of a video-assisted training Program for Generalist Clinicians in Rural Nepal.
BackgroundIn low- and middle-income countries, mental health training often includes sending few generalist clinicians to specialist-led programs for several weeks. Our objective is to develop and test a video-assisted training model addressing the shortcomings of traditional programs that affect scalability: failing to train all clinicians, disrupting clinical services, and depending on specialists.MethodsWe implemented the program -video lectures and on-site skills training- for all clinicians at a rural Nepali hospital. We used Wilcoxon signed-rank tests to evaluate pre- and post-test change in knowledge (diagnostic criteria, differential diagnosis, and appropriate treatment). We used a series of 'Yes' or 'No' questions to assess attitudes about mental illness, and utilized exact McNemar's test to analyze the proportions of participants who held a specific belief before and after the training. We assessed acceptability and feasibility through key informant interviews and structured feedback.ResultsFor each topic except depression, there was a statistically significant increase (Î) in median scores on knowledge questionnaires: Acute Stress Reaction (Î = 20, p = 0.03), Depression (Î = 11, p = 0.12), Grief (Î = 40, p < 0.01), Psychosis (Î = 22, p = 0.01), and post-traumatic stress disorder (Î = 20, p = 0.01). The training received high ratings; key informants shared examples and views about the training's positive impact and complementary nature of the program's components.ConclusionVideo lectures and on-site skills training can address the limitations of a conventional training model while being acceptable, feasible, and impactful toward improving knowledge and attitudes of the participants
Compactification on negatively curved manifolds
We show that string/M theory compactifications to maximally symmetric
space-times using manifolds whose scalar curvature is everywhere negative, must
have significant warping, large stringy corrections, or both.Comment: 18 pages, JHEP3.cl
Stabilizing All Kahler Moduli in Type IIB Orientifolds
We describe a simple and robust mechanism that stabilizes all Kahler moduli
in Type IIB orientifold compactifications. This is shown to be possible with
just one non-perturbative contribution to the superpotential coming from either
a D3-instanton or D7-branes wrapped on an ample divisor. This
moduli-stabilization mechanism is similar to and motivated by the one used in
the fluxless G_2 compactifications of M-theory. After explaining the general
idea, explicit examples of Calabi-Yau orientifolds with one and three Kahler
moduli are worked out. We find that the stabilized volumes of all two- and
four-cycles as well as the volume of the Calabi-Yau manifold are controlled by
a single parameter, namely, the volume of the ample divisor. This feature would
dramatically constrain any realistic models of particle physics embedded into
such compactifications. Broad consequences for phenomenology are discussed, in
particular the dynamical solution to the strong CP-problem within the
framework.Comment: RevTeX, 24 pages, 2 tables, 1 figure
The problematic backreaction of SUSY-breaking branes
In this paper we investigate the localisation of SUSY-breaking branes which,
in the smeared approximation, support specific non-BPS vacua. We show, for a
wide class of boundary conditions, that there is no flux vacuum when the branes
are described by a genuine delta-function. Even more, we find that the smeared
solution is the unique solution with a regular brane profile. Our setup
consists of a non-BPS AdS_7 solution in massive IIA supergravity with smeared
anti-D6-branes and fluxes T-dual to ISD fluxes in IIB supergravity.Comment: 27 pages, Latex2e, 5 figure
Classical kinetic energy, quantum fluctuation terms and kinetic-energy functionals
We employ a recently formulated dequantization procedure to obtain an exact
expression for the kinetic energy which is applicable to all kinetic-energy
functionals. We express the kinetic energy of an N-electron system as the sum
of an N-electron classical kinetic energy and an N-electron purely quantum
kinetic energy arising from the quantum fluctuations that turn the classical
momentum into the quantum momentum. This leads to an interesting analogy with
Nelson's stochastic approach to quantum mechanics, which we use to conceptually
clarify the physical nature of part of the kinetic-energy functional in terms
of statistical fluctuations and in direct correspondence with Fisher
Information Theory. We show that the N-electron purely quantum kinetic energy
can be written as the sum of the (one-electron) Weizsacker term and an
(N-1)-electron kinetic correlation term. We further show that the Weizsacker
term results from local fluctuations while the kinetic correlation term results
from the nonlocal fluctuations. For one-electron orbitals (where kinetic
correlation is neglected) we obtain an exact (albeit impractical) expression
for the noninteracting kinetic energy as the sum of the classical kinetic
energy and the Weizsacker term. The classical kinetic energy is seen to be
explicitly dependent on the electron phase and this has implications for the
development of accurate orbital-free kinetic-energy functionals. Also, there is
a direct connection between the classical kinetic energy and the angular
momentum and, across a row of the periodic table, the classical kinetic energy
component of the noninteracting kinetic energy generally increases as Z
increases.Comment: 10 pages, 1 figure. To appear in Theor Chem Ac
Electroweak Baryogenesis and Dark Matter with an approximate R-symmetry
It is well known that R-symmetric models dramatically alleviate the SUSY
flavor and CP problems. We study particular modifications of existing
R-symmetric models which share the solution to the above problems, and have
interesting consequences for electroweak baryogenesis and the Dark Matter (DM)
content of the universe. In particular, we find that it is naturally possible
to have a strongly first-order electroweak phase transition while
simultaneously relaxing the tension with EDM experiments. The R-symmetry (and
its small breaking) implies that the gauginos (and the neutralino LSP) are
pseudo-Dirac fermions, which is relevant for both baryogenesis and DM. The
singlet superpartner of the U(1)_Y pseudo-Dirac gaugino plays a prominent role
in making the electroweak phase transition strongly first-order. The
pseudo-Dirac nature of the LSP allows it to behave similarly to a Dirac
particle during freeze-out, but like a Majorana particle for annihilation today
and in scattering against nuclei, thus being consistent with current
constraints. Assuming a standard cosmology, it is possible to simultaneously
have a strongly first-order phase transition conducive to baryogenesis and have
the LSP provide the full DM relic abundance, in part of the allowed parameter
space. However, other possibilities for DM also exist, which are discussed. It
is expected that upcoming direct DM searches as well as neutrino signals from
DM annihilation in the Sun will be sensitive to this class of models.
Interesting collider and Gravity-wave signals are also briefly discussed.Comment: 50 pages, 10 figure
Moduli Stabilization and Cosmology of Type IIB on SU(2)-Structure Orientifolds
We consider type IIB flux compactifications on six-dimensional
SU(2)-structure manifolds with O5- and O7-planes. These six-dimensional spaces
allow not only for F_3 and H_3 fluxes but also for F_1 and F_5 fluxes. We
derive the four-dimensional N=1 scalar potential for such compactifications and
present one explicit example of a fully stabilized AdS vacuum with large volume
and small string coupling. We then discuss cosmological aspects of these
compactifications and derive several no-go theorems that forbid dS vacua and
slow-roll inflation under certain conditions. We also study concrete examples
of cosets and twisted tori and find that our no-go theorems forbid dS vacua and
slow-roll inflation in all but one of them. For the latter we find a dS
critical point with \epsilon numerically zero. However, the point has two
tachyons and eta-parameter \eta \approx -3.1.Comment: 35 pages + appendices, LaTeX2e; v2: numerical dS extremum added,
typos corrected, references adde
Dark Radiation and Dark Matter in Large Volume Compactifications
We argue that dark radiation is naturally generated from the decay of the
overall volume modulus in the LARGE volume scenario. We consider both
sequestered and non-sequestered cases, and find that the axionic superpartner
of the modulus is produced by the modulus decay and it can account for the dark
radiation suggested by observations, while the modulus decay through the
Giudice-Masiero term gives the dominant contribution to the total decay rate.
In the sequestered case, the lightest supersymmetric particles produced by the
modulus decay can naturally account for the observed dark matter density. In
the non-sequestered case, on the other hand, the supersymmetric particles are
not produced by the modulus decay, since the soft masses are of order the heavy
gravitino mass. The QCD axion will then be a plausible dark matter candidate.Comment: 27 pages, 4 figures; version 3: version published in JHE
Catastrophic health expenditure among industrial workers in a large-scale industry in Nepal, 2017: a cross-sectional study
Objectives The study aimed at estimating out-of-pocket (OOP) expenditure, catastrophic health expenditure (CHE) and distress financing due to hospitalisation and outpatient care among industrial workers in Eastern Nepal. Methods We conducted a cross-sectional study involving industrial workers employed in a large-scale industry in Eastern Nepal. Those who were hospitalised in the last 1âyear or availed outpatient care within the last 30 days were administered a structured questionnaire to estimate the cost of illness. CHE was defined as expenditure more than 20% of annual household income. Distress financing was defined as borrowing money/loan or selling assets to cope with OOP expenditure on health. Results Of 1824 workers eligible for the study, 1405 (77%) were screened, of which 85 (6%) were hospitalised last year; 223 (16%) attended outpatient department last month. The median (IQR) OOP expenditure from hospitalisation and outpatient care was US36 (19â61), respectively. Among those hospitalised, the prevalence of CHE and distress financing was found to be 13% and 42%, respectively, and due to outpatient care was 0.4% and 42%, respectively. Drugs and diagnostics account for a large share of direct costs in both public and private sectors. More than 80% sought hospitalisation and outpatient care in a private sector. Conclusion Industrial workers face significant financial risks due to ill health compared with the general population. Poor utilisation and higher cost of care in public health facilities warrant strengthening of public sector through increased government spending. The labour act 2014 of Nepal should be strictly adhered
Study of ZÎł events and limits on anomalous ZZÎł and Zγγ couplings in ppÌ collisions at s=1.96TeV
We present a measurement of the ZÎł production cross section and limits on anomalous ZZÎł and Zγγ couplings for form-factor scales of Î=750 and 1000 GeV. The measurement is based on 138 (152) candidates in the eeÎł (ÎŒÎŒÎł) final state using 320(290)pb-1 of ppÌ collisions at s=1.96TeV. The 95% C.L. limits on real and imaginary parts of individual anomalous couplings are |h10,30Z|<0.23, |h20,40Z|<0.020, |h10,30Îł|<0.23, and |h20,40Îł|<0.019 for Î=1000GeV. © 2005 The American Physical Society
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