Sun protective behaviors at an outdoor entertainment event in Australia

An observational study was conducted to examine the use of sun protective hats, clothing, and sunglasses of people attending an outdoor entertainment event in an area of high‐to‐extreme ultraviolet radiation in New South Wales, Australia. Armidale is unique, as it is a highly‐elevated area, almost 1000 m above sea level, and temperatures are often mild with very high‐to‐extreme levels of ultraviolet radiation. Four trained data collectors observed attendees as they entered the event, and recorded their use of sun protective hats, clothing, and sunglasses. While more than half of the attendees wore sun protective hats, only 14% wore sun protective clothing. Broad‐brimmed hats were considered sun protective, while sun protective clothing was defined by shirts with at least three‐quarter‐length sleeves. Females were more likely to wear both a sun protective hat and clothing than males, and children were less protected than adults. Legislative changes are required to ensure that organizers of outdoor events have a legal responsibility to provide a safe environment for attendees, including strategies to help reduce ultraviolet radiation exposure.     

General hospital health professionals’ attitudes and perceived dangerousness towards patients with comorbid mental and physical health conditions: Systematic review and meta‐analysis

The stigmatization of mental health is present in general hospital settings impacting quality of care. We hypothesized that health professionals in these areas would elicit negative attitudes and a perceived level of dangerousness across a range of mental health disorders. We aimed to conduct a systematic review and meta‐analysis to examine these attitudes and perceptions. We searched the bibliographic databases of CINAHL Complete, MEDLINE Complete, PsycINFO, and Psychology and Behavioral Sciences Collection in May 2017 (no date parameters were set). Quantitative studies investigating generalist health professionals’ attitudes towards mental health conditions were selected. Initially, prevalence meta‐analyses were conducted to assess the extent of perceived danger, followed by a series of comparative meta‐analyses in which the perceived dangerousness of mental health conditions was compared. Of the 653 citations retrieved, eight studies met the inclusion criteria. The overall sample included 2548 health professionals. A majority of health professionals perceived patients with substance use disorder as dangerous 0.60 (95% CI: 0.32–0.88) when compared with patients who had an alcohol‐related disorder, schizophrenia, and depression. The results also indicated that a large proportion of staff perceived patients with a diagnosis of schizophrenia as dangerous 0.42 (95% CI: 0.33–0.52). Negative attitudes towards people experiencing mental illness in general hospital settings may be attributed to poor mental health literacy, skills and limited exposure, and social and cultural beliefs about mental illness. Ongoing professional development targeting mental health knowledge is recommended for health professionals working in general hospital settings.     

Reconstruction of Chest Wall Using a Two-Layer Prolene Mesh and Bone Cement Sandwich

Wide surgical resection is the most effective treatment for the vast majority of chest wall tumors. This study evaluated the clinical success of chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich. The records of all patients undergoing chest wall resection and reconstruction were reviewed. Surgical indications, the location and size of the chest wall defect, diaphragm resection, pulmonary performance, postoperative complications, and survival of each patient were recorded. From 1998 to 2008, 43 patients (27 male, 16 female; mean age of 48 years) underwent surgery in our department to treat malignant chest wall tumors: chondrosarcoma (23), osteosarcoma (8), spindle cell sarcoma (6), Ewing''s sarcoma (2), and others (4). Nine sternectomies and 34 antero-lateral and postero-lateral chest wall resections were performed. Postoperatively, nine patients experienced respiratory complications, and one patient died because of respiratory failure. The overall 4-year survival rate was 60 %. Chest wall reconstruction using a Prolene mesh and bone cement prosthetic sandwich is a safe and effective surgical procedure for major chest wall defects.     

Nodding syndrome in Mundri county,South Sudan: environmental,nutritional and infectious factors

Background

Nodding Syndrome is a seizure disorder of children in Mundri County, Western Equatoria, South Sudan. The disorder is reported to be spreading in South Sudan and northern Uganda.

Objective

To describe environmental, nutritional, infectious, and other factors that existed before and during the de novo 1991 appearance and subsequent increase in cases through 2001.

Methods

Household surveys, informant interviews, and case-control studies conducted in Lui town and Amadi village in 2001–2002 were supplemented in 2012 by informant interviews in Lui and Juba, South Sudan.

Results

Nodding Syndrome was associated with Onchocerca volvulus and Mansonella perstans infections, with food use of a variety of sorghum (serena) introduced as part of an emergency relief program, and was inversely associated with a history of measles infection. There was no evidence to suggest exposure to a manmade neurotoxic pollutant or chemical agent, other than chemically dressed seed intended for planting but used for food. Food use of cyanogenic plants was documented, and exposure to fungal contaminants could not be excluded.

Conclusion

Nodding Syndrome in South Sudan has an unknown etiology. Further research is recommended on the association of Nodding Syndrome with onchocerciasis/mansonelliasis and neurotoxins in plant materials used for food.     

Personal barriers to antiretroviral therapy adherence: case studies from a rural Uganda prospective clinical cohort

Background

Although good adherence to antiretroviral therapy (ART) is essential for successful treatment outcomes, some patients may have specific personal barriers to ART adherence.

Objectives

To study specific personal barriers to ART adherence.

Methods

Quantitative data on patients'' health status, ART adherence, CD4 cell counts and viral loads were collected, and qualitative data on life experiences of five patients with poor ART outcomes and adherence were also collected.

Results

Out of 35 patients with poor immunological and virological ART outcomes, 17 (49%) also had poor ART adherence. Patient 1 had no living child and did not disclose her HIV serostatus to her spouse because she wanted to have a child. Patient 2 was an orphan with neither social nor family support. Patient 3 stopped ART when she conceived, returned to the study clinic when pregnant again and was sickly. She was switched to second-line ART with satisfactory outcomes. Patient 4, a 14 year old orphan had missed ART for 2 months when his treatment supporter was away. Patient 5 aged 66 years stopped ART which he blamed for his erectile dysfunction.

Conclusion

ART adherence counselling should target specific personal barriers to ART adherence like: lack of family support, health and sexual life concerns, desire to have children and family instability.