Pattern and Prevalence of Psychiatric Consultations in Other Non-Psychiatric In-patient Facilities in the University of Port Harcourt Teaching Hospital( UPTH): A 5-year Review

Background The tendency of other medical conditions to comorbid or present with psychiatric complications is on the increase. Several studies have put the prevalence of psychiatric co-morbidity with medical conditions at about 10- 20%, with an unmatched diagnostic ability by most clinicians. This has resulted in poor management and unfavorable outcomes. The aim of this study was to determine the pattern and prevalence of psychiatric comorbidity with other medical conditions in other non-psychiatric wards in UPTH.Methods Approval for the study was obtained from the ethical committee of the hospital. A record was kept of all the consultations to psychiatry from every other unit in the hospital over 5 years. Both the psychiatric and non-psychiatric diagnoses made were all noted. Cases selected included any clinical conditions with comorbid psychiatric disorders while patients with only psychiatric diagnosis seen especially in the Accident and Emergency Department were all excluded from the study. The cases were reviewed by consultant neuropsychiatrists and psychiatric diagnoses were made using the DSM-IV TR diagnostic criteria. The total admissions in each unit of the hospital over the period under review were also determined.Results The study showed that out of a total admission of 54, 7 45 in the entire clinical department within the period, 3217 consultations (representing 5.9%) were made to psychiatry. Out ofthis figure, 2778 cases of psychiatric comorbidities were diagnosed, (representing 86.4% of total consultations). This  shows a prevalence of psychiatric comorbidity (consultations) of 5.1%. (p=0.0001, Chi value= 3330.10). Internal Medicine was the highest, 604(22%) followed by Surgery with 496 (17%), Accident and  Emergency, 320 (12%), Obstetrics and Gynaecology 280(1 0%), Orthopaedic 267(9%), Burns and  Plastics 266(9%), Paediatrics 244 (9%), Ophthalmology 147(5.3%), ENT 102(4%) and ICU the least with 27(1%). The observed differences in psychiatric consultations among the department were statistically significant (p=0.001).Conclusion The prevalence of psychiatric comorbidity is 5.1% in UPTH. There is need for sensitization  among clinicians to increase their clinical acumen to enable them recognizes cases requiring psychiatric attention, in addition to increasing their willingness to make necessary and timely consultations and I or referrals.Keywords Pattern; Prevalence; Psychiatric consultations; UPTH

The burden of disease and injury in Aboriginal and Torres Strait Islander peoples 2003

This report provides the first comprehensive assessment of the burden of disease of Indigenous Australians. Fatal and non-fatal outcomes are combined, but can be examined separately as well. This report provides details of the extent of premature mortality and disability estimated for over 170 disease and injury categories and for Aboriginal and Torres Strait Islander peoples living in remote and non-remote areas of Australia. Burden of disease analysis gives a unique perspective on health. Fatal and non-fatal outcomes are combined, but can be examined separately as well. This report provides details of the extent of premature mortality and disability estimated for over 170 disease and injury categories and for Aboriginal and Torres Strait Islander peoples living in remote and non-remote areas of Australia. It also presents estimates of the amount of disease and injury caused by 11 major risk factors. More importantly, it measures the Indigenous Health Gap, which is the difference between the observed burden of disease in Indigenous Australians and what it would have been if the same rates of burden of disease as in the total Australian population would have applied. This is of major policy interest. The diseases and risk factors that contribute most to the Indigenous Health Gap are identified as health areas where appropriately resourced health services, combined with interventions to address the social and economic disadvantages faced by Indigenous Australians, are likely to have the greatest impact on reducing the burden of disease

Understanding of Iban Women Political Participation through Analysing the Decision-Making Process in Iban Society

An individual is said to have become involved in politics if he or she participated in activities such as voting, campaigning, soliciting for votes, giving political speeches to influence the actions or the decisions of the other persons, becoming a member of a political organisation, distributing party fliers, carrying banners, or supporting a political party. A person’s involvement in politics may be classified as active involvement or passive involvement. The highest level of a political participation is when a person puts himself or herself up to be chosen as the people’s representative in a competitive election. To date no Iban women have ever been elected to the country’s House of Representatives. This is not to say that their involvement in ‘low politics’ is any better either. Niggling issues such as the customary practices, the longhouse systems, the political socialisation, the decision-making processes, and the notion of manliness may still be the decisive factors in how and why the Iban select or determine their leaders. This paper is an attempt to understand how and why the involvement of Iban women in politics is still at an infancy stage, as well as exploring the challenges that hinder its progress and development. Keywords: Decision making, community leader, longhouse tradition, participation, socialisatio

The burden of disease and injury in Australia 2003

The report measures mortality, disability, illness and injury arising from over 170 diseases and injuries. Burden of disease analysis gives a unique perspective on healt

Understanding of Iban Women Political Participation through Analysing the Decision-Making Process in Iban Society

An individual is said to have become involved in politics if he or she participated in activities such as voting, campaigning, soliciting for votes, giving political speeches to influence the actions or the decisions of the other persons, becoming a member of a political organisation, distributing party fliers, carrying banners, or supporting a political party. A person’s involvement in politics may be classified as active involvement or passive involvement. The highest level of a political participation is when a person puts himself or herself up to be chosen as the people’s representative in a competitive election. To date no Iban women have ever been elected to the country’s House of Representatives. This is not to say that their involvement in ‘low politics’ is any better either. Niggling issues such as the customary practices, the longhouse systems, the political socialisation, the decision-making processes, and the notion of manliness may still be the decisive factors in how and why the Iban select or determine their leaders. This paper is an attempt to understand how and why the involvement of Iban women in politics is still at an infancy stage, as well as exploring the challenges that hinder its progress and development

Discovery of antivirulence agents against methicillin-resistant staphylococcus aureus

Antivirulence agents inhibit the production of disease-causing virulence factors but are neither bacteriostatic nor bactericidal. Antivirulence agents against methicillin-resistant Staphylococcus aureus (MRSA) strain USA300, the most widespread community-associated MRSA strain in the United States, were discovered by virtual screening against the response regulator AgrA, which acts as a transcription factor for the expression of several of the most prominent S. aureus toxins and virulence factors involved in pathogenesis. Virtual screening was followed by similarity searches in the databases of commercial vendors. The small-molecule compounds discovered inhibit the production of the toxins alpha-hemolysin and phenol-soluble modulin α in a dose-dependent manner without inhibiting bacterial growth. These antivirulence agents are small-molecule biaryl compounds in which the aromatic rings either are fused or are separated by a short linker. One of these compounds is the FDA-approved nonsteroidal anti-inflammatory drug diflunisal. This represents a new use for an old drug. Antivirulence agents might be useful in prophylaxis and as adjuvants in antibiotic therapy for MRSA infections

Health facilities preparedness to deliver maternal and newborn health care in Kilifi and Kisii Counties, Kenya

Introduction: Health facility preparedness is essential for delivering quality maternal and newborn care, minimizing morbidity and mortality by addressing delays in seeking skilled care, reaching appropriate facilities, and receiving emergency care. A rapid assessment of 23 government health facilities in Kilifi and Kisii counties identified poor maternal and newborn indicators in 16 facilities. The Access to Quality Care through Extending and Strengthening Health Systems (AQCESS) project supported these facilities with training, equipment, and referral linkages. This study focuses on facility preparedness of the 16 facilities to deliver maternal and newborn health services, specifically delays two and three at the end of the project implementation. Methods: A descriptive cross-sectional study was carried-out on behalf of AQCESS project team by respective county ministry of health in-charge of reproductive maternal newborn and child health programs and trained nurses and medical doctors from Aga Khan health services in December 2019. The study evaluated the accessibility and reliability of drugs, commodities, equipment, personnel, basic necessities (such as water and electricity), and guidelines using validated World Health Organization service availability and readiness assessment tool. The findings of the assessment are presented through frequency and percentage analysis, along with a comparative analysis between the two counties. Results: All the 16 facilities assessed offered routine antenatal care (ANC) and normal delivery, but only two provided comprehensive emergency obstetric and newborn care (CEmONC). Most essential medicines, commodities, and required equipment were available. BEmONC and CEmONC guidelines were present in Kilifi, not in Kisii. One staff member was available 24/7 for cesarean section (CS) in each county, with one anesthetist in Kilifi. Electricity was accessible in all facilities, but only half had secondary power supply. Facilities offering CS had backup generators. Conclusion: The Facilities assessed had necessary drugs, commodities, equipment, and requirements, but staffing and guidelines were limited. Kilifi outperformed Kisii in most indicators. Additional support is needed for infrastructure and human resources to deliver quality maternal and newborn health services. Continuous monitoring will facilitate resource allocation based on facility needs

Associations between schizophrenia genetic risk, anxiety disorders and manic/hypomanic episode in a longitudinal population cohort study.

BACKGROUND: Studies involving clinically recruited samples show that genetic liability to schizophrenia overlaps with that for several psychiatric disorders including bipolar disorder, major depression and, in a population study, anxiety disorder and negative symptoms in adolescence.AimsWe examined whether, at a population level, association between schizophrenia liability and anxiety disorders continues into adulthood, for specific anxiety disorders and as a group. We explored in an epidemiologically based cohort the nature of adult psychopathology sharing liability to schizophrenia. METHOD: Schizophrenia polygenic risk scores (PRSs) were calculated for 590 European-descent individuals from the Christchurch Health and Development Study. Logistic regression was used to examine associations between schizophrenia PRS and four anxiety disorders (social phobia, specific phobia, panic disorder and generalised anxiety disorder), schizophrenia/schizophreniform disorder, manic/hypomanic episode, alcohol dependence, major depression, and - using linear regression - total number of anxiety disorders. A novel population-level association with hypomania was tested in a UK birth cohort (Avon Longitudinal Study of Parents and Children). RESULTS: Schizophrenia PRS was associated with total number of anxiety disorders and with generalised anxiety disorder and panic disorder. We show a novel population-level association between schizophrenia PRS and manic/hypomanic episode. CONCLUSIONS: The relationship between schizophrenia liability and anxiety disorders is not restricted to psychopathology in adolescence but is present in adulthood and specifically linked to generalised anxiety disorder and panic disorder. We suggest that the association between schizophrenia liability and hypomanic/manic episodes found in clinical samples may not be due to bias.Declarations of interestNone

Chandra X-ray spectroscopy of the very early O supergiant HD 93129A: constraints on wind shocks and the mass-loss rate

We present analysis of both the resolved X-ray emission line profiles and the broadband X-ray spectrum of the O2 If* star HD 93129A, measured with the Chandra HETGS. This star is among the earliest and most massive stars in the Galaxy, and provides a test of the embedded wind shock scenario in a very dense and powerful wind. A major new result is that continuum absorption by the dense wind is the primary cause of the hardness of the observed X-ray spectrum, while intrinsically hard emission from colliding wind shocks contributes less than 10% of the X-ray flux. We find results consistent with the predictions of numerical simulations of the line-driving instability, including line broadening indicating an onset radius of X-ray emission of several tenths Rstar. Helium-like forbidden-to-intercombination line ratios are consistent with this onset radius, and inconsistent with being formed in a wind-collision interface with the star's closest visual companion at a distance of ~100 AU. The broadband X-ray spectrum is fit with a dominant emission temperature of just kT = 0.6 keV along with significant wind absorption. The broadband wind absorption and the line profiles provide two independent measurements of the wind mass-loss rate: Mdot = 5.2_{-1.5}^{+1.8} \times 10^{-6} Msun/yr and Mdot = 6.8_{-2.2}^{+2.8} \times 10^{-6} Msun/yr, respectively. This is the first consistent modeling of the X-ray line profile shapes and broadband X-ray spectral energy distribution in a massive star, and represents a reduction of a factor of 3 to 4 compared to the standard H-alpha mass-loss rate that assumes a smooth wind.Comment: Accepted for publication in Monthly Notices of the Royal Astronomical Society. 12 pages, 10 figures (incl. 5 color