The quality of mental disorder treatment varies widely, with many patients not receiving treatments based on evidence-based guidelines. We examine data from the World Mental Health (WMH) surveys to investigate prevalence and correlates of receiving effective treatment coverage (ETC) among patients receiving minimally adequate treatment (MAT) in the 12 months before interview. Data come from 25 WMH surveys carried out in 21 countries that included n = 1,119 participants who met the criteria for at least one of nine 12-month disorders considered here who received MAT for n = 2,313 disorders. MAT was defined as either (i) medication with 4 + healthcare visits or (ii) 8 + counseling sessions. ETC was defined as a subset of MAT that additionally required (i) medication appropriate for the disorder (e.g., mood stabilizers, anticonvulsant, or antipsychotic for bipolar disorder) taken with adequate control and adherence; and/or (ii) 8 + counseling sessions with a mental healthcare provider. Multivariable regression analysis with person-disorder treated as the case was used to examine associations of socio-demographic, disorder-related, and treatment-related factors with receiving ETC given MAT. Fewer than half (47.1

Perceived need for treatment is a first step along the pathway to effective mental health treatment. Perceived need encompasses a person’s recognition that they have a problem and their belief that professional help is needed to manage the problem. These two components could have different predictors. Respondents aged 18+ years with 12-month mental disorders from 25 representative household surveys in 21 countries in the World Mental Health Survey Initiative (n = 12,508). All surveys included questions about perceived need; 16 surveys (13 countries) included additional questions about respondents’ main reason for perceived need—problem recognition or perceived inability to manage without professional help (n = 9814). Associations of three sets of predictors (disorder, socio-demographics, past treatment) with perceived need and its components were examined using Poisson regression models. Across the 16 surveys with additional questions, 42.4

High unmet need for treatment of mental disorders exists throughout the world. An understanding of barriers to treatment is needed to develop effective programs to address this problem. Data on barriers were obtained from face-to-face interviews in 22 community surveys across 19 countries (n = 102,812 respondents aged ≥ 18 years, 57.7

This study research power supply systems for low-power consumers, incorporating foldable photovoltaic panels (PV) and portable power stations with low-power capacity. This innovative technology offers an efficient solution for powering devices that lack access to the electrical grid. The study presents the current-voltage characteristics of foldable PV panels under real operating conditions. Measurements have been conducted in conditions closely approximating standard test parameters, and the impact of shading on their electrical performance has been also examined.

Data from the World Mental Health (WMH) surveys on the coverage cascade has underscored the importance of perceived need for seeking treatment of mental disorders. However, little research has focused on treatment contact after adjusting for perceived need. We do so here in analysis of WMH data. The WMH data considered here come from 25 community surveys implemented between 2001 and 2019 across 21 countries. n = 12,508 of the n = 117,739 respondents in these surveys aged 18 and older met criteria for one or more 12-month DSM-IV anxiety, mood, or substance use disorders assessed across all these surveys. Information was obtained about 12-month treatment of each disorder. The predictors considered were disorder type, socio-demographics, and history of prior treatment. Twelve-month treatment was obtained for 17.7

This paper examines the energy flows from a 30kWp photovoltaic (PV) system paired with a 30kWh battery. It presents the hourly energy generation of the system and the fluctuations in electricity market prices in Bulgaria. A model has been developed to calculate the energy flows between the PV system, the battery, and the grid. This model also includes the energy prices and calculation of financial income. The paper details the annual electricity production of the system and the corresponding variations in energy prices over the same period. An optimized algorithm has been created to determine the optimal times for battery energy injection. The study includes graphs comparing income scenarios with and without the battery. It demonstrates the increased income potential when integrating a battery into a PV system. Several simulation results are presented in graphical form, showing income comparisons over one month and one year.

Background Mental health service providers are increasingly interested in patient perspectives. We examined rates and predictors of patient-reported satisfaction and perceived helpfulness in a cross-national general population survey of adults with 12-month DSM-IV disorders who saw a provider for help with their mental health. Methods Data were obtained from epidemiological surveys in the World Mental Health Survey Initiative. Respondents were asked about satisfaction with treatments received from up to 11 different types of providers (very satisfied, satisfied, neither satisfied nor dissatisfied, somewhat dissatisfied, very dissatisfied) and helpfulness of the provider (a lot, some, a little, not at all). We modelled predictors of satisfaction and helpfulness using a dataset of patient-provider observations ( n = 5,248). Results Most treatment was provided by general medical providers (37.4%), psychiatrists (18.4%) and psychologists (12.7%). Most patients were satisfied or very satisfied (65.9-87.5%, across provider) and helped a lot or some (64.4-90.3%). Spiritual advisors and healers were most often rated satisfactory and helpful. Social workers in human services settings were rated lowest on both dimensions. Patients also reported comparatively low satisfaction with general medical doctors and psychiatrists/psychologists and found general medical doctors less helpful than other providers. Men and students reported lower levels of satisfaction than women and nonstudents. Respondents with high education reported higher satisfaction and helpfulness than those with lower education. Type of mental disorder was unrelated to satisfaction but in some cases (depression, bipolar spectrum disorder, social phobia) was associated with low perceived helpfulness. Insurance was unrelated to either satisfaction or perceived helpfulness but in some cases was associated with elevated perceived helpfulness for a given level of satisfaction. Conclusions Satisfaction with and perceived helpfulness of treatment varied as a function of type of provider, service setting, mental status, and socio-demographic variables. Invariably, caution is needed in combining data from multiple countries where there are cultural and service delivery variations. Even so, our findings underscore the utility of patient perspectives in treatment evaluation and may also be relevant in efforts to match patients to treatments.

Abstract Objective The standard method of generating disorder‐specific disability scores has lay raters make rankings between pairs of disorders based on brief disorder vignettes. This method introduces bias due to differential rater knowledge of disorders and inability to disentangle the disability due to disorders from the disability due to comorbidities. Methods We propose an alternative, data‐driven, method of generating disorder‐specific disability scores that assesses disorders in a sample of individuals either from population medical registry data or population survey self‐reports and uses Generalized Random Forests (GRF) to predict global (rather than disorder‐specific) disability assessed by clinician ratings or by survey respondent self‐reports. This method also provides a principled basis for studying patterns and predictors of heterogeneity in disorder‐specific disability. We illustrate this method by analyzing data for 16 disorders assessed in the World Mental Health Surveys (n = 53,645). Results Adjustments for comorbidity decreased estimates of disorder‐specific disability substantially. Estimates were generally somewhat higher with GRF than conventional multivariable regression models. Heterogeneity was nonsignificant. Conclusions The results show clearly that the proposed approach is practical, and that adjustment is needed for comorbidities to obtain accurate estimates of disorder‐specific disability. Expansion to a wider range of disorders would likely find more evidence for heterogeneity.

This paper studies the degradation of the performances of photovoltaic (PV) panels during the years of operation, which is crucial for owners of PV installations of different scales and in urban or rural areas. PV panels produced by five different technologies are investigated using experimental data from five grid-connected photovoltaic systems installed in Sofia, Bulgaria. The data cover ten years of operation under continental climate various meteorological conditions. The results of the study allow a more informed choice of suitable panel technology during the design and sizing process of PV systems. Finally, a brief comparison of the performance of different generations of PV panels is made.

Background Around the world, people living in objectively difficult circumstances who experience symptoms of generalized anxiety disorder (GAD) do not qualify for a diagnosis because their worry is not 'excessive' relative to the context. We carried out the first large-scale, cross-national study to explore the implications of removing this excessiveness requirement.Methods Data come from the World Health Organization World Mental Health Survey Initiative. A total of 133 614 adults from 12 surveys in Low- or Middle-Income Countries (LMICs) and 16 surveys in High-Income Countries (HICs) were assessed with the Composite International Diagnostic Interview. Non-excessive worriers meeting all other DSM-5 criteria for GAD were compared to respondents meeting all criteria for GAD, and to respondents without GAD, on clinically-relevant correlates.Results Removing the excessiveness requirement increases the global lifetime prevalence of GAD from 2.6% to 4.0%, with larger increases in LMICs than HICs. Non-excessive and excessive GAD cases worry about many of the same things, although non-excessive cases worry more about health/welfare of loved ones, and less about personal or non-specific concerns, than excessive cases. Non-excessive cases closely resemble excessive cases in socio-demographic characteristics, family history of GAD, and risk of temporally secondary comorbidity and suicidality. Although non-excessive cases are less severe on average, they report impairment comparable to excessive cases and often seek treatment for GAD symptoms.Conclusions Individuals with non-excessive worry who meet all other DSM-5 criteria for GAD are clinically significant cases. Eliminating the excessiveness requirement would lead to a more defensible GAD diagnosis.

Photovoltaic electricity generation saves worldwide no less than one billion tons of CO 2 , which is equivalent to approximately 3% of annual global emissions, which reached 33 gigatons in 2021. Thus, photovoltaics are already a key source of electricity decarbonization and achieving greater diversification in individual regions of the countries. In the present work, the focus is placed on hybrid solar inverters, their specific features, principle of operation, and advantages. Application of hybrid inverters in photovoltaic systems for energy self-consumption will be discussed more in detail by presenting a case study of such systems.

The paper studies the feasibility of a hybrid excited claw-pole alternator, using an analytical method for calculation of magnetic flux in the machine air gap. This study will serve as a preliminary calculation to prove or disprove the feasibility and show the advantages and the disadvantages of the proposed topology. The proposed method permits to assess the area of the permanent magnet that is required to obtain a desired voltage at the machine's terminals at a required speed and to properly size the additional excitation winding. The advantages and disadvantages as well as possible applications are discussed.

The paper presents an approach for modeling of operation and performance of photovoltaic systems intended for electricity production for self-consumption. With the recent development of technologies for solar electricity generation the usage of PV systems for self-consumption increases rapidly. The models developed by the authors give the possibility for accurate calculation of powers and energies in PV systems for self-consumption. Different configurations are studied: with and without connection to the public electrical grid, with and without energy storage, with and without limitation of energy export. The work reveals that setting an accurate hourly load profile is of utmost importance for the precision of the calculations and the results obtained. The models also give the possibility for optimization of: the battery usage strategy, the load profile (to match the generation from the PV panels), the battery capacity as well as the PV system as a whole.

Background Information on the frequency and timing of mental disorder onsets across the lifespan is of fundamental importance for public health planning. Broad, cross-national estimates of this information from coordinated general population surveys were last updated in 2007. We aimed to provide updated and improved estimates of age-of-onset distributions, lifetime prevalence, and morbid risk. Methods In this cross-national analysis, we analysed data from respondents aged 18 years or older to the World Mental Health surveys, a coordinated series of cross-sectional, face-to-face community epidemiological surveys administered between 2001 and 2022. In the surveys, the WHO Composite International Diagnostic Interview, a fully structured psychiatric diagnostic interview, was used to assess age of onset, lifetime prevalence, and morbid risk of 13 DSM-IV mental disorders until age 75 years across surveys by sex. We did not assess ethnicity. The surveys were geographically clustered and weighted to adjust for selection probability, and standard errors of incidence rates and cumulative incidence curves were calculated using the jackknife repeated replications simulation method, taking weighting and geographical clustering of data into account. Findings We included 156 331 respondents from 32 surveys in 29 countries, including 12 low-income and middle-income countries and 17 high-income countries, and including 85 308 (54.5%) female respondents and 71 023 (45.4%) male respondents. The lifetime prevalence of any mental disorder was 28.6% (95% CI 27.9-29.2) for male respondents and 29.8% (29.2-30.3) for female respondents. Morbid risk of any mental disorder by age 75 years was 46.4% (44.9-47.8) for male respondents and 53.1% (51.9-54.3) for female respondents. Conditional probabilities of first onset peaked at approximately age 15 years, with a median age of onset of 19 years (IQR 14-32) for male respondents and 20 years (12-36) for female respondents. The two most prevalent disorders were alcohol use disorder and major depressive disorder for male respondents and major depressive disorder and specific phobia for female respondents. Interpretation By age 75 years, approximately half the population can expect to develop one or more of the 13 mental disorders considered in this Article. These disorders typically first emerge in childhood, adolescence, or young adulthood. Services should have the capacity to detect and treat common mental disorders promptly and to optimise care that suits people at these crucial parts of the life course. Copyright (c) 2023 Elsevier Ltd. All rights reserved.

Patient‐reported helpfulness of treatment is an important indicator of quality in patient‐centered care. We examined its pathways and predictors among respondents to household surveys who reported ever receiving treatment for major depression, generalized anxiety disorder, social phobia, specific phobia, post‐traumatic stress disorder, bipolar disorder, or alcohol use disorder. Data came from 30 community epidemiological surveys – 17 in high‐income countries (HICs) and 13 in low‐ and middle‐income countries (LMICs) – carried out as part of the World Health Organization (WHO)’s World Mental Health (WMH) Surveys. Respondents were asked whether treatment of each disorder was ever helpful and, if so, the number of professionals seen before receiving helpful treatment. Across all surveys and diagnostic categories, 26.1% of patients (N=10,035) reported being helped by the very first professional they saw. Persisting to a second professional after a first unhelpful treatment brought the cumulative probability of receiving helpful treatment to 51.2%. If patients persisted with up through eight professionals, the cumulative probability rose to 90.6%. However, only an estimated 22.8% of patients would have persisted in seeing these many professionals after repeatedly receiving treatments they considered not helpful. Although the proportion of individuals with disorders who sought treatment was higher and they were more persistent in HICs than LMICs, proportional helpfulness among treated cases was no different between HICs and LMICs. A wide range of predictors of perceived treatment helpfulness were found, some of them consistent across diagnostic categories and others unique to specific disorders. These results provide novel information about patient evaluations of treatment across diagnoses and countries varying in income level, and suggest that a critical issue in improving the quality of care for mental disorders should be fostering persistence in professional help‐seeking if earlier treatments are not helpful.

Purpose To investigate the prevalence and predictors of perceived helpfulness of treatment in persons with a history of DSM-IV social anxiety disorder (SAD), using a worldwide population-based sample. Methods The World Health Organization World Mental Health Surveys is a coordinated series of community epidemiological surveys of non-institutionalized adults; 27 surveys in 24 countries (16 in high-income; 11 in low/middle-income countries; N = 117,856) included people with a lifetime history of treated SAD. Results In respondents with lifetime SAD, approximately one in five ever obtained treatment. Among these ( n = 1322), cumulative probability of receiving treatment they regarded as helpful after seeing up to seven professionals was 92.2%. However, only 30.2% persisted this long, resulting in 65.1% ever receiving treatment perceived as helpful. Perceiving treatment as helpful was more common in female respondents, those currently married, more highly educated, and treated in non-formal health-care settings. Persistence in seeking treatment for SAD was higher among those with shorter delays in seeking treatment, in those receiving medication from a mental health specialist, and those with more than two lifetime anxiety disorders. Conclusions The vast majority of individuals with SAD do not receive any treatment. Among those who do, the probability that people treated for SAD obtain treatment they consider helpful increases considerably if they persisted in help-seeking after earlier unhelpful treatments.

The paper presents a study of the influence of the photovoltaic (PV) technology on the sizing of the battery capacity in an irrigation system. The proposed methodology is based on simulation of the system’s operation during the irrigation period with a step of 1 hour. Five different PV technologies, influenced differently by the meteorological conditions are considered. Different criteria are used to estimate the optimal configuration. The methodology is applied to 5 sites in Bulgaria with high yield of the considered crop – cherries. The results show some trends in the battery sizing according to the PV technology and the installation site.

With increasing uncertainty in the supply of the main energy carriers (gas and oil), as well as the increasing cost of electricity on a European scale, the use of small photovoltaic systems (PV), is gaining more and more interest. The development of power electronic technologies would help the faster implementation of small PV systems in households and in places without an electricity grid. In the present work, the focus is placed on the modeling of a DC-DC converter for connecting a thin-film PV panel to a microinverter. The goal is to integrate such a converter to connect the panel to the microinverter seamlessly. The volt-ampere characteristic of the panel is transformed by the converter so that the PV module voltage matches the input voltage of the microinverter. A simulation model of the system involving thin-film PV panel, DC-DC converter and input stage of the microinverter with MPPT controller was developed in Matlab/Simulink environment. The obtained results show the adequacy of the approach and the flawless operation of the proposed DC-DC converter with a microinverter.

Self-consumption for residential and industrial buildings is important in order to reduce energy consumption from the electricity grid. As energy prices rise, more and more consumers are installing PV systems for their self-consumption. Self-consumption systems have a number of specific difficulties to solve related to variations in solar energy production and the user's load profile. Each installed system will contribute to the reduction of CO2 emissions and encourage the installation of low-power PV systems to produce green energy. In this way, users will reduce their dependence on the use of energy from the mains. The aim of this work is to develop simulation model for calculation of energy balance of PV system for self-consumption. Comparison of performance of two PV system types is done - without and with battery storage.

Abstract Background Community Mental Health Teams (CMHTs) deliver healthcare that supports the recovery of people with mental illness. The aim of this paper was to explore to what extent team members of five CMHTs newly implemented in five countries perceived that they had introduced aspects of the recovery-oriented, strength-based approach into care after a training week on recovery-oriented practice. In addition, it evaluated what the team members’ perceptions on their care roles and their level of confidence with this role were. Method An observational intervention study using a quantitative survey that was administered among 52 health professionals (21 Nurses, 13 Psychiatrists, 9 Psychologists, 8 Social Workers) and 14 peer workers including the Recovery Self-Assessment Tool Provider Version (RSA-P), the Team Member Self-Assessment Tool (TMSA), and demographic questions was conducted. The measures were self-reported. Descriptive statistics were used to calculate the means and standard deviations for continuous variables and frequencies and percentages for categorical variables (TMSA tool and demographic data). The standard technique to calculate scale scores for each subscale of the RSA-P was used. Bivariate linear regression analyses were applied to explore the impact of predictors on the subscales of the RSA-P. Predictors with significant effects were included in multiple regression models. Result The RSA-P showed that all teams had the perception that they provide recovery–oriented practice to a moderately high degree after a training week on recovery-oriented care (mean scores between 3.85–4.46). Health professionals with fewer years of professional experience perceived more frequently that they operated in a recovery-oriented way (p = 0.036, B = − 0.268). Nurses and peer workers did not feel confident or responsible to fulfil specific roles. Conclusion The findings suggest that a one-week training session on community-based practices and collaborative teamwork may enhance recovery-oriented practice, but the role of nurses and peer workers needs further attention. Trial registration Each trial was registered before participant enrolment in the clinicaltrials.gov database: Croatia, Zagreb (Trial Reg. No. NCT03862209 ); Montenegro, Kotor (Trial Reg. No. NCT03837340 ); Romania, Suceava (Trial Reg. No. NCT03884933 ); Macedonia, Skopje (Trial Reg. No. NCT03892473 ); Bulgaria, Sofia (Trial Reg. No. NCT03922425 ).