Towards a better understanding of attitudes and beliefs held by traditional healers and recipients of traditional medicine concerning mental health conditions in post-conflict Liberia: a qualitative investigation

Background

A better understanding of attitudes and beliefs held by traditional healers and utilizers of traditional medicine concerning mental health conditions in Liberia is important as Liberia seeks to improve its delivery of mental healthcare in the context of scarce resources and recovery from civil war.

Methods

A qualitative research design was used to collect data from 24 Liberian traditional healers, and 11 utilizers of Liberian traditional medicine. Participants were queried about mental health problems in Liberia, treatments, and attitudes towards modern healthcare. Qualitative data were probed and aggregated using content analysis.

Results

Mental health problems described by study participants included: Open Mole, African Science, Epilepsy, Depression and Mental Illness (trauma/substance use). Mental health problems were often associated with socioeconomic distress, and participants described their attitudes and beliefs concerning mental healthcare, traditional medicine, and modern healthcare.

Conclusion

Traditional medicine is an important part of mental healthcare in Africa. Mental illness, social factors, and healthcare access were important problems in Liberia. Mental health problems blended local cultural beliefs with Westernized nosology and social factors. Traditional healer's attitudes towards Western medicine reflected ambivalence. There is a desire for collaboration with ‘modern’ health care providers, but this will require reciprocal trust-building.

Care in patients with epidermal necrolysis in burn units. A nursing perspective

OBJECTIVE

To describe how nursing care is delivered to patients with epidermal necrolysis in burn units/specialized units in Spain and a selection of countries.

METHOD

Descriptive cross-sectional study. Data were collected through a structured questionnaire which was sent to nurse managers in all burn units in Spain and a selection of countries. Descriptive statistics was used to summarize the results.

RESULTS

All BU/SUs in Spain (n=12) and seven BU/SUs from a selection of countries completed the questionnaire. A lack of specific nursing protocols on Epidermal Necrolysis was observed in most burn units in Spain. Skin cleansing techniques such as showering were only reported by participants from Spain. Use of antiseptics was less frequent in other countries. Conservative skin management was the most extended practice reported by all participants. The use of vaginal molds to prevent synechiae and coverage of the ocular surface with amniotic membrane to minimize sequelae were rarely reported. Pain assessment was not always documented in sedated patients and few participants reported the use of specific scales for this purpose. All nurses agreed in the need for consensus nursing care guidelines on the disease.

CONCLUSIONS

Nursing care in patients with epidermal necrolysis varied between burn units in Spain. Differences and similarities were observed when compared with burn units in other countries. Genital and ocular care were outdated in all BU/SUs. Pain assessment documentation was suboptimal. Evidence-based nursing care guidelines were generally demanded by all participants to help reduce mortality and morbidity of this rare and often devastating disease.

Use of Space in Open Field by Zebra Finches

This paper is a descriptive study of the spatial preferences of the zebra finch, Taeniopygia guttata, when exposed to a novel environment. 18 subjects were observed in a cubic open field of 1 × 1 × 1 m during four 30-min. sessions. Two spatial variables were considered, height and center/periphery. Data show that birds did not position themselves randomly in the open field but chose more frequently the central and higher part of the enclosure and that general activity was greater when the animal was in the center rather than on the periphery. There were no sex differences in the height preferred, but females spent significantly more time in the center than did males. The type of activity engaged in by the birds was also important in relation to the place occupied.

Improving patient provider communication for Latinos at Temple University Hospital and Temple University School of Medicine

This Report from the Field documents a series of interventions developed by Temple University Health System and School of Medicine through participation in the RWJF initiative entitled Hablamos Juntos. The report delineates outcomes to date demonstrating that these interventions have met the challenge of improving patient provider communication for Latinos.

Mitochondrial DNA (mtDNA) and schizophrenia

The poorly understood aetiology of schizophrenia is known to involve a major genetic contribution even though the genetic factors remain elusive. Most genetic studies are based on Mendelian rules and focus on the nuclear genome, but current studies indicate that other genetic mechanisms are probably involved. This review focuses on mitochondrial DNA (mtDNA), a maternally inherited, 16.6-Kb molecule crucial for energy production that is implicated in numerous human traits and disorders. The aim of this review is to summarise the studies that have explored mtDNA in schizophrenia patients and those which provide evidence for its implication in this illness. Alterations in mitochondrial morphometry, brain energy metabolism, and enzymatic activity in the mitochondrial respiratory chain suggest a mitochondrial dysfunction in schizophrenia that could be related to the genetic characteristics of mtDNA. Moreover, evidence of maternal inheritance and the presence of schizophrenia symptoms in patients suffering from a mitochondrial disorder related to an mtDNA mutation suggest that mtDNA is involved in schizophrenia. The association of specific variants has been reported at the molecular level; however, additional studies are needed to determine whether the mitochondrial genome is involved in schizophrenia.

Asperger's disorder in adulthood: a case report

Asperger's disorder is a pervasive development disorder. It involves qualitative disorders in social relationship and communication as well as restricted and repetitive interests and activities, with no delay in language acquisition. Although Asperger's disorder is an illness that begins in childhood, its diagnosis may frequently not be done until later stages. The case presented is about a 21 year old man with a diagnosis of schizoaffective disorder who, after several admissions, was sent to the Rehabilitation Hospital Unit for stabilization and diagnostic study given the atypical features of his case. The psychopathological examination showed disorders in social relationships, psychomotricity and communications that had begun in his childhood. All these data, and the results of the biomedical and psychological diagnostic tests oriented us towards the presence of a dual diagnosis of Asperger's disorder and schizoaffective disorder. The presence of common symptoms between the AD and other psychiatric diseases as well as the possible existence of comorbidity may lead to an incorrect or late diagnosis.

The Miami Special: a simple tool for quality section mounting in Mohs surgery

High quality frozen sections are fundamental in Mohs surgery, and one of the main elements in tissue processing is the mounting of the specimen. The Miami Special has been used for this purpose at the University of Miami for over 30 years. Since 1989 the Miami Special has languished in the literature among a growing list of mounting instruments. Therefore, new generations of Mohs surgeons may not be acquainted with the advantages of this instrument. This article describes the Miami Special and outlines its use for the benefit of current practitioners.

Characterization of recombinant invertase expressed in methylotrophic yeasts

We studied, for the first time, characterization of the invertase expressed in the methylotrophic yeasts Hansenula polymorpha and Pichia pastoris in terms of enzyme conformational stability and structural behaviour induced by temperature as a function of pH using enzymic assays, differential scanning calorimetry, fluorescence and CD. The enzyme produced in both hosts was very stable over a broad range of pH values, keeping its enzymic activity and structure above 60 degrees C. Thermal denaturation, as measured by differential scanning calorimetry, was always irreversible. However, the fact that scanning rate had no effect on the calorimetric curves gave us the chance to analyse the data from a thermodynamic point of view. The conformational stabilities were essentially identical under the experimental conditions studied, but stability was always slightly higher in the enzyme expressed in H. polymorpha. This fact indicates that the greater degree of glycosylation of this enzyme form contributed to its increased global stability. Reactivation upon heating at 80 degrees C depends on protein concentration, suggesting that irreversibility could be associated with slow refolding kinetics at high protein concentration.

[Effect of pets on human health: is there a correlation?]

Is there a Relationship? Despite an increasing number of studies devoted to the health benefits of interacting with pets, the empirical evidence of such an effect still remains weak. Many reports comparing health-related variables in pet owners and non-owners do not find significant differences. Some studies find a statistical correlation between pet ownership and better health, but they do not adequately demonstrate that the better health is a result of the pet. There is experimental evidence suggesting that the presence of animals is associated with a lowering of cardiovascular responses to stressors. Accordingly, pets could be used in the therapy of stress-related diseases. Nevertheless, no consistent clinical studies testing this hypothesis have been carried out. Moreover, neither evolutionary nor learning hypothesis for the observed decrease in cardiovascular reactivity have been tested till now. Research on the benefits of pet ownership still are in its preliminary steps. Further studies are needed for the understanding of the underlying psychological mechanisms of human/animal relationship and its therapeutic possibilities.

Geophysical variables and behavior: LXXII. Barometric pressure, lunar cycle, and traffic accidents

This study assessed relationships between traffic accidents and variables of the physical environment. Daily data on traffic accidents over a 4-year period were compared with daily records of barometric pressure and synodic lunar cycle. No significant variations in the number of accidents were found related to barometric height but a significant lunar periodicity was observed for one of the years considered. The number of accidents occurring during the full moon day was lowest; the highest occurred two days before the full moon. Accidents occurred more frequently during crescent moon than during waning moon, but no significant differences were noted when the lunar month was divided into four intervals of new moon, first quarter, full moon, and second quarter.