Search

Aims.To discuss the potential usefulness of a public health approach for ‘mental health and psychosocial support’ (MHPSS) interventions in humanitarian settings.Methods.Building on public mental health terminology in accordance with recent literature on this topic and considering existing international consensus guidelines on MHPSS interventions in humanitarian settings, this paper reflects on the relevance of the language of promotion and prevention for supporting the rationale, design and evaluation of interventions, with a particular focus on populations affected by disasters and conflicts in low- and middle-income countries.Results.A public mental health approach and associated terminology can form a useful framework in the design and evaluation of MHPSS interventions, and may contribute to reducing a divisive split between ‘mental health’ and ‘psychosocial’ practice in the humanitarian field. Many of the most commonly implemented MHPSS interventions in humanitarian settings can be described in terms of promotion and prevention terminology.Conclusions.The use of a common terminology across health, protection, education, nutrition and other relevant sectors providing humanitarian interventions has the potential to allow for integration of MHPSS activities in one overall framework, with diverse humanitarian practitioners working to achieve a common goal.

There is limited evidence on the acceptability, feasibility and cost-effectiveness of task-sharing interventions to narrow the treatment gap for mental disorders in sub-Saharan Africa. The purpose of this article is to describe the rationale, aims and methods of the Africa Focus on Intervention Research for Mental health (AFFIRM) collaborative research hub. AFFIRM is investigating strategies for narrowing the treatment gap for mental disorders in sub-Saharan Africa in four areas. First, it is assessing the feasibility, acceptability and cost-effectiveness of task-sharing interventions by conducting randomised controlled trials in Ethiopia and South Africa. The AFFIRM Task-sharing for the Care of Severe mental disorders (TaSCS) trial in Ethiopia aims to determine the acceptability, affordability, effectiveness and sustainability of mental health care for people with severe mental disorder delivered by trained and supervised non-specialist, primary health care workers compared with an existing psychiatric nurse-led service. The AFFIRM trial in South Africa aims to determine the cost-effectiveness of a task-sharing counselling intervention for maternal depression, delivered by non-specialist community health workers, and to examine factors influencing the implementation of the intervention and future scale up. Second, AFFIRM is building individual and institutional capacity for intervention research in sub-Saharan Africa by providing fellowship and mentorship programmes for candidates in Ethiopia, Ghana, Malawi, Uganda and Zimbabwe. Each year five Fellowships are awarded (one to each country) to attend the MPhil in Public Mental Health, a joint postgraduate programme at the University of Cape Town and Stellenbosch University. AFFIRM also offers short courses in intervention research, and supports PhD students attached to the trials in Ethiopia and South Africa. Third, AFFIRM is collaborating with other regional National Institute of Mental Health funded hubs in Latin America, sub-Saharan Africa and south Asia, by designing and executing shared research projects related to task-sharing and narrowing the treatment gap. Finally, it is establishing a network of collaboration between researchers, non-governmental organisations and government agencies that facilitates the translation of research knowledge into policy and practice. This article describes the developmental process of this multi-site approach, and provides a narrative of challenges and opportunities that have arisen during the early phases. Crucial to the long-term sustainability of this work is the nurturing and sustaining of partnerships between African mental health researchers, policy makers, practitioners and international collaborators.

A subset of the single-crystal elastic moduli of natural antigorite has been measured using Brillouin scattering at high-pressure up to 9?GPa. Aggregate properties and axial compressibilities are in good agreement with equation-of-state results from X-ray diffraction. Stiffness along the c-axis increases, becoming close to those within the silicate layer near 7?GPa. A slight discontinuity in the evolution of the elastic moduli near 7?GPa is associated with a phase transition. Raman spectroscopy shows that the transition does not occur in subducting slabs, except in the core of the coldest slabs where serpentine may be subducted to depths of about 200?km. Varying temperature and pressure has limited effects on the interpretation of seismic velocities, principally because of the limited depth range of serpentine stability (mostly above 100?km depth), and also due to the compensating effects of pressure and temperature that maintain velocity variations well within the uncertainties and statistical variability of seismological studies. Serpentinites are excellent candidates for explaining low velocities in the hydrated mantle wedge, inversion of the Moho, and thin anisotropic low-velocity layers at the plate interface. Serpentinite layers provide an alternative explanation to fluid-saturated oceanic crust for explaining these phenomena, and account for a transition to an aseismic, decoupled plate interface. Elasticity of antigorite serpentine is measured at high pressures up to 9 GPaSerpentine can be detected as low seismic-velocity areas down to 200 km depthThin and deformed serpentine layers are detected at the subudction interface

Medical liaisons were initially established in the pharmaceutical industry in the late 1960s. Since this time, their role has been evolving in such a way that today medical liaisons are helping to improve outcomes for patients in a variety of venues. They accomplish this through the timely, responsive dissemination of medical information, by exploring mutual clinical and scientific interests with health care providers, and through understanding the dynamics and unmet needs within therapeutic areas. In an effort to assess medical liaison trends across the pharmaceutical industry, three surveys of medical liaison practices were previously administered and published. The intent of these surveys was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this fourth survey to focus on areas identified by participants as major challenges and opportunities. The current survey focused on three areas: tools used by medical liaisons, career strategies, and medical liaison clinical trial involvement. The survey results indicated the following: medical liaisons are given the tools needed to be successful in their role, almost half of the medical liaisons surveyed have been in their current role for more than 3 years, and more than half plan on staying in a medical liaison role for at least 3 more years, and the majority of medical liaisons desire more involvement in clinical trial activities.

In an effort to assess medical liaison trends across the pharmaceutical industry, two surveys of medical liaison managers were previously administered and published. The intent of these surveys was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this third survey to focus on areas identified by the initial survey participants as major challenges. In addition, we aimed to broaden our survey to include responses from both medical liaison managers and field-based medical liaisons. The current survey focused on four areas: the role of medical liaisons in competitive intelligence, health outcomes, compliance, and nontraditional medical liaison staffing options. The survey results indicated the following: a majority of companies have defined competitive intelligence plans that include the medical liaison organization; the health outcomes role is less prevalent than the traditional medical liaison role; compliance standards vary across the industry; and the contract medical liaison field will potentially grow in the future.

Medical liaisons were initially established in the pharmaceutical industry in the late 1960s. Since this time, their role has been evolving in such a way that today medical liaisons are helping to improve outcomes for patients in a variety of venues. They accomplish this through the timely, responsive dissemination of medical information, by exploring mutual clinical and scientific interests with health care providers, and through understanding the dynamics and unmet needs within therapeutic areas. In an effort to assess medical liaison trends across the pharmaceutical industry, three surveys of medical liaison practices were previously administered and published. The intent of these surveys was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this fourth survey to focus on areas identified by participants as major challenges and opportunities. The current survey focused on three areas: tools used by medical liaisons, career strategies, and medical liaison clinical trial involvement. The survey results indicated the following: medical liaisons are given the tools needed to be successful in their role, almost half of the medical liaisons surveyed have been in their current role for more than 3 years, and more than half plan on staying in a medical liaison role for at least 3 more years, and the majority of medical liaisons desire more involvement in clinical trial activities.

In an effort to assess medical liaison trends across the pharmaceutical industry, two surveys of medical liaison managers were previously administered and published. The intent of these surveys was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this third survey to focus on areas identified by the initial survey participants as major challenges. In addition, we aimed to broaden our survey to include responses from both medical liaison managers and field-based medical liaisons. The current survey focused on four areas: the role of medical liaisons in competitive intelligence, health outcomes, compliance, and nontraditional medical liaison staffing options. The survey results indicated the following: a majority of companies have defined competitive intelligence plans that include the medical liaison organization; the health outcomes role is less prevalent than the traditional medical liaison role; compliance standards vary across the industry; and the contract medical liaison field will potentially grow in the future.

The beginning of medical liaison programs can be traced back to a small group of technically oriented sales representatives at the Upjohn Company in 1967. Today, medical liaison programs exist in many pharmaceutical and biotechnology companies. These medical liaisons are involved in helping to improve outcomes for patients in a variety of therapeutic areas. Previously, limited benchmarking data on medical liaison groups across the pharmaceutical industry existed in the published literature. To fill this information gap. an initial survey was conducted by this group in 2005 with the intent of identifying the overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. This survey was followed by subsequent annual surveys to gain additional insights into medical liaison practices across the pharmaceutical industry. The surveys have collected information on a wide variety of topics related to the medical liaison role including team characteristics, specific roles and responsibilities, performance review, training, value demonstration, competitive intelligence, health outcomes, regulatory compliance, nontraditional staffing options, virtual offices, clinical trial activities, and career Strategies. This article serves as a review of the first four surveys completed 2005 through 2008.

The beginning of medical liaison programs can be traced back to a small group of technically oriented sales representatives at the Upjohn Company in 1967. Today, medical liaison programs exist in many pharmaceutical and biotechnology companies. These medical liaisons are involved in helping to improve outcomes for patients in a variety of therapeutic areas. Previously, limited benchmarking data on medical liaison groups across the pharmaceutical industry existed in the published literature. To fill this information gap, an initial survey was conducted by this group in 2005 with the intent of identifying the overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. This survey was followed by subsequent annual surveys to gain additional insights into medical liaison practices across the pharmaceutical industry. The surveys have collected information on a wide variety of topics related to the medical liaison role including team characteristics, specific roles and responsibilities, performance review, training, value demonstration, competitive intelligence, health outcomes, regulatory compliance, nontraditional staffing options, virtual offices, clinical trial activities, and career strategies. This article serves as a review of the first four surveys completed 2005 through 2008.

In an effort to assess medical liaison trends across the pharmaceutical industry, a survey of medical liaison managers was previously administered and published. The intent of the initial survey was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this follow-up survey to focus on areas identified by the initial survey participants as major challenges. The current survey focused on developing and conducting medical liaison training, as well as demonstrating and communicating the value of medical liaison programs. The survey was sent to approximately 1,275 recipients with instructions requesting that the survey was to be completed only by managers or directors of medical liaison programs. The survey results indicated the following: There is a broad range of new hire and experienced medical liaison training practices, training of newly hired medical liaison differs from that of experienced medical liaisons, and many innovative practices are used to overcome the challenge of demonstrating the value of a medical liaison.

In an effort to assess medical liaison trends across the pharmaceutical industry, a survey of medical liaison managers was previously administered and published. The intent of the initial survey was to identify overall approaches used by pharmaceutical companies in defining and managing the medical liaison role. We conducted this follow-up survey to focus on areas identified by the initial survey participants as major challenges. The current survey focused on developing and conducting medical liaison training, as well as demonstrating and communicating the value of medical liaison programs. The survey was sent to approximately 1,275 recipients with instructions requesting that the survey was to be completed only by managers or directors of medical liaison programs. The survey results indicated the following: There is a broad range of new hire and experienced medical liaison training practices, training of newly hired medical liaison differs from that of experienced medical liaisons, and many innovative practices are used to overcome the challenge of demonstrating the value of a medical liaison.

Elevating the temperature of cancerous cells is known to increase their susceptibility to subsequent radiation or chemotherapy treatments, and in the case in which a tumor exists as a well‐defined region, higher intensity heat sources may be used to ablate the tissue. These facts are the basis for hyperthermia based cancer treatments. Of the many available modalities for delivering the heat source, the application of a laser heat source under the guidance of real‐time treatment data has the potential to provide unprecedented control over the outcome of the treatment process (McNichols et al., Lasers Surg Med 34 (2004), 48–55; Salomir et al., Magn Reson Med 43 (2000), 342–347). The goals of this work are to provide a precise mathematical framework for the real‐time finite element solution of the problems of calibration, optimal heat source control, and goal‐oriented error estimation applied to the equations of bioheat transfer and demonstrate that current finite element technology, parallel computer architecture, data transfer infrastructure, and thermal imaging modalities are capable of inducing a precise computer controlled temperature field within the biological domain. © 2007 Wiley Periodicals, Inc. Numer Methods Partial Differential Eq 23: 904–922, 2007

Medical liaisons were initially established in the pharmaceutical industry in the late 1960s. Since that time, their role has been evolving in such a way that today medical liaisons are helping to improve outcomes for patients in a variety of venues. They accomplish this through the timely, responsive dissemination of medical information, by exploring mutual clinical and scientific interests with health care providers, by facilitating medical education, and through understanding the dynamics and unmet needs within therapeutic areas. In the literature, there are no recent, published benchmarking data available on medical liaison programs within the pharmaceutical industry. To fill this gap, we conducted a 29-question survey to gather information on 10 key categories of medical liaison programs. The areas for which we sought information included company demographics, medical liaison division background, individual medical liaison information, roles and responsibilities, client demographics, training, knowledge assessment, performance review/performance management, administrative tasks, and current challenges. The survey was sent to approximately 400 members of the Drug Information Association's Medical Communications Special Interest Area Community. Instructions were provided requesting that the survey be filled out only by managers of medical liaison programs. We received 42 complete responses; these indicated that there are many similarities in medical liaison positions across the industry, such as reporting structure, job responsibilities, and medical liaison credentials. Despite these similarities, there are many areas in which medical liaison roles differ between companies.

Medical liaisons were initially established in the pharmaceutical industry in the late 1960s. Since that time, their role has been evolving in such a way that today medical liaisons are helping to improve outcomes for patients in a variety of venues. They accomplish this through the timely, responsive dissemination of medical information, by exploring mutual clinical and scientific interests with health care providers, by facilitating medical education, and through understanding the dynamics and unmet needs within therapeutic areas. In the literature, there are no recent, published benchmarking data available on medical liaison programs within the pharmaceutical industry. To fill this gap, we conducted a 29-question survey to gather information on 10 key categories of medical liaison programs. The areas for which we sought information included company demographics, medical liaison division background, individual medical liaison information, roles and responsibilities, client demographics, training, knowledge assessment, performance review/performance management, administrative tasks, and current challenges. The survey was sent to approximately 400 members of the Drug Information Association’s Medical Communications Special Interest Area Community. Instructions were provided requesting that the survey be filled out only by managers of medical liaison programs. We received 42 complete responses; these indicated that there are many similarities in medical liaison positions across the industry, such as reporting structure, job responsibilities, and medical liaison credentials. Despite these similarities, there are many areas in which medical liaison roles differ between companies.

Abstract: High-pressure synchrotron infrared (IR) absorption spectra were collected between 650 and 4,000 cm−1 at ambient temperature for hydrous Mg-ringwoodite (γ-Mg2SiO4) up to 30 GPa. The main feature in the OH− stretching region is an extremely broad band centred at 3,150 cm−1. The hydrogen bond is strong for most protons and the most probable site for protonation is the tetrahedral edge. With increasing pressure, this band shifts downward while decreasing its integrated intensity until disappearance at a pressure of 25 GPa. Only one band at 2,450 cm−1 and an absorption plateau persist with a maximum wavenumber of 3,800 cm−1. This behaviour is reversible upon pressure release. We interpret this as a second-order phase transition occurring in hydrated Mg-ringwoodite at high pressure (beyond ∼ 25 GPa). This result is compatible with the observation by Kleppe et al. (Phys Chem Miner 29:473–476, 2002a) who suggested the presence of Si–O–Si linkages and/or partial increase in the coordination of Si. Beyond the phase transition, the protons are delocalized and their environment on the ringwoodite structure is probably quite different from that at low pressure. Data obtained in situ at high pressures and temperatures are needed to better understand the effect of protonation on the structure and to better constrain this phase transition.

The fetotoxic effects of angiotensin converting enzyme inhibitors when used during the second half of pregnancy are well known. The more recently developed angiotensin II receptor antagonists appear to yield similar fetal abnormalities. We report a premature infant born to a 41-year-old mother with a long history of infertility who had received losartan therapy for hypertension throughout an undetected pregnancy. Ultrasound examination 2 days prior to delivery identified a single fetus at 29 weeks gestation, anhydramnios, and an empty fetal bladder. The neonatal course was complicated by oliguria, hyperkalemia, marked renal dysfunction, respiratory failure, joint contractures, and a large anterior fontanelle with widely separated sutures. Hypotension (mean arterial pressure < 25 torr) on day 1 responded to volume expansion, dopamine, and hydrocortisone. Serum creatinine reached a maximum of 2.7 mg/dL on day 6 and decreased to 0.4 by day 56. No formal urinalysis was performed, but the urine was reported to be visually clear throughout the course. Although a renal ultrasound on day 2 was normal, a follow-up study at 7 months revealed bilateral generalized parenchymal echogenicity, consistent with medical renal disease. Since then, weight and length have been at the 5th percentile or less, with apparent renal tubular acidosis necessitating the addition of sodium citrate supplements. This case emphasizes the importance of maintaining a high index of suspicion for potential pregnancy when contemplating the use of a drug of this class, and considering serial testing for pregnancy when using such drugs, even in patients with a longstanding history of infertility.

The nature of the self-assembled core−shell interface in gold@silica nanoparticles synthesized via a 3-aminopropyltrimethoxysilane (APTMS) route is investigated using materials synthesis as a sensitive tool for elucidating interfacial composition and organization. Our approach involves condensation of the gold@silica nanoparticles within a silica framework for synthesis of a composite gold−silica material containing ~30 wt % gold. This material contains one of the highest gold loadings reported, but maintains gold core isolation as ascertained via a single surface plasmon resonance absorption band frequency corresponding to that of gold nanoparticles in dilute aqueous solution. The immobilized gold cores are subsequently etched using cyanide anion for the synthesis of templated porosity, which corresponds to the space that was occupied by the gold. Characterization of immobilized amines is performed using probe molecule binding experiments, which demonstrate a lack of accessible amines after gold removal. Solid-state ¹³C CPMAS NMR spectroscopy on these materials demonstrates that the amount of amine immobilization must be less than 10% of the expected yield, assuming that all of the APTMS becomes bound to the gold nanoparticle template. These results require a core−shell interface in the gold@silica nanoparticles that is predominantly occupied by inorganic silicate species, such as Si−O−Si and Si−OH, rather than primary amines. Such a result is likely a consequence of the weak interaction between primary amines and gold in aqueous solution. Our method for investigating the core−shell interface of gold@silica nanoparticles is generalizable for other interfacial structures and enables the synthesis of bulk imprinted silica using colloidal templates.

In 1996, Berger and Slonczewski independently predicted that a large enough spin–polarized dc current density sent perpendicularly through a ferromagnetic layer could produce magnetic excitations (spin–waves) or reversal of magnetization (switching). In the past few years, both current-driven switching and current-driven excitation of spin–waves have been observed. The switching is of potential technological interest for direct ‘writing’ of magnetic random access memory (MRAM) or magnetic media. The spin–wave generation could provide a new source of dc generated microwave frequency radiation. We will describe what has been learned experimentally about these two related phenomena, and some models being tested to explain these observations. (© 2004 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

The synthesis of bulk, hydrophilic imprinted silica is reported via a novel method relying on the thermolysis of carbamates. This method is used to synthesize single-site materials consisting of either isolated primary amines or multiple organized primary amines within an imprinted site. Materials are characterized by multinuclear solid-state NMR spectroscopy, high-resolution thermogravimetric analysis, and potentiometric titration. Diffuse-reflectance UV/Vis and solid-state fluorescence spectroscopies of probe molecule-bound materials are used to demonstrate the site-isolated and polar nature of the imprinted sites resulting from this process. The polar nature is due to hydrophilic silanol groups ingenerate to the framework of the material. These permit the partitioning of polar reagents, such as 1,3,5-trinitrobenzenesulfonic acid (TNBS), which are unable to access the imprinted sites when framework silanols are end-capped with hydrophobic trimethylsilyl functionality. The latter observation provides a mechanism to elucidate diminished reactivity of TNBS with lysine residues that are buried within the hydrophobic pocket of a protein.

Mechanistic studies employing in situ NMR analysis implicate intermediate silicon enolates as reactive intermediates in the Rh-DuPhos catalyzed two-step reductive aldol reaction with Cl2MeSiH. These enolates undergo noncatalyzed reaction with a variety of aldehydes to give the derived syn-aldol adduct in high yields and diastereoselection.

Oestrogenic growth promotants stimulate lean carcass growth and reduce carcass fat in livestock but little is known about their actions on musculo-skeletal growth per se. To investigate such effects, selected bones and muscles were measured in castrated male and entire ewe lambs treated from 4 weeks of age with implants containing oestradiol-17β. Half of the animals were slaughtered at 14 weeks and half at 23 weeks of age. Oestradiol treatment significantly stimulated the linear growth of vertebrae, with the effect being most pronounced in ewe lambs slaughtered at 14 weeks. The treatment also increased the diameter of some limb bones and slightly increased the length and girth of attached muscles. Castrated male lambs tended to have longer bones and longer and heavier muscles than entire ewes. This study showed that, in sheep, oestrogens cause a short-term increase in length in growing bones.

The series resistor and Valet–Fert models widely used to describe the current-perpendicular-to-plane (CPP) magnetoresistances of ferromagnetic/non-magnetic (F/N) metal multilayers were recently claimed to apply only for mean-free paths shorter than layer thicknesses; otherwise the mean-free-path was claimed to be an important length scale in the CPP-MR. Contradicting these claims, we show that the behaviors on which they were based do not change when the mean-free path in the N-layer is reduced from about five times to one-fifth its layer thickness. Part of these behaviors can be ascribed to finite spin-memory-loss (spin-flipping) in the F and N metals and the rest might be due to spin flipping at F/N interfaces.

Atmospheric drag is the largest uncertainty in determining orbits of low altitude satellites. Deficiencies in operational satellite drag models persist due to empirical model limitations as well as inadequacies of proxy indices used as model drivers. Satellite drag errors result in degraded accuracy, requirements for frequent updates and inadequate predictions of true positions for accurate catalog maintenance, collision avoidance and re-entry operations. Time-dependent global corrections to operational drag models have been derived based on assimilation of satellite tracking data. These corrected drag values circumvent the persisting deficiencies of current drag models and provide significant improvements in precision orbit determination and prediction for low-earth orbit satellites.

The hormone binding site of members of the insulin receptor family is contained within a highly conserved extracellular region of the receptor. Recent crystallization of the N-terminal region of the binding site revealed two large domains (L1, L2), each organized as a single-stranded right-handed beta-helix, connected by a rod-shaped cysteine-rich domain. Here, we analyze two new naturally occurring mutations in a single beta-sheet within L1, D59G and L62P, that we previously identified in a young woman with classic congenital insulin resistance (type A). Substitution of D59G, a beta-sheet connecting loop residue, caused decreased hormone binding but did not disrupt overall folding, assembly, or movement to the cell surface. In contrast, replacement of the adjacent residue L62P, which is located within the beta-sheet, and positioned in a hormone binding surface, completely disrupted intracellular folding, oligomerization, and trafficking and resulted in aberrant proteolytic degradation. Immunohistochemistry in combination with biosynthetic studies showed that misfolded receptors were retained in an incorrect cellular location and that they colocalized with the resident endoplasmic reticulum chaperone calnexin. This study, together with other mutagenesis data, shows that formation of beta-sheet elements within the L1 beta-helix are critical for the folding of the entire extracellular domain of the receptor and that the hormone contact site is composed in part by residues in this domain.