Assessing the Effectiveness of a Mental Health Literacy Programme for Refugee Teachers in Malaysia

@#Background: Children and young refugees often experience negative events that affect their mental health. Their caregivers may also be in the same predicament, implying that the teachers in schools are a potential source of help and support. However, most teachers have little understanding of mental health and are, thus, clueless in helping their students. To address this need, a newly developed one-day mental health literacy programme was conducted among 68 refugee teachers in Malaysia. Methods: Participants learned the symptoms of mental health issues among children and adolescents in the context of post-trauma, provision of early intervention, and channel for professional supports. They also answered a packet of measurements of mental health literacy before and after the programme. Results: The paired sample t-test showed that participants reported higher willingness to contact with people having mental health problems (t = 2.787, P = 0.008, Cohen’s d = 0.394), less stereotypes toward mental illness (t = 4.603, P < 0.001, d = 0.651) and a better understanding of self-help strategies (t = 2.16, P = .036, d = 0.322) than baseline. Conclusion: The results of this study offered preliminary empirical evidence on the effectiveness of the programme as a promising channel for alleviating mental health issues among refugees.

Automated peritoneal dialysis in Brunei Darussalam

Introduction Chronic kidney disease in Brunei Darussalam is a growing problem. The number of patients reaching end stage kidney failure has increased dramatically in the last ten years. Currently, most are managed with haemodialysis while a smaller proportion is managed with continuous ambulatory peritoneal dialysis (CAPD). Automated peritoneal dialysis (APD) is a form of peritoneal dialysis and has been used in Brunei Darussalam since May 2008. Materials and Methods Eight patients participated in this prospective clinical trial. As all APD patients were previously on CAPD, comparisons are made between the outcomes of APD against CAPD. Results The median and mean age of APD patients were 42 and 45.5 ± 12.73 years respectively. After switching to APD, the serum haemoglobin and albumin improved from 10.56 ± 1.95 gm/L and 27.88 ± 7.71 gm/dL to 12.26 ± 1.82 gm/L and 33.63 ± 6.89 gm/dL respectively (p values <0.05). This corresponded to improvements in seven (87.5%) and six (75%) patients respectively in both parameters. Erythropoietin requirement was reduced in six (75%) patients, including three (37.5%) patients who were able to stop erythropoietin completely. There was no peritonitis encountered. All patients reported improved quality of life with better sleep, appetite and general well-being. Conclusions Our study showed that APD was as good as CAPD with improvement seen in both laboratory and quality of life parameters. There was also reduction in erythropoietin requirement. Based on these findings, we will actively encourage and promote APD usage as oppose to CAPD usage in our population.

Cardiac complication secondary to jugular catheter insertion in a renal failure patient

Central venous catheterisation is a common procedure performed for emergency dialysis. It is usually carried out without any cardiac monitoring. Cardiac arrhythmias with associated conduction blocks are rare complications. The underlying pathogenesis is trauma to the endocardium by the guide wire or catheter. It occurs more frequently in patients with acute renal failure and azotaemia than patients with established end stage renal disease. Disturbances in acid base balance and electrolyte abnormalities are contributing factors. Fortunately, most are benign but occasionally can lead to potentially fatal arrhythmias. We report a case of a 46-year-old lady with end stage renal failure secondary to diabetes mellitus who developed runs of transient ventricular ectopics and right bundle branch block during internal jugular catheterisation. This spontaneously resolved 12 hours later.