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Fulltext Impact of psychiatry training on attitudes of undergraduate medical students

Ramamurthy, C., Srikumar, P.S., Joshua, E., Rasamy, G.

Malaysian Journal of Psychiatry, 2008;17(2):1-8.
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Objective: This study assesses the impact of prescribed undergraduate psychiatry training program on medical students’ attitudes to psychiatry. It is hypothesized that training may cause positive attitude changes towards the discipline and status perceptions of the profession of psychiatry. Methods: A 23 item questionnaire was administered to 89 medical students before and after prescribed training in psychiatry as per the medical curriculum. Results: Participation in psychiatry training enhanced students’ belief that it is a rapidly expanding frontier of medicine and that psychiatry can be viewed as precise and scientific. Psychiatric referrals were seen as useful to medical and surgical patients. However there was less agreement that psychiatric treatment is helpful to most people. Support for choice of psychiatry as a career was less as students were more negatively influenced by family. Poor income prospects and perceived low status among other medical disciplines were also endorsed following the completion of training.Conclusion: There is a pressing need to revise the psychiatric training for medical students. A total attitude change is difficult to achieve and hence, the curriculum has to identify focal areas for emphasis. A multidisciplinary, bio-psychosocial model through liaison with other disciplines like medicine and surgery is a definite option. Psychiatrists have to be role models to alter the image of psychiatry among other medical professionals.
Fulltext COVID-19 impacts on coastal communities in Kenya

Lau J, Sutcliffe S, Barnes M, Mbaru E, Muly I, Muthiga N, et al.

Mar Policy, 2021 Dec;134:104803.
PMID: 34566239 DOI: 10.1016/j.marpol.2021.104803

COVID-19 is continuing to have far-reaching impacts around the world, including on small-scale fishing communities. This study details the findings from 39 in-depth interviews with community members, community leaders, and fish traders in five communities in Kenya about their experiences since the beginning of the COVID-19 pandemic in March, 2020. The interviews were conducted by mobile phone between late August and early October 2020. In each community, people were impacted by curfews, rules about gathering, closed travel routes, and bans on certain activities. Fish trade and fisheries livelihoods were greatly disrupted. Respondents from all communities emphasized how COVID-19 had disrupted relationships between fishers, traders, and customers; changed market demand; and ultimately made fishing and fish trading livelihoods very difficult to sustain. While COVID-19 impacted different groups in the communities-i.e., fishers, female fish traders, and male fish traders-all experienced a loss of income and livelihoods, reduced cash flow, declining food security, and impacts on wellbeing. As such, although small-scale fisheries can act as a crucial safety net in times of stress, the extent of COVID-19 disruptions to alternative and informal livelihoods stemmed cash flow across communities, and meant that fishing was unable to fulfil a safety net function as it may have done during past disruptions. As the pandemic continues to unfold, ensuring that COVID-19 safe policies and protocols support continued fishing or diversification into other informal livelihoods, and that COVID-19 support reaches the most vulnerable, will be critical in safeguarding the wellbeing of families in these coastal communities.
Fulltext Identification of Helicobacter pylori in Saliva of Patients with and without Gastritis by Polymerase Chain Reaction

Sekhar Goud EVS, Kannan R, Rao UK, Joshua E, Tavaraja R, Jain Y

J Pharm Bioallied Sci, 2019 Nov;11(Suppl 3):S523-S529.
PMID: 31920269 DOI: 10.4103/jpbs.JPBS_260_18

Aims and Objective: The aim of this study was to identify the presence of Helicobacter pylori in saliva of patients with and without gastritis by polymerase chain reaction (PCR) method.
Materials and Methods: The study comprised 20 patients in Group I presenting with various symptoms of gastritis and 10 asymptomatic subjects in Group II. The intestinal endoscopy antral biopsies were collected from 20 symptomatic patients with gastroduodenal disorders. The saliva specimens were taken from all patients before endoscopy. PCR was performed using genomic DNA, isolated from the saliva and the biopsies of the patients as the template to detect the presence of the 16S ribosomal RNA gene in H. pylori.
Results: In Group I, 10 (50%) cases of clinical gastritis were positive for H. pylori by endoscopy biopsy and 10 (50%) were negative. Of the 10 endoscopy biopsy positive cases for H. pylori, eight were PCR positive in saliva and two were negative. Of the 10 endoscopy biopsy negative cases, three were PCR positive for H. pylori in saliva and seven were negative. In Groups II, four were symptomatic for gastritis and six were negative. Of the six gastritis negative cases, three were PCR positive, four were gastritis positive, and three were PCR positive. Sensitivity and specificity of PCR were found to be 80% and 70%, respectively. The positive predictive and negative predictive values of PCR in saliva were 72.7% and 77.7%, respectively.
Conclusion: PCR analysis of saliva may be handy in identification of H. pylori and serves as a noninvasive technique to diagnose and monitor the prognosis.
Social-environmental drivers inform strategic management of coral reefs in the Anthropocene

Darling ES, McClanahan TR, Maina J, Gurney GG, Graham NAJ, Januchowski-Hartley F, et al.

Nat Ecol Evol, 2019 Sep;3(9):1341-1350.
PMID: 31406279 DOI: 10.1038/s41559-019-0953-8

Without drastic efforts to reduce carbon emissions and mitigate globalized stressors, tropical coral reefs are in jeopardy. Strategic conservation and management requires identification of the environmental and socioeconomic factors driving the persistence of scleractinian coral assemblages-the foundation species of coral reef ecosystems. Here, we compiled coral abundance data from 2,584 Indo-Pacific reefs to evaluate the influence of 21 climate, social and environmental drivers on the ecology of reef coral assemblages. Higher abundances of framework-building corals were typically associated with: weaker thermal disturbances and longer intervals for potential recovery; slower human population growth; reduced access by human settlements and markets; and less nearby agriculture. We therefore propose a framework of three management strategies (protect, recover or transform) by considering: (1) if reefs were above or below a proposed threshold of >10% cover of the coral taxa important for structural complexity and carbonate production; and (2) reef exposure to severe thermal stress during the 2014-2017 global coral bleaching event. Our findings can guide urgent management efforts for coral reefs, by identifying key threats across multiple scales and strategic policy priorities that might sustain a network of functioning reefs in the Indo-Pacific to avoid ecosystem collapse.
Global status and conservation potential of reef sharks

MacNeil MA, Chapman DD, Heupel M, Simpfendorfer CA, Heithaus M, Meekan M, et al.

Nature, 2020 07;583(7818):801-806.
PMID: 32699418 DOI: 10.1038/s41586-020-2519-y

Decades of overexploitation have devastated shark populations, leaving considerable doubt as to their ecological status1,2. Yet much of what is known about sharks has been inferred from catch records in industrial fisheries, whereas far less information is available about sharks that live in coastal habitats3. Here we address this knowledge gap using data from more than 15,000 standardized baited remote underwater video stations that were deployed on 371 reefs in 58 nations to estimate the conservation status of reef sharks globally. Our results reveal the profound impact that fishing has had on reef shark populations: we observed no sharks on almost 20% of the surveyed reefs. Reef sharks were almost completely absent from reefs in several nations, and shark depletion was strongly related to socio-economic conditions such as the size and proximity of the nearest market, poor governance and the density of the human population. However, opportunities for the conservation of reef sharks remain: shark sanctuaries, closed areas, catch limits and an absence of gillnets and longlines were associated with a substantially higher relative abundance of reef sharks. These results reveal several policy pathways for the restoration and management of reef shark populations, from direct top-down management of fishing to indirect improvement of governance conditions. Reef shark populations will only have a high chance of recovery by engaging key socio-economic aspects of tropical fisheries.
Author Correction: Global status and conservation potential of reef sharks

MacNeil MA, Chapman DD, Heupel M, Simpfendorfer CA, Heithaus M, Meekan M, et al.

Nature, 2020 09;585(7825):E11.
PMID: 32848253 DOI: 10.1038/s41586-020-2692-z

An Amendment to this paper has been published and can be accessed via a link at the top of the paper.
Widespread diversity deficits of coral reef sharks and rays

Simpfendorfer CA, Heithaus MR, Heupel MR, MacNeil MA, Meekan M, Harvey E, et al.

Science, 2023 Jun 16;380(6650):1155-1160.
PMID: 37319199 DOI: 10.1126/science.ade4884

A global survey of coral reefs reveals that overfishing is driving resident shark species toward extinction, causing diversity deficits in reef elasmobranch (shark and ray) assemblages. Our species-level analysis revealed global declines of 60 to 73% for five common resident reef shark species and that individual shark species were not detected at 34 to 47% of surveyed reefs. As reefs become more shark-depleted, rays begin to dominate assemblages. Shark-dominated assemblages persist in wealthy nations with strong governance and in highly protected areas, whereas poverty, weak governance, and a lack of shark management are associated with depauperate assemblages mainly composed of rays. Without action to address these diversity deficits, loss of ecological function and ecosystem services will increasingly affect human communities.