Acute Pancreatitis in Individuals with Sickle Cell Disease: A Systematic Review.

Background/Objectives: Sickle cell disease (SCD) impacts about 100,000 people in the US. SCD increases the risk of cholelithiasis and microvascular ischemia, which could increase the risk of acute pancreatitis (AP). Abdominal pain is a common presenting symptom of AP and sickle cell vaso-occlusive crisis. The purpose of our systematic review is to estimate the prevalence and determine the severity of AP in individuals with SCD compared to the general population. Methods: Multiple electronic databases were searched. We included studies that included children and adults (population) and addressed the association of SCD (exposure) with AP (outcome) compared to the same population without SCD (control). Two authors screened titles and abstracts independently, and data were abstracted in duplication from included studies. We registered this protocol in PROSPERO-CRD42023422397. Results: Out of 296 studies screened from multiple electronic databases, we identified 33 studies. These studies included 17 case reports, one case series, and 15 retrospective cohort studies, and 18 studies included children. Eight of the AP case reports were in patients with HbSS genotype, two with sickle beta thalassemia, and one with HbSoArab, and in six case reports, a genotype was not specified. Complications were reported in 11 cases-respiratory complication (in at least four cases), splenic complications (three cases), pancreatic pseudocyst (two cases) and death from AP (one case). Of the four AP cases in the case series, three had HbSS genotype, and two cases had complications and severe pancreatitis. AP prevalence in SCD was estimated to be 2% and 7% in two retrospective studies, but they lacked a comparison group. In retrospective studies that evaluated the etiology of AP in children, biliary disease caused mostly by SCD was present in approximately 12% and 34%, respectively. Conclusions: Data on the prevalence of AP in individuals with SCD are limited. Prospectively designed studies aiming to proactively evaluate AP in individuals with SCD who present with abdominal pain are needed to improve timely diagnosis of AP in SCD and outcomes.

A Universal Program to Improve Mental Health among Youth from Low-Income Predominantly Minority Communities: Implementation of Advocates 4 ALL Youth (ALLY).

Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs). The feasibility of delivering ALLY in a racially and minoritized low-income community is discussed and modifications required to implement the program documented. Students completed questionnaires and sessions with an ALLY. Aspects of program delivery deemed feasible included training ALLYs to delivery program, stakeholder buy-in regarding missing class time, and students attending the sessions. Further modifications included adjustments to materials due to lower reading level and health literacy related-educational needs. Programs designed in one demographic setting may not work in a different setting.

Teenage Blues: Predictors of depression among adolescents in Nigeria.

BACKGROUND: Depressive disorders, with a prevalence of 15-21%, are among the most common disorders in children and adolescents, and increases the risk of suicide, the second leading cause of death in children aged 10 to 19. AIM: To determine the prevalence and correlates of depressive disorders among senior students attending secondary schools in Abeokuta. METHOD: The study was conducted in five schools randomly selected from a representative sample and was carried out in 2 phases. In the first phase, students were selected via systematic random sampling and given consent forms and GHQ-12 to administer to the parents. In the second phase, students who returned a signed informed consent form and filled out GHQ-12 were interviewed using MINI-KID, Rosenberg's Self-Esteem Scale, Family-APGAR, and sociodemographic questionnaire. Multivariate regression analyses were conducted with p-value <0.05 as level of significance. RESULTS: The mean age was 15.3 years (SD = 1.27); 48.8% were male. The twelve-month prevalence of major depression was 11.3% and dysthymia was 1.4%. In the final regression analysis, female gender [OR = 4.3, p = 0.046], the experience of bullying [OR = 7.96, p = 0.004], difficulty getting along with friends, [OR = 7.5, p = 0.004], history of sexual abuse [OR = 8.1, p = 0.01], and perceived family dysfunction [OR = 4.9, p = 0,023] were found to be independent predictors of depressive disorders. CONCLUSION: Depressive syndromes are a significant health burden in adolescents. Being female, being bullied, having a history of sexual abuse, and family dysfunctionality are risk factors associated with depression among these population.

Nigerian prisoners' experience: prison circumstances, family support and sleep quality.

PURPOSE: This study aims to determine the association between prison circumstances, perceived family support and sleep quality among male inmates at the Ibara prison, Ogun State. DESIGN/METHODOLOGY/APPROACH: It was a cross-sectional study of 300 male inmates interviewed with socio-demographic proforma and Pittsburgh sleep quality index. FINDINGS: While all respondents described the prison as being overcrowded, half of them used inappropriate sleeping materials daily and 41.4% decried a very noisy environment at night. Twenty-seven percent of the respondents described poor family support while 47.3% experienced poor sleep quality. Though nature of sleeping material and self-awareness of sleep problem were associated with poor sleep quality, no predictor of the latter was identified. RESEARCH LIMITATIONS/IMPLICATIONS: The study was conducted among males only because of the relative dominance of the male gender in the prison population. This makes analysis of gender difference impossible. Furthermore, sleep studies may be preferred over reports by some sleep experts. PRACTICAL IMPLICATIONS: Findings from this study may culminate in taking steps to improve the Nigerian prison conditions as well as the prisoner's welfare. SOCIAL IMPLICATIONS: Developing support group for relatives of inmates may be a focus of social intervention for these inmates. Also, inmates with good sleep quality are likely to partake effectively in the prison reformation programmes and may not self-medicate with sedatives. ORIGINALITY/VALUE: This study provides a scholarly documentation of the state of Nigerian prisons; inmates' perception of family support; prevalence and correlates of poor sleep quality among a group of male inmates.

Specificity of associations between parental psychopathology and offspring brain structure.

Multiple forms of parental psychopathology have been associated with differences in subcortical brain volume. However, few studies have considered the role of comorbidity. Here, we examine if alterations in child subcortical brain structure are specific to parental depression, anxiety, mania, or alcohol/substance use parental psychopathology, common across these disorders, or altered by a history of multiple disorders. We examined 6581 children aged 9 to 10 years old from the ABCD study with no history of mental disorders. We found several significant interactions such that the effects of a parental history of depression, anxiety, and substance use problems on amygdala and striatal volumes were moderated by comorbid parental history of another disorder. Interactions tended to suggest smaller volumes in the presence of a comorbid disorder. However, effect sizes were small, and no associations remained significant after correcting for multiple comparisons. Results suggest that associations between familial risk for psychopathology and offspring brain structure in 9-10-year-olds are modest, and relationships that do exist tend to implicate the amygdala and striatal regions and are moderated by a comorbid parental psychopathology history. Several methodological factors, including controlling for intracranial volume and other forms of parental psychopathology and excluding child psychopathology, likely contribute to inconsistencies in the literature.

A call to create evidence-based mental health promotion interventions for youth that are equitable across ethnic/racial subgroups: Advocates 4-ALL Youth.

Background: Adolescents from historically racial and ethnic minoritized and low-income communities have higher rates of early-life and chronic difficulties with anxiety and depression compared to non-Hispanic White youth. With mental health distress exacerbated during and in the wake of the COVID-19 pandemic, there is a need for accessible, equitable evidence-based programs that promote psychological well-being, strengthen one's ability to adapt to adversity, and build self-efficacy prior to adolescence. Methods: An evidenced-based resiliency-focused health coaching intervention was adapted using a health equity implementation framework to meet the needs of a Title I elementary school in rural Alabama (AL) that serves over 80% Black and Hispanic students. To ensure that the program met local community needs while maintaining core program educational activities, all adaptations were documented utilizing a standard coding system. Results: Leveraging an existing academic-community partnership with Auburn University and a local AL school district, a new program, Advocates 4-All Youth (ALLY), was created. Three major adaptations were required: (1) the use of local community volunteers (ALLYs) to deliver the program versus health coaches, (2) the modification of program materials to meet the challenge of varying levels of general and health-related literacy, and (3) the integration of the Empower Action Model to target protective factors in a culturally-tailored delivery to ensure key program outcomes are found equitable for all students. Conclusion: With continued increases in youth mental health distress, there is a need for the development of universal primary prevention interventions to promote mental well-being and to strengthen protective factors among youth from historically disadvantaged backgrounds. ALLY was created to meet these needs and may be an effective strategy if deemed efficacious in improving program outcomes.

Insomnia and quality of life of prisoners at a Nigerian maximum-security prison.

PURPOSE: This study aims to determine the prevalence of insomnia as well as its association with the quality of life of the inmates in a Nigerian prison. Prisoners are a disadvantaged group of people whose needs are often unmet. Many authors have focussed on investigating the prevalence and pattern of psychiatric morbidity, as well as substance use among prisoners. However, sleep disorders, which can predispose or precipitate psychiatric disorders, have been largely neglected in research. The relationship between insomnia and quality of life (QoL) among the general population has been documented but similar investigations have yet to be conducted among the prisoner population. DESIGN/METHODOLOGY/APPROACH: This was a cross-sectional study with 300 male prisoners at the Ibara prison, Abeokuta, Nigeria who were not diagnosed with depressive, generalized anxiety or post-traumatic stress disorders. Each respondent was interviewed with a sociodemographic proforma, Insomnia module of the Schedule for Clinical Assessment in Neuropsychiatry and the brief World Health Organisation Quality of Life questionnaire. FINDINGS: About half of the respondents (45.7%) met diagnostic criteria for insomnia. A diagnosis of insomnia and some sleep-related variables were significantly associated with QoL. RESEARCH LIMITATIONS/IMPLICATIONS: All the possible correlates of insomnia could not be investigated. Further research should be conducted to identify more correlates and investigate the impact of insomnia on prisoners' lives. PRACTICAL IMPLICATIONS: Improvement of prison climate (relationships in prison, safety and order, contact with the outside world, facilities, meaningful activities and autonomy) may mitigate insomnia among prisoners. Prison psychiatry in Nigerian correctional centres should be made a priority. SOCIAL IMPLICATIONS: The findings have brought to light the need to address the current social welfare system in place for Nigerian correctional centres. ORIGINALITY/VALUE: The study provided information on the prevalence of insomnia and poor QoL among prisoners in a Nigerian correctional facility.