Family-inclusive practice in a psychiatric intensive care unit

Aims and Method: The National Institute for Health and Care Excellence recommends involving the families of patients admitted to psychiatric hospital care, without specific guidance on how to do it. To improve family involvement in a National Health Service psychiatric intensive care unit, a relatives’ and carers’ clinic was set up. Fifty family members attended and completed questionnaires. Nine went on to take part in interviews, the results of which were analysed using thematic analysis. Results: Families felt more informed and found the increased access to information useful. They felt that the process showed respect for them and their family member, and that their contribution was valued. Running throughout the interviews was the contrast with previous experiences; families reported feeling heard and understood and attributed this in part to timing and environment. Clinical implications: The clinic was viewed positively by families and met the trust’s commitment to including carers, as well as national guidance which suggests it should be part of routine practice

Circumcision: Its nature and practice among some ethnic groups in Southern Nigeria

A questionnaire survey carried out in five rural communities in mid-southern Nigeria documents the degree and range of male and female circumcision practices among Bini, Esan, Etsako, Ijaw and Ukwuani ethnic groups. Two hundred and eighty adults (154 males and 126 females) reported on themselves and their 1417 children (757 sons and 660 daughters). Circumcision of both sexes remains widely practised, though the timing of the event and extent of surgery show wide variations among, and sometimes, within ethnic groups. The commonest reason for the practice is a strong desire to continue ethnic traditions. Altered sexual urge for women, increased sexual performance for men, protection of baby's health, as well as general reproductive and aesthetic consideration are also important reasons. Traditional surgeons usually perform the operation and few complications were reported to be associated with the procedure in either sex. Female circumcision in this area is not as destructive or mutilating as in some Arabic and East African cultures. Because of the relatively low rate of complications a major campaign against circumcision in these areas does not at present seem warranted.

Sickle cell anaemia in Nigeria: a comparison between Benin and Lagos

The clinical and haematological features of 77 patients of Bini and 107 patients of Yoruba origin with homozygous sickle cell (SS) disease have been compared. The Bini population were generally younger and had a slightly lower incidence of alpha thalassaemia but even after correction for age and alpha thalassaemia status, this group had significantly lower HbA2 and higher HbF and MCV values. Clinically the Bini group had significantly less dactylitis and more acute chest syndrome. The decreased frequency of dactylitis is consistent with the higher HbF level in the Bini population and the mechanism of the other effects are discusse