Outpatient Mental Health Services in Mozambique: Use and Treatments.

To describe current outpatient mental health service use and treatments in Mozambique, the authors reviewed registry entries for 2,071 outpatient psychiatric visits at the Beira Central Hospital in Sofala Province from January 2012 to September 2014. Service use was most common for schizophrenia, followed by epilepsy, delirium, and organic behavioral disorders. Only 3% of consultations for schizophrenia were first-visit patients. Treatment seeking among women was more likely for mood and neurotic disorders and less likely for substance use disorders and epilepsy. First-generation antipsychotics, most often paired with promethazine, dominated treatment regimens. Evidence-based reforms are needed to improve identification of mood disorders and broaden care beyond severe mental disorders.

Chinese Men and "Leftover Women" : How do Chinese Men Position Themselves in Relation to the Concept of Labelling Women as "Leftover"?

In recent years there has been a resurgence of gender inequality in China. Today, women are pressured to get married by the state and their social surroundings, as they told if they remain unmarried and have the "three highs"; high age, education and salary, they will become leftovers on the marriage market. Previous research on the concept of labelling women as "leftover" has 4 shown that labelling women as "leftover" can have several different negative impacts. In this thesis, both the theory of masculine hegemony and the theory of symbolic interaction have been used. The concept creates a hegemonic masculinity as it is a normative practice that promotes the subordination of women. However, as the concept is based on the notion that all Chinese men, or at least those of relevant social standing, would find the "three highs" undesirable, it is relevant to see how Chinese men in fact do position themselves in relation to the hegemonic masculinity on an individual level. In symbolic interaction, the concept of gender is created through social construction when people attach special meanings to the sex of a person, a process which is called "doing gender". Therefore symbolic interaction is used to see what special meaning Chinese men attach to women having the "three highs" and masculine hegemony to put their answers into a larger context. If it could be shown that Chinese men do not comply with the hegemonic masculinity, Chinese women would not have to feel obliged to adjust to the hegemonic masculinity and thereby making it easier for them to pursue higher education, high paying jobs and marrying at a later age. However, as this thesis is a qualitative study, and therefore a limited number of data subjects, the generalizability of the result should not be exaggerated. The interviews that were conducted for this thesis showed that the data subjects were familiar with the concept and that they considered it to be natural for there to be women China labelled as "leftover". Nevertheless, in relation to their own marital choices, the data subjects did not attach the negative meaning as set out by the hegemonic masculinity, a result which to some extent was confirmed by the data subjects’ experiences and other control questions. The result is interesting, and enforces Connell and MesserSchmidt’s theory, that even though a hegemonic masculinity is normative, not everyone has to comply with it. As the cornerstone of the concept is that Chinese men find women with the "three highs" undesirable, the result of the study shows that there is a need for the concept to be further examined and questioned.

Ancient clam gardens, traditional management portfolios, and the resilience of coupled human-ocean systems

Indigenous communities have actively managed their environments for millennia using a diversity of resource use and conservation strategies. Clam gardens, ancient rock-walled intertidal beach terraces, represent one example of an early mariculture technology that may have been used to improve food security and confer resilience to coupled human-ocean systems. We surveyed a coastal landscape for evidence of past resource use and management to gain insight into ancient resource stewardship practices on the central coast of British Columbia, Canada. We found that clam gardens are embedded within a diverse portfolio of resource use and management strategies and were likely one component of a larger, complex resource management system. We compared clam diversity, density, recruitment, and biomass in three clam gardens and three unmodified nonwalled beaches. Evidence suggests that butter clams (Saxidomus gigantea) had 1.96 times the biomass and 2.44 times the density in clam gardens relative to unmodified beaches. This was due to a reduction in beach slope and thus an increase in the optimal tidal range where clams grow and survive best. The most pronounced differences in butter clam density between nonwalled beaches and clam gardens were found at high tidal elevations at the top of the beach. Finally, clam recruits (0.5-2 mm in length) tended to be greater in clam gardens compared to nonwalled beaches and may be attributed to the addition of shell hash by ancient people, which remains on the landscape today. As part of a broader social-ecological system, clam garden sites were among several modifications made by humans that collectively may have conferred resilience to past communities by providing reliable and diverse access to food resources.

Eficácia e segurança no uso da Acupunctura como meio anestésico em Medicina Dentária

Introdução: A Acupunctura, enquanto área terapeutica mais popular na arte de cura na Medicina Tradicional Chinesa, tem sido amplamente utilizada para tratar variadíssimas patologias. A Acupunctura, de acordo com a nova terminologia da Organização Mundial da Saúde, é considerado um método de tratamento complementar. Nas últimas décadas têm surgido diversos estudos que se debruçam sobre a utilização da Acupunctura como meio anestésico, nomeadamente na Medicina Dentária. Objetivo: O presente trabalho visou rever os conceitos associados ao uso da Acupunctura na Medicina Dentária, enfatizando as suas vantagens e limitações e explorar as potencialidades da Acupunctura como meio anestésico em Medicina Dentária. Os objetivos deste trabalho consubstanciam-se em i) estabelecer uma comparação entre os estudos publicados, concretamente entre (1984-1999) e publicados recentemente (2000-2016) e ii) averiguar acerca da eficácia da Acupunctura como meio anestésico em Medicina Dentária. Conclusão: A Acupunctura enquanto técnica de intervenção na Medicina Dentária tem sido relevante devido ao grande número de trabalhos científicos publicados recentemente, que muito têm contribuído para a sua compreensão enquanto meio anestésico. Um grande número de profissionais já aderiu a esta prática, dado que esta apresenta resultados positivos no Tratamento de Distúrbios Temporomandibulares, Xerostomia, Nevralgia do Trigémeo, entre outras patologias odontológicas, e na diminuição do consumo de medicamentos pelos efeitos analgésicos e inflamatórios. O valor da Acupunctura como meio anestésico em Medicina Dentária deve ser tido em linha de conta, pois os estudos sugerem que esta pode ser uma alternativa valiosa, na medida em que representa uma terapia complementar satisfatória no tratamento da dor. Metodologia: A pesquisa bibliográfica foi efetuada nos motores de pesquisa da PubMed, B-On e ScienceDirect no período compreendido entre janeiro de 1984 e fevereiro de 2016 com um limite temporal de 32 anos. Dos 760 artigos encontrados foram selecionados 148 conforme os critérios de inclusão.

LUNG CANCER IN NEPAL: THE ROLE OF TRADITIONAL TOBACCO PRODUCTS AND COMBUSTION RELATED HOUSEHOLD AIR POLLUTION

The burden of chronic diseases such as cancer is increasing in low and middle income countries around the globe. Nepal, one of the world’s poorest countries, is no exception to this trend, with lung cancer as the leading causes of cancer deaths. Despite this, limited data is available on the environmental and behavioral risk factors that contribute to the lung cancer etiology in Nepal. The objectives of this dissertation are to: 1) investigate the ethnic differences in consumption of local tobacco products and their role in lung cancer risk in Nepal; 2) evaluate urinary metabolite of 1,3-butadiene as a biomarker of exposure to combustion related household air pollution (CRHAP); 3) investigate the association between CRHAP exposure and lung cancer risk using urinary metabolite of 1,3-butadiene as a biomarker of exposure; 4) investigate the association between CRHAP exposure and lung cancer risk using questionnaire based measure of exposure. Lung cancer cases (n=606) and frequency matched controls (N=606) were recruited from B.P. Koirala Memorial Cancer Hospital. We obtained biological samples and information on lifestyles including cooking habits and type of fuels used. We used liquid chromatograph tandem mass spectrometer (LC-MS/MS) to quantify urinary metabolites of 1,3-butadiene in urine samples. We employed a combination of logistic and linear regression models to detect any exposure-disease associations while controlling for known confounding variables. Overall, we found that ethnic groups in Nepal use different tobacco products that have different differing cancer potency -we observed the highest odds ratios for the traditional tobacco products. The biomarker analysis showed strong evidence that monohydroxybutyl mercapturic acid is associated with biomass fuel use among participants. However, we did not find significant association between urinary MHMBA and lung cancer risk. When we used questionnaire based measure of exposure to household air pollution, we observed significant, dose-response associations between CRHAP exposure and lung cancer risk, particularly among never-smokers. Our results show that important role of local tobacco products in lung cancer risk in Nepal. Furthermore, we demonstrate that CRHAP exposure is a risk factor for lung cancer risk, independent of tobacco smoking.

Biobanks: Experience of the School of Medicine and the “Dr. José Eleuterio González” University Hospital of the Universidad Autónoma de Nuevo León

Medical research has greatly beneited from molecular biology and increasingly relies on tools from the “omics” disciplines (mainly genomics, transcriptomics, proteomics and metabolomics). The availability of biological samples preserved with high quality standards is a sine qua non condition for such studies and their repositories are referred to as biobanks. Biobanks support the transportation, storage, preservation, and initial pathological and analytical examinations of biospecimens, as well as the protection of relevant information and the comparison of clinical and laboratory findings. A biobank facility is one of the most valuable tools the academic medicine organizations can offer to their researchers to improve the competitiveness of their current and future medical research. it acts as an essential bridge and an effective catalyst for research synergies between basic and clinical sciences, and it can be potentiated with efforts to raise funds for acquiring and maintaining cutting-edge analytical infrastructure to better serve its clinical, pharmaceutical and biotech clients.

Dipsacus asperoides (Xue Duan) inhibits spinal cord injury-induced inflammatory responses in rats

Purpose: To investigate the effect of Dipsacus asperoides (Xue Duan), a traditional Chinese medicine, on rats with spinal cord injury (SCI). Methods: In this study a total of 40 adult rats were used after inducing SCI where Xue Duan was applied on experimental group and phosphate-buffered saline (PBS) was administered in corresponding control groups. Intraperitoneal administration of both compounds for a period of four weeks (28 days) was carried out at a dose of 10 mg/kg/day. Bright field microscopy was performed on the tissues. Results: Bright Field microscopy of tissue sections showed significant reduction in cavity area that resulted from injury, that is from 0.19 ± 0.05 mm2 to 0.09 ± 0.03 mm2 (p < 0.01) in untreated and treated groups respectively. Similarly western blotting results showed a decrease in the expression of NF-kB p65 and I-kBα (p < 0.01). These two compounds are important in increasing secondary pathophysiology in SCI. The results for MPO activity also revealed significantly reduced infiltration of leukocytes to the injury site (p < 0.01). Conclusion: This study reveals the positive effect of the plant material in reducing inflammation in rats with traumatic SCI.

An exploration of two female principals’ leadership in mainland China

Purpose: The purpose of this paper is to explore two dimensions of leadership practices (i.e. teaching and learning and sources of power) used by two exemplary principals in mainland China against a background of education reform and to identify how broader contextual factors have shaped these two dimensions of their leadership.--------- Design/methodology/approach: An exploratory case study was used that drew upon semi-structured interviews, observations and document analysis. Interviews were conducted with two principals, six teachers from each of the two schools and a superintendent who was the supervisor of the two principals.---------- Findings: The findings reveal that there are some common elements in both of the leaders’ practices but also some subtle differences. Both leaders emphasise teaching and learning. One sees herself as curriculum expert; the other delegate teaching responsibilities. While both uses a top down approach, one principal uses an adversarial approach and the other a more facilitative approach.---------- Research limitations/implications: The study used a small sample size. It explored the leaders’ practices in the light of broader contextual factors rather than personal factors or gender-based factors Originality/value – Given the limited empirical research conducted on female principals in mainland China, this qualitative study provides insights into two dimensions of leadership used by two exemplary principals and explains their practices in the light of critical contextual factors such as contemporary and traditional Chinese culture and the school’s organisational context.