The stigma of mental illness in Southern Ghana: attitudes of the urban population and patients’ views

PURPOSE: Stigma is a frequent accompaniment of mental illness leading to a number of detrimental consequences. Most research into the stigma connected to mental illness was conducted in the developed world. So far, few data exist on countries in sub-Saharan Africa and no data have been published on population attitudes towards mental illness in Ghana. Even less is known about the stigma actually perceived by the mentally ill persons themselves. METHOD: A convenience sample of 403 participants (210 men, mean age 32.4 ± 12.3 years) from urban regions in Accra, Cape Coast and Pantang filled in the Community Attitudes towards the Mentally Ill (CAMI) questionnaire. In addition, 105 patients (75 men, mean age 35.9 ± 11.0 years) of Ghana's three psychiatric hospitals (Accra Psychiatry Hospital, Ankaful Hospital, Pantang Hospital) answered the Perceived Stigma and Discrimination Scale. RESULTS: High levels of stigma prevailed in the population as shown by high proportions of assent to items expressing authoritarian and socially restrictive views, coexisting with agreement with more benevolent attitudes. A higher level of education was associated with more positive attitudes on all subscales (Authoritarianism, Social Restrictiveness, Benevolence and Acceptance of Community Based Mental Health Services). The patients reported a high degree of experienced stigma with secrecy concerning the illness as a widespread coping strategy. Perceived stigma was not associated with sex or age. DISCUSSION: The extent of stigmatising attitudes within the urban population of Southern Ghana is in line with the scant research in other countries in sub-Saharan Africa and mirrored by the experienced stigma reported by the patients. These results have to be seen in the context of the extreme scarcity of resources within the Ghanaian psychiatric system. Anti-stigma efforts should include interventions for mentally ill persons themselves and not exclusively focus on public attitudes

Lack of effective communication between communities and hospitals in Uganda: a qualitative exploration of missing links

<p>Abstract</p> <p>Background</p> <p>Community members are stakeholders in hospitals and have a right to participate in the improvement of quality of services rendered to them. Their views are important because they reflect the perspectives of the general public. This study explored how communities that live around hospitals pass on their views to and receive feedback from the hospitals' management and administration.</p> <p>Methods</p> <p>The study was conducted in eight hospitals and the communities around them. Four of the hospitals were from three districts from eastern Uganda and another four from two districts from western Uganda. Eight key informant interviews (KIIs) were conducted with medical superintendents of the hospitals. A member from each of three hospital management boards was also interviewed. Eight focus group discussions (FGDs) were conducted with health workers from the hospitals. Another eight FGDs (four with men and four with women) were conducted with communities within a five km radius around the hospitals. Four of the FGDs (two with men and two with women) were done in western Uganda and the other four in eastern Uganda. The focus of the KIIs and FGDs was exploring how hospitals communicated with the communities around them. Analysis was by manifest content analysis.</p> <p>Results</p> <p>Whereas health unit management committees were supposed to have community representatives, the representatives never received views from the community nor gave them any feed back from the hospitals. Messages through the mass media like radio were seen to be non specific for action. Views sent through suggestion boxes were seen as individual needs rather than community concerns. Some community members perceived they would be harassed if they complained and had reached a state of resignation preferring instead to endure the problems quietly.</p> <p>Conclusion</p> <p>There is still lack of effective communication between the communities and the hospitals that serve them in Uganda. This deprives the communities of the right to participate in the improvement of the services they receive, to assume their position as stakeholders. Various avenues could be instituted including using associations in communities, rapid appraisal methods and community meetings.</p

Accommodating Dynamic Oceanographic Processes and Pelagic Biodiversity in Marine Conservation Planning

Pelagic ecosystems support a significant and vital component of the ocean's productivity and biodiversity. They are also heavily exploited and, as a result, are the focus of numerous spatial planning initiatives. Over the past decade, there has been increasing enthusiasm for protected areas as a tool for pelagic conservation, however, few have been implemented. Here we demonstrate an approach to plan protected areas that address the physical and biological dynamics typical of the pelagic realm. Specifically, we provide an example of an approach to planning protected areas that integrates pelagic and benthic conservation in the southern Benguela and Agulhas Bank ecosystems off South Africa. Our aim was to represent species of importance to fisheries and species of conservation concern within protected areas. In addition to representation, we ensured that protected areas were designed to consider pelagic dynamics, characterized from time-series data on key oceanographic processes, together with data on the abundance of small pelagic fishes. We found that, to have the highest likelihood of reaching conservation targets, protected area selection should be based on time-specific data rather than data averaged across time. More generally, we argue that innovative methods are needed to conserve ephemeral and dynamic pelagic biodiversity

Omics-based molecular techniques in oral pathology centred cancer: Prospect and challenges in Africa

: The completion of the human genome project and the accomplished milestones in the human proteome project; as well as the progress made so far in computational bioinformatics and “big data” processing have contributed immensely to individualized/personalized medicine in the developed world.At the dawn of precision medicine, various omics-based therapies and bioengineering can now be applied accurately for the diagnosis, prognosis, treatment, and risk stratifcation of cancer in a manner that was hitherto not thought possible. The widespread introduction of genomics and other omics-based approaches into the postgraduate training curriculum of diverse medical and dental specialties, including pathology has improved the profciency of practitioners in the use of novel molecular signatures in patient management. In addition, intricate details about disease disparity among diferent human populations are beginning to emerge. This would facilitate the use of tailor-made novel theranostic methods based on emerging molecular evidences

P-D-R Blueprint for an Ideal Corporate Information Center

Innovation is fostered by information and knowledge. Information therefore has always been a key competitive asset in any research based corporation and fundamental for decision making on all levels. Hence corporate libraries, managing this key asset, have formed a natural and indispensable function for any R&D driven business and enterprise for many decades. The last 20 years have transformed the information world and libraries have played a very active role in this transition. Following and paralleling the transition of publishers into information solution providers, corporate libraries evolved into information management and knowledge centers. This transition has turned them into innovation partners rather than raw information providers or physical shelving facilities. Especially in the pharmaceutical industry, organizations and functions are constantly adjusting to leverage any financial or competitive advantage. This applies equally to corporate scientific libraries or information cen-ters which, within a technology-enabled landscape and tight resource management, are expected to constantly gain efficiency, and to provide greater value while serving a global community consisting of interdisciplinary multi-site teams. Thus, corporate information centers (this term will be used within this article) are constantly facing reorganization and need to define the functions that are required to fulfil the tasks of fostering innova-tion, enabling access to internal and external knowledge, and integrating content into the workflow of corporate knowledge workers. There are only few publications that deal with life sciences libraries or corporate information centers at all. One, entitled “2015 – The Future of Medical libraries” [1] tried predict what would happen to medical libraries in the post-Google world but did not discuss developments in a corporate setting nor describe the functions needed to have future-proof organisation that helps developing better medicines. Other focus on benchmarking, best practices or needs assessments [2–5]. Therefore, the P-D-R (Pharma Documentation Ring), an organization that represents the scientific informa-tion departments of the leading R&D-based pharmaceutical corporations, worked on a blueprint for an Ideal Corporate Information Center (ICIC), a blueprint that may be used by any company – not only in the pharmaceutical industry. The P-D-R has defined twelve building blocks of which such an ICIC should consist, which are described in the following sections. In the last section, it is discussed how an ICIC could be integrated into the corporation

Potential Futures of Biological Invasions in South Africa

Biological invasions are having a moderately negative impact on human livelihoods and the environment in South Africa, but the situation is worsening. Predicting future trends is fraught with many assumptions, so this chapter takes an outcome-orientated approach. We start by envisaging four scenarios for how biological invasions might look like 200–2000 years from now: (1) “Collapse of Civilisation, but no return to Eden”, there is no advanced human civilisation left on Earth and current biological invasions play out in full; (2) “New Pangea”, a combination of the unregulated and rapid movement of species around the world and other global change drivers leads to the biotic homogenisation of areas that were previously distinct biogeographic regions such that the concept of biological invasions no longer has meaning; (3) “Preserve or Use”, while parts of the Earth continue to be utilised, some areas are actively managed and native biodiversity and biogeographic distributions are maintained; and (4) “Conservation Earth”, a highly advanced civilisation restores the Earth to a state prior to the human-mediated movement of organisms (i.e. biological invasions are reversed). Based on various horizon-scanning exercises and our own deliberations, we discuss how technological, socio-political, trade, global change, and ecological-evolutionary processes in South Africa might affect biological invasions by 2070 (i.e. when people born today will be the key decision-makers). Finally, we explore how planning, regulation, funding, public support, and research might affect invasions by 2025 (i.e. over the next planning/management/political cycle). There are many things we can neither predict nor influence, but, in part based on the insights from this book, we highlight some actions that could enable the next generation to decide what they want their future to be. A greater focus on appropriate and innovative training opportunities would increase the efficacy and responsiveness of the management of biological invasions. A shift in regulatory approach from “identify and direct” to a variety of flexible, inclusive, and sophisticated approaches underpinned by evidence might provide more societally acceptable means of addressing the multitude of competing interests. Greater co-operation on biosecurity and implementation with neighbouring countries would assist prevention measures. Finally, monitoring and research aimed at documenting, tracking, and predicting invasions and their impacts would assist with efforts to identify priorities and help us to understand the consequence of different management and policy decisions. While this was a sobering exercise, it was also empowering. If South Africans can agree on a long-term trajectory for how they want to deal with biological invasions, the potential consequences of decision-making over the short-term will become much clearer