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Objectives: This study aims to describe the views of key stakeholders in mental health in Ghana on the challenges faced with regard to the implementation of, and priorities for implementation of, the 2012 Mental Health Act of Ghana. Design: A cross-sectional qualitative study with 12 participants, using semi-structured interviews. Setting: Greater Accra Region. Participants: The study population consisted of three groups; Members of the Mental Health Authority Board (MHAB), Providers of Mental Health Care working for the Mental Health Authority and Representatives of non-governmental and educational organisations working in mental health, Four participants were identified from each group. Interventions: Not Available Main outcome measures: The interviews, subsequent analysis and output were based around three main topics of discussion: awareness of the Act, challenges to the implementation of the Act, and priorities for implementation. Results: Challenges identified include: financial limitations, the limited dissemination of the act, delays in the approval of the Legislative Instrument by the Attorney General's Department, losing access to patients in non-orthodox mental health facilities, inadequate resources for implementation, legal infrastructure, timeframe, and the lack of a physical presence for the new Mental Health Authority. Suggested priorities for implementation include: development of human and financial resources, education, passing of the LI (Legislative Instrument), infrastructure development and human rights protection. Conclusions: Challenges identified in this study are likely to be applicable to other nations seeking to implement modern Mental Health Legislation. Key stakeholders in the mental health system showed broad concordance in the immediate priorities for Ghana's Mental Health System. [ABSTRACT FROM AUTHOR]

Background Existing nutritional guidelines suggest that protein requirements of adults with stage five chronic kidney disease undergoing haemodialysis ( HD) or peritoneal dialysis ( PD) are increased as a result of protein losses during dialysis. The present review aimed to update previous guidance and develop evidence-based practice guidelines on the protein requirements of adults undergoing maintenance dialysis. Methods Following a PICO approach (Participants or Population, Intervention or Exposure, Comparison and Outcome), four research questions were formulated to investigate the total protein requirement and protein quality required by adults undergoing HD and PD. A comprehensive, systematic review was undertaken using the databases Medline, EMBASE and the Cochrane Library from 2005 to September 2009 for HD studies and from 1997 to September 2009 for PD studies. Results The literature search yielded 2931 studies, which were assessed for inclusion. Following appraisal, 19 studies in HD and 18 studies in PD met the inclusion criteria and were systematically reviewed. Limited good quality evidence supports the recommendations that: (i) adults undergoing maintenance HD require a minimum protein intake of 1.1 g kg−1 ideal body weight ( IBW) per day; and (ii) adults undergoing maintenance PD require a minimum protein intake of 1.0-1.2 kg−1 IBW per day, in conjunction with an adequate energy intake. There were no studies that addressed the quality of protein for either HD or PD. Conclusions Evidence suggests that nutritional status may be maintained with lower protein intakes than previously recommended. However, the evidence base is limited and further randomised controlled trials are required to establish the optimal protein intake for dialysis patients. [ABSTRACT FROM AUTHOR]

The objective of this paper is to illustrate the interconnections between the different phases (or tools) within the cognitive work analysis framework; the benefits of extending an analysis across each of the five phases are highlighted through these interconnections. The paper uses a command and control micro-world example to describe how each of the five phases can be used to describe the constraints within the micro-world domain from a different perspective. Based upon the social organisation and cooperation analysis, design requirements are extracted in order to develop role specific customisable interfaces for use within the micro-world. The interfaces have been specifically developed to communicate real time reconfiguration of the network through each of the individual interfaces; the reallocations of functions or roles are communicated to the actors through changes to the interface. [ABSTRACT FROM AUTHOR]

The Deep Impact mission’s Education and Public Outreach (E/PO) program brings the principles of physics relating to the properties of matter, motions and forces and transfer of energy to school-aged and public audiences. Materials and information on the project web site convey the excitement of the mission, the principles of the process of scientific inquiry and science in a personal and social perspective. Members of the E/PO team and project scientists and engineers, share their experiences in public presentations and via interviews on the web. Programs and opportunities to observe the comet before, during and after impact contribute scientific data to the mission and engage audiences in the mission, which is truly an experiment. [ABSTRACT FROM AUTHOR]