Independent Evaluation of the Water and Sanitation Hibah Program Indonesia

This evaluation assess the effectiveness of Indonesia's Water and Sanitation Hibah Program pilot and identifies lessons for applying this mechanism more broadly. The program, which operates by paying an agreed amount for verified household water or sanitation service connections installed by local water and sanitation utilities, takes advantage of excess capacity of water companies to bypass the need for infrastructure investment. It was evaluated through a document review, key informant interviews, a key stakeholder workshop, field work, and a beneficiary survey, along with quantitative data from existing sources

Power up: patient and public involvement in developing a shared decision-making app for mental health

Background The importance of patient and public involvement (PPI) in designing interventions to support young people’s mental health is becoming a central tenet of the research process. Existing research has indicated that co-design with service users may help to engender multiple improvements in research projects, from design through to applications of study findings. Aims The aim of this study is to examine our experience of making the involvement of young people an ongoing part of the research process. We report on PPI in relation to a feasibility trial of the development of an app called Power Up, which is designed to support shared decision-making in mental health. Method Young people, carers, and clinicians were involved in each aspect of the project from governance, needs and environment analysis, to development and revisions of the Power Up smartphone app intended for use within child and adolescent mental health services. Involvement was achieved through ongoing contributions to steering groups, co-design workshops, and interviews. The project model was approached as a cyclical multidirectional process of ideas, PPI input, reflection, and alterations. Conclusion PPI was embedded into the project model from the outset, to be iterative and cyclical informing the development and direction of the digital tool at each stage. Involving service users resulted in the identification and implementation of multiple changes to the app, both conceptual and tangible. Several challenges associated with PPI were also encountered, warranting future research and discussion

A Feasibility Trial of Power Up: Smartphone App to Support Patient Activation and Shared Decision Making for Mental Health in Young People

Background: Digital tools have the potential to support patient activation and shared decision making in the face of increasing levels of mental health problems in young people. There is a need for feasibility trials of digital interventions to determine the usage and acceptability of interventions. In addition, there is a need to determine the ability to recruit and retain research participants to plan rigorous effectiveness trials and therefore, develop evidence-based recommendations for practice.Objective: To determine the feasibility of undertaking a cluster randomized control trial to test the effectiveness of a smartphone app, Power Up, co-designed with young people to support patient activation and shared decision making for mental health.Methods: Overall, 270 young people were screened for participation and 53% (N = 142) were recruited and completed baseline measures across eight specialist child mental health services (n = 62, mean (SD) age = 14.66 (1.99) years, 52% female) and two mainstream secondary schools (n = 80; mean (SD) age = 16.88 (0.68) years, 46% female). Young people received Power Up in addition to management as usual or received management as usual only. Post-trial interviews were conducted with 11 young people from the intervention arms (specialist services n = 6; schools n = 5).Results: Usage data showed that there were an estimated 50 (out of 64) users of Power Up in the intervention arms. Findings from the interviews indicated that young people found Power Up to be acceptable. Young people reported: 1) their motivation for use of Power Up, 2) the impact of use, and 3) barriers to use. Out of the 142 recruited participants, 45% (64/142) completed follow up measures, and the approaches to increase retention agreed by the steering group are discussed.Conclusions: The findings of the present research indicate that the app is acceptable and it is feasible to examine the effectiveness of Power Up in a prospective cluster randomized control trial

Reading for Charles Burchfield

Featuring poets who participated in the March 8th Heat Waves in a Swamp workshop

Viability of Travel-time Sensitivity Testing for Estimating Uncertainty of Tomographic Velocity Models: A Case Study

Seismic tomography is now a common approach to estimating velocity structure of the Earth, regardless of whether the data sources are earthquake recordings or controlled sources such as explosions, airguns or Vibroseis. Seismic tomography is convenient to implement because it requires little to no a priori knowledge of Earth structure and is much less time consuming than forward modeling schemes. Despite its convenience, the method still lacks satisfactory quantitative assessments of model reliability. Here we explore the viability of applying travel-time sensitivity testing that uses a modified Cauchy distribution as its statistical foundation to assessing the uncertainty in velocity models produced with seismic tomography. Using a crustal refraction survey as a test data set, we find that this approach produces a more realistic estimate of the velocity uncertainty than does either a resampling approach or travel-time sensitivity testing that uses a Gaussian distribution as its statistical foundation. The velocity uncertainty estimates provide an important complement to other estimates of model reliability including checkerboard tests

Using expert knowledge in solving the seismic inverse problem

For many practical applications, it it important to solve the seismic inverse problem, i.e., to measure seismic travel times and reconstruct velocities at different depths from this data. The existing algorithms for solving the seismic inverse problem often take too long and/or produce un-physical results – because they do not take into account the knowledge of geophysicist experts. In this paper, we analyze how expert knowledge can be used in solving the seismic inverse problem. Key words: seismic inverse problem, expert knowledg

Using Expert Knowledge in Solving the Seismic Inverse Problem

For many practical applications, it it important to solve the seismic inverse problem, i.e., to measure seismic travel times and reconstruct velocities at different depths from this data. The existing algorithms for solving the seismic inverse problem often take too long and/or produce un-physical results -- because they do not take into account the knowledge of geophysicist experts. In this paper, we analyze how expert knowledge can be used in solving the seismic inverse problem

Monte-carlo-type techniques for processing interval uncertainty, and their geophysical and engineering applications

To determine the geophysical structure of a region, we measure seismic travel times and reconstruct velocities at different depths from this data. There are several algorithms for solving this inverse problem, but these algorithms do not tell us how accurate these reconstructions are. Traditional approach to accuracy estimation assumes that the measurement errors are independently normally distributed. Problem: the resulting accuracies are not in line with geophysical intuition. Reason: a typical error is when we miss the first arrival of the seismic wave; it is not normal (bounded by the wave period ∆) and not independent. Typically, all we know is the upper bound ∆ on the measurement error, so when the measured value is ˜x, we conclude that x ∈ [˜x − ∆, ˜x + ∆]. For this interval uncertainty, the resulting velocity accuracy is, qualitatively, in much better accordance with geophysics. Interval uncertainty naturally appears in other applications as well. In this paper, we describe Monte-Carlo-Type techniques for processing interval uncertainty, and their geophysical and engineering applications

Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report

Peer reviewed: TrueAcknowledgements: The authors would like to thank Nicki Wharton, LCSW, the treating clinician on this case, for her collaboration and continued work on CAP. They would also like to acknowledge the patient for courageously sharing her life and treatment experiences.Background: A dissociative subtype of posttraumatic stress disorder, known as “D-PTSD”, has been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In addition to meeting criteria for PTSD, patients endorse prominent dissociative symptoms, namely depersonalization and derealization, or detachment from one's self and surroundings. At present, this population is supported by a highly heterogeneous and undeveloped literature. Targeted interventions are therefore lacking, and those indicated for PTSD are limited by poor efficacy, delayed onset of action, and low patient engagement. Here, we introduce cannabis-assisted psychotherapy (CAP) as a novel treatment for D-PTSD, drawing parallels to psychedelic therapy. Case presentation: A 28-year-old female presented with complex D-PTSD. In a naturalistic setting, she underwent 10 sessions of CAP, scheduled twice monthly over 5 months, coupled with integrative cognitive behavioral therapy. An autonomic and relational approach to CAP was leveraged, specifically psychedelic somatic interactional psychotherapy. Acute effects included oceanic boundlessness, ego dissolution, and emotional breakthrough. From baseline to post-treatment, the patient showed a 98.5% reduction in pathological dissociation, as measured by the Multidimensional Inventory of Dissociation, no longer meeting criteria for D-PTSD. This was accompanied by decreased cognitive distractibility and emotional suffering, as well as increased psychosocial functioning. Anecdotally, the patient has sustained improvements for over 2 years to date. Conclusions: There is urgency to identify treatments for D-PTSD. The present case, while inherently limited, underscores the potential of CAP as a therapeutic option, leading to robust and sustained improvement. Subjective effects were comparable to those produced by classic and non-classic psychedelics, such as psilocybin and ketamine. Further research is warranted to explore, establish, and optimize CAP in D-PTSD, and to characterize its role in the pharmacological landscape

Cannabis-assisted psychotherapy for complex dissociative posttraumatic stress disorder: A case report.

BackgroundA dissociative subtype of posttraumatic stress disorder, known as "D-PTSD", has been included in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. In addition to meeting criteria for PTSD, patients endorse prominent dissociative symptoms, namely depersonalization and derealization, or detachment from one's self and surroundings. At present, this population is supported by a highly heterogeneous and undeveloped literature. Targeted interventions are therefore lacking, and those indicated for PTSD are limited by poor efficacy, delayed onset of action, and low patient engagement. Here, we introduce cannabis-assisted psychotherapy (CAP) as a novel treatment for D-PTSD, drawing parallels to psychedelic therapy.Case presentationA 28-year-old female presented with complex D-PTSD. In a naturalistic setting, she underwent 10 sessions of CAP, scheduled twice monthly over 5 months, coupled with integrative cognitive behavioral therapy. An autonomic and relational approach to CAP was leveraged, specifically psychedelic somatic interactional psychotherapy. Acute effects included oceanic boundlessness, ego dissolution, and emotional breakthrough. From baseline to post-treatment, the patient showed a 98.5% reduction in pathological dissociation, as measured by the Multidimensional Inventory of Dissociation, no longer meeting criteria for D-PTSD. This was accompanied by decreased cognitive distractibility and emotional suffering, as well as increased psychosocial functioning. Anecdotally, the patient has sustained improvements for over 2 years to date.ConclusionsThere is urgency to identify treatments for D-PTSD. The present case, while inherently limited, underscores the potential of CAP as a therapeutic option, leading to robust and sustained improvement. Subjective effects were comparable to those produced by classic and non-classic psychedelics, such as psilocybin and ketamine. Further research is warranted to explore, establish, and optimize CAP in D-PTSD, and to characterize its role in the pharmacological landscape