Search

Your search keyword '"Mutiso, V."' showing total 153 results
Start Over Author "Mutiso, V."
153 results on '"Mutiso, V."'

1. More anxious than depressed: Prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus

Author

Chaturvedi, S, Manche Gowda, S, Ahmed, H, Alosaimi, F, Andreone, N, Bobrov, A, Bulgari, V, Carra, G, Castelnuovo, G, Girolamo, G, Gondek, T, Jovanovic, N, Kamala, T, Kiejna, A, Lalic, N, Lecic-Tosevski, D, Minhas, F, Mutiso, V, Ndetei, D, Rabbani, G, Somruk, S, Srikanta, S, Taj, R, Valentini, U, Vukovic, O, Wolwer, W, Cimino, L, Nouwen, A, Lloyd, C, Sartorius, N, Chaturvedi S. K., Manche Gowda S., Ahmed H. U., Alosaimi F. D., Andreone N., Bobrov A., Bulgari V., Carra G., Castelnuovo G., Girolamo G. D., Gondek T., Jovanovic N., Kamala T., Kiejna A., Lalic N., Lecic-Tosevski D., Minhas F., Mutiso V., Ndetei D., Rabbani G., Somruk S., Srikanta S., Taj R., Valentini U., Vukovic O., Wolwer W., Cimino L., Nouwen A., Lloyd C., Sartorius N., Chaturvedi, S, Manche Gowda, S, Ahmed, H, Alosaimi, F, Andreone, N, Bobrov, A, Bulgari, V, Carra, G, Castelnuovo, G, Girolamo, G, Gondek, T, Jovanovic, N, Kamala, T, Kiejna, A, Lalic, N, Lecic-Tosevski, D, Minhas, F, Mutiso, V, Ndetei, D, Rabbani, G, Somruk, S, Srikanta, S, Taj, R, Valentini, U, Vukovic, O, Wolwer, W, Cimino, L, Nouwen, A, Lloyd, C, Sartorius, N, Chaturvedi S. K., Manche Gowda S., Ahmed H. U., Alosaimi F. D., Andreone N., Bobrov A., Bulgari V., Carra G., Castelnuovo G., Girolamo G. D., Gondek T., Jovanovic N., Kamala T., Kiejna A., Lalic N., Lecic-Tosevski D., Minhas F., Mutiso V., Ndetei D., Rabbani G., Somruk S., Srikanta S., Taj R., Valentini U., Vukovic O., Wolwer W., Cimino L., Nouwen A., Lloyd C., and Sartorius N.

Abstract

Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18-65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.

Published
2019

2. Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries; results from the INTERPRET-DD prospective study

Author

Lloyd, Cathy E., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., Bobrov, A. E., Burti, L., Chaturvedi, S. K., Gaebel, W., de Girolamo, G., Gondek, T. M., Guinzbourg, M., Heinze, M. G., Khan, A., Kiejna, A., Kokoszka, A., Lalic, N. M., Lecic-Tosevski, D., Mannucci, E., Mankovsky, B., Müssig, K., Mutiso, V., Ndetei, D., Nouwen, Arie, Rabbani, G., Srikanta, S. S., Starostina, E. G., Shevchuk, M., Taj, R., Valentini, U, van Dam, Kristina, Vukovic, O., and Wölwer, W.

Subjects
mental disorders, behavioral disciplines and activities
Abstract

Aims\ud To examine the factors that associated with changes in depression in people with type 2 diabetes living in 12 different countries.\ud Methods\ud People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose Major Depressive Disorder (MDD) at baseline and follow-up. At both time points participants completed the Patient Health Questionnaire (PHQ-9), the WHO 5-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables.\ud Results\ud In total there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS.\ud Conclusion\ud This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors may help to mitigate their impact on diabetes self-management as well as MDD, thus early screening and treatment for symptoms is recommended.

Published
2020

3. Understanding the neuroprotective effect of tranexamic acid: an exploratory analysis of the CRASH-3 randomised trial

Author

Brenner, A., Belli, A., Chaudhri, R., Coats, T., Frimley, L., Jamaluddin, S. F., Jooma, R., Mansukhani, R., Sandercock, P., Shakur-Still, H., Shokunbi, T., Roberts, I., Aeron-Thomas, A., Chaudary, M. A., Jamaluddin, S. F. B., Javaid, K., Kayani, A., Leech, C., Mahmood, K., Noor, J. M., Mejia-Mantilla, J., Moss, P., Pott, J., Vallecilla, L., Hartzenberg, H. B., Joshipura, M., Perel, P., Clarke, M. J., Ohaegbulam, S. C., Rodgers, A., Brady, T., Dewan, Y., Edwards, P., Komolafe, E. O., Arribas, M., Austin, E., Balogun, E., Barneston, L., Barrow, C., Beaumont, D., Benyahia, M., Brooks, I., Cargill, M., Carrington, L., Cook, L., Cornu-Hewitt, B., Geer, A., Gilbert, D., Gilliam, C., Gil-Onandia, J., Hetherington, D., Howe, C., Hughes, C., I'Anson, D., Jackson, R., Joshi, M., Kansagra, S., Kawahara, T., Ker, K., Kostrov, S., Mahmood, A., Miah, H., Ndungu, B., Needham, K., Okusi, C., Outtandy, A., Pardinaz-Solis, R., Pearson, D., Pepple, T., Pisani, C., Prieto-Merino, D., Prowse, D., Quashi, N., Quinn, A., Ramos, M., Reid, M., Roukas, C., Scrapa, G., Squires, C., Tanner, J., Thayne, A., Vidaurre, L., Woods, E., Fawole, B., Adetayo, O., Okunade, O., Gogichaishvili, T., de los Angeles Munoz-Sanchez, M., Olldashi, F., Krishnan, S., Djientcheu, V., Castellanos, J. L., Rasulo, F., Hama, Q., Mulla, Y., Florian, I. S., Tobar, J., Khamis, H., Deasy, C., Wellsh, B., Williams-Johnson, J., Chandra, S., Mutiso, V., Butt, R., Nasir, M. H., Ahmad, S., Aslam, F., Ishaque, K., Usmani, F., Rizvi, S., Ali, F., Sajjad, O., Zunair, A., Rehman, L., Rizvi, R., Javeed, F., Ahmed, S., Abbas, A., Afzal, A., Mikdad, A., Bashir, A., Chaudary, A., Salahuddin, T., Ahemed, B., Aziz, A., Ashraf, N., Hussain, S., Ahmad, U., Asif, M., Adil, M., Rauf, A., Khan, R., Ahmad, B., Afzal, U., Raza, H., Ain, Q., Yaqoob, S., Waseem, Q., Nishat, M., Semvel, S., Iqbal, J., Majeed, S., Zulfiqar, S., Iqbal, M., Majeed, N., Ahmed, M., Akhtar, N., Malik, M., Shehzad, Y., Yousaf, M., Wahid, A., Samad, A., Shah, S., Ali, M., Zeb, J., Khan, A. S., Irfan, A., Sharif, S., Memon, R., Bloom, B., Harris, T., Skene, I., Bellhouse, G., Boulton, O., Ward, G., Jarvis, C., Swann, C., Ratnam, S., Carrera, R., Yakoub, K., Davies, D., Fellows, E., Jarman, H., Rounding, S., Johnson, E., Loughran, C., Lecky, F., Clayton, K., Michael, A., Coumbarides, A., Kendall, J., Faulkner, B., Worner, R., Gendall, E., Hopkins, P., Riozzi, P., Cotton, H., Astin-Chamberlain, R., Wilson, M., Bodnar, J., Williams, R., Rigoni, A., Sattout, A., Fletcher, J., Edge, C., Maryanji, N., Boyle, A., Hardwick, S., Nichols, E., Hayhurst, C., Coffey, F., Gough, C., Miller, P., Ryan, L., Darwent, M., Espinosa, A., Beer, S., Norton, J., Maguire, H., Finney, K., Kehoe, A., Squire, R., Jeffery, A., Vorwerk, C., Foord, D., Wilkinson, E., Kuhrt, A., Ramlakhan, S., Reid, S., Curran, A., Mcmullan, S., Hassan, T., Nuttall, S., Haig, S., Al-Nahhas, S., Bulters, D., Zolnourian, A., Ribbons, T., Mew, I., de Weymarn, T., Hughes, V., Mcvicar, J., Mckiernan, C., Keating, L., Reschreiter, H., Wright, J., Chan, L., Kataria, H., Ireland, A., Body, R., Corfield, A., Francis, S., Townend, W., Gagg, J., Wilson, S., Cottingham, R., Tucker, S., Sutherland, F., Mitchell, L., Parker, L., Afolabi, O., Hunter, F., Jadav, M., Adeboye, K., Grocutt, M., May, G., Watson, D., Wootten, A., Robertshaw, S., Dorrian, S., Perry, R., Choi, H., Mcgroarty, C., Shone, P., Maritz, D., Jamaluddin, S., Noor, J., Rosli, N., Xian, L. L. S., De Jun, Y., Mohamed, F., Song, C. H., Hawari, A., Chin, L. Y., Hussein, H. M., Lotfi, M., Hamid, H., Udin, N., Lian, P., Choo, S., Wong, K., Gani, F., Jusoh, M., Rajakumar, D., Yang, C. B., Dzulkiflee, N. S. B., W. C., Ky, Azman, M. A. B. M., Osman, A. B., Ahmad, A. H., Ismail, R., Lai, S. Q., Mohidin, M. A. B., Deraman, N. B., Selamat, S. B., Abidin, I., Halim, N., Bakar, Z., Ismail, Z. M., Hisham, B., Kamal, R., Effendy, Z., Ismail, M., Azleen, N., Seng, L. Y., Baharuddin, K. A., Kandasamy, R., Kamalludin, A., Asmee, S., Fadzil, M., Basitz, A., Abdullah, N., Ingorokva, G., Ingorokva, S., Agdgomelashvili, I., Mumladze, K., Maisuradze, I., Kugusheva, I., Shalamberidze, B., Tomadze, G., Fernandez-Ortega, J., Seara-Valero, R., Ibanez-Botella, G., Garcia-Martinez, V., Martul, M. G., Ramos, S. F., Preciado, G. L., Garcia-Alfaro, C., Munoz-Sanchez, A., Bellido-Alba, R., Corcobado, C., Bueno, A., Ambros, A., Jimenez, J. T., Ramirez, J. R., Martin, J., Rodriguez, L. I., Fontanals, J., Jimenez-Moragas, J. M., Berbegal, J. P., Oluwole, O., Mahmud, R., Ukwu, N., Bankole, F., Oseni, A., Adebayo, B., Malomo, A., Tiamiyu, L., Adekanmbi, A., Thanni, L., Olubodun, A., Ojeblenu, F., Uwaezuoke, M., Komolafe, E., Owagbemi, O., Ishola, F., Durodola, A., Udoffa, U., James, A., Tella, A., Dongo, A., Ekpemiro, U., Anyanwu, S., Aigoro, N., Mezue, W., Shilong, D., Azeez, A., Babalola, O., Ibrahim, M., Obande, J., Franco, A. C., Salazar, E. V., Londono, S. B., Cardona, V. M., Morales, C., Naranjo, S., Agudelo, J., Carvajal, S., Fajardo-Gaviria, Y., Roka, Y., Ghising, U., Roka, N., Shrestha, M., Devkota, U., Vaidya, B., Nepal, P., Thapa, A., Kc, B., Shrestha, A., Jha, R., Shrestha, P., Hodaj, I., Spaho, E., Selaj, A., Bendo, N., Shoko, T., Endo, H., Senda, A., Hagihara, Y., Fuse, T., Masunaga, N., Otomo, Y., Egashira, R., Ohnuki, T., Almazmi, A., Saha, S., Suvarov, A., Aung, T. L., Tun, K. M., Khaing, T. T., Maw, T., Ndome, O., Moumi, M., Mbida, A., Fondop, J., Sebastien, M., Azim, A., Adil, J., Amiry, Z., Loria-Castellanos, J., Rubio, N. G., Leon, P. O., Estrada, F., de Oca-Garcia, E. M., Sanchez, H., Soria, A., Bonucci, P., Franchi, F., Girardini, A., Hameed, H., Basim, M., Stock, S., Hourt, E., Ilunga, A., Mulenga, J., Ples, H., Danil, A., Gorgan, M., Florian, I., Vlahovic, D., French, J., East, J., Kurniawan, A., and Kiboi, J.

Subjects
medicine.medical_specialty, Tranexamic acid, Traumatic brain injury, Epidemiology, Critical Care and Intensive Care Medicine, Placebo, CRASH-3 trial, Neuroprotection, Intracranial haemorrhage, law.invention, Emergence care, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, Internal medicine, Medicine, Humans, 030212 general & internal medicine, Randomised controlled trial, business.industry, Multiple Trauma, Research, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 030208 emergency & critical care medicine, lcsh:RC86-88.9, Protective Factors, medicine.disease, Polytrauma, Antifibrinolytic Agents, 3. Good health, Neuroprotective Agents, Relative risk, Brain Injuries, business, medicine.drug
Abstract

Background The CRASH-3 trial hypothesised that timely tranexamic acid (TXA) treatment might reduce deaths from intracranial bleeding after traumatic brain injury (TBI). To explore the mechanism of action of TXA in TBI, we examined the timing of its effect on death. Methods The CRASH-3 trial randomised 9202 patients within 3 h of injury with a GCS score ≤ 12 or intracranial bleeding on CT scan and no significant extracranial bleeding to receive TXA or placebo. We conducted an exploratory analysis of the effects of TXA on all-cause mortality within 24 h of injury and within 28 days, excluding patients with a GCS score of 3 or bilateral unreactive pupils, stratified by severity and country income. We pool data from the CRASH-2 and CRASH-3 trials in a one-step fixed effects individual patient data meta-analysis. Results There were 7637 patients for analysis after excluding patients with a GCS score of 3 or bilateral unreactive pupils. Of 1112 deaths, 23.3% were within 24 h of injury (early deaths). The risk of early death was reduced with TXA (112 (2.9%) TXA group vs 147 (3.9%) placebo group; risk ratio [RR] RR 0.74, 95% CI 0.58–0.94). There was no evidence of heterogeneity by severity (p = 0.64) or country income (p = 0.68). The risk of death beyond 24 h of injury was similar in the TXA and placebo groups (432 (11.5%) TXA group vs 421 (11.7%) placebo group; RR 0.98, 95% CI 0.69–1.12). The risk of death at 28 days was 14.0% in the TXA group versus 15.1% in the placebo group (544 vs 568 events; RR 0.93, 95% CI 0.83–1.03). When the CRASH-2 and CRASH-3 trial data were pooled, TXA reduced early death (RR 0.78, 95% CI 0.70–0.87) and death within 28 days (RR 0.88, 95% CI 0.82–0.94). Conclusions Tranexamic acid reduces early deaths in non-moribund TBI patients regardless of TBI severity or country income. The effect of tranexamic acid in patients with isolated TBI is similar to that in polytrauma. Treatment is safe and even severely injured patients appear to benefit when treated soon after injury. Trial registration ISRCTN15088122, registered on 19 July 2011; NCT01402882, registered on 26 July 2011.

Published
2020

4. More anxious than depressed: Prevalence and correlates in a 15-nation study of anxiety disorders in people with type 2 diabetes mellitus

Author

Chaturvedi, S. K., Manche Gowda, S., Ahmed, H. U., Alosaimi, F. D., Andreone, N., Bobrov, A., Bulgari, V., Carra, G., Castelnuovo, G., Girolamo, G. D., Gondek, T., Jovanovic, N., Kamala, T., Kiejna, A., Lalic, N., Lecic-Tosevski, D., Minhas, F., Mutiso, V., Ndetei, D., Rabbani, G., Somruk, S., Srikanta, S., Taj, R., Valentini, U., Vukovic, O., Wolwer, W., Cimino, L., Nouwen, A., Lloyd, C., Sartorius, N., Castelnuovo G. (ORCID:0000-0003-2633-9822), Chaturvedi, S. K., Manche Gowda, S., Ahmed, H. U., Alosaimi, F. D., Andreone, N., Bobrov, A., Bulgari, V., Carra, G., Castelnuovo, G., Girolamo, G. D., Gondek, T., Jovanovic, N., Kamala, T., Kiejna, A., Lalic, N., Lecic-Tosevski, D., Minhas, F., Mutiso, V., Ndetei, D., Rabbani, G., Somruk, S., Srikanta, S., Taj, R., Valentini, U., Vukovic, O., Wolwer, W., Cimino, L., Nouwen, A., Lloyd, C., Sartorius, N., and Castelnuovo G. (ORCID:0000-0003-2633-9822)

Abstract

Anxiety disorder, one of the highly disabling, prevalent and common mental disorders, is known to be more prevalent in persons with type 2 diabetes mellitus (T2DM) than the general population, and the comorbid presence of anxiety disorders is known to have an impact on the diabetes outcome and the quality of life. However, the information on the type of anxiety disorder and its prevalence in persons with T2DM is limited. Aims To assess the prevalence and correlates of anxiety disorder in people with type 2 diabetes in different countries. Methods People aged 18-65 years with diabetes and treated in outpatient settings were recruited in 15 countries and underwent a psychiatric interview with the Mini-International Neuropsychiatric Interview. Demographic and medical record data were collected. Results A total of 3170 people with type 2 diabetes (56.2% women; with mean (SD) duration of diabetes 10.01 (7.0) years) participated. The overall prevalence of anxiety disorders in type 2 diabetic persons was 18%; however, 2.8% of the study population had more than one type of anxiety disorder. The most prevalent anxiety disorders were generalised anxiety disorder (8.1%) and panic disorder (5.1%). Female gender, presence of diabetic complications, longer duration of diabetes and poorer glycaemic control (HbA1c levels) were significantly associated with comorbid anxiety disorder. A higher prevalence of anxiety disorders was observed in Ukraine, Saudi Arabia and Argentina with a lower prevalence in Bangladesh and India. Conclusions Our international study shows that people with type 2 diabetes have a high prevalence of anxiety disorders, especially women, those with diabetic complications, those with a longer duration of diabetes and poorer glycaemic control. Early identification and appropriate timely care of psychiatric problems of people with type 2 diabetes is warranted.

Published
2019

8. [Accepted Manuscript] Nurses’ perceptions of universal health coverage and its implications for the Kenyan health sector

Author

Koon, A.D., Smith, L., Ndetei, D., Mutiso, V., and Mendenhall, E.

Abstract

Universal health coverage, comprehensive access to affordable and quality health services, is a key component of the newly adopted 2015 Sustainable Development Goals. Prior to the UN resolution, several countries began incorporating elements of universal health coverage into their domestic policy arenas. In 2013, the newly elected President of Kenya announced initiatives aimed at moving towards universal health coverage, which have proven to be controversial. Little is known about how frontline workers, increasingly politically active and responsible for executing these mandates, view these changes. To understand more about how actors make sense of universal health coverage policies, we conducted an interpretive policy analysis using well-established methods from critical policy studies. This study utilized in-depth semi-structured interviews from a cross section of 60 nurses in three health facilities (public and private) in Kenya. Nurses were found to be largely unfamiliar with universal health coverage and interpreted it in myriad ways. One policy in particular, free maternal health care, was interpreted positively in theory and negatively in practice. Nurses often relied on symbolic language to express powerlessness in the wake of significant health systems reform. Study participants linked many of these frustrations to disorganization in the health sector as well as the changing political landscape in Kenya. These interpretations provide insight into charged policy positions held by frontline workers that threaten to interrupt service delivery and undermine the movement towards universal health coverage in Kenya.

Published
2016

10. Changing patterns of mental health knowledge in rural Kenya after intervention using the WHO mhGAP-Intervention Guide.

Author

Mutiso, V. N., Pike, K. M., Musyimi, C. N., Rebello, T. J., Tele, A., Gitonga, I., Thornicroft, G., and Ndetei, D. M.

Subjects
*ATTITUDE (Psychology), *CHANGE, *EMPLOYMENT, *HEALTH facilities, *LITERACY, *MARITAL status, *MENTAL illness, *PSYCHOLOGISTS, *RURAL conditions, *SEX distribution, *SOCIOECONOMIC factors, *EDUCATIONAL attainment, *HUMAN services programs, *PRE-tests & post-tests, *HEALTH literacy
Abstract

Background: Despite the high prevalence of mental disorders, mental health literacy has been comparatively neglected. People's symptom-management strategies will be influenced by their mental health literacy. This study sought to determine the feasibility of using the World Health Organization mhGAP-Intervention Guide (IG) as an educational tool for one-on-one contact in a clinical setting to increase literacy on the specified mental disorders. Methods: This study was conducted in 20 health facilities in Makueni County, southeast Kenya which has one of the poorest economies in Kenya. It has no psychiatrist or clinical psychologist. We recruited 3267 participants from a community that had already been exposed to community mental health services. We used Mental Health Knowledge Schedule to measure the changing patterns of mental health knowledge after a period of 3 months, following a training intervention using the WHO mhGAP-IG. Results: Overall, there was a significant increase in mental health related knowledge [mean range 22.4–23.5 for both post-test and pre-test scores (p < 0.001)]. This increase varied with various socio-demographic characteristics such as sex, marital status, level of education, employment status and wealth index. Conclusions: mhGAP-IG is a feasible tool to increase mental health literacy in low-resource settings where there are no mental health specialists. Our study lends evidence that the WHO Mental Health Action Plan 2013–2020 and reduction of the treatment gap may be accelerated by the use of mhGAP-IG through improving knowledge about mental illness and potentially subsequent help seeking for early diagnosis and treatment. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

11. Feasibility of WHO mhGAP-intervention guide in reducing experienced discrimination in people with mental disorders: a pilot study in a rural Kenyan setting.

Author

Mutiso, V. N., Pike, K., Musyimi, C. W., Rebello, T. J., Tele, A., Gitonga, I., Thornicroft, G., and Ndetei, D. M.

Subjects
MENTAL health services, COMMUNITY mental health services, MENTAL illness, HEALTH service areas, SOCIAL stigma
Abstract

Aims: Stigma can have a negative impact on help-seeking behaviour, treatment adherence and recovery of people with mental disorders. This study aimed to determine the feasibility of the WHO Mental Health Treatment Gap Interventions Guidelines (mhGAP-IG) to reduce stigma in face-to-face contacts during interventions for specific DSM-IV/ICD 10 diagnoses over a 6-month period. Methods: This study was conducted in 20 health facilities across Makueni County in southeast Kenya which has one of the poorest economies in the country and has no psychiatrist or clinical psychologist. We recruited 2305 participants from the health facilities catchment areas that had already been exposed to community mental health services. We measured stigma using DISC-12 at baseline, followed by training to the health professionals on intervention using the WHO mhGAP-IG and then conducted a follow-up DISC-12 assessment after 6 months. Proper management of the patients by the trained professionals would contribute to the reduction of stigma in the patients. Results: There was 59.5% follow-up at 6 months. Overall, there was a significant decline in 'reported/experienced discrimination' following the interventions. A multivariate linear mixed model regression indicated that better outcomes of 'unfair treatment' scores were associated with: being married, low education, being young, being self-employed, higher wealth index and being diagnosed with depression. For 'stopping self' domain, better outcomes were associated with being female, married, employed, young, lower wealth index and a depression diagnosis. In regards to 'overcoming stigma' domain; being male, being educated, employed, higher wealth index and being diagnosed with depression was associated with better outcomes. Conclusions: The statistically significant (p < 0.05) reduction of discrimination following the interventions by trained health professionals suggest that the mhGAP-IG may be a useful tool for reduction of discrimination in rural settings in low-income countries. [ABSTRACT FROM AUTHOR]

Published
2019
Full Text
View/download PDF

16. ELEVATED SERUM OSTEOCALCIN LEVELS AS A SURROGATE MARKER OF PRIMARY OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN.

Author

Mulbah, R. G., Sitati, F. C., Gakuya, E. M., and Mutiso, V. M.

Subjects
SERUM, OSTEOCALCIN, OSTEOPOROSIS, POSTMENOPAUSE, DUAL-energy X-ray absorptiometry
Abstract

Background: Primary osteoporosis is increasingly becoming a major public health concern in African populations. Complications arising from this condition can be catastrophic; ranging from hip fractures to lumbar spinal injuries. Early diagnosis and prevention are useful in mitigating its effects. The Dual Energy X-ray Absorptiometry (DXA) scan is not a widely affordable and accessible diagnostic tool to many in our setting. There is need for an alternative, affordable and accessible marker for early screening of osteoporosis. Objective: To correlate serum osteocalcin level with DXA findings in the diagnosis of osteoporosis in postmenopausal women. Design: This was an analytical cross-sectional study. Setting: Orthopaedic outpatient clinic of the Kenyatta national Hospital. Participants: 61 postmenopausal women aged 50 years and above were assessed for both neck of femur and lumbar vertebrae DXA bone mineral density and serum osteocalcin levels. Results: Twenty-eight (46%), 11 (18%) and 22 (36%) women had normal, osteoporoticnd ate osic bopenone mineral density levels respectively. Serum Osteocalcin levels for normal, osteopenic and ostepoorotic groups was 12.51±2.5 ng/ml, 22.14±5ng/ml and 31.46±8ng/ml respectively (p<0.00). There was a negative correlation between osteocalcin levels and DXA femoral neck bone mineral density (Coefficient - 0.68, P = 0.00). Women with Osteoporosis (T-score ≤ -2.5 SD) consistently had osteocalcin levels of ≥ 25.1 ng/ml. Conclusion: Serum Osteocalcin levels are predictive of DXA findings and elevated levels can be considered as a surrogate marker of primary osteoporosis in postmenopausal women. [ABSTRACT FROM AUTHOR]

Published
2018

18. Outcome of a working diagnosis of \'psychosis\' in relation to DSM-IV diagnostic criteria in a Kenyan in-patient cohort at Mathari hospital, Nairobi

Author

Ndetei, D. M., Khasakhala, L. I., Ongecha, F. A., Mutiso, V., and Donald Kokonya

Abstract

Background: When a patient presents with mental illness and displays psychotic symptoms which are not clearly delineated, a clinical diagnosis of psychosis is usually entertained. Aim: To determine the underlying Diagnostic and Statistical Manual of Mental Disorders-Fourth edition (DSM-IV) disorders in clinical entities admitted with a working diagnosis of \"psychosis\" at Mathari Psychiatric Hospital, Nairobi, Kenya. Study Design: Descriptive cross-sectional quantitative study Method: A total of 138 patients with a working diagnosis of \"psychosis\" on admission at Mathari Hospital during the period of this study were recruited over a one-month period. Their DSM-IV diagnoses were made using the Structured Clinical Interview for DSM-IV (SCID). Analysis of the results was done using SPSS version 11.5. Results: Nearly three quarters (72.5%) of the patients were male, 68.5% were aged between 20 and 34 years and 63.7% reported that they were single. Nearly half (49.2%) had attained up to 12 years of formal education and 90% were dependants of a member of the family. The most common DSM-IV diagnoses were schizophrenia, bipolar disorder, substance abuse, depression and anxiety disorders. Co-morbidity was recorded with an average of three DSM-IV disorders. Conclusion: \"Psychosis\" as a working diagnosis was reported in relatively young adults. The patients whose working clinical diagnosis was \"psychosis\" met the criteria for an average of three DSM-IV diagnoses. There is need for a proactive policy in clinical practice so that definitive diagnoses rather than just \"psychosis\" are made and appropriate management initiated as early as possible. African Health Sciences Vol. 7 (4) 2007: pp. 197-201

Published
2008

19. A study of drug use in five urban centres in Kenya

Author

Ndetei, DM, Khasakhala, L, Ong’echa, FA, Kokonya, D, Mutiso, V, Kuria, M, Odhiambo, G, Akanga, S, Ndetei, DM, Khasakhala, L, Ong’echa, FA, Kokonya, D, Mutiso, V, Kuria, M, Odhiambo, G, and Akanga, S

Abstract

Few studies have addressed the reasons for substance use in Kenya, with most focusing on prevalence rates in school-based and general population samples. None have been carried out among people already using drugs. This study, based on five samples of drug users, aimed to identify patterns of factors contributing to and consequences of substance use; compare socio-demographic characteristics; document help-seeking behaviours of substance abusers as well as their family and social dynamics. Active or former substance abusers (N =1,420) were interviewed using a structured questionnaire format. The peak age for substance abuse was between 21 and 30 years and most abusers were male. Leisure, stress and peer pressure were the most common reasons given for abusing substances. There were negative economic and work-related impacts of abusing substances. Risky sexual behaviour may have been a consequenc of abusing substances. Substance abusers need assistance as most of them could benefit from programmes for treatment and rehabilitation. Keywords: substance abuse, Kenya, urban, peri-urban

Published
2009

32. Prevalence of Low Back Pain amongst Workers at a Paediatric Hospital in Nairobi.

Author

Mutiso, V. M., Amayo, E., Muoki, A. S., and Kimeu, M. M.

Subjects
*EMPLOYEES, *BACKACHE, *EMOTIONS, *HUMAN body
Abstract

Background: Back pain is a common complaint among working individuals worldwide. It is a significant cause of reduced work productivity and sick days. Methods: This was a prospective hospital based study done to determine the pattern of back pain amongst workers at a paediatric hospital in Nairobi. Results: Validated structured questionnaires were administered to 347 employees with a response rate of 19.3% The age range was 25 to 57 years with a mean of 34 years Females comprised 72.6% of the total with a Male to Female ratio of 2.6:1.Nurses comprised 42.2% of the total. 63.6% had suffered back pain in that year. 90.5% of back pain was located in the lower back. Conclusion: Back pain is a common affliction amongst staff especially the nursing staff. This is in keeping with other health Institutions around the world. [ABSTRACT FROM AUTHOR]

Published
2015

34. Epidemiology of Burns in Patients Aged 0 - 13 Years at a Paediatric Hospital in Kenya.

Author

Mutiso, V. M., Khainga, S. O., Muoki, A. S., and Kimeu, M. M.

Subjects
*BURNS & scalds, *WOUNDS & injuries, *PUBLIC health, *MEDICAL care
Abstract

Background: Burns are a common and significant cause of admission following injury in children. Methods: This was a retrospective hospital based multivariate survey conducted on burns patients aged 0 to 13 years over a five year period 2003 to 2007. It was conducted at a paediatric hospital in Nairobi, Kenya. During this period there were 1,052 patients admitted due to injury of which 202 (19.2%) had suffered a burns injury. Epidemiological data from the 202 patients was collected and analyzed. Results: The age range was 5 months to 13 years. The mean age was 3.4 years. 84.6% were in the age group 0 - 5 years. Males made up 59.7% giving a male to female ratio was 1.65:1. The main cause of burns was scalds with hot fluids accounting for 84.2%. Of the scalds, 175 (87.1%) took place at home. Unintentional burns accounted for the majority at 198 (98.5%). The majority of the patients [124, n= 176, 70.5%] had burns of Total Burnt Surface Area of less than 10%. Conclusion: Our results were similar to other studies in literature especially from developing countries for burns in the paediatric age group. Prevention is the key. [ABSTRACT FROM AUTHOR]

Published
2014

35. Psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) amongst Nairobi public secondary school children, Kenya.

Author

Ndetei, David M., Khasakhala, L. I., Seedat, Soraya, Syanda, Judy, Ongecha-Owuor, F. A., Kokonya, D. A., and Mutiso, V. N.

Subjects
ANXIETY in children, PSYCHOLOGICAL stress, DEPRESSION in children, MENTAL depression, PSYCHOMETRICS
Abstract

Background: There are few psychometric instruments whose properties have been studied in a developing country's context. Aim: To determine the psychometric properties of the Multidimensional Anxiety Scale for Children (MASC) in Nairobi public secondary school children, Kenya. Method: Concurrent self-administration of the MASC and Children's Depression Inventory (CDI) to students in Nairobi public secondary schools. Results: The MASC had a high overall internal consistency alpha co-efficient (0.85) in the Kenyan sample, which is similar to Western findings, and is hence a reliable tool for measuring anxiety in the study population. It was also similar to the findings from two Western studies in the anxiety domains of physical symptoms, social anxiety, separation anxiety and harm avoidance. The correlation co-efficient with CDI was similar to Scandinavian findings. Conclusion: The MASC can be used in Kenyan children and, by extension, other Africa children. [ABSTRACT FROM AUTHOR]

Published
2008
Full Text
View/download PDF

37. International orthopaedic Multicentre study (INORMUS) in fracture care: Protocol for a large prospective observational study INORMUS investigators

Author

Bhandari, M., PJ Devereaux, Ivers, R. Q., Miclau, T., Moroz, P., Thabane, L., Sprague, S., Mckay, P., Li, C. S., Jagnoor, J., Slobogean, G., Boniface, R., Browner, B., La Huerta, F., Pollak, A., Petrisor, B., Sancheti, P., Schemitsch, E., Zhou, J., Guyatt, G., Devereaux, P. J., Mundi, R., O Hara, N., Heels-Ansdell, D., Buckingham, L., Simunovic, N., Norton, R., Zhang, J., Tian, M., Yadav, L., Caldwell, A., Liu, Y., Wang, Q., Li, J., Zhang, Z., Zhang, W., Tian, S., Jia, Z., Guo, T., Ma, Y., Wu, G., Ma, X., Ma, J., Jia, H., Hu, S., Wang, Y., Sun, M., Qin, Y., Wang, J., Zhou, S., Qi, B., Wu, B., Zhi, C., Xing, B., Zhu, Y., Zhang, X., Yang, J., Dai, W., Lu, D., He, S., Cai, X., Liu, G., Rui, G., Hu, B., Chen, H., Hu, Y., Wang, T., Shyam, A., Borate, M., Gawande, N., Jadhav, N., Patil, S. D., Karkamakar, S., Patil, S., Ranaware, A., Tamboli, S., Gandhalikar, M., Tupe, R., Choudhary, V., Patil, P. V., Shetty, V., Shetty, N., Hegde, C., Shrivastava, S., Singh, P., Dhillon, M. S., Dhatt, S. S., Agrawal, G., Mittal, R., Sharma, V., John, B., Mahajan, A., Afzal, P. A., Prakash, J. S., Cherian, V. M., Jepegnanam, T. S., Titus, V. T. K., Nithyananth, M., Boopalan, P. R., Varghese, V. D., George, V. M., Rajagopalan, N., Nair, N., Amaravathy, R., Santhanagopal, S., Pilar, A., Chhabra, H. S., D Souza, A., Chawla, P., Raina, D., Vaksha, V., Subramanian, P., Moabelo, R. S., Segbefia, M., Baidoo, P. K., Ocloo, C. A., Baddoo, D. T., Ativor, V., Yeboah, D. K., Konadu, P., Kumah-Ametepey, R., Awariyah, D., Quartey, R., Saani, O., Quansah, R. E., Trafton, P., Anyitey-Kokor, D., Leat, M., Sobotey, J., Opuni, G., Agbenorwu, F., Gis, B. B. W. G., Ayana, B., Otsyeno, F. M. T., Jani, P., Mutiso, V. M., Atinga, J. E. O., Kilonzo, P. K., Muoki, J., Mbogori, M., Wambugu, J. W., Torutt, D., Odok, C., Kipkemoi, E., Otsyeno, D., Desmondnzioka, J. W., Owende, D., Lucinde, R., Kariuki, B., Kinyua, D., Kamau, M., Mwancha, M., Murgor, M., Nyabuti, M., Njoki, R., Lutomia, M., Nancy, N., Ndeleva, B. M., Johnson, M., Kimani, M., Gichui, K., Mara, M., Mwangi, G. C., Maina, A. M., Wamae, D., Mwangi, C., Kingori, I., Watson, P., Kiptoo, E. M., Temiloluwa, O. O., Ikechukwu, A. A., Bamidele, O. I., Akanbi, O. O., Olugbenga, I. O., Firth, G., Biscardi, A. G., Machuene, A. P., Moolman, J., Miller, B., Ramokgopa, M., Deventer, S., Pikor, T., Bhaga, R., Marealle, P., Wanini, A., Elisha, M., Zumbulu, D., Boniface, R. L., Temu, R., Mutanda, T., Ntuulo, J., Lubega, F., Tracy, G. T., Zaitun, K., Godfrey, P. B., Mandizvidza, V., Gova, M. F., Sabur, M. A., Qavi, M. I., Khundkar, T., Wangdi, K., Wangmo, N., Dorji, S., Baker, S., Thapa, J., Lodrel, K., Dorji, U., Saadat, S., Zafarghandi, M., Golbakhsh, M., Byanjankar, S., Joshi, R. R., Dwivedi, R., Sharma, J. R., Qadir, R. I., Bukhari, S. I., Baz, K. A., Wahid, I., Quang, L. N., Cuong Pham, V., Chinh, N. D., Amanquez, C., Vincenti, S. I., Bobarin, A. P., Sanchez, D. S., Elias, N., Ribeiro, J. E. G., Belangero, W. D., Mariolani, J. R. L., Livani, B., Lugnani, A., Rossi, F., Katayama, A., Kfuri, M., Fogagnolo, F., Baldy, F., Moraes, V. Y., Kojima, K. E., Dos Santos Silva, J., Demange, M. K., Andrade E Silva, F. B., Dan Silva, A. C. G., Quintero, J. E., Contreras, F., Merchan, G., Beauvoir, G., Mercado, E., Medina, F., Aguilar, G., Rubio-Avila, J., Ochoa, H. C., Cano, H. C., González, A. V., Gutierrez, N. I. G., Orozco, C. F., Jesús Martínez Ruíz, J., Martinez, D. A., Garuz, M., Altieri, J. S., Cutipa, I. J. S., Lurita, C. L., Manrique, D. T., Fernandez, J. H., Barquet, A., Rienzi, D., Elguezabal, I. A. E., Rizzo, E. A., Hovsepian, J. M., and Rodriguez, V.

38. Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2) a randomised, placebo-controlled trial

Author

Olldashi, F., Kerçi, M., Zhurda, T., Ruçi, K., Banushi, A., Traverso, M. S., Jiménez, J., Balbi, J., Dellera, C., Svampa, S., Quintana, G., Piñero, G., Teves, J., Seppelt, I., Mountain, D., Balogh, Z., Zaman, M., Druwé, P., Rutsaert, R., Mazairac, G., Pascal, F., Yvette, Z., Chancellin, D., Okwen, P., Djokam-Liapoe, J., Jangwa, E., Mbuagbaw, L., Fointama, N., Pascal, N., Baillie, F., Jiang, J. -Y, Gao, G. -Y, Bao, Y. -H, Morales, C., Sierra, J., Naranjo, S., Correa, C., Gómez, C., Herrera, J., Caicedo, L., Rojas, A., Pastas, H., Miranda, H., Constaín, A., Perdomo, M., Muñoz, D., Duarte, Á, Vásquez, E., Ortiz, C., Ayala, B., Delgado, H., Benavides, G., Rosero, L., Mejía-Mantilla, J., Varela, A., Calle, M., Castillo, J., García, A., Ciro, J., Villa, C., Panesso, R., Flórez, L., Gallego, A., Puentes-Manosalva, F., Medina, L., Márquez, K., Romero, A. R., Hernández, R., Martínez, J., Gualteros, W., Urbina, Z., Velandia, J., Benítez, F., Trochez, A., Villarreal, A., Pabón, P., López, H., Quintero, L., Rubiano, A., Tamayo, J., Piñera, M., Navarro, Z., Rondón, D., Bujan, B., Palacios, L., Martínez, D., Hernández, Y., Fernández, Y., Casola, E., Delgado, R., Herrera, C., Arbolaéz, M., Domínguez, M., Iraola, M., Rojas, O., Enseñat, A., Pastrana, I., Rodríguez, D., La Campa, S. Á, Fortún, T., Larrea, M., Aragón, L., Madrazo, A., Svoboda, P., Izurieta, M., Daccach, A., Altamirano, M., Ortega, A., Cárdenas, B., González, L., Ochoa, M., Ortega, F., Quichimbo, F., Guiñanzaca, J., Zavala, I., Segura, S., Jerez, J., Acosta, D., Yánez, F., Camacho, R., Khamis, H., Shafei, H., Kheidr, A., Nasr, H., Mosaad, M., Rizk, S., El Sayed, H., Moati, T., Hokkam, E., Amin, M., Lowis, H., Fawzy, M., Bedir, N., Aldars, M., Rodríguez, V., Tobar, J., Alvarenga, J., Shalamberidze, B., Demuria, E., Rtveliashvili, N., Chutkerashvili, G., Dotiashvili, D., Gogichaishvili, T., Ingorokva, G., Kazaishvili, D., Melikidze, B., Iashvili, N., Tomadze, G., Chkhikvadze, M., Khurtsidze, L., Lomidze, Z., Dzagania, D., Kvachadze, N., Gotsadze, G., Kaloiani, V., Kajaia, N., Dakubo, J., Naaeder, S., Sowah, P., Yusuf, A., Ishak, A., Selasi-Sefenu, P., Sibiri, B., Sarpong-Peprah, S., Boro, T., Bopaiah, K., Shetty, K., Subbiah, R., Mulla, L., Doshi, A., Dewan, Y., Grewal, S., Tripathy, P., Mathew, J., Gupta, B., Lal, A., Choudhury, M., Gupta, S., Chug, A., Pamidimukkala, V., Jagannath, P., Maharaj, M., Vommi, R., Gudipati, N., Chhang, W. H., Patel, P., Suthar, N., Banker, D., Patel, J., Dharap, S., Kamble, R., Patkar, S., Lohiya, S., Saraf, R., Kumar, D., Parihar, S., Gupta, R., Mangual, R., Alagumuthu, Kooper, D., Mohapatra, C., David, S., Rajaleelan, W., Pangi, A., Saraf, V., Chikareddy, S., Mankar, S., Golhar, A., Sakhare, R., Wagh, N., Hazarika, D., Chaudhuri, P., Ketan, P., Purohit, G., Purohit, Y., Pandya, M., Kiran, S., Walia, S., Goyal, S., Attri, A., Sharma, R., Oberai, A., Oberai, M., Oberoi, S., Tripathi, G. K., Peettakkandy, V., Karuthillath, P., Vadakammuriyil, P., Pol, J., Pol, S., Saste, M., Raul, S., Tiwari, S., Nelly, N., Chidambaram, M., Kollengode, V., Thampan, S., Rajan, S., Raju, S., Babu, S. V., Sumathi, C., Chatterjee, P., Agarwal, A., Magar, H., Magar, M., Singh, M., Gupta, D., Haloi, K., Sagdeo, V., Giri, P., Verma, N., Jariwala, R., Goti, A., Prabhu-Gaonkar, A., Utagi, S., Joshi, M., Agrawal, R., Sharma, G., Saini, G., Tewari, V., Yadav, Y., Parihar, V., Venkataramana, N., Rao, S., Reddy, N., Chander, S. G., Hathila, V., Das, V., Agaja, K., Purohit, A., Lahari, A., Bhagchandani, R., Vidyasagar, B., Sachan, P. K., Das, T., Vyas, S., Bhattacharjee, S., Sancheti, P., Manoj, T., Moideen, M., Pansey, K., Chandrasekaran, V. P., Saikia, K., Tata, H., Vhora, S., Shah, A., Rangad, G., Rajasekaran, S., Shankarlal, S. T., Devadoss, S., Saleem, M., Pillay, H., Hazarika, Z., Deshmukh, P., Murugappan, S. P., Jaiswal, A., Vangani, D., Modha, P., Chonzik, C., Praveen, M., Sethurayar, V., Ipe, S., Shetty, N., Gupta, R. P., Jain, V., Shah, K., Dwikoryanto, M., Golden, N., Atmadjaya, K., Wiargitha, K., Sudiasa, K., Suwedagatha, G., Bal Afif, F., Budipramana, V., Tabrani, Lemuel, A., Chandra, S., Ama, F., Sherafatkazemzadeh, E., Moradi, E., Sheikhi, A., Ziaee, A., Fanaei, A., Hajinasrollah, E., Amini, A., Mohammad, B., Hadi, N., Perone, G., Peri, E., Volpi, A., Johnson, J., Abe, M., Mutiso, V., Okanga, B., Ojuka, D., Abdullah, B., Rahman, H., Noh, Y., Jamaluddin, S., Dawal, H., Roslani, A., Law, C. -W, Devashanti, P., Wahab, Y., Velaiutham, S., Dato, R., Loría, J., Montes, E., Gómez, E., Cazales, V., Bautista, P., Bautista, R., Ahumada, D., Hernández, E., Velásquez, G., Ortega, P., Lira, G., Estrada, F., Casasola, J., Olaomi, O., Abubakar, Y., Apollo, K., Badejo, O., Ihekire, O., Iribhogbe, P., Oludiran, O., Obeta, E., Okojie, C., Udefiagbon, E., Komolafe, E., Olaleye, P., Uzochukwu, T., Onakpoya, U., Dongo, A., Uhunmwagho, O., Eighemerio, E., Morgan, E., Thanni, L., Afolabi, A., Akinola, T., Ademola, A., Akute, O., Khalid, L., Abubakar, L., Aminu, M., Ogirima, M., Attansey, A., Michael, D., Aremu, O., Olugbenga, O., Ukpong, U., Salman, Y., Obianyo, N., Ani, C., Ezeadawi, R., Kehinde, O., Olaide, A., Jogo, A., Bitto, T., Anyanwu, S., Mbonu, O., Oludara, M., Somoye, M., Shehu, B., Ismail, N., Katchy, A., Ndoma-Egba, R., Grace-Inah, N., Songden, Z., Abdulraheem, A., Otu, A., Nottidge, T., Inyang, D., Idiapho, D., Giebel, H., Hassan, R., Adisa, A., Akinkuolie, A., Okam, K., Musa, A., Falope, I., Eze, J., Caballero, J., Azabache, W., Salirrosas, O., Soto, A., Torres, E., Ramírez, G., Malca, C., Velez, J., Yepez, R., Yupanqui, H., Lagos, P., Rodriguez, D., Flores, J., Moya, A., Barrionuevo, A., Gonzales-Portillo, M., Nunez, E., Eldawlatly, A., Al Naami, M., Delvi, B., Khalid, K., Alyafi, W., Djurovic, B., Ng, I., Yaghi, A., Laincz, A., Trenkler, S., Valky, J., Modiba, M., Legodi, P., Rangaka, T., Wallis, L., Muñoz, Á, Serrano, A., Misis, M., Rubi, M., La Torre, V., Ellawala, R., Wijeratna, S., Gunaratna, L., Wijayanayaka, C., Nungu, K., Billy Haonga, Mtapa, G., Yutthakasemsunt, S., Kittiwattanagul, W., Piyavechvirat, P., Impool, T., Thummaraj, S., Salaeh, R., Tangchitvittaya, S., Wattanakrai, K., Soonthornthum, C., Jiravongbunrod, T., Meephant, S., Subsompon, P., Pensuwan, P., Chamnongwit, W., Jerbi, Z., Cherif, A., Nash, M., Harris, T., Banerjee, J., Freij, R., Kendall, J., Moore, S., Townend, W., Cottingham, R., Becker, D., Lloyd, S., Burdett-Smith, P., Mirza, K., Webster, A., Brady, S., Grocutt, A., Thurston, J., Lecky, F., Goodacre, S., Mulla, Y., Sakala, D., and Chengo, C.

39. Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study

Author

Lloyd, C. E., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., Bobrov, A. E., Burti, L., Chaturvedi, S. K., Gaebel, W., de Girolamo, G., Gondek, T. M., Guinzbourg, M., Heinze, M. G., Khan, A., Kiejna, A., Kokoszka, A., Kamala, T., Lalic, N. M., Lecic-Tosevski, D., Mannucci, E., Mankovsky, B., Müssig, K., Mutiso, V., Ndetei, D., Nouwen, A., Rabbani, G., Srikanta, S. S., Starostina, E. G., Shevchuk, M., Taj, R., Valentini, U., van Dam, K., Vukovic, O., Wölwer, W., Lloyd, C. E., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., Bobrov, A. E., Burti, L., Chaturvedi, S. K., Gaebel, W., de Girolamo, G., Gondek, T. M., Guinzbourg, M., Heinze, M. G., Khan, A., Kiejna, A., Kokoszka, A., Kamala, T., Lalic, N. M., Lecic-Tosevski, D., Mannucci, E., Mankovsky, B., Müssig, K., Mutiso, V., Ndetei, D., Nouwen, A., Rabbani, G., Srikanta, S. S., Starostina, E. G., Shevchuk, M., Taj, R., Valentini, U., van Dam, K., Vukovic, O., and Wölwer, W.

Abstract

Aims: To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. Methods: People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. Results: In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. Conclusion: This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to m

40. Factors associated with the onset of major depressive disorder in adults with type 2 diabetes living in 12 different countries: results from the INTERPRET-DD prospective study

Author

Lloyd, C. E., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., Bobrov, A. E., Burti, L., Chaturvedi, S. K., Gaebel, W., de Girolamo, G., Gondek, T. M., Guinzbourg, M., Heinze, M. G., Khan, A., Kiejna, A., Kokoszka, A., Kamala, T., Lalic, N. M., Lecic-Tosevski, D., Mannucci, E., Mankovsky, B., Müssig, K., Mutiso, V., Ndetei, D., Nouwen, A., Rabbani, G., Srikanta, S. S., Starostina, E. G., Shevchuk, M., Taj, R., Valentini, U., van Dam, K., Vukovic, O., Wölwer, W., Lloyd, C. E., Sartorius, N., Ahmed, H. U., Alvarez, A., Bahendeka, S., Bobrov, A. E., Burti, L., Chaturvedi, S. K., Gaebel, W., de Girolamo, G., Gondek, T. M., Guinzbourg, M., Heinze, M. G., Khan, A., Kiejna, A., Kokoszka, A., Kamala, T., Lalic, N. M., Lecic-Tosevski, D., Mannucci, E., Mankovsky, B., Müssig, K., Mutiso, V., Ndetei, D., Nouwen, A., Rabbani, G., Srikanta, S. S., Starostina, E. G., Shevchuk, M., Taj, R., Valentini, U., van Dam, K., Vukovic, O., and Wölwer, W.

Abstract

Aims: To examine the factors that are associated with changes in depression in people with type 2 diabetes living in 12 different countries. Methods: People with type 2 diabetes treated in out-patient settings aged 18-65 years underwent a psychiatric assessment to diagnose major depressive disorder (MDD) at baseline and follow-up. At both time points, participants completed the Patient Health Questionnaire (PHQ-9), the WHO five-item Well-being scale (WHO-5) and the Problem Areas in Diabetes (PAID) scale which measures diabetes-related distress. A composite stress score (CSS) (the occurrence of stressful life events and their reported degree of 'upset') between baseline and follow-up was calculated. Demographic data and medical record information were collected. Separate regression analyses were conducted with MDD and PHQ-9 scores as the dependent variables. Results: In total, there were 7.4% (120) incident cases of MDD with 81.5% (1317) continuing to remain free of a diagnosis of MDD. Univariate analyses demonstrated that those with MDD were more likely to be female, less likely to be physically active, more likely to have diabetes complications at baseline and have higher CSS. Mean scores for the WHO-5, PAID and PHQ-9 were poorer in those with incident MDD compared with those who had never had a diagnosis of MDD. Regression analyses demonstrated that higher PHQ-9, lower WHO-5 scores and greater CSS were significant predictors of incident MDD. Significant predictors of PHQ-9 were baseline PHQ-9 score, WHO-5, PAID and CSS. Conclusion: This study demonstrates the importance of psychosocial factors in addition to physiological variables in the development of depressive symptoms and incident MDD in people with type 2 diabetes. Stressful life events, depressive symptoms and diabetes-related distress all play a significant role which has implications for practice. A more holistic approach to care, which recognises the interplay of these psychosocial factors, may help to m

42. Aplasia Cutis Congenita. A Case Report and Review of Literature.

Author

Muoki, A., Gatinu, B. W., and Mutiso, V. M.

Subjects
*SKIN, *PHILOLOGY, *COMPARATIVE literature, *CLASSICAL philology, *COMPARATIVE grammar
Abstract

Aplasia cutis congenita is a birth defect characterised by absence of skin and, in some cases, the subcutaneous tissues. This is a case report of the initial conservative management of a neonate in a rural hospital who presented with aplasia cutis congenita involving the trunk and the lower limbs. The literature is reviewed and the case discussed. [ABSTRACT FROM AUTHOR]

Published
2013

43. Acceptability and feasibility of a brief intervention to enhance resilience among young people and their families in India and Kenya.

Author

Bhui K, Basu D, Nagpal S, Mutiso V, Pillai R, Hadfield K, Lauwrens Z, and Ndetei D

Abstract

Enhancing resilience is one way to prevent future mental illnesses and encourage recovery in the face of adversity. To develop and test the acceptability and feasibility (A&F) of a combined family and individual resilience intervention in two rural/semi-rural low-income settings in India and Kenya. We developed a five-session intervention including Life Skills Education (LSE) and a model of family resiliency. Among adolescents aged 14-16 years and their families in India and Kenya, we collected socio-demographics and audio records of delivery and undertook a process evaluation. Due to COVID-19, we developed a hybrid intervention. The facilitators and participants preferred the in-person model. India: Of 17 families, 10 fully completed the intervention. They identified three critical components: 1) story-telling, 2) cooperation and working together and 3) expressing feelings. Kenya: All 15 families completed the intervention. Critical elements were 1) seeing social value in learning to make good decisions, 2) promoting an optimistic view of life, 3) hearing stories that resonated with their situation and 4) enhancing family performance through knowledge-building. We mapped the active ingredients, showing fidelity and acceptability. The intervention showed promising A&F parameters. Flexibility and local adaptation were important for delivery., Competing Interests: The authors report no conflict of interest., (© The Author(s) 2024.)

Published
2024
Full Text
View/download PDF

44. Kenyans' perspectives on parenting roles and strategies used to raise young children in Kenya.

Author

Shanley JR, Mutiso V, Musyimi C, Armistead L, Olumbe R, Ishiekwene MN, and Ndetei D

Subjects
Humans, Kenya, Female, Male, Adult, Child, Preschool, Child, Qualitative Research, Parent-Child Relations ethnology, Adolescent, Parents psychology, Infant, Child Rearing psychology, Child Rearing ethnology, Young Adult, Parenting psychology, Parenting ethnology
Abstract

Research and parenting programs across the world emphasize two dimensions of parenting: warmth and control. Cross-country literature demonstrates many commonalities across samples on warmth; however, differences are evident with control, largely due to cultural and contextual nuances. Scant literature exists on parenting in Kenya, where half of Kenyans report experiencing child maltreatment typically by parents. Kenyan culture is a unique developmental niche important to understand and inform policies and parenting program development to reduce maltreatment. The purpose of this study was to understand perspectives on parenting strategies with young children, from a sample of Kenyans with varying experiences involving children (e.g., parents, community members). To our knowledge, this study is the first qualitative assessment of parenting practices among children under age 6 in Kenya. The 91 participants (62% female, all ≥ 18 years) completed interviews or focus groups. Based on a thematic data analysis, five themes emerged: (a) parental roles, (b) expressions of warmth, (c) cultural practices with children, (d) control strategies, and (e) factors impacting effective parenting. This study's findings have several implications for both informal and formal supports of families with young children. The findings offer insight into how Kenyans engage in parental warmth and control strategies, including those that are seen as culturally acceptable or harmful, and can inform the development or adaptation of parenting programs for Kenya. Furthermore, these findings offer important considerations for local and federal leaders in how to advance Kenya's policies and efforts to reduce childhood violence and promote healthy child development. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Published
2024
Full Text
View/download PDF

45. The correlations on psychopathology in children self-rating, psychopathology in children as related by their parents and psychopathology in parents self-rating in a Kenyan school setting: towards an inclusive family-centered approach.

Author

Ndetei DM, Mutiso V, Nyamai P, and Musyimi C

Subjects
Humans, Kenya, Child, Male, Female, Adult, Adolescent, Schools, Mental Disorders psychology, Mental Disorders epidemiology, Psychopathology, Parents psychology, Self Report
Abstract

Several studies have reported on the association between parental and childhood psychopathologies. Despite this, little is known about the psychopathologies between parents and children in a non-clinical population. We present such a study, the first in a Kenyan setting in an attempt to fill this gap. The objective of this study was to determine the association between self-rating psychopathology in children, parent-rating psychopathology in their children and self-rating psychopathology in parents in a non-clinical population of children attending schools in Kenya. We identified 113 participants, comprising children and their parents in 10 randomly sampled primary schools in South East Kenya. The children completed the Youth Self-Report (YSR) scale and parents completed the Child Behavior Check List (CBCL) on their children and the Adult Self-Reports (ASR) on themselves. These instruments are part of the Achenbach System of Empirically Based Assessment (ASEBA), developed in the USA for a comprehensive approach to assessing adaptation and maladaptive behavior in children and adolescents. There was back and forth translation of the instruments from English to Swahili and the local dialect, Kamba. Every revision of the English translation was sent to the instrument author who sent back comments until the revised version was in sync with the version developed by the author. We used the ASEBA in-built algorithm for scoring to determine cut-off points for problematic and non-problematic behavior. Correlations, linear regression and independent sample t-test were used to explore these associations. The mean age of the children was 12.7. While there was no significant association between child problems as measured by YSR (self-reported) and parent problems as measured by ASR and CBCL in the overall correlations, there was a significant association when examining specific groups (clinical range vs. non-clinical). Moreover, significant association existed between total problems on YSR and ASR internalizing problems (t=-2.3,p = 0.023), with clinical range having a higher mean than the normal range. In addition, a significant relationship (p < 0.05) was found between psychopathology in children as reported by both parents (CBCL) and psychopathology in parents as self-reported (ASR).Mothers were more likely to report lower syndrome scores of their children as compared to fathers. Our findings indicate discrepancies between children self-rating and parent ratings, suggesting that one cannot manage psychopathology in children without reference to psychopathology in their parents. We suggest broad-based psycho-education to include children and parents to enhance shared awareness of psychopathology and uptake of treatment., (© 2024. The Author(s).)

Published
2024
Full Text
View/download PDF

46. Diagnostic Accuracy of the World Health Organization Pediatric Emergency Triage, Assessment and Treatment Tool Plus Among Patients Seeking Care in Nairobi, Kenya: A Cross-sectional Study.

Author

Chen J, Aluisio AR, Tang OY, Nwakibu UA, Hunold KM, Wangara AA, Kiruja J, Maingi A, Mutiso V, Thompson P, Wachira B, Dunlop SJ, Martin IBK, and Myers JG

Subjects
Humans, Cross-Sectional Studies, Kenya, Male, Female, Child, Preschool, Child, Infant, Adolescent, Sensitivity and Specificity, ROC Curve, Hospitalization statistics & numerical data, Triage, Emergency Service, Hospital statistics & numerical data, World Health Organization
Abstract

Introduction: The World Health Organization developed Emergency Triage Assessment and Treatment Plus (ETAT+) guidelines to facilitate pediatric care in resource-limited settings. ETAT+ triages patients as nonurgent, priority, or emergency cases, but there is limited research on the performance of ETAT+ regarding patient-oriented outcomes. This study assessed the diagnostic accuracy of ETAT+ in predicting the need for hospital admission in a pediatric emergency unit at Kenyatta National Hospital in Nairobi, Kenya., Methods: This was a secondary analysis of a cross-sectional study of pediatric emergency unit patients enrolled over a 4-week period using fixed random sampling. Diagnostic accuracy of ETAT+ was evaluated using receiver operating curves (ROCs) and respective 95% confidence intervals (CIs) with associated sensitivity and specificity (reference category: nonurgent). The ROC analysis was performed for the overall population and stratified by age group., Results: A total of 323 patients were studied. The most common reasons for presentation were upper respiratory tract disease (32.8%), gastrointestinal disease (15.5%), and lower respiratory tract disease (12.4%). Two hundred twelve participants were triaged as nonurgent (65.6%), 60 as priority (18.6%), and 51 as emergency (15.8%). In the overall study population, the area under the ROC curve was 0.97 (95% CI, 0.95-0.99). The ETAT+ sensitivity was 93.8% (95% CI, 87.0%-99.0%), and the specificity was 82.0% (95% CI, 77.0%-87.0%) for admission of priority group patients. The sensitivity and specificity for the emergency patients were 66.0% (95% CI, 55.0%-77.0%) and 98.0% (95% CI, 97.0%-100.0%), respectively., Conclusions: ETAT+ demonstrated diagnostic accuracy for predicting patient need for hospital admission. This finding supports the utility of ETAT+ to inform emergency care practice. Further research on ETAT+ performance in larger populations and additional patient-oriented outcomes would enhance its generalizability and application in resource-limited settings., Competing Interests: Disclosure: The authors declare no conflict of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Published
2024
Full Text
View/download PDF

47. Association of type 2 diabetes with family history of diabetes, diabetes biomarkers, mental and physical disorders in a Kenyan setting.

Author

Ndetei DM, Mutiso V, Musyimi C, Nyamai P, Lloyd C, and Sartorius N

Subjects
Humans, Kenya epidemiology, Male, Female, Middle Aged, Adult, Aged, Mental Disorders epidemiology, Mental Disorders diagnosis, Depression epidemiology, Diabetes Mellitus, Type 2 epidemiology, Biomarkers
Abstract

This study aimed to determine the degree of family relations and associated socio-demographics characteristics, clinical/physical and mental disorders in type 2 diabetes mellitus in a Kenyan diabetes clinic. This study was part of a large multicentre study whose protocol and results had been published. It took place at the outpatient diabetes clinic at a County Teaching and Referral Hospital in South East Kenya involving 182 participants. We used a socio-demographic questionnaire, the Hamilton Depression (HAM-D) and PHQ-9 rating scales for depression, the MINI International Neuropsychiatric Interview (MINI; V5 or V6) for DSM-5 diagnoses, the WHO-5 Well-being scale and Problem Areas in Diabetes Scale (PAID). We extracted from the notes all physical conditions. We enquired about similar conditions in 1st and 2nd degree relatives. Descriptive, Chi-square test, Fisher's exact test, one way ANOVA, and Multinomial logistic regression analysis were conducted to test achievements of our specific aims. Of the 182 patients who participated in the study, 45.1% (82/182) reported a family history of diabetes. Conditions significantly (p < 0.05) associated with a degree of family history of diabetes were retinopathy, duration of diabetes (years), hypertension, and depressive disorder. On average 11.5% (21/182) scored severe depression (≥ 10) on PHQ-9 and 85.2% (115/182) scored good well-being (≥ 13 points). All DSM-5 psychiatric conditions were found in the 182 patients in varying prevalence regardless of relations. In addition, amongst the 182 patients, the highest prevalence was poor well-being on the WHO quality of life tool. This was followed by post-traumatic disorders (current), suicidality, and psychotic lifetime on DSM-5. The least prevalent on DSM-5 was eating disorders. Some type 2 diabetes mellitus physical disorders and depression have increased incidence in closely related patients. Overall, for all the patients, the prevalence of all DSM-5 diagnoses varied from 0.5 to 9.9%., (© 2024. The Author(s).)

Published
2024
Full Text
View/download PDF

48. Methods and associations of suicidality in Kenyan high school students: clinical and public health implications.

Author

Ndetei DM, Wasserman D, Mutiso V, Shanley JR, Musyimi C, Nyamai P, Munyua T, Swahn MH, Osborn TL, Johnson NE, Memiah P, Bhui K, Gilbert S, Weisz JR, Javed A, and Sourander A

Abstract

Background: Most evidence on suicidal thoughts, plans and attempts comes from Western countries; prevalence rates may differ in other parts of the world., Aims: This study determined the prevalence of suicidal thoughts, plans and attempts in high school students in three different regional settings in Kenya., Method: This was a cross-sectional study of 2652 high school students. We asked structured questions to determine the prevalence of various types of suicidality, the methods planned or effected, and participants' gender, age and form (grade level). We provided descriptive statistics, testing significant differences by chi-squared and Fisher's exact tests, and used logistic regression to identify relationships among different variables and their associations with suicidality., Results: The prevalence rates of suicidal thoughts, plans and attempts were 26.8, 14.9 and 15.7%, respectively. These rates are higher than those reported for Western countries. Some 6.7% of suicide attempts were not associated with plans. The most common method used in suicide attempts was drinking chemicals/poison (18.8%). Rates of suicidal thoughts and plans were higher for older students and students in urban rather than rural locations, and attempts were associated with female gender and higher grade level - especially the final year of high school, when exam performance affects future education and career prospects., Conclusion: Suicidal thoughts, plans and attempts are prevalent in Kenyan high school students. There is a need for future studies to determine the different starting points to suicidal attempts, particularly for the significant number whose attempts are not preceded by thoughts and plans.

Published
2024
Full Text
View/download PDF

49. Kenya Psychosis-Risk Outcomes Study (KePROS): Development of an Accelerated Medicine Partnership Schizophrenia-Aligned Project in Africa.

Author

Mamah D, Mutiso V, Musyimi C, Harms MP, Anokhin AP, Chen S, Torous J, Muyela L, Nashed J, Al-Hosni Y, Odera A, Yarber A, Golosheykin S, Faghankhani M, Sneed M, and Ndetei DM

Abstract

Background and Hypothesis: The Accelerating Medicines Partnership Schizophrenia (AMP SCZ) funds a longitudinal study of 43 research sites across 5 continents to develop tools to stratify developmental trajectories of youth at clinical high risk for psychosis (CHR) and identify homogenous targets for future clinical trials. However, there are no sites in Africa, leaving a critical gap in our knowledge of clinical and biological outcomes among CHR individuals., Study Design: We describe the development of the Kenya Psychosis-Risk Outcomes Study (KePROS), a 5-year NIH-funded project in Kenya designed to harmonize with AMP SCZ. The study will recruit over 100 CHR and 50 healthy participants and conduct multiple clinical and biomarker assessments over 2 years. Capacity building is a key component of the study, including the construction of an electroencephalography (EEG) laboratory and the upgrading of a local 3 T magnetic resonance imaging (MRI) machine. We detail community recruitment, study methodologies and protocols, and unique challenges with this pioneering research in Africa., Study Results: This paper is descriptive only. Planned future analyses will investigate possible predictors of clinical outcomes and will be compared to results from other global populations., Conclusions: KePROS will provide the research community with a rich longitudinal clinical and biomarker dataset from an African country in the developing Global South, which can be used alongside AMP SCZ data to delineate CHR outcome groups for future treatment development. Training in mental health assessment and investment in cutting-edge biomarker assessment and other technologies is needed to facilitate the inclusion of African countries in large-scale research consortia., Competing Interests: The authors have declared that there are no conflicts of interest in relation to the subject of this study., (© The Author(s) 2024. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.)

Published
2024
Full Text
View/download PDF

50. Face-to-face bullying in and outside of schools and cyberbullying are associated with suicidality in Kenyan high school students: a public health issue.

Author

Ndetei DM, Mutiso V, Shanley JR, Musyimi C, Nyamai P, Munyua T, Osborn TL, Johnson NE, Gilbert S, Abio A, Javed A, and Sourander A

Subjects
Adult, Adolescent, Humans, Male, Child, Female, Kenya epidemiology, Suicidal Ideation, Cross-Sectional Studies, Schools, Students, Self Report, Cyberbullying, Suicide, Bullying
Abstract

Background: Childhood bullying has been classified as a major public health concern by WHO, with negative effects on the health education and social outcomes of both bullies and victims. There is no current Kenyan data on the prevalence of face-to-face bullying and cyberbullying co-occurring in the same cohort of youth and how they are associated with different aspects of suicidality and socio-demographic characteristics. This study aims to fill these gaps in the Kenyan situation so as to inform current policy and practice., Methodology: This cross-sectional study involved 2,652 students from ten secondary schools in Kenya, selected from three regions representing different levels of public funded schools and socioeconomic spaces. The outcome variable was derived from the questionnaire which asked students questions related to self-harm, suicide thoughts, plans, and attempts. Predictor variables were based on response on experience of bullying in school, out of school, at home, and cyberbullying. Other variables such as gender, age, family background, and class were also collected from the self-reported questions. Data were analyzed using SPSS version 25, with descriptive summary statistics and chi-square tests used to examine variables, and logistic regression analysis used to determine the associations between suicidality and experience of bullying., Results: The mean age was 16.13 years. More than half of the participants were male, with the largest proportion living in rural areas. Face-to-face bullying was more prevalent than cyberbullying, with 82% of participants experiencing bullying and 68% experiencing it almost daily in the past six months. Both face-to-face bullying and cyberbullying were associated with suicidal thoughts, plans, and attempts. Predictors of suicidal attempts included being bullied outside of school and being a victim of group bullying, while being bullied every day and being bullied by adult men were predictors of suicidal attempts in cyberbullying., Conclusion: There is a high prevalence of face-to-face bullying both in and outside schools. There is also a high prevalence of cyberbullying. Both face-to-face and cyberbullying are associated with suicidality in Kenyan high school students., (© 2024. The Author(s).)

Published
2024
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results