Mental health conceptualization and resilience factors in the Kalasha youth: an indigenous ethnic and religious minority community in Pakistan

The Kalasha are a religious, ethnic, and linguistic minority community in Pakistan. They are indigenous people living in remote valleys of the Hindu Kush Mountains in northern Pakistan, neighboring Afghanistan. The Kalasha are pastoral, as well as agricultural people to some extent, although they are increasingly facing pressures from globalization and social change, which may be influencing youth and community development. Their traditional world view dichotomizes and emphasizes on the division of the pure (Onjeshta) and the impure (Pragata). There remains a scarcity of literature on mental health and resilience of indigenous communities in South Asia and Pakistan generally, and the polytheistic Kalasha community specifically. Thus, the current study was conducted with the aim to explore the cultural protective factors (resilience) of the Kalasha youth (adolescents and emerging adults) and to explore their perceived etiological understandings and preferred interventions for mental health support systems. The theoretical framework of Bronfenbrenner's (1, 2) ecological systems model was used. Interpretative Phenomenological Analysis (IPA) was conducted, considering the advantage of its idiographic approach and the “double hermeneutic” analytic process. This methodology was consistent with the aim to understand and make sense of mental health and resilience from the Kalasha indigenous perspective. A total of 12 in-depth interviews were conducted with adolescents and emerging adults (5 males, 7 females), along with ethnographic observations. The analysis revealed 3 superordinate themes of mental health perceptions and interventions, each with more specific emergent themes: (1) Psychological Resilience/Cultural Protective Factors Buffering Against Mental Health Problems (Intra-Communal Bonding & Sharing; Kalasha Festivals & Traditions; Purity Concept; Behavioral Practice of Happiness and Cognitive Patterns); (2) Perceived Causes of Mental Health Issues (Biological & Psychosocial; Supernatural & Spiritual; Environmental); and (3) Preferred Interventions [Shamanic Treatment; Ta'awiz (Amulets); Communal Sharing & Problem Solving; Medical Treatment; Herbal Methods]. The overall findings point to the need for developing culturally-sensitive and indigenous measures and therapeutic interventions. The findings highlighted the Kalasha cultural practices which may promote resilience. The findings also call for indigenous sources of knowledge to be considered when collaboratively designing public health programs

Effect of White Matter Stimulation on Clinical Outcomes in Deep Brain Stimulation for Neurological Movement Disorders

Introduction Neuromodulation is the altering of neural activity using external mechanisms, including but not limited to electrical stimulation and chemical agents. Deep brain stimulation (DBS) is a type of neuromodulation that is largely used to treat movement disorders, such as Parkinson disease (PD) and essential tremor. Recent DBS research has also showed promising results in neuropsychological disorders, such as treatment-resistant depression. The DBS treatment procedure involves implanting electrodes in a region of the brain associated with a particular condition that is producing abnormal signals to apply electrical pulses which essentially overwrite the pathological neural activity. The success of the DBS treatment is highly dependent upon the precision in the placement of the electrodes in the brain and the parameters of stimulation settings, including frequency, amplitude, and pulse width. The traditional DBS target for PD patients is subthalamic nucleus (STN), a gray matter (GM) structure. However, some white matter (WM) structures, such as hyperdirect pathway (HDP) and dentatorubrothalamic tract (DRT), have been proposed as alternatives. Objective The objective of the present study is to investigate the effect of WM stimulation for STN DBS treatment of PD patients by determining what proportion of WM activation is associated with therapeutic stimulation. Approach In this study, the motor symptom improvement of PD patients who underwent STN DBS treatment was clinically determined using the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). The internal capsule (IC) and STN voxels are known; however, the volume of tissue activation (VTA) voxels that are non-STN and non-IC are unknown. Therefore, a novel classification algorithm that can differentiate WM and GM voxels of patient specific volumes of tissue activation (VTAs) was developed. The relationship between the amount of WM within therapeutic VTAs and overall motor symptom improvement in PD patients was investigated. Results The WM/GM classification algorithm was able to distinguish WM and GM voxels of patient specific therapeutic VTAs at an approximately 84.5% accuracy rate. Using the classification algorithm, the proportion of WM activation that is associated with therapeutic stimulation was calculated. Increase in WM activation had no significant effect on the overall clinical motor symptom improvement for PD patients. Significance The techniques used in this study are applicable to model other target sites which are composed of WM and GM. Hence, such a framework could be used to better characterize stimulation in the brain in regards to therapeutic and side effects associated with DBS

Implementation Of Web Usage Mining Using Log Markup Language (LOGML) and Closed Association Rule Mining Algorithm (CHARM)

Web usage mining is the discovery of useraccess patterns from Web usage logs. The paperpresents two XML (Extensible Markup Language) 1.0applications and a web data mining applicationwhich utilizes it to extract web data from web logfiles. The two XML 1.0 applications are: LOGML(Log Markup Language) is a web-log reportdescription language and XGMML (ExtensibleGraph Markup and Modeling Language) is a graphdescription language. As a case study, the systemimplements a sample website for web graphinformation and usage information. The main goal ofthis paper is that web graph information transformsto XGMML document and then this graphinformation and cleaned usage information offinished user sessions transforms to LOGMLdocument. The next goal is that these cleaned datawith LOGML document are mined with CHARM(Closed Association Rule Mining) algorithm toimplement the most frequently accessed pages fromone site. CHARM is an efficient algorithm for miningall closed frequent itemsets (set of all subsets ofitems)

Burden of Chikungunya Virus Infection during an Outbreak in Myanmar

Chikungunya virus (CHIKV) infection is a re-emerging arboviral disease with no approved vaccine, although numerous options are in development. Before vaccine implementation, disease burden, affected age group, and hospitalization rate information should be documented. In 2019, a sizeable outbreak of the East Central South African genotype of CHIKV occurred in Myanmar, and during this period, a cross-sectional study was conducted in two regions, Mandalay and Yangon, to examine the molecular and seropositivity rate of the CHIKV infection. The participants (1124) included dengue-suspected pediatric patients, blood donors, and healthy volunteers, who were assessed using molecular assays (quantitative real-time RT-PCR), serological tests (anti-CHIKV IgM capture and IgG indirect enzyme-linked immunosorbent assays), and neutralization tests. The tests confirmed the following positivity rates: 11.3% (127/1124) for the molecular assay, 12.4% (139/1124) for the anti-CHIKV IgM Ab, 44.5% (500/1124) for the anti-CHIKV IgG Ab, and 46.3% (520/1124) for the CHIKV neutralizing Ab. The highest rate for the molecular test occurred with the dengue-suspected pediatric patients. The seroprevalence rate through natural infection was higher in the healthy volunteers and blood donors than that in the pediatric patients. The results of this study will help stakeholders determine the criteria for choosing appropriate recipients when a CHIKV vaccine is introduced in Myanmar