Randomised trials relevant to mental health conducted in low and middle-income countries: protocol for a survey of studies published in 1991, 1995 and 2000 and assessment of their relevance

BACKGROUND A substantial proportion of the psychiatric burden of disease falls on the world's poorest nations. Despite this, relatively little is known about the quality and content of clinical research undertaken in these countries, or the relevance of the interventions evaluated and specifically that of randomised trials. This project aims to survey the content, quality and accessibility of a sample of trials relevant to mental health conducted within low and middle-income countries; to compare these with studies conducted in high-income countries; and to assess their relevance for the needs of low and middle-income countries. METHODS An extensive search for all trials, or possible trials, published in 1991, 1995 and 2000 with participants in low and middle-income countries has already been conducted. Studies evaluating prevention or treatment of a mental health problem within these three years will be identified and further searches conducted to assess completeness of the initial search. Data on study quality and characteristics will be extracted from each report. Accessibility will be estimated based on whether each citation is available on MEDLINE. Trials relevant to schizophrenia will be compared with a random sample of schizophrenia trials from high-income countries in the same years. Topics covered by the trials will be compared with the estimated burden of disease. CONCLUSION Trials and systematic reviews of trials are the gold standard of evaluation of care and increasingly provide the basis for recommendations to clinicians, to providers of care and to policy makers. Results from this study will present the first assessment of the scope, quality and accessibility of mental health trials in low and middle-income countries

Ubiquitous Internet in an integrated satellite-terrestrial environment: The SUITED solution

yesThe current Internet architecture appears to not be particularly suited to addressing the emerging needs of new classes of users who wish to gain access to multimedia services made available by ISPs, regardless of their location, while in motion and with a guaranteed level of quality. One of the main objectives of so-called nextgeneration systems is to overcome the limitations of today¿s available Internet by adopting an approach based on the integration of different mobile and fixed networks. The SUITED project moves in this direction since it aims at contributing to the design and deployment of the global mobile broadband system (GMBS), a unique satellite/terrestrial infrastructure ensuring nomadic users access to Internet services with a negotiated QoS. A description of the main features of the GMBS architecture, characterized by the integration of a multisegment access network with a federated ISP network is given in this article. The GMBS multimode terminal is schematically described, and an overview of the so-called QoS-aware mobility management scheme, devised for such a heterogeneous scenario,is provided

A bottom-up definition of self-sufficiency: Voices from low-income jobseekers.

Self-sufficiency (SS) is the epitome of America’s ‘reluctant’welfare state. It is generally accepted in social welfare policycircles as a concept related to independence and financialstability. Nevertheless, SS is not a term agreed upon inpractice by policymakers, researchers, or service providersand is frequently used without a clear common definition.In this sense, the purpose of this study is to explore the extentto which the top-down definition of ‘economic’ SS as thesocial policy goal is consistent with how the clients of job training programs perceive the term. Using a groundedtheory approach, a bottom-up definition of SS was derivedfrom a focus group of low-income jobseekers. The focusgroup was transcribed for a content analysis from which a client-centered definition of SS was drawn. Findings suggestthat SS is a process of developing psychological strength properties and a goal-oriented progression toward realistic financial outcomes.Implications for evidence-based community interventions for client empowerment and workforce development are suggested

An experimental and modelling study of dual fuel aqueous ammonia and diesel combustion in a single cylinder compression ignition engine

The ability of ammonia to act as a hydrogen carrier, without the drawbacks of hydrogen gas-storage costs and low stability-renders it a potential solution to the decarbonisation of transport. This study combines both modelling and experimental techniques to determine the effect of varying the degree of aspiration of ammonium hydroxide (NH4OH) solution, at different engine loads, in the combustion of a compression ignition engine. Ignition delay was extended as ammonia injection increased, causing an increase in peak in-cylinder temperature, but generally lower combustion quality-increasing incomplete combustion products, while decreasing particle size. The higher peak in-cylinder temperatures generally correlated with a higher nitrous oxide (NOx) emissions in the exhaust, though fuel-bound nitrogen effect was apparent. Chemical kinetic modelling at equivalent conditions found increasing levels of unburnt ammonia with greater aspiration. Moreover, the ignitability of NH4OH was found to improve in simulations substituting diesel with hydrogen peroxide direct injection

The future cost of cancer in South Africa: An interdisciplinary cost management strategy

The exponential rise in cancer costs in South Africa (SA) was illustrated in a recent Sunday Times article entitled ‘The cost of cancer can be a debt sentence’.[1] Our minister of health talks of a ‘war’ against the high costs of cancer drugs, and epidemiologists project a sharply rising incidence. Eminent international medical journals, such as The Lancet, underline the fact that cancer cost is a growing international problem that confronts even the richest countries. Indeed, the question may be posed: if richer countries in the world are battling to cover the costs of cancer, what is the prognosis for SA

Error management theory and the adaptive significance of transgenerational maternal-stress effects on offspring phenotype

It is well established that circulating maternal stress hormones (glucocorticoids, GCs) can alter offspring phenotype. There is also a growing body of empirical work, within ecology and evolution, indicating that maternal GCs link the environment experienced by the mother during gestation with changes in offspring phenotype. These changes are considered to be adaptive if the maternal environment matches the offspring\u27s environment and maladaptive if it does not. While these ideas are conceptually sound, we lack a testable framework that can be used to investigate the fitness costs and benefits of altered offspring phenotypes across relevant future environments. We present error management theory as the foundation for a framework that can be used to assess the adaptive potential of maternal stress hormones on offspring phenotype across relevant postnatal scenarios. To encourage rigorous testing of our framework, we provide field-testable hypotheses regarding the potential adaptive role of maternal stress across a diverse array of taxa and life histories, as well as suggestions regarding how our framework might provide insight into past, present, and future research. This perspective provides an informed lens through which to design and interpret experiments on the effects of maternal stress, provides a framework for predicting and testing variation in maternal stress across and within taxa, and also highlights how rapid environmental change that induces maternal stress may lead to evolutionary traps

Error management theory and the adaptive significance of transgenerational maternal‐stress effects on offspring phenotype

It is well established that circulating maternal stress hormones (glucocorticoids, GCs) can alter offspring phenotype. There is also a growing body of empirical work, within ecology and evolution, indicating that maternal GCs link the environment experienced by the mother during gestation with changes in offspring phenotype. These changes are considered to be adaptive if the maternal environment matches the offspring’s environment and maladaptive if it does not. While these ideas are conceptually sound, we lack a testable framework that can be used to investigate the fitness costs and benefits of altered offspring phenotypes across relevant future environments. We present error management theory as the foundation for a framework that can be used to assess the adaptive potential of maternal stress hormones on offspring phenotype across relevant postnatal scenarios. To encourage rigorous testing of our framework, we provide field‐testable hypotheses regarding the potential adaptive role of maternal stress across a diverse array of taxa and life histories, as well as suggestions regarding how our framework might provide insight into past, present, and future research. This perspective provides an informed lens through which to design and interpret experiments on the effects of maternal stress, provides a framework for predicting and testing variation in maternal stress across and within taxa, and also highlights how rapid environmental change that induces maternal stress may lead to evolutionary traps.This article provides a quantitative framework as a means of generating field‐testable hypotheses regarding the adaptive potential of maternal stress under different scenario combinations. By providing a mechanistic basis for examining the adaptive potential of maternal stress effects, our overall aim is not only to provide a means for explaining patterns and testing new hypotheses, but to catalyze the study of maternal stress effects under this framework across a diversity of species, life histories, and environments.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/145404/1/ece34074_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/145404/2/ece34074.pd

Error management theory and the adaptive significance of transgenerational maternal-stress effects on offspring phenotype

It is well established that circulating maternal stress hormones (glucocorticoids, GCs) can alter offspring phenotype. There is also a growing body of empirical work, within ecology and evolution, indicating that maternal GCs link the environment experienced by the mother during gestation with changes in offspring phenotype. These changes are considered to be adaptive if the maternal environment matches the offspring\u27s environment and maladaptive if it does not. While these ideas are conceptually sound, we lack a testable framework that can be used to investigate the fitness costs and benefits of altered offspring phenotypes across relevant future environments. We present error management theory as the foundation for a framework that can be used to assess the adaptive potential of maternal stress hormones on offspring phenotype across relevant postnatal scenarios. To encourage rigorous testing of our framework, we provide field-testable hypotheses regarding the potential adaptive role of maternal stress across a diverse array of taxa and life histories, as well as suggestions regarding how our framework might provide insight into past, present, and future research. This perspective provides an informed lens through which to design and interpret experiments on the effects of maternal stress, provides a framework for predicting and testing variation in maternal stress across and within taxa, and also highlights how rapid environmental change that induces maternal stress may lead to evolutionary traps