364 research outputs found
Mental distress in the general population in Zambia: Impact of HIV and social factors
No full textAbstract Background Population level data on mental health from Africa are limited, but available data indicate mental problems to represent a substantial public health problem. The negative impact of HIV on mental health suggests that this could particularly be the case in high prevalence populations. We examined the prevalence of mental distress, distribution patterns and the ways HIV might influence mental health among men and women in a general population. Methods The relationship between HIV infection and mental distress was explored using a sample of 4466 participants in a population-based HIV survey conducted in selected rural and urban communities in Zambia in 2003. The Self-reporting questionnaire-10 (SRQ-10) was used to assess global mental distress. Weights were assigned to the SRQ-10 responses based on DSM IV criteria for depression and a cut off point set at 7/20 for probable cases of mental distress. A structural equation modeling (SEM) was established to assess the structural relationship between HIV infection and mental distress in the model, with maximum likelihood ratio as the method of estimation. Results The HIV prevalence was 13.6% vs. 18% in the rural and urban populations, respectively. The prevalence of mental distress was substantially higher among women than men and among groups with low educational attainment vs. high. The results of the SEM showed a close fit with the data. The final model revealed that self-rated health and self perceived HIV risk and worry of being HIV infected were important mediators between underlying factors, HIV infection and mental distress. The effect of HIV infection on mental distress was both direct and indirect, but was particularly strong through the indirect effects of health ratings and self perceived risk and worry of HIV infection. Conclusion These findings suggest a strong effect of HIV infection on mental distress. In this population where few knew their HIV status, this effect was mediated through self-perceptions of health status, found to capture changes in health perceptions related to HIV, and self-perceived risk and worry of actually being HIV infected.</p
Peter Kean to Susan Niemcewicz, January 29, 1808
No full textPeter Kean wrote from Albany, New York to Susan Niemcewicz in Elizabethtown, New Jersey. After Peter wrote to Susan that morning, Mr. Barber visited and gave him a letter from Susan enclosing $15 for which Peter returned his sincere thanks. Col. Rutgers was not planning on visiting Albany that winter. The piece signed “Thousands of the People” was written by Mr. Bears of Albany. Peter was unsure of the author who signed a piece “An American.” He continued to discuss the study of law in the Western Country. Peter had not seen Miss Jay except at church for a week.
People mentioned: Mr. Barber, Mr. Bears, Mr. Henry, Mr. Westerlo, Col. Troup, and Sarah Louisa Jay (1792-1818).https://digitalcommons.kean.edu/lhc_1800s/1473/thumbnail.jp
books piece on a reading by Jay Cantor, author of Great Neck, which is being
No full textbooks piece on a reading by Jay Cantor, author of Great Neck, which is being presented at the Portland Public Library, April 30
Peter Kean to Susan Niemcewicz August 9, 1809
No full textPeter Kean wrote from Albany, New York to Susan Niemcewicz in Elizabethtown, New Jersey. After a most charming ride with Mrs. Banyer, Mr. Ridley, Sally Jay, and Susan Livingston, Susan’s letter together with Papa’s arrived as if to crown the happiness of the day. Thanked Susan for the assurances and good advice. It was important to Peter to know Susan’s reasons for him not reposing confidence in Mrs. Bz. As the confidence originated on the part of Sally Jay and she said she would consult her on the subject. Mrs. B. had in a measure become the only organ by which Peter could discover Sally’s thoughts as it respected the object he most earnestly desired to obtain. Peter discovered no change of sentiments and relied upon the bounty and goodness of God. Susan said she was reading Seneca and Peter claimed that while he was a charming and beautiful author, he was a pagan and not too fit a source to derive the precepts of true wisdom. Tom Grimké passed through Albany on his way to Balltown and informed Peter that he left his father’s family well and that Colonel Shubrick had not yet commenced the suit, neither had anything been done by Mr. B about the Paris Island Land.
People mentioned: Mrs. Banyer, Mr. Ridley, Sarah Louisa Jay (1792-1818), Susan Livingston, Mrs. B., Thomas Smith Grimké (1786-1834), and Colonel Shubrick.https://digitalcommons.kean.edu/lhc_1800s/1493/thumbnail.jp
Comparative Validity of Screening Instruments for Mental Distress in Zambia
No full textBackground: The recognition of mental health as a major contributor to the global burden of disease has led to an increase in the demand for the inclusion of mental health services in primary health care as well as in community-based health surveys in order to improve screening, diagnosis and treatment of mental distress. Many screening instruments are now available. However, the cultural validity of these instruments to detect mental distress has rarely been investigated in developing countries. In these countries, limited trained staff and specialized psychiatric facilities hamper improvement of mental health services. It is therefore imperative to develop a quick, low cost screening instrument that does not require specialized training. We validated different well established screening instruments among primary health care clinic attendees in Lusaka, Zambia. We also assess the face, content and criterion validity of the SRQ’s and determined the most commonly reported symptoms for mental distress. Methods: The screening instruments, SRQ-20, SRQ-10 and GHQ-12 were used as concurrent criteria for each other and compared against a gold standard, DSM-IV. Their correlation, sensitivity and specificity were assessed. All instruments were administered to 400 primary health care clinic attendees. In-depth interviews were also conducted with 28 of these clinic attendees. Results: Both the SRQ-20 and SRQ-10 had high properties for identifying mental distress correctly with an AUC of 0.96 and 0.95 respectively while the GHQ-12 had modest properties (AUC, 0.81). The optimum cut-off points for this population were 7 and 3 for the SRQ and GHQ-12 respectively. The SRQ was also found to have good face and content validity. Conclusion: The study establishes the utility of the SRQ-20 for detecting mental distress cases and also underscores the importance of validating instruments to suit the context of the target population. It also validates the SRQ-10 as the first reliable abbreviated and easy-to-use screening instrument for mental distress in primary health care facilities in Zambia
Piecing together modular : understanding the benefits and limitations of modular construction methods for multifamily development
No full textThesis (S.M. in Real Estate Development)--Massachusetts Institute of Technology, Dept. of Architecture, 2007.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Includes bibliographical references (leaves [100]-107).The primary purpose of this thesis is to explain the benefits and limitations of modular construction as it pertains to primarily wood-frame, multifamily housing in the United States. This thesis attempts to educate the consumer/builder/developer about what the modular construction process entails from beginning to end. Long term demographic trends point to a steady and increasing need for housing production. Decreasing development yields and increasing construction costs and regulations are making it more difficult for the market to meet this need. It is the authors' goal that the knowledge contained in this thesis helps to introduce developers to the basic issues involved in this relatively underutilized but potentially beneficial process.by Peter J. Cameron, Jr. and Nadia G. Di Carlo.S.M.in Real Estate Developmen
Interview of L.W. Jay, February 21, 2010
No full textThis is a recording of a woman interviewing L.W. Jay who worked in the Atlanta Rome district. He states he started working for the church in 1958 or 1959, and was appointed as minister of Butler Street in the 1960s, and was appointed by Peter Randolph Shy. He talks about how during his tenure, churches moved, sold and were built depending on the congregation, and the culture of the different churches. He lists the churches that were under his direction, and how some other churches suffered financial problems and pulled out of districts. He talks about situations happening in the different churches, mainly from the Hosley Temple and Mount Sinai churches.The Atlanta University Center Robert W. Woodruff Library acknowledges the generous support of the National Endowment for Humanities - Humanities Collections and Reference Resources Implementation Project Grant in supporting the processing and digitization of a number of its major archival collections as part of the project: Spreading the Word: Expanding Access to African American Religious Archival Collections at the Atlanta University Center Robert W. Woodruff Library
The Anasazi Origins Project
No full textJay Complex to Basketmaker time period in the Arroyo Cuervo area. Includes palynological observations by Peter J. Mehringer and J. Schoenwetter, report on the area's alluvial/paleoclimatic chronology by C. Vance Haynes, C. Irwin-Williams' radiocarbon-based interpretaations of inter-site chronology, and Schoenwetter's proposed pollen sequence. Publication required identification of artifact associations with sample/episodes of the pollen sequence, but Irwin-Williams did not accomplish the necessary archaeological analyses before her death.: Set of studies and documents relevant to the Anasazi Origins archaeological project directed by Cynthia Irwin- Williams in central New Mexico 1965-1970. Pollen records of surface samples and rockshelter and dune sites representing whole of the Paleoindia
Conceptual models for Mental Distress among HIV-infected and uninfected individuals: A contribution to clinical practice and research in primary-health-care centers in Zambia
No full textAbstract Background Mental distress is common in primary care and overrepresented among Human Immunodeficiency virus (HIV)-infected individuals, but access to effective treatment is limited, particularly in developing countries. Explanatory models (EM) are contextualised explanations of illnesses and treatments framed within a given society and are important in understanding an individual's perspective on the illness. Although individual variations are important in determining help-seeking and treatment behaviour patterns, the ability to cope with an illness and quality of life, the role of explanatory models in shaping treatment preferences is undervalued. The aim was to identify explanatory models employed by HIV-infected and uninfected individuals and to compare them with those employed by local health care providers. Furthermore, we aimed to build a theoretical model linking the perception of mental distress to treatment preferences and coping mechanisms. Methods Qualitative investigation nested in a cross-sectional validation study of 28 (male and female) attendees at four primary care clinics in Lusaka, Zambia, between December 2008 and May 2009. Consecutive clinic attendees were sampled on random days and conceptual models of mental distress were examined, using semi-structured interviews, in order to develop a taxonomic model in which each category was associated with a unique pattern of symptoms, treatment preferences and coping strategies. Results Mental distress was expressed primarily as somatic complaints including headaches, perturbed sleep and autonomic symptoms. Economic difficulties and interpersonal relationship problems were the most common causal models among uninfected individuals. Newly diagnosed HIV patients presented with a high degree of hopelessness and did not value seeking help for their symptoms. Patients not receiving anti-retroviral drugs (ARV) questioned their effectiveness and were equivocal about seeking help. Individuals receiving ARV were best adjusted to their status, expressed hope and valued counseling and support groups. Health care providers reported that 40% of mental distress cases were due to HIV infection. Conclusions Patient models concerning mental distress are critical to treatment-seeking decisions and coping mechanisms. Mental health interventions should be further researched and prioritized for HIV-infected individuals.</p
Strong effects of home-based voluntary HIV counselling and testing on acceptance and equity: A cluster randomised trial in Zambia
No full textHome-based voluntary HIV counselling and testing (HB-VCT) has been reported to have a high uptake, but it has not been rigorously evaluated. We designed a model for HB-VCT appropriate for wider scale-up, and investigated the acceptance of home-based counselling and testing, equity in uptake and negative life events with a cluster-randomized trial. Thirty six rural clusters in southern Zambia were pair-matched based on baseline data and randomly assigned to the intervention or the control arm. Both arms had access to standard HIV testing services. Adults in the intervention clusters were offered HB-VCT by local lay counsellors. Effects were first analysed among those participating in the baseline and post-intervention surveys and then as intention-to-treat analysis. The study was registered with www.controlled-trials.com, number ISRCTN53353725. A total of 836 and 858 adults were assigned to the intervention and control clusters, respectively. In the intervention arm, counselling was accepted by 85% and 66% were tested (n = 686). Among counselled respondents who were cohabiting with the partner, 62% were counselled together with the partner. At follow-up eight months later, the proportion of adults reporting to have been tested the year prior to follow-up was 82% in the intervention arm and 52% in the control arm (Relative Risk (RR) 1.6, 95% CI 1.4–1.8), whereas the RR was 1.7 (1.4–2.0) according to the intention-to-treat analysis. At baseline the likelihood of being tested was higher for women vs. men and for more educated people. At follow-up these differences were found only in the control communities. Measured negative life events following HIV testing were similar in both groups. In conclusion, this HB-VCT model was found to be feasible, with a very high acceptance and to have important equity effects. The high couple counselling acceptance suggests that the home-based approach has a particularly high HIV prevention potential
- …
