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Introduction Suicide is a global health concern. Sociocultural factors have an impact on self-harm and suicide rates. In Pakistan, both self-harm and suicide are considered as criminal offence’s and are condemned on both religious and social grounds. The proposed intervention ‘Youth Culturally Adapted Manual Assisted Problem Solving Training (YCMAP)’ is based on principles of problem-solving and cognitive–behavioural therapy. YCMAP is a brief, culturally relevant, scalable intervention that can be implemented in routine clinical practice if found to be effective. Method and analysis A multicentre rater blind randomised controlled trial to evaluate the clinical and cost-effectiveness of YCMAP including a sample of 652 participants, aged 12–18 years, presenting to general physicians/clinicians, emergency room after self harm or self referrals. We will test the effectiveness of 8–10 individual sessions of YCMAP delivered over 3 months compared with treatment as usual. Primary outcome measure is repetition of self-harm at 12 months. The seconday outcomes include reduction in suicidal ideation, hopelessness and distress and improvement in health related quality of life. Assessments will be completed at baseline, 3, 6, 9 and 12 months postrandomisation. The nested qualitative component will explore perceptions about management of self-harm and suicide prevention among adolescents and investigate participants’ experiences with YCMAP. The study will be guided by the theory of change approach to ensure that the whole trial is centred around needs of the end beneficiaries as key stakeholders in the process. Ethics and dissemination Ethics approval has been obtained from the Ethics Committee of University of Manchester, the National Bioethics Committee in Pakistan. The findings of this study will be disseminated through community workshops, social media, conference presentations and peer-reviewed journals.

Because of the need for new sustainable future alternatives, the re-inhabitation of rural areas, hinterlands, small historical urban centres and villages has become a unique real opportunity. Therefore, it is necessary to define and adopt new sustainable urban planning and building permits to follow this path. These processes involve both various actors and disciplines and a variety of spatial and semantic data. For this reason, the present research aims at providing a methodology to build the necessary spatial documentation of historical centres and villages by adopting an ontology-based workflow. Existing ontologies and conceptualisations have been considered together with classes and rules from city historical core regulations. A case study has been selected considering its available spatial datasets and national data models. The bottom-up approach here adopted aims at validating and enriching a reference ontology previously developed in the domain of historical centre by adding new concepts and relations from selected regulation plans and other existing ontologies and data models. Finally, the obtained ontology is also populated with instances of concepts and relations., Urban Data Science

Ten individuals of immigrant or refugee background, who had experienced mental health or emotional issues, participated in an immersive workshop to create digital stories as part of a national multicultural mental health initiative. Known collectively as ‘Finding our way’, the stories combine the power of first-person narrative with digital technologies. Three years on, six workshop participants and two coordinators reflect on the project’s effects, and offer recommendations for conducting and evaluating similar projects in the future. Individuals experienced the project as personally empowering. The stories have been used to facilitate community and service-based conversations about diversity, mental health and recovery.

Architectural, built heritage and historical buildings embody cultural heritage value and-as known-they need to be studied, documented, persevered and represented. Although there are many fields involved in these activities, none of these considered individually can fully represent the heritage with a complete level of detail and information. The present work aims to investigate the different levels of detail and granularity among different communities involved in historical buildings tasks to semantically define different concepts. In this context, ontologies are considered as an effective solution for the formal conceptualization of the domains involved, providing a common language for knowledge sharing and reuse. The study starts from existing knowledge (standards, vocabularies, thesauri, classifications) and conceptualisations for regional, urban and architectural heritage and geographic information for various tasks (restoration, documentation and heritage studies, risk prevention, heritage asset and facility management, education and tourism, urban planning and energy refurbishment/performance). A specific use case involving historical buildings in fortified centres across different levels of detail is described to show how existing knowledge and standards conceptualisation need to be integrated and extended., Urban Data Science

Access to mental healthcare in low- and middle-income countries (LMICs) is one of the greatest challenges in public health today. One suggestion for improving accessibility is through collaboration between biomedical practitioners and traditional healers. This paper reviews studies of traditional healers' and biomedical practitioners' perceptions of collaboration. We conducted a systematic review of online databases, selected journals, and reference lists for relevant studies. Eligible papers were assessed using a tool designed for this review for quality and study characteristics, and qualitative data demonstrating participants' views were extracted. A total of 14 papers from seven countries were included. The published literature on this topic is relatively homogenous and studies are of variable quality. The findings suggest that, despite differing conceptualisations of mental illness causation, both traditional healers and biomedical practitioners recognise that patients can benefit from a combination of both practices and demonstrate a clear willingness to work together. There are concerns about patients' safety and human rights regarding traditional methods and some healers are sceptical about the effectiveness of Western psychiatric medication. Despite keeping the inclusion criteria open to all LMICs, 13 of the studies were conducted in Africa, seven of which were in South Africa. This limits the applicability of the findings of this review to the wider LMIC context. The paper concludes with recommendations for research and practice.

health services and could be particularly important for low and middle-income countries (LMICs), which are rapidly developing to respond to the burden of poor mental health. Research from high income countries has found many challenges associated with the meaningful implementation of CE in practice, but this has been underexplored in LIMCS and in South East Asia (SEA) in particular. Methods: We completed a realist synthesis and systematic review of peer reviewed publications and grey literature to identify the context and actions which promote successful implementation of CE approaches in SEA. We used a theory-driven approach—realist synthesis—to analyse data and develop context-mechanism-outcome configurations that can be used to explain how civic engagement approaches operate in South East Asian contexts. We worked closely with patient and public representatives to guide the review from the outset. Results: Fifty-seven published and unpublished articles were included, 24 were evaluations of CE, including two Randomized Controlled Trials. The majority of CE interventions featured uptake or adaptation of Western models of care. We identified important cultural differences in the enactment of civic engagement in SEA contexts and four mechanisms which, alongside their contextual barriers and facilitators, can be used to explain how civic engagement produces a range of outcomes for people experiencing mental health problems, their families and communities. Our review illustrates how CE interventions can be successfully implemented in SEA, however Western models should be adapted to fit with local cultures and values to promote successful implementation. Barriers to implementation included distrust of services/outside agencies, stigma, paternalistic cultures, limited resource and infrastructure. Conclusion: Our findings provide guidance for the implementation of CE approaches within SEA contexts and identify areas for further research. Due to the collectivist nature of

BACKGROUND: Patient and public involvement (PPI) has the potential to strengthen mental health systems in Indonesia and improve care for people living with psychosis. Current evidence from other parts of the world demonstrates the need to understand the contexts in which PPI is to be enacted to ensure optimal implementation. OBJECTIVE: To understand service users' and carers' views on the current use and potential applicability of PPI within Indonesian mental health services. DESIGN: Qualitative study incorporating focus groups analysed using thematic analysis. SETTING AND PARTICIPANTS: Participants included 22 service users and 21 carers recruited from two study sites in Indonesia (Jakarta and Bogor). All participants had experience of psychosis either as a service user or carer. RESULTS: Despite the value attributed to PPI in relation to improving services and promoting recovery, current use of such activities in Indonesian mental health services was limited. Participants expressed a desire for greater levels of involvement and more holistic care but felt community organizations were best placed to deliver this because PPI was considered more congruent with the ethos of third-sector organizations. Additional barriers to PPI included stigma and low levels of mental health literacy in both health services and communities. DISCUSSION AND CONCLUSION: Participants felt that there was potential value in the use of PPI within Indonesian mental health services with careful consideration of individual contexts. Future aspirations of involvement enactment should ensure a central design and delivery role for third-sector organizations. Facilitators to global collaborative research in the context of the current study are also discussed.

BACKGROUND: Public engagement events are an important early strategy in developing a meaningful research agenda, which is more impactful and beneficial to the population. Evidence indicates the potential of such activities to promote mental health literacy. However, this has not yet been explored in Indonesia. AIM: This paper describes a mental health public engagement festival carried out in Indonesia in November 2018 and uses evaluation data to consider the acceptability and use of such activities in Indonesia in the future. METHOD: Evaluation data was collected from 324 of the 737 people who attended a six-day mental health festival comprising 18 events including public lectures, film screenings, arts activities, exercise classes and panel discussions. Attendees were asked to evaluate the festival in terms of its quality, benefits and areas for improvement. Descriptive statistics were used to analyse the evaluation data. 87 service users, carers, academics and professionals also engaged in a research prioritisation exercise to collaboratively determine mental health research priorities for Indonesia. RESULTS: Participants evaluated the festival extremely positively with a significant majority (92%) rating the quality of the festival as good or excellent. Attendees reported an increase in their understanding of mental health issues and identified intended behaviour change including an increased propensity for future engagement with mental health research. Key strengths of the festival included the central role of patients, carers and the local community in the design and delivery of the festival which promoted emotional engagement and development of shared understanding and the use of international experts which in attendees' opinion further enhanced the credibility of festival activities. CONCLUSION: This manuscript indicates that a co-produced mental health public engagement festival is a potentially acceptable way to increase awareness of mental health in Indon

Uptake of vitamin B12 is essential for many prokaryotes, but in most cases the membrane proteins involved are yet to be identified. We present the biochemical characterization and high-resolution crystal structure of BtuM, a predicted bacterial vitamin B12 uptake system. BtuM binds vitamin B12 in its base-off conformation, with a cysteine residue as axial ligand of the corrin cobalt ion. Spectroscopic analysis indicates that the unusual thiolate coordination allows for decyanation of vitamin B12. Chemical modification of the substrate is a property other characterized vitamin B12-transport proteins do not exhibit.

BACKGROUND: Indonesia has the highest rate of years of life lost to disability or early death from Schizophrenia than any other country in the world. More than 90% of people with mental illness do not get any treatment and tens of thousands of people with psychosis are illegally detained ('pasung') in the family home. Civic engagement, a core part of the recent World Health Organisation global strategy, has the potential to address some of these challenges through the development of person-centered models of care. The aim of the study is to develop a testable systems level, culturally appropriate, civic engagement framework for use in Jakarta and Bogor, Indonesia to strengthen local mental health services. METHODS: A mixed methods study underpinned by a realist approach will be undertaken across four phases in two study sites in Indonesia (Jakarta and Bogor). Phase 1 will explore the use of civic engagement across South East Asia by conducting a systematic review of existing evidence. By surveying 300 mental health professionals, phase 2 will identify the stakeholders, the sources of collaboration and the evidence used by professionals in decision making within local mental health systems and identify potential opportunities for civic engagement within the system. In order to explore the potential use of civic engagement within Indonesian mental health services and identify priorities for a culturally appropriate framework, phase 3 will undertake two focus groups with participants with experience of psychosis or caring for someone with psychosis (n = 20-30). Professionals and other key decision makers in a range of roles across the system at a national (n = 5) and local level (n = 10-15/site) will also take part in semi-structured interviews. Phase 4 will co-produce a civic engagement framework for use in Indonesia by synthesising evidence from phases 1-3 collaboratively with key stakeholders. DISCUSSION: Civic engagement is a potential way in which health services

BACKGROUND: A number of Delphi expert consensus studies have been carried out with different countries and cultural groups to develop guidelines on how a member of the public should provide assistance to a person who is suicidal. The present study aimed to determine whether cross-culturally generalizable suicide first aid actions are possible by comparing agreement across these Delphi studies. METHODS: Data on endorsement rates for items were compared across six Delphi studies. These studies involved panels of professionals and consumer advocates from English-speaking countries, professionals from Sri Lanka, professionals from Japan, professionals from India, professionals from the Philippines, and professionals and consumer advocates in refugee and immigrant mental health. Correlations were calculated between item endorsement rates across panels. RESULTS: There were 18 items that were highly endorsed across all eight of the Delphi panels and an additional 15 items highly endorsed across the panels from the three lower middle-income countries (India, Philippines and Sri Lanka). Correlations across panels in item endorsement rates were all 0.60 or above, but were higher between panels from countries that are socioeconomically similar. CONCLUSIONS: There is broad agreement across the diverse expert panels about what are appropriate suicide first aid actions for members of the public, indicating that cross-cultural generalizability is possible. However, there is also some cultural specificity, indicating the need for local tailoring.

The connection between spirituality and wellbeing, including its benefits for physical and mental health, has been recognized in the Eastern cultures for a very long time, although the sharp division between science and religion has caused, for the most part, its neglect inWestern cultures until recently. Nevertheless, limited efforts have been made to explore the impact of spirituality and religion on wellbeing, including the prevention of suicide. We begin with an overview of the literature on religiousness, spirituality, and health and wellbeing. Further, we present a novel study focused on a sample of 160 Indian students from a spiritually oriented university in North India with the aim to understand how spirituality affects their lives and wellbeing and their views about suicide. Our results show that spirituality, generally, has a positive impact on participants’ wellbeing with a potential protective effect against suicidal behavior, although more research on spiritual/religious beliefs as a source of difficulties is warranted.

The World Health Organization report Preventing Suicide: A Global Imperative provides governments with guidance for comprehensive suicide prevention strategies. However, it does not mention the role that compulsory admission to hospital of psychiatric patients should have in policies for suicide prevention. This was a missed opportunity for international discussion and guidance about a measure that, although widely used, is becoming increasingly controversial in light of the existing evidence and human rights norms.

The aim of this study was to establish mental health and suicide research priorities for people from immigrant and refugee background in Australia. This article focuses on the data relevant to the development of the suicide research agenda. This study was conducted using Delphi consensus method with two rounds of online questionnaires. A total of 138 and 86 participants, respectively, completed the first and second rounds of survey. Participants were policy makers, service providers, academics, service users, and carer advocates in Australia with expertise in mental health and/or suicide among people from immigrant and refugee backgrounds. Of the total 268 research questions included in the questionnaires, 70 questions about suicide were ranked as essential by over 50% respondents (i.e., the set level of consensus). In particular, research questions regarded as the greatest priority related to access and engagement with suicide prevention services, suicide protective and risk factors compared to populations not from immigrant and refugee backgrounds, and culturally appropriate assessment of suicide risk.

BACKGROUND: Sri Lanka has one of the highest suicide rates in the world. Gatekeeper programs aimed at specific target groups could be a promising suicide prevention strategy in the country. The aim of this study was to develop guidelines that help members of the public to provide first aid to persons in Sri Lanka who are at risk of suicide. METHODS: The Delphi method was used to elicit consensus on potential helping statements to include in the guidelines. These statements describe information members of the public should have and actions they can take to help a person who is experiencing suicidal thoughts. An expert panel, comprised of mental health and suicide experts in Sri Lanka, rated each statement. The panellists were encouraged to suggest any additional action that was not included in the original questionnaire and, in particular, to include items that were culturally appropriate or gender specific. Responses to open-ended questions were used to generate new items. These items were included in the subsequent Delphi rounds. Three Delphi rounds were carried out. Statements were accepted for inclusion in the guidelines if they were endorsed (rated as essential or important) by at least 80 % of the panel. Statements endorsed by 70-79 % of the panel were re-rated in the following round. Statements with less than 70 % endorsement, or re-rated items that did not receive 80 % or higher endorsement were rejected. RESULTS: The output from the Delphi process was a set of endorsed statements. In the first round questionnaire 473 statements were presented to the panel and 58 new items were generated from responses to the open-ended questions. Of the total 531 statements presented, 304 were endorsed. These statements were used to develop the suicide first aid guidelines for Sri Lanka. CONCLUSION: By engaging Sri Lankans who are experts in the field of mental health or suicide this research developed culturally appropriate guidelines for providing mental health first aid t