The impact of a psychiatry clinical rotation on the attitude of Nigerian medical students to psychiatry

Objective: Undergraduate medical students have ingrained and often negative attitudes towards psychiatry as a field and as a career. This in turn has affected recruitment of graduate medical students into the specialty. Little is known about the impact of psychiatry rotations during undergraduate medical training on students’ attitudes about psychiatry and eventual specialty choice in developing countries. This study examined the impact of a psychiatry clinical rotation on medical students’ attitudes to psychiatry and possible career choice. Method: Eighty-one and one hundred and six fifth year medical students completed the ATP-30, socio-demographic and career choice questionnaires at the beginning and the end of a four week clinical rotation respectively. Results: The overall attitude of the students to psychiatry was favourable at the beginning of the rotation with significant improvement following the rotation (p=0.003). Significant improvement in attitude was observed among female and younger students. Students who indicated preference for specialties other than psychiatry showed a greater improvement in their attitude to psychiatry following the rotation (p= 0.011). The rotation however did not enhance students’ preference for psychiatry as a future career. Conclusion: The four-week clinical rotation in psychiatry resulted in increased mean attitudinal score, but not in enhanced preference for psychiatry as a career.Keywords: Psychiatry; Attitude; Medical students; Nigeri

Infection after fracture osteosynthesis – Part I: Pathogenesis, diagnosis and classification

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Infection after fracture osteosynthesis – Part II: Treatment

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Septic arthritis caused by Brucella melitensis in urban Shenzhen, China: a case report

Abstract Introduction: Brucellosis is a systemic infectious disease which is still a challenging medical problem in rural areas such as northern China. It rarely occurs in urban areas such as Shenzhen in southern China. Osteoarticular involvements are frequently seen in brucellosis, and rarely is arthritis the only clinical presentation. We report a case of hip septic arthritis caused by Brucella melitensis in an urban area of Shenzhen, China. Case presentation: A 29-year-old Chinese woman, Han ethnical group presented to our hospital with left hip pain persisting for one month. She had a history of contact with goats one month before admission. Her clinical examination showed marked tenderness and limited movement of her left hip. Further imaging showed effusion of her left hip joint. Inflammatory markers including erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP) were raised. Our clinical diagnosis was septic arthritis of the left hip. A left hip arthroscopy was performed and the culture was positive for Brucella melitensis. She returned to normal activity after completing a standard antibiotic regimen, including gentamicin at 120mg daily for 2 weeks, doxycycline at 100mg daily and rifampicin at 450mg for a total of 12 weeks. Conclusions: Brucellosis is endemic in some rural areas of China, but rare in urban areas such as Shenzhen in southern China. However, more cases will be expected in urban areas due to increasing migration within China. Physicians should consider brucellosis as one of the differential diagnosis of arthritis. Early surgical intervention is recommended to prevent further joint destruction.published_or_final_versio

Containing the Not-Invented-Here Syndrome in external knowledge absorption and open innovation: The role of indirect countermeasures

This paper builds new theory and provides supporting evidence to contain the Not-Invented-Here Syndrome (NIHS) – a persistent decision-making error arising from an attitude-based bias against external knowledge. Conceptually, we draw on the 4i framework of organizational learning to develop a novel process perspective on NIHS. This allows us not only to unpack how and where NIHS impedes organizational learning, but also to identify the key requirements for effective NIHS countermeasures. Importantly, countermeasures fall into two categories: those that seek to change the negative attitude directly (direct NIHS countermeasures) and those that seek to attenuate the behavioral impact of negative attitudes without addressing the attitudes as such (indirect NIHS countermeasures). While the evidence base on direct NIHS countermeasures has grown over the last decade, indirect NIHS countermeasures have received little research attention. To address this gap, we adopt a mixed methods research design composed of two complementary empirical studies – the first qualitative and the second quantitative. Study 1 explores the prevalence of distinct NIHS countermeasures in collaborative R&D practice. Based on 32 interviews and three focus group meetings with R&D employees, we find that a broad array of primarily direct NIHS countermeasures is employed in R&D practice. Study 2 addresses the scarcity of scholarly and managerial insights on indirect NIHS countermeasures by testing the effectiveness of perspective taking as a debiasing technique to contain negative attitudes at the level of the individual. Based on quantitative survey data from 565 global R&D projects, it provides empirical evidence not only for the prevalence and negative effects of NIHS on project success as mediated by external knowledge absorption, but also for the effectiveness of perspective taking as an exemplary indirect NIHS countermeasure

Microbiological Safety of Ready-to-eat Foods Sold in Primary Schools in Abeokuta, South-West Nigeria

A study was conducted to assess the microbial safety of ready-to-eat (RTE) foods sold in private and public primary schools in Abeokuta, South-western Nigeria. One hundred and sixty RTE food samples were collected from forty food vendors in thirty primary schools and analysed microbiologically. Socio-economic status and their knowledge of food safety were assessed using the structured questionnaires. Total bacterial counts, total coliform counts and total fungal counts of RTE foods in public primary schools ranged from 6.27 log10cfu/g to 6.47 log10cfu/g, 6.00 log10cfu/g to 6.28 log10cfu/g and 5.85 log10cfu/g to 6.16 log10cfu/g respectively while those of private primary schools ranged from 6.30 log10cfu/g to 7.47 log10cfu/g, 6.15 log10cfu/g to 6.54 log10cfu/g and 5.60 log10cfu/g to 6.70 log10cfu/g respectively. Bacteria isolated from these samples were Bacillus cereus, Pseudomonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Proteus spp, Enterobacter aerogenes, Shigella dysenteriae and Escherichia coli while the fungal isolates includeAspergillus niger, Aspergillus fumigatus, Rhizopus spp, Penicillium  viridicatum, Mucor spp and Fusarium spp. RTE foods sold in both private and public primary schools were found to be highly contaminated. Inappropriate storage conditions, inadequate knowledge of food safety, attitudes and practices of the food vendors are the factors that may allow the food contamination. These findings demonstrate that ready-to-eat foods vended in public and private primary schools in Abeokuta, South-western Nigeria constitute an hazard to the pupils’ health. Provision of health education to the vendors and enforcing implementation of appropriate hygienic practices would improve food quality.Keywords · Ready-to-eat foods · Microbial safety · Primary school

The use of three-dimensional printing technology in orthopaedic surgery: A review

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.published_or_final_versio

Fasciola hepatica hijacks host macrophage miRNA machinery to modulate early innate immune responses

Fasciola hepatica, a global worm parasite of humans and their livestock, regulates host innate immune responses within hours of infection. Host macrophages, essential to the first-line defence mechanisms, are quickly restricted in their ability to initiate a classic protective pro-inflammatory immune response. We found that macrophages from infected animals are enriched with parasite-derived micro(mi)RNAs. The most abundant of these miRNAs, fhe-miR-125b, is released by the parasite via exosomes and is homologous to a mammalian miRNA, hsa-miR-125b, that is known to regulate the activation of pro-inflammatory M1 macrophages. We show that the parasite fhe-miR-125b loads onto the mammalian Argonaut protein (Ago-2) within macrophages during infection and, therefore, propose that it mimics host miR-125b to negatively regulate the production of inflammatory cytokines. The hijacking of the miRNA machinery controlling innate cell function could be a fundamental mechanism by which worm parasites disarm the early immune responses of their host to ensure successful infection

Output from VIP cells of the mammalian central clock regulates daily physiological rhythms

The suprachiasmatic nucleus (SCN) circadian clock is critical for optimising daily cycles in mammalian physiology and behaviour. The roles of the various SCN cell types in communicating timing information to downstream physiological systems remain incompletely understood, however. In particular, while vasoactive intestinal polypeptide (VIP) signalling is essential for SCN function and whole animal circadian rhythmicity, the specific contributions of VIP cell output to physiological control remains uncertain. Here we reveal a key role for SCN VIP cells in central clock output. Using multielectrode recording and optogenetic manipulations, we show that VIP neurons provide coordinated daily waves of GABAergic input to target cells across the paraventricular hypothalamus and ventral thalamus, supressing their activity during the mid to late day. Using chemogenetic manipulation, we further demonstrate specific roles for this circuitry in the daily control of heart rate and corticosterone secretion, collectively establishing SCN VIP cells as influential regulators of physiological timing

Children's unique experience of depression: Using a developmental approach to predict variation in symptomatology

<p>Abstract</p> <p>Background</p> <p>Current clinical knowledge suggests that children can have different types of depressive symptoms (irritability and aggression), but presents no theoretical basis for these differences. Using a developmental approach, the present study sought to test the relationship between developmental level (mental age) and expression of depressive symptoms. The primary hypothesis was that as children's mental age increased, so would the number of internalizing symptoms present.</p> <p>Methods</p> <p>Participants were 252 psychiatric inpatients aged 4 to 16 with a diagnosed depressive disorder. All children were diagnosed by trained clinicians using DSM criteria. Patients were predominantly male (61%) with varied ethnic backgrounds (Caucasian 54%; African American 22%; Hispanic 19%; Other 5%). Children were given an IQ test (KBIT or WISC) while within the hospital. Mental age was calculated by using the child's IQ score and chronological age. Four trained raters reviewed children's records for depressive symptoms as defined by the DSM-IV TR. Additionally, a ratio score was calculated to indicate the number of internalizing symptoms to total symptoms.</p> <p>Results</p> <p>Mental age positively correlated (<it>r </it>= .51) with an internalizing total symptom ratio score and delineated between several individual symptoms. Mental age also predicted comorbidity with anxiety and conduct disorders. Children of a low mental age were more likely to be comorbid with conduct disorders, whereas children with a higher mental age presented more often with anxiety disorders. Gender was independently related to depressive symptoms, but minority status interacted with mental age.</p> <p>Conclusion</p> <p>The results of this study indicate that a developmental approach is useful in understanding children's depressive symptoms and has implications for both diagnosis and treatment of depression. If children experience depression differently, it follows that treatment options may also differ from that which is effective in adults.</p