Tension and Other Idioms of Distress Among Slum Dwelling Young Men: A Qualitative Study of Depression in Urban Bangladesh.

In low- and middle-income countries (LMIC) it is vital to understand acceptable, comprehensive, and culturally appropriate ways of communicating about mental distress. Diagnostic terminology is rarely used, may be stigmatizing, and is subject to misinterpretation. Local terms, such as idioms of distress, can improve mental health literacy and service delivery. Our objective was to examine lived experience and coping connected to distress and depression in an under-researched population: young men from LMIC urban slums. We conducted 60 qualitative interviews with men (ages 18–29) in Bhashantek slum, Bangladesh. Themes were generated using thematic analysis and grounded theory techniques. The heart-mind (mon), mentality (manoshikota), mood (mejaj), head (matha or “brain”), and body (shorir) comprised the self-concept, and were related to sadness, hopelessness, anger, worry, and mental illness. The English word “tension” was the central idiom of distress. “Tension” existed on a continuum, from mild distress or motivational anxiety, to moderate distress including rumination and somatic complaints, to severe psychopathology including anhedonia and suicidality. Respondents connected “tension” to burnout experiences and mental illness which was summarized in an ethnopsychological model. These findings can inform culturally sensitive measurement tools and interventions that are acceptable to the community, potentially increasing engagement and enhancing therapeutic outcomes

Sedimentary facies, depositional environments and conceptual outcrop analogue (Dam Formation, early Miocene) Eastern Arabian Platform, Saudi Arabia: a new high-resolution approach

Abstract This paper presents the facies and depositional environment of the early Miocene Dam Formation, Eastern Arabian platform, Saudi Arabia. Deposition of Dam Formation (Fm.) was considered as a restricted shallow marine deposition. Few studies suggest the role of sea-level change in its deposition but were without decisive substantiation. Here, we describe the facies and high-resolution model of Dam Fm. under varying depositional conditions. The depositional conditions were subjected to changing relative sea level and tectonics. High-resolution outcrop photographs, sedimentological logs, and thin sections present that the mixed carbonate–siliciclastic sequence was affected by a regional tectonics. The lower part of Dam Fm. presents the development of carbonate ramp conditions that are represented by limestones and marl. The depositional conditions fluctuated with the fall of sea level, and uplift in the region pushed the siliciclastic down-dip and covered the whole platform. The subsequent rise in sea level was not as pronounced and thus allowed the deposition of microbial laminites and stromatolitic facies. The southeast outcrops, down-dip, are more carbonate prone as compared to the northwest outcrop, which allowed the deposition of siliciclastic-prone sedimentation up-dip. All facies, architecture, heterogeneity, and deposition were controlled by tectonic events including uplift, subsidence, tilting, and syn-sedimentary faulting, consequently affecting relative sea level. The resulting conceptual outcrop model would help to improve our understanding of mixed carbonate–siliciclastic systems and serve as an analogue for other stratigraphic units in the Arabian plate and region. Our results show that Dam Fm. can be a good target for exploration in the Northern Arabian Gulf

A distress-continuum, disorder-threshold model of depression: a mixed-methods, latent class analysis study of slum-dwelling young men in Bangladesh.

BACKGROUND: Binary categorical approaches to diagnosing depression have been widely criticized due to clinical limitations and potential negative consequences. In place of such categorical models of depression, a ‘staged model’ has recently been proposed to classify populations into four tiers according to severity of symptoms: ‘Wellness;’ ‘Distress;’ ‘Disorder;’ and ‘Refractory.’ However, empirical approaches to deriving this model are limited, especially with populations in low- and middle-income countries. METHODS: A mixed-methods study using latent class analysis (LCA) was conducted to empirically test non-binary models to determine the application of LCA to derive the ‘staged model’ of depression. The study population was 18 to 29-year-old men (n = 824) from an urban slum of Bangladesh, a low resource country in South Asia. Subsequently, qualitative interviews (n = 60) were conducted with members of each latent class to understand experiential differences among class members. RESULTS: The LCA derived 3 latent classes: (1) Severely distressed (n = 211), (2) Distressed (n = 329), and (3) Wellness (n = 284). Across the classes, some symptoms followed a continuum of severity: ‘levels of strain’, ‘difficulty making decisions’, and ‘inability to overcome difficulties.’ However, more severe symptoms such as ‘anhedonia’, ‘concentration issues’, and ‘inability to face problems’ only emerged in the severely distressed class. Qualitatively, groups were distinguished by severity of tension, a local idiom of distress. CONCLUSIONS: The results indicate that LCA can be a useful empirical tool to inform the ‘staged model’ of depression. In the findings, a subset of distress symptoms was continuously distributed, but other acute symptoms were only present in the class with the highest distress severity. This suggests a distress-continuum, disorder-threshold model of depression, wherein a constellation of impairing symptoms emerge together after exceeding a high level of distress, i.e., a tipping point of tension heralds a host of depression symptoms

Therapeutics discovery: From bench to first in-human trials

The ‘Therapeutics discovery: From bench to first in-human trials’ conference, held at the King Abdullah International Medical Research Center (KAIMRC), Ministry of National Guard Health Affairs (MNGHA), Kingdom of Saudi Arabia (KSA) from October 10-12, 2017, provided a unique opportunity for experts worldwide to discuss advances in drug discovery and development, focusing on phase I clinical trials. It was the first event of its kind to be hosted at the new research center, which was constructed to boost drug discovery and development in the KSA in collaboration with institutions, such as the Academic Drug Discovery Consortium in the United States of America (USA), Structural Genomics Consortium of the University of Oxford in the United Kingdom (UK), and Institute of Materia Medica of the Chinese Academy of Medical Sciences in China. The program was divided into two parts. A pre‑symposium day took place on October 10, during which courses were conducted on clinical trials, preclinical drug discovery, molecular biology and nanofiber research. The attendees had the opportunity for one-to-one meetings with international experts to exchange information and foster collaborations. In the second part of the conference, which took place on October 11 and 12, the clinical trials pipeline, design and recruitment of volunteers, and economic impact of clinical trials were discussed. The Saudi Food and Drug Administration presented the regulations governing clinical trials in the KSA. The process of preclinical drug discovery from small molecules, cellular and immunologic therapies, and approaches to identifying new targets were also presented. The recommendation of the conference was that researchers in the KSA must invest more fund, talents and infrastructure to lead the region in phase I clinical trials and preclinical drug discovery. Diseases affecting the local population, such as Middle East Respiratory Syndrome and resistant bacterial infections, represent the optimal starting point