Diagnoses of children and adolescents on initial presentation to a Nigerian outpatient psychiatry clinic.

Child and adolescent psychiatry is an underdeveloped specialty in Nigeria, relegated by more entrenched cultural systems, such as traditional healers and syncretic churches, to merely an auxiliary role in child mental health care. Little is therefore known about the epidemiology of childhood disorders as encountered in psychiatric settings. We reviewed the outpatient psychiatric clinic's patient register at the Psychiatric Hospital of Uselu in Benin City, Nigeria, over a twenty-four week period. Fifty-three patients who presented in the twenty-four week index period had definite diagnoses indicated in the register. Of these, 68% had diagnoses denoting significant behavioral disturbances that would motivate their visit to allopathic hospitals after other, more culturally sanctioned healers were of little help. Our findings are compared with similar studies in other cultures.

A support group for mentally ill people.

The Sizanani Club is an outpatient psychiatry support group in rural South Africa whose activities appear to have reduced the number and duration of hospitalizations of mentally ill patients. Against a background trend towards decentralization and home-based health care the findings suggest the desirability of expanding the role of such groups.

The AIDS prevention magic show: avoiding the tragic with magic.

Teenagers are a crucial target group for interventions concerning acquired immunodeficiency syndrome (AIDS) and human immunodeficiency virus (HIV). Experimenting with their burgeoning sexuality and increased ability to obtain drugs, they are prime candidates for AIDS prevention and education strategies. The intervention described in this paper is a 30-minute magic show, presented by Cyrus (or Iris) the Virus, a sinister but entertaining character portrayed by any health educator willing to spend a few hours learning the magic tricks. The tricks explain why sharing needles and choosing sexual partners based on appearance alone can result in AIDS. Cyrus also uses magic to communicate the ways that AIDS is not transmitted, how to refuse sex, and how to use condoms correctly. The show, as well as increasing the audience's knowledge about HIV, attempts to induce behavioral change by increasing participants' perceived self-efficacy--a predictor of healthful behavior. Still in its pilot phase, the show has been seen by 281 students ages 10-15 years. Viewers rate the show highly, and preliminary analysis suggests that perceived self-efficacy has been significantly improved.

Divalent cation competition with [3H]saxitoxin binding to tetrodotoxin-resistant and -sensitive sodium channels. A two-site structural model of ion/toxin interaction.

Monovalent and divalent cations competitively displace tetrodotoxin and saxitoxin (STX) from their binding sites on nerve and skeletal muscle Na channels. Recent studies of cloned cardiac (toxin-resistant) and brain (toxin-sensitive) Na channels suggest important structural differences in their toxin and divalent cation binding sites. We used a partially purified preparation of sheep cardiac Na channels to compare monovalent and divalent cation competition and pH dependence of binding of [3H]STX between these toxin-resistant channels and toxin-sensitive channels in membranes prepared from rat brain. The effects of several chemical modifiers of amino acid groups were also compared. Toxin competition curves for Na+ in heart and Cd2+ in brain yielded similar KD values to measurements of equilibrium binding curves. The monovalent cation sequence for effectiveness of [3H]STX competition is the same for cardiac and brain Na channels, with similar KI values for each ion and slopes of -1. The effectiveness sequence corresponds to unhydrated ion radii. For seven divalent cations tested (Ca2+, Mg2+, Mn2+, Co2+, Ni2+, Cd2+, and Zn2+) the sequence for [3H]STX competition was also similar. However, whereas all ions displaced [3H]STX from cardiac Na channels at lower concentrations, Cd2+ and Zn2+ did so at much lower concentrations. In addition, and by way of explication, the divalent ion competition curves for both brain and cardiac channels (except for Cd2+ and Zn2+ in heart and Zn2+ in brain) had slopes of less than -1, consistent with more than one interaction site. Two-site curves had statistically better fits than one-site curves. The derived values of KI for the higher affinity sites were similar between the channel types, but the lower affinity KI's were larger for heart. On the other hand, the slopes of competition curves for Cd2+ and Zn2+ were close to -1, as if the cardiac Na channel had one dominant site of interaction or more than one site with similar values for KI. pH titration of [3H]STX binding to cardiac channels showed a pKa of 5.5 and a slope of 0.6-0.9, compared with a pKa of 5.1 and slope of 1 for brain channels. Tetramethyloxonium (TMO) treatment abolished [3H]STX binding to cardiac and brain channels and STX protected channels, but the TMO effect was less dramatic for cardiac channels. Trinitrobenzene sulfonate preferentially abolished [3H]STX binding to brain channels by action at an STX protected site.(ABSTRACT TRUNCATED AT 400 WORDS)