Improving work-life balance among administrative officers in Catholic primary schools: Assessing the effect of a Christian religious rational emotive behavior therapy

Objective:Work-life balance (WLB) is an essential precursor of workers’ mental health. The theory of rational emotive behaviour therapy proposes that an imbalance in work and family life may result from people''s dysfunctional perceptions of their work and other aspects of their personal life. Also, the constructive philosophies of rational emotive behavior therapy are said to be congruent with most religious belief systems of Christian clients. Therefore, our research examined the efficacy of Christian religious rational emotive behaviour therapy (CRREBT) on WLB among administrative officers in Catholic primary schools.Methods:This is a group randomized trial involving 162 administrative officers from Catholic primary schools in Southeast Nigeria. The treatment process involved an 8-session CRREBT programme.Results:The scores for WLB of the administrative officers enrolled in the CRREBT programme were significantly improved compared to those in the control group at the end of the study. At the follow-up phase, the CRREBT programme proved to be effective over a 3-month period.Conclusion:CRREBT is an effective therapeutic strategy for managing WLB among Catholic school administrative officers.     

Human–Bat Interactions in Rural West Africa

Because some bats host viruses with zoonotic potential, we investigated human–bat interactions in rural Ghana during 2011–2012. Nearly half (46.6%) of respondents regularly visited bat caves; 37.4% had been bitten, scratched, or exposed to bat urine; and 45.6% ate bat meat. Human–bat interactions in rural Ghana are frequent and diverse.     

Human immunodeficiency virus-associated nephropathy (HIVAN) in Nigerian children

Human immunodeficiency virus-associated nephropathy (HIVAN) has rarely been reported in African children. In this single-center study, we analyzed ten children diagnosed with HIVAN from January 2000 to October 2006. There were eight boys and two girls, with a male:female ratio of 4:1. Their ages were from 5 months to 15 years (mean 6.8 ± 6.2 years), with a peak age of 5–9 years. The presenting complaints included generalized edema (60%) and hypertension (50%). All patients had proteinuria on urine dipstick, with four (40%) at nephrotic range (proteinuria ≥500 mg/dl). Nine (90%) patients were in renal failure, with elevated serum creatinine (6.3–24 mg/dl) and serum urea (70–120 mg/dl). Renal disease was the first manifestation of HIV infection in six patients, whereas the diagnosis was made on autopsy in three. The duration from HIV infection to development of HIVAN ranged from 5 months to 10 years. CD4⁺ cell count, done in only three patients due to financial constraints, was below 200/mm³. The kidneys were hyperechoic on abdominal ultrasound in all patients, and three (30%) showed grossly enlarged kidneys. Histology of renal tissues available by autopsy in three patients showed mainly collapsing focal segmental glomerulosclerosis. Treatments given were angiotensin-converting enzyme (ACE) inhibitors and highly active antiretroviral therapy (HAART) in four and two patients, respectively, and one patient underwent peritoneal dialysis. On outcome analysis, seven (70%) patients died, two were lost to follow-up, and one was alive on HAART therapy at the writing of this article. In conclusion, HIVAN occurs in Nigeria children, and the mortality is very high from uremia.     

Cerebral dysfunction in type 1 diabetes: effects of insulin, vascular risk factors and blood-glucose levels

Type 1 diabetes can lead to several well-described complications such as retinopathy, nephropathy and peripheral neuropathy. Evidence is accumulating that it is also associated with gradually developing end-organ damage in the central nervous system. This relatively unknown complication can be referred to as ‘diabetic encephalopathy’ and is characterised by electrophysiological and neuroradiological changes, such as delayed latencies of evoked potentials, modest cerebral atrophy and (periventricular) white matter lesions. Furthermore, individuals with type 1 diabetes may show performance deficits in a wide range of cognitive domains. The exact mechanisms underlying this diabetic encephalopathy are only partially known. Chronic metabolic and vascular changes appear to play an important role. Interestingly, the differences in the ‘cognitive profile’ between type 1 and type 2 diabetes also suggest a critical role for disturbances of insulin action in the central nervous system.     

Femoral lengthening in young patients: An evidence-based comparison between motorized lengthening nails and external fixation

BACKGROUNDFemoral lengthening is a procedure of great importance in the treatment of congenital and acquired limb deficiencies. Technological advances have led to the latest designs of fully implantable motorized intramedullary lengthening nails. The use of these nails has increased over the last few years.AIMTo review and critically appraise the literature comparing the outcome of femoral lengthening in children using intramedullary motorized lengthening nails to external fixation.METHODSElectronic databases (MEDLINE, CINAHL, EMBASE, Cochrane) were systematically searched in November 2019 for studies comparing the outcome of femoral lengthening in children using magnetic lengthening nails and external fixation. The outcomes included amount of gained length, healing index, complications and patient reported outcomes.RESULTSOf the 452 identified studies, only two (retrospective and non-randomized) met the inclusion criteria. A total of 91 femora were included. In both studies, the age of patients treated with nails ranged from 15 to 21 years compared to 9 to 15 years for patients in the external fixation group. Both devices achieved the target length. Prevalence of adverse events was less in the nail (60%-73%) than in the external fixation (81%-100%) group. None of the studies presented patient reported outcomes.CONCLUSIONThe clinical effectiveness of motorized nails is equivalent or superior to external fixation for femoral lengthening in young patients. The available literature is limited and does not provide evidence on patient quality of life or cost effectiveness of the interventions.     

Abnormal vertebral segmentation and the notch signaling pathway in man.

Abnormal vertebral segmentation (AVS) in man is a relatively common congenital malformation but cannot be subjected to the scientific analysis that is applied in animal models. Nevertheless, some spectacular advances in the cell biology and molecular genetics of somitogenesis in animal models have proved to be directly relevant to human disease. Some advances in our understanding have come through DNA linkage analysis in families demonstrating a clustering of AVS cases, as well as adopting a candidate gene approach. Only rarely do AVS phenotypes follow clear Mendelian inheritance, but three genes-DLL3, MESP2, and LNFG-have now been identified for spondylocostal dysostosis (SCD). SCD is characterized by extensive hemivertebrae, trunkal shortening, and abnormally aligned ribs with points of fusion. In familial cases clearly following a Mendelian pattern, autosomal recessive inheritance is more common than autosomal dominant and the genes identified are functional within the Notch signaling pathway. Other genes within the pathway cause diverse phenotypes such as Alagille syndrome (AGS) and CADASIL, conditions that may have their origin in defective vasculogenesis. Here, we deal mainly with SCD and AGS, and present a new classification system for AVS phenotypes, for which, hitherto, the terminology has been inconsistent and confusing.     

Skeletal imaging of child abuse (non-accidental injury)

In recent years there has been a worldwide increased awareness that children are physically abused by their carers. Radiologists play a vital role in the detection of inflicted injuries. This article reviews the skeletal imaging findings seen in child abuse.