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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
Exact 1/N and Optimized Perturbative Evaluation of mu_c for Homogeneous Interacting Bose Gases
In the framework of the O(N) three-dimensional effective scalar field model
for homogeneous dilute weakly interacting Bose gases we use the 1/N expansion
to evaluate, within the large N limit, the parameter r_c which is directly
related to the critical chemical potential mu_c. This quantity enters the
order-a^2 n^{2/3} coefficient contributing to the critical temperature shift
Delta T_c where a represents the s-wave scattering length and n represents the
density. Compared to the recent precise numerical lattice simulation results,
our calculation suggests that the large N approximation performs rather well
even for the physical case N=2. We then calculate the same quantity but using
different forms of the optimized perturbative (variational) method, showing
that these produce excellent results both for the finite N and large-N cases.Comment: 12 pages, 2 figures. We have performed a refined and extended
numerical analysis to take into account the very recent results of Ref. [15
Observing the build-up of the colour-magnitude relation at redshift ~0.8
We analyse the rest-frame (U-V) colour-magnitude relation for 2 clusters at
redshift 0.7 and 0.8, drawn from the ESO Distant Cluster Survey. By comparing
with the population of red galaxies in the Coma cluster, we show that the high
redshift clusters exhibit a deficit of passive faint red galaxies. Our results
show that the red-sequence population cannot be explained in terms of a
monolithic and synchronous formation scenario. A large fraction of faint
passive galaxies in clusters today has moved onto the red sequence relatively
recently as a consequence of the fact that their star formation activity has
come to an end at z<0.8.Comment: 5 pages, 2 figures, to appear in Proc. of IAU Colloq. 195: "Outskirts
of Galaxy Clusters: Intense Life in the Suburbs" -- minor typos correcte
The evolution of deep water mixing and weathering inputs in the central Atlantic Ocean over the past 33 Myr
The isotopic composition of Nd in present-day deep waters of the central and northeastern Atlantic Ocean is
thought to fingerprint mixing of North Atlantic Deep Water with Antarctic Bottom Water. The central Atlantic
Romanche and Vema Fracture Zones are considered the most important pathways for deep water exchange
between the western and eastern Atlantic basins today. We present new Nd isotope records of the deepwater
evolution in the fracture zones obtained from ferromanganese crusts, which are inconsistent with simple water
mass mixing alone prior to 3 Ma and require additional inputs from other sources. The new Pb isotope time
series from the fracture zones are inexplicable by simple mixing of North Atlantic Deep Water and Antarctic
Bottom Water for the entire past 33 Myr. The distinct and relatively invariable Nd and Pb isotope records of
deep waters in the fracture zones appear instead to have been controlled to a large extent by contributions from
Saharan dust and the Orinoco/Amazon Rivers. Thus the previously observed similarity of Nd and Pb isotope
time series from the western and eastern North Atlantic basins is better explainable by direct supply of Labrador
Seawater to the eastern basin via a northern pathway rather than by advection of North Atlantic Deep Water via
the Romanche and Vema Fracture Zones
Weak lensing mass reconstructions of the ESO Distant Cluster Survey
We present weak lensing mass reconstructions for the 20 high-redshift
clusters i n the ESO Distant Cluster Survey. The weak lensing analysis was
performed on deep, 3-color optical images taken with VLT/FORS2, using a
composite galaxy catalog with separate shape estimators measured in each
passband. We find that the EDisCS sample is composed primarily of clusters that
are less massive than t hose in current X-ray selected samples at similar
redshifts, but that all of the fields are likely to contain massive clusters
rather than superpositions of low mass groups. We find that 7 of the 20 fields
have additional massive structures which are not associated with the clusters
and which can affect the weak lensing mass determination. We compare the mass
measurements of the remaining 13 clusters with luminosity measurements from
cluster galaxies selected using photometric redshifts and find evidence of a
dependence of the cluster mass-to-light ratio with redshift. Finally we
determine the noise level in the shear measurements for the fields as a
function of exposure time and seeing and demonstrate that future ground-based
surveys which plan to perform deep optical imaging for use in weak lensing
measurements must achieve point-spread functions smaller than a median of 0.6"
FWHM.Comment: 35 pages, 24 figures, accepted to A&A, a version with better figure
resolution can be found at http://www.mpa-garching.mpg.de/ediscs/papers.htm
Stable chromium isotopic composition of meteorites and metal-silicate experiments: Implications for fractionation during core formation
We present new mass independent and mass dependent Cr isotope compositions for meteorites measured by double spike thermal ionisation mass spectrometry. Small differences in both mass independent 53Cr and 54Cr relative to the Bulk Silicate Earth are reported and are very similar to previously published values. Carbonaceous chondrites are characterised by an excess in 54Cr compared to ordinary and enstatite chondrites which make mass independent Cr isotopes a useful tool for distinguishing between meteoritic groups. Mass dependent stable Cr isotope compositions for the same samples are also reported. Carbonaceous and ordinary chondrites are identical within uncertainty with average ÎŽ53CrÎŽ53Cr values of â0.118±0.040â°â0.118±0.040â° and â0.143±0.074â°â0.143±0.074â° respectively. The heaviest isotope compositions are recorded by an enstatite chondrite and a CO carbonaceous chondrite, both of which have relatively reduced chemical compositions implying some stable Cr isotope fractionation related to redox processes in the circumstellar disk. The average ÎŽ53CrÎŽ53Cr values for chondrites are within error of the estimate for the Bulk Silicate Earth (BSE) also determined by double spiking. The lack of isotopic difference between chondritic material and the BSE provides evidence that Cr isotopes were not fractionated during core formation on Earth. A series of high-pressure experiments was also carried out to investigate stable Cr isotope fractionation between metal and silicate and no demonstrable fractionation was observed, consistent with our meteorites data. Mass dependent Cr isotope data for achondrites suggest that Cr isotopes are fractionated during magmatic differentiation and therefore further work is required to constrain the Cr isotopic compositions of the mantles of Vesta and Mars.
Fixed twist dynamics of SO(3) gauge theory
We perform a throughout study of 3+1 dim. SO(3) LGT for any fixed-twist
background. We concentrate in particular on the physically significant trivial
and 1-twist sectors. Introducing a Z(2) monopole chemical potential the 1st
order bulk transition is moved down in the strong coupling region and weakened
to 2nd order in the 4-dim Ising model universality class. In this extended
phase diagram we gain access to a confined phase in every fixed twist sector of
the theory. The Pisa disorder operator is employed together with the Polyakov
loop to study the confinement-deconfinement transition in each sector. Due to
the specific properties of both operators, most results can be used to gain
insight in the ergodic theory, where all twist sectors should be summed upon.
An explicit mapping of each fixed twist theory to effective positive plaquette
models with fixed twisted boundary conditions is applied to better establish
their properties in the different phases.Comment: 20 pages, 11 Figures. Minor changes in text and figures, to appear in
Eur.Phys.J.
Universality, vortices and confinement: modified SO(3) lattice gauge theory at non-zero temperature
We investigate the adjoint SU(2) lattice gauge theory in 3+1 dimensions with
the Wilson plaquette action modified by a Z(2) monopole suppression term. For
the zero-twist sector we report indications for the existence of a finite
temperature effect decoupled from the unphysical bulk transitions.Comment: 17 pages, 10 figures. Some figures and text added. To appear on Phys.
Rev.
Convergence of the Optimized Delta Expansion for the Connected Vacuum Amplitude: Zero Dimensions
Recent proofs of the convergence of the linear delta expansion in zero and in
one dimensions have been limited to the analogue of the vacuum generating
functional in field theory. In zero dimensions it was shown that with an
appropriate, -dependent, choice of an optimizing parameter \l, which is an
important feature of the method, the sequence of approximants tends to
with an error proportional to . In the present paper we
establish the convergence of the linear delta expansion for the connected
vacuum function . We show that with the same choice of \l the
corresponding sequence tends to with an error proportional to . The rate of convergence of the latter sequence is governed by
the positions of the zeros of .Comment: 20 pages, LaTeX, Imperial/TP/92-93/5
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