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Saving and Empowering young lives in PAKistan (SEPAK): An Exploratory Cluster Randomized Controlled Trial (cRCT)
- M. Panagioti, T. Kiran, S. Irshad, R. Sattar, A. Hodkinson, S. Tofique, N. Tyler, I. Angelakis, Z. Zadeh, A. Maqsood, S. Sultana, S. Dawood, M. Bhattia, A. Tamiduddin Nizami, H. A. Khan, I. B. Chaudhry, N. Husain, N. Chaudhry
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S317
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Introduction
Suicide is a leading cause of death among young people and most deaths by suicide occur in low and middle-income countries. School is the best place where we can identify and respond to youth suicide risk. School-based interventions for suicide prevention in young people have been successful across US, Europe and Australia, but require adaptations to be acceptable and feasible in Pakistan.
ObjectivesTo develop and test culturally adapted preventative interventions for suicidal behaviours among pupils in secondary schools in Pakistan. The qualitative component aimed at exploring the views of students, parents, teachers and general practitioners on cultural adaptation, experience of participation, areas of improvement and suggestions for scale-up of the school-based suicide prevention program (SEPAK).
MethodsA clustered randomised controlled trial. The four culturally modified interventions 1) Linking Education and Awareness of Depression and Suicide Awareness (LEADS) Training for pupils (students=260) 2) the Question, Persuade, and Refer (QPR) for teachers (students=203) 3) QPR for parents (students=445); 4) Screening by Professionals (Profscreen) (students=260) were compared against control intervention (educational posters) (students=227). Structured questionnaires were administered at baseline and 1-month post-intervention to assess suicidal behaviours, psychological well-being and quality of life. A total of 8 focus groups (FGs) were conducted at pre and post intervention stage with each stakeholders.
ResultsPatient and public involvement and Engagement (PPIE) was strongly embedded in the project to ensure meaningful benefits for participants. A total of 40 schools were recruited from 8 cities across Pakistan. A total of 243 students attended LEADS intervention, 92 teachers and 304 parents completed QPR training, and 9 general practitioners were trained in ProfScreen. The retention rate at follow-up was 99% that shows feasibility of delivering intervention package in Pakistan. All participants marked SEPAK as effective in identifying risk of and preventing self-harm and suicide in young people and in improving pathways to treatment. Interventions were perceived as helpful in improving knowledge about mental health, impact of mental health difficulties on functioning, reducing stigma, equipping stakeholders to identify and signpost at-risk people. Improvement in clinical and teaching practice as well as understanding others behaviors were also reported.
ConclusionsThis study suggest feasibility of integrating a suicide prevention program in existing educational system and highlights positive role of creating awareness about suicide in youth, introduction of school-based mental health programs, parental counseling and strengthening of the health system by training general practitioners in early identification of suicide risk and promoting suicide prevention strategies
Disclosure of InterestNone Declared
Diversity and geographical gaps in Cajanus scarabaeoides (L.) Thou. germplasm conserved at the ICRISAT genebank
- H. D. Upadhyaya, K. N. Reddy, R. P. S. Pundir, Sube Singh, C. L. L. Gowda, M. Irshad Ahmed
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- Journal:
- Plant Genetic Resources / Volume 11 / Issue 1 / April 2013
- Published online by Cambridge University Press:
- 01 June 2011, pp. 3-14
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Crop wild relatives are important components of agro-ecosystems as potential gene contributors for crop improvement programmes. Cajanus scarabaeoides (L.) Thou., a pigeonpea wild relative is crossable with cultivated pigeonpea and possesses several beneficial traits. Hundred accessions conserved at the ICRISAT genebank were characterized for 13 quantitative and ten qualitative traits to assess the diversity in the collection. Highly significant genotypic variance for leaflet length, days to 5% maturity, seeds per pod, 100-seed weight, seed protein content and trichome density and length was observed. All C. scarabaeoides accessions used in the present study are the best sources for extra early ( < 80 d to 50% flowering) and early maturity (80–100 d to 50% flowering). Eight accessions (ICP 15692, ICP 15696, ICP 15698, ICP 15699, ICP 15712, ICP 15719, ICP 15732 and ICP 15758) and the control ICP 15695 have produced more than 92% healthy pods per plant and higher number of seed per pod (4–6 seeds). Accessions in cluster 2, 3 and 4 with low mean values for days to 50% flowering were found as the best sources for early flowering and maturity. Accessions in cluster 2 and 3 for seeds per pod and cluster 2 for healthy pods per plant were found as promising sources for use in crop improvement. Mean diversity over all clusters was highest (H= 0.57 ± 0.01) for seeds per pod and lowest for days to 50% flowering (0.48 ± 0.02). Significant negative correlation between pods per raceme and healthy pods per plant ( − 0.213) indicated high pod damage in racemes having more pods. Trichome length had highly significant negative association with healthy pods per plant ( − 0.293). The probability map generated using FloraMap, a GIS tool, revealed the occurrence of C. scarabaeoides quite close to the origin and dispersal of pigeonpea. The probability (>75%) map identified a total of 118 provinces covering 790 districts in Bangladesh, Cambodia, India, Indonesia, Laos, Malaysia, Myanmar, Nepal, Papua New Guinea, Philippines, Thailand and Vietnam as geographical gaps in the collection. Complete passport data including location coordinates should be collected while collecting the germplasm to analyze the spatial aspects of species distribution.