A preliminary study of psychological pain among patients attending the dental clinic of a tertiary hospital

Objective: Dental practitioners frequently encounter individuals who suffer from psychological pain at the dental clinics. Most dentists do not have the training or the instrument to recognise and manage psychological pain associated with dental treatment. This study was carried out to determine the level of psychological pain among dental patients visiting the dental clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria. Method: One hundred and twenty five patients who attended the dental clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria were invited to take part in the study. They completed a sociodemographic questionnaire, Psychache Scale (PAS) and the Hamilton Anxiety Rating Scale (HARS) in order to determine their levels of psychological pain and anxiety. Result: Of the total respondents, 43% were males and 57% females, mean age 30.2 years (SD=10.7, ranging from 15-80), 74.2% were married and 22.5% single. With regards to psychological pain and anxiety, 31.9% scored high in the PAS, indicating probable psychological pain while 25.8%, 19.4% and 54.8% were detected to suffer from mild, moderate and severe anxiety as detected by HARS. Conclusion: The finding from this study demonstrated that Nigerian dental patients also suffer from psychological pain and various degrees of dental anxiety. Therefore there is a need for Nigerian dental surgeons to acquire some knowledge of mental health in order to recognise these psychopathologies among their patients

Eyes wide open: perceived exploitation and its consequences

Drawing on the array of literature on exploitation from several social science disciplines, we propose a new way of seeing employer-employee relationships by introducing the concept of perceived exploitative employee-organization relationships, distinguish it from related concepts, and conduct five studies to develop a scale and test our theoretical model of the effects of such employee perceptions. Contributing to the Employee-Organization Relationships and workplace emotions literatures, perceived exploitation is defined as employees’ perceptions that they have been purposefully taken advantage of in their relationship with the organization, to the benefit of the organization itself. We propose and find that such perceptions are associated with both outward-focused emotions of anger and hostility toward the organization and inward-focused ones of shame and guilt at remaining in an exploitative job. In two studies including construction workers and a time-lagged study of medical residents, we find that the emotions of anger and hostility partially mediate the effects of perceived exploitation on employee engagement, revenge against the organization, organizational commitment, and turnover intentions, whereas the emotions of shame and guilt partially mediate the effects of perceived exploitation on employee burnout, silence, and psychological withdrawal

Rationale and design of the comparison of 3 combination therapies in lowering blood pressure in black Africans (CREOLE study): 2 × 3 factorial randomized single-blind multicenter trial

BACKGROUND: Current hypertension guidelines recommend the use of combination therapy as first-line treatment or early in the management of hypertensive patients. Although there are many possible combinations of blood pressure(BP)-lowering therapies, the best combination for the black population is still a subject of debate because no large randomized controlled trials have been conducted in this group to compare the efficacy of different combination therapies to address this issue. METHODS: The comparison of 3 combination therapies in lowering BP in the black Africans (CREOLE) study is a randomized single-blind trial that will compare the efficacy of amlodipine plus hydrochlorothiazide versus amlodipine plus perindopril and versus perindopril plus hydrochlorothiazide in blacks residing in sub-Saharan Africa (SSA). Seven hundred two patients aged 30-79 years with a sitting systolic BP of 140 mm Hg and above, and less than 160 mm Hg on antihypertensive monotherapy, or sitting systolic BP of 150 mm Hg and above, and less than 180 mm Hg on no treatment, will be centrally randomized into any of the 3 arms (234 into each arm). The CREOLE study is taking place in 10 sites in SSA, and the primary outcome measure is change in ambulatory systolic BP from baseline to 6 months. The first patient was randomized in June 2017, and the trial will be concluded by 2019. CONCLUSIONS: The CREOLE trial will provide unique information as to the most efficacious 2-drug combination in blacks residing in SSA and thereby inform the development of clinical guidelines for the treatment of hypertension in this subregion

The national portfolio of learning for postgraduate family medicine training in South Africa : experiences of registrars and supervisors in clinical practice

Please cite as follows:Jenkins, L., Mash, B. & Derese, A. 2013. The national portfolio of learning for postgraduate family medicine training in South Africa: experiences of registrars and supervisors in clinical practice. BMC Medical Education, 13(1):149, doi:10.1186/1472-6920-13-149.The original publication is available at http://www.biomedcentral.com/1472-6920/13/149Background: In South Africa the submission of a portfolio of learning has become a national requirement for assessment of family medicine training. A national portfolio has been developed, validated and implemented. The aim of this study was to explore registrars’ and supervisors’ experience regarding the portfolio’s educational impact, acceptability, and perceived usefulness for assessment of competence. Methods: Semi-structured interviews were conducted with 17 purposively selected registrars and supervisors from all eight South African training programmes. Results: The portfolio primarily had an educational impact through making explicit the expectations of registrars and supervisors in the workplace. This impact was tempered by a lack of engagement in the process by registrars and supervisors who also lacked essential skills in reflection, feedback and assessment. The acceptability of the portfolio was limited by service delivery demands, incongruence between the clinical context and educational requirements, design of the logbook and easy availability of the associated tools. The use of the portfolio for formative assessment was strongly supported and appreciated, but was not always happening and in some cases registrars had even organised peer assessment. Respondents were unclear as to how the portfolio would be used for summative assessment. Conclusions: The learning portfolio had a significant educational impact in shaping work-place based supervision and training and providing formative assessment. Its acceptability and usefulness as a learning tool should increase over time as supervisors and registrars become more competent in its use. There is a need to clarify how it will be used in summative assessment.Publishers' Versio