Prevalence of probable post-traumatic stress disorder and experiences of trauma in emerging adults living with HIV in Zimbabwe.

Background: Little is known about the prevalence of post-traumatic stress disorder (PTSD) in emerging adults living with HIV in low-income countries.

Aims: Determine prevalence of trauma exposure, prevalence of probable PTSD and conditional prevalence of probable PTSD for different traumatic events; and better understand the experiences of individuals with HIV and PTSD.

Method: This mixed method study used secondary data from a cross-sectional survey of people ( = 222) aged 18 to 29 living with HIV in Zimbabwe and primary qualitative data collection.

A Case of a Rectal Gastrointestinal Stromal Tumor: An Unexpected Cause of Lower Gastrointestinal Bleeding in an Immunocompromised Man.

GISTs are rare, with only around 5,000 cases diagnosed annually in the United States. However, these tumors are the most common mesenchymal neoplasm in the gastrointestinal (GI) tract. 5%-15% of GISTS arise in the colon and rectum.

ADHD Remote Technology study of cardiometabolic risk factors and medication adherence (ART-CARMA): a multi-centre prospective cohort study protocol.

Background: Emerging evidence points at substantial comorbidity between adult attention deficit hyperactivity disorder (ADHD) and cardiometabolic diseases, but our understanding of the comorbidity and how to manage cardiometabolic disease in adults with ADHD is limited. The ADHD Remote Technology study of cardiometabolic risk factors and medication adherence (ART-CARMA) project uses remote measurement technology to obtain real-world data from daily life to assess the extent to which ADHD medication treatment and physical activity, individually and jointly, may influence cardiometabolic risks in adults with ADHD. Our second main aim is to obtain valuable real-world data on adherence to pharmacological treatment and its predictors and correlates during daily life from adults with ADHD.

Piloting the use of objective structured clinical examinations (OSCEs) to assess undergraduate medical students' clinical competence in psychiatry in Zimbabwe.

This report describes a pilot project which involved undergraduate medical students' clinical competence in psychiatry assessed through objective structured clinical examinations for the first time in Zimbabwe. The pilot describes how gaps in medical education can be addressed by collaborative partnerships that allow sharing of knowledge by local institutions and international experts.

Shock Without Wires: A Look at Subcutaneous Implantable Cardioverter-Defibrillator Compared to Transvenous Implantable Cardioverter-Defibrillator for Ventricular Arrhythmias.

Sudden cardiac death is a major cause of cardiovascular mortality in the United States with 250,000-450,000 deaths annually. Transvenous Implantable Cardioverter-Defibrillator (ICD) has been conventionally used for both primary and secondary prevention of ventricular tachycardia or fibrillation (VT/VF). It is also associated with a high risk of complications like hemothorax, pneumothorax, cardiac tamponade, lead failure, and increased risk for infections.

Neural Correlates of Duration Discrimination in Young Adults with Autism Spectrum Disorder, Attention-Deficit/Hyperactivity Disorder and Their Comorbid Presentation.

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often co-occur and share neurocognitive deficits. One such shared impairment is in duration discrimination. However, no studies using functional magnetic resonance imaging (fMRI) have investigated whether these duration discrimination deficits are underpinned by the same or different underlying neurofunctional processes.

Immune signatures and disorder-specific patterns in a cross-disorder gene expression analysis.

Background: Recent studies point to overlap between neuropsychiatric disorders in symptomatology and genetic aetiology.

Aims: To systematically investigate genomics overlap between childhood and adult attention-deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD) and major depressive disorder (MDD).

Method: Analysis of whole-genome blood gene expression and genetic risk scores of 318 individuals.

Use of a bibliometric literature review to assess medical research capacity in post-conflict and developing countries: Somaliland 1991-2013.

Objectives: Effective healthcare systems require high-quality research to guide evidence-based interventions and strategic planning. In low- and middle-income countries, especially those emerging from violent conflict, research capacity often lags behind other aspects of health system development. Here, we sought to bibliometrically review health-related research output in Somaliland, a post-conflict self-declared, autonomous nation on the Horn of Africa, as a means of assessing research capacity.

Improved Attitudes to Psychiatry: A Global Mental Health Peer-to-Peer E-Learning Partnership.

Objective: Health links aim to strengthen healthcare systems in low and middle-income countries through mutual exchange of skills, knowledge, and experience. However, student participation remains limited despite growing educational emphasis upon global health. Medical students continue to report negative attitudes to psychiatry in high-income countries, and in Somaliland, the lack of public sector psychiatrists limits medical students' awareness of mental healthcare.

Impact of psychotic disorder on transplant eligibility and outcomes.

Purpose Of Review: Organ transplantation decisions are complex, and psychosocial assessment is an important part of the process. The impact of pretransplant psychotic disorder on posttransplant outcomes is unclear, but some guidelines cite psychosis as a relative contraindication to organ transplantation because of concerns about medication adherence and poor postoperative outcomes. This review explores the evidence for poorer solid organ transplant outcomes for people with preexisting psychotic disorders and discusses future directions for how research can contribute to a better understanding of how organ transplantation outcomes are affected by psychotic illness.

Teaching psychiatry to undergraduate medical students in Somalia.

This paper describes a pilot project in which (for the first time, worldwide) psychiatry was taught to undergraduate medical students in Somalia using an evidence-based intervention - the World Health Organization's Mental Health Gap Action Programme Intervention Guide.

Use of interactive teaching techniques to introduce mental health training to medical schools in a resource poor setting.

Objective: There are currently no practising psychiatrists in Somaliland. In 2007 the first medical students graduated from universities in Somaliland without mental health training. We aimed to pilot an intensive but flexible package of mental health training to all senior medical students and interns using interactive training techniques and to evaluate its effectiveness by assessing knowledge, skills and attitudes.

Telemedicine for peer-to-peer psychiatry learning between U.K. and Somaliland medical students.

Objective: The proportion of U.K. medical students applying for psychiatry training continues to decline, whereas, in Somaliland, there are no public-sector psychiatrists.

Can UK healthcare workers remotely support medical education in the developing world?: Focus group evaluation.

Objectives: To evaluate the feasibility of providing regular, live, text-based teaching to medical students and junior doctors in Somaliland using a dedicated case-based medical education website (www.MedicineAfrica.com).

Effect of communicating DNA based risk assessments for Crohn's disease on smoking cessation: randomised controlled trial.

Objective: To test the hypothesis that communicating risk of developing Crohn's disease based on genotype and that stopping smoking can reduce this risk, motivates behaviour change among smokers at familial risk.

Design: Parallel group, cluster randomised controlled trial.

Setting: Families with Crohn's disease in the United Kingdom.

Randomized controlled double-blind trial of optimal dose methylphenidate in children and adolescents with severe attention deficit hyperactivity disorder and intellectual disability.

Background: Attention deficit hyperactivity disorder is increased in children with intellectual disability. Previous research has suggested stimulants are less effective than in typically developing children but no studies have titrated medication for individual optimal dosing or tested the effects for longer than 4 weeks.

Method: One hundred and twenty two drug-free children aged 7-15 with hyperkinetic disorder and IQ 30-69 were recruited to a double-blind, placebo-controlled trial that randomized participants using minimization by probability, stratified by referral source and IQ level in a one to one ratio.

Why does genetic causal information alter perceived treatment effectiveness? An analogue study.

Objectives: When a health problem is perceived as having a genetic cause, this appears to increase the perceived effectiveness of pharmacological treatments and reduce perceived effectiveness of non-pharmacological treatments. Potential mediators of this effect include causal attributions, perceived severity, and perceived control over the health problem. This study aimed to use experimental methods to establish which beliefs mediate the effect of genetic causal information on perceived effectiveness of treatments.

Mental health in Somalia.

Somalia, in the Horn of Africa, suffers violence, political instability and high mortality rates. The recent major drought in Somalia led to what was termed the worst humanitarian disaster in the world. In July 2011 it was reported that nearly 60 000 people had entered into Kenya from Somalia already that year, including 1300 new arrivals every day to the Dadaab refugee camp, described as 'the largest, most congested and one of the most remote refugee camps in the world' (see http://www.

Trial Protocol: Communicating DNA-based risk assessments for Crohn's disease: a randomised controlled trial assessing impact upon stopping smoking.

Background: Estimates of the risk of developing Crohn's disease (CD) can be made using DNA testing for mutations in the NOD2 (CARD15) gene, family history, and smoking status. Smoking doubles the risk of CD, a risk that is reduced by stopping. CD therefore serves as a timely and novel paradigm within which to assess the utility of predictive genetic testing to motivate behaviour change to reduce the risk of disease.

Trial Protocol: Using genotype to tailor prescribing of nicotine replacement therapy: a randomised controlled trial assessing impact of communication upon adherence.

Background: The behavioural impact of pharmacogenomics is untested; informing smokers of genetic test results for responsiveness to smoking cessation medication may increase adherence to this medication. The objective of this trial is to estimate the impact upon adherence to nicotine replacement therapy (NRT) of informing smokers that their oral dose of NRT has been tailored to a DNA analysis. Hypotheses to be tested are as follows: I Adherence to NRT is greater among smokers informed that their oral dose of NRT is tailored to an analysis of DNA (genotype), compared to one tailored to nicotine dependence questionnaire score (phenotype).

The impact of numeracy on reactions to different graphic risk presentation formats: An experimental analogue study.

Objectives: Numeracy, the ability to process basic mathematical concepts, may affect responses to graphical displays of health risk information. Displays of probabilistic risk information using grouped dots are easier to understand than displays using dispersed dots. However, dispersed dots may better convey the randomness with which health threats occur, so increasing perceived susceptibility.