Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates (vol 13, pg 8, 2017)

Originally published in Biomedical Optics Express on 01 March 2014 (boe-5-3-907

Relationship Between Self-Reported Lifestyle Habits, Social Support, and Physiological Factors Associated with Hypertension : A Biopsychosocial Investigation

The relationship between hypertension and related biological, psychological, and social variables among patients diagnosed with hypertension was investigated utilizing the biopsychosocial model. Fifty-four participants from one outpatient private medical office were administered a demographic form, the Beck Anxiety Inventory (BAI), the Health Adherence Behavior Inventory (HABIT), the Inventory for Cognitive Distortions (ICD), and the Multidimensional Scale of Perceived Social Support (MSPSS). Results indicated that the participants\u27 use of caffeine positively correlated with their high blood pressure readings. In addition, participants who reported having significant social support engaged in more health promoting behaviors. These findings were consistent with the hypotheses. Limitations of this research and directions for further research are discussed. These findings may have indications for primary care physicians, as they may better understand factors related to hypertension

Energy Aware Deep Reinforcement Learning Scheduling for Sensors Correlated in Time and Space

Millions of battery-powered sensors deployed for monitoring purposes in a multitude of scenarios, e.g., agriculture, smart cities, industry, etc., require energy-efficient solutions to prolong their lifetime. When these sensors observe a phenomenon distributed in space and evolving in time, it is expected that collected observations will be correlated in time and space. In this paper, we propose a Deep Reinforcement Learning (DRL) based scheduling mechanism capable of taking advantage of correlated information. We design our solution using the Deep Deterministic Policy Gradient (DDPG) algorithm. The proposed mechanism is capable of determining the frequency with which sensors should transmit their updates, to ensure accurate collection of observations, while simultaneously considering the energy available. To evaluate our scheduling mechanism, we use multiple datasets containing environmental observations obtained in multiple real deployments. The real observations enable us to model the environment with which the mechanism interacts as realistically as possible. We show that our solution can significantly extend the sensors' lifetime. We compare our mechanism to an idealized, all-knowing scheduler to demonstrate that its performance is near-optimal. Additionally, we highlight the unique feature of our design, energy-awareness, by displaying the impact of sensors' energy levels on the frequency of updates

Evaluating effectiveness and cost-effectiveness of a group psychological intervention using cognitive behavioural strategies for women with common mental disorders in conflict-affected rural Pakistan: study protocol for a randomised controlled trial

The impact of humanitarian disasters upon mental health is well recognised. The evidence for psychological interventions for mental health is mounting, but few interventions have been rigorously tested in humanitarian settings. To be sustainable in humanitarian settings interventions need to be short, simple, deliverable by nonspecialists under supervision, and adopt a transdiagnostic approach where an array of mental health outcomes are addressed simultaneously. These elements have been incorporated into the newly developed WHO Problem Management Plus (PM+) Group intervention. The aim of this trial is to evaluate the locally adapted PM+ Group intervention for women in Swat, Pakistan. This PM+ Group trial is a two-arm, single-blind, cluster randomised controlled trial conducted in a community-based setting with women in rural Pakistan. PM+ is delivered in partnership with the Lady Health Worker (LHW) Programme which provides community-based health care to women in Pakistan. Thirty-four LHW clusters will be randomised in a 1:1 allocation ratio using a permuted-block randomisation method. Participants screened and found to meet the inclusion criteria will be allocated to either the PM+ intervention group (n = 306), or the control arm (n = 306). The manualised PM+ intervention involves five sessions, each lasting 3 h, and introduces four strategies applied by participants to problems that they are facing. It is delivered by local female facilitators with a minimum of 16 years of education who are provided with targeted training and supervision. The primary outcome is individual psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale at 20 weeks after baseline. Secondary outcomes include major depression, post-traumatic stress disorder, levels of social support, levels of functioning, and economic effectiveness. Intervention acceptability will be explored through an embedded qualitative study. The PM+ Group trial will provide important evidence on the effectiveness of an empirically supported psychological treatment delivered by nonspecialists in a humanitarian setting. If proven effective, the qualitative component will inform strategies for PM+ Group scale-up in health systems in other humanitarian settings. Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000037404. Registered on 19 January 2016; WHO Protocol ID RPC705, v.4, 2 November 2015

Task-Sharing Psychosocial Support with Refugees and Asylum Seekers: Reflections and Recommendations for Practice from the PROSPER Study

To address the unmet need for accessible mental health services for refugees and asylum seekers in high-income countries, the PROSPER study is testing implementation of the World Health Organization Problem Management Plus (PM+) intervention. Incorporating task-sharing strategies, the intervention is delivered by Peer Lay Therapists with lived experience of seeking asylum or migration. The PM+ training adopts a cascade apprenticeship model, where Master Trainers train and supervise Wellbeing Mentors; who subsequently train and supervise the Peer Lay Therapists. We describe application of this training and supervision approach in PROSPER, drawing on Master Trainer and Wellbeing Mentor perspectives. We then reflect on our experiences, highlighting logistical challenges when working with refugee and asylum-seeking Peer Lay Therapists, the strategies to promote their ongoing engagement and the opportunities for team and personal growth. A core learning point has been the role of straddling the intervention and research components of the PROSPER study. Based on our experiences, we make recommendations for others adopting a task-sharing approach by training refugees and asylum seekers as Peer Lay Therapists in high-income countries, so that this might inform service programming and/or associated research activity

The intercultural development and validation of the Indigenous ‘Escala de Bienestar Kankuamo’ (Kankuamo Well-Being Scale): A capability approach

This article describes the development and validation of a capability-based well-being scale: ‘Escala de Bienestar Kankuamo’ (EBK; the Kankuamo Well-Being Scale). The EBK is designed to measure the well-being of the Indigenous Kankuamo community of Colombia from an intercultural perspective. The mixed-methods study was composed of two phases. In phase I, an initial 27 items, which had been generated using qualitative data from a previous study, were reviewed and adjusted through workshops with the Kankuamo community. In phase II, an adapted list of 28 items was piloted within the Kankuamo communities (sample N = 213). A preliminary exploratory factor analysis was carried out. The internal consistency of the EBK was measured using McDonald's ω. Convergent and divergent validity were tested with the World Health Organization-Five Well-Being Index (WHO-5) and the Patient Health Questionnaire-9. Incremental validity was tested through a hierarchical regression analysis to determine the effect on the WHO-5 of age, gender, community and EBK. The exploratory factor analysis resulted in a 14-item scale with seven domains: (1) Relating (to others and one's emotions), (2) Guiding principles, (3) Choice of healthcare, (4) Self-grown food, (5) Community contributions, (6) Agency and (7) Respect and equality. The EBK had high internal consistency (McDonald's ω = 0.86). Statistical analyses aimed at determining the convergent and divergent validity were inconclusive, suggesting a need for caution in using western standardised mental health measures in Indigenous communities because these may lack adequate cultural fit. The findings of the current study identify local priorities and needs, and evidence the feasibility of operationalising the capability approach for Indigenous populations