Fear of prostate biopsy: a limitation in the management of prostate cance

The incidence of prostate cancer is increasing in the country and now constitutes 11% of allmale cancers. For diagnosis of prostate cancer, a histological diagnosis is necessary and this requires that a prostate biopsy be performed but patientsmay not readily accept this invasive procedure. A 2-year retrospective study was carried out in Baptist Medical Centre, Eku, Delta State from January1 2004 toDecember 31 2005; datawere collected from case notes of patientswho had serum prostate specific antigen (PSA) done to review the response of patients to the offer of prostate biopsy after an elevated serumprostate specific antigen result. There were 65 patients aged between 48years to 97years, mean age was 71years. 45 patients were offered prostate biopsy based on elevated serum prostate specific antigen (PSA) and/or findings on digital rectal examination (DRE). Only 12 (26.67%) accepted and of these, 4 (33.33%) had a histological diagnosis of adenocarcinoma of the prostrate. Our study has shown that majority of symptomatic prostate cancer patients refuse biopsy regardless of adequate counseling.Keywords: Prostate biopsy, digital rectal examination, prostate-specific antigen, prostate cance

Review of Obstetrics Genito-urinary Fistulae in the University of Calabar Teaching Hospital Calabar, Nigeria

Obstetric fistulae with Urinary incontinence are one of the most distressing maternal morbidities. It is associated with physical and social deprivation such as wife abandonment and violent reactions against the victims particularly in the developing countries of the world. To study the demographic and reproductive profiles as well as management of patientswith obstetric fistulae inUCTH,Calabar,Nigeria. Afiver-year retrospective study of case records of 37 patients managed inMaternity Annex of University of Calabar Teaching Hospital, Calabar Nigeria for obstetric genito-urinary fistulae was carried out. One in every 122 parturients during the period had fistula. Eleven (29.7%) were teenagers. Many patients weremarried (54.1%), nulliparous (59.4%), come from low socioeconomic class (72.9%) and did not utilize modern obstetric facilities properly. Many cases resulted from prolonged obstructed labour (51.4%) and 70.2% presented with total incontinence of urine. Eighteen (48.7%)were diagnosed within 6 month of delivery. Themain types encountered includedwere vesico-vaginal (34.4%) or complex (10.8%) fistulaewho were manage conservatively (21.6%) or with bladder repairs. Majority (29.7 %) were referred for further treatment. Parturient in Calabar still suffer from this age long obstetric morbidity mainly due to poor utilization of modern obstetric care facilities. Results of treatment are largely unsatisfactory; therefore resources should be channeled towards prevention.Keywords: Obstetrics, : Genito-urinary, fistula

Management of Lower Urinary Retention in a Limited Resource Setting

Background: There is a projected increase in lower urinary tract obstruction by 2018, especially in the developing economies of Asia and Africa. However in many of these countries, the problems encountered both by the patients and the clinicians are not well documented. Our aims are, to prospectively analyse the management of urinary retention, the associated difficulties, and complications in our setting, where access to investigative modalities such as Computerize Tomography and Magnetic Resonance Imaging are not available.Patients and Methods: The study was approved by the University Of Calabar Teaching Hospital ethical committee. A validated Proforma was used to collect data from all patients who were clinically diagnosed with urinary retention based on history, and physical examination, from July 2009 to June 2010. Data collected from the 1st of July 2009 to the 30th of June 2010, include demographics, findings on physical examination, previous medical history and co-morbid conditions. The results of investigations done such as: urinalysis, full blood count, electrolytes, urea and creatinine, intravenous urography, trans- abdominal ultrasonography, chest X-ray and histology of trans-rectal biopsies of the prostate . The total number of new patients seen, including those with urinary retention during the study was documented. The retentions were also classified into acute and chronic. All the patients were followed up throughout the study. The data was analysed using Epi-Info statistical program version 3.4 of 2007 to analyse the data, estimating averages, mean, median and percentages. Results: The total number of new patients seen, including those with urinary retention was Seventy thousand, one hundred and thirty nine (70,139).Of this number, hundred and fifty nine (0.23%), presented with urinary retention; 145 (91.2%) were acute, and14 (8.8%) were chronic. The male: female ratio was 39:1.The patients ages ranged from 4 to 94 years, with a mean of 53.7±11.2. Seventy seven [48.4%] of them were in the 6th and 7th decades of life. The common causes were; prostatic diseases [BPH and cancer of the prostate] 77.0%, infections 75.8%, trauma 12.1%, and congenital 12.1%. Urinary retention was relieved by: indwelling urethral catheterization [IUC] 120 patients (75.5%), supra- pubic cystostomy [SC] 34 (21.4%) and intermittent urethral catheterization [IC] 5 (3.1%). The most frequently encountered complications include pyuria (18.2%), pericatheter sepsis 17.5%, and haemorrhage during change of catheter 16.8% [figure 2].Conclusion: Lower urinary retention is common in our environment. The management is appropriate and standard. The man power and facilities are inadequate, and requires urgent improvement.Keywords: Urinary retention; management; limited resource

Chemical composition and antioxidant potentials of Kigelia pinnata root oil and extracts

The chemical composition of Kigelia pinnata root oil extracted with n-hexane was analyzed by GC/GCMS. The antioxidant potential of the oil was compared to that of ethyl acetate and methanol extracts of the root. UV and IR spectroscopic techniques were used to carry out partial characterization of the oil and extracts. The free radical scavenging activity by spectrophotometric assay on the reduction of 1,1-diphenyl-2-picrylhydrazyl (DPPH) was examined while the total antioxidant activity (TAA) and relative antioxidant activity (RAA) were compared with standard antioxidant, α-tocopherol. The antioxidant activity (which correlated with the total phenolic content of the extracts) was assumed to be from the total phenolic content of the extracts. TAA was found to be higher in methanol extract (at 0.25 mg/mL). We hereby report for the first time the major component of the oil from the root of Kigelia pinnata to be elaidic acid (56.12 %). It is a reported toxicant which thereby underscores the risk in the use of the plant in traditional therapies

Art Meets Sport::What Can Actor Training Bring to Physical Literacy Programs?

The aim of this communication is to highlight synergies and opportunities between the fields of education, sport and health and the performing arts for the promotion of physical literacy. First, physical literacy is introduced and then defined according to the definition used in this communication. Secondly, we highlight the gap in physical literacy interventions, in that they do not address learning based on a holistic comprehensive definition of physical literacy. Then we provide examples of interventions that do borrow from the arts, such as circus arts, and show how these approaches explicitly link to the discipline of arts. This is followed by program examples, which approach motor and language development from discipline-specific perspectives. Then we introduce actor training (within the discipline of arts) in terms of how this approach may be useful to our understanding of physical literacy and how to expand the conception of physical literacy to include affective meaning making, and tolerance for ambiguity and discomfort in not-knowing. Finally, we conclude with the next step for the bridging of disciplines in order to further our journey to understand and improve physical literacy

Evaluation of antiplasmodial effects of the ethanolic leaf extract of Salacia lehmbachii on Plasmodium berghei infected mice

Salacia lehmbachii leaves are used in Nigerian traditional medicine for the treatment of malaria and other diseases. The ethanolic extract was tested for its activities against suppressive, prophylactic and established infections in Plasmodium berghei infected albino mice at dose levels of 100, 200 and 400 mg/kg; while chloroquine (10 mg/kg) was used as positive control. The extract exhibited significant dose-related antiplasmodial activities on parasites with the used-dose levels, showing significant mean survival time. The results, therefore, co-relate with claims by traditional users for the treatment of malaria and other feverish conditions; and could serve as source of potential new antimalarial  agents. DOI: http://dx.doi.org/10.5281/zenodo.55610

Equipping future teachers with innovative strategies that increase physical activity in the classroom : A hybrid implementation trial across three Australian universities

Introduction: TransformEd targets initial teacher education (ITE) to equip future teachers with innovative strategies that increase physical activity in the Primary school classroom. Methods: This hybrid implementation-effectiveness trial investigated the effects of the TransformEd program when embedded in ITE degrees at two Australian universities (University 1 Single Unit offering; University 2 Dual Unit offering) over a 12-week period, on pre-service teachers’ perceived competence, confidence, and willingness to deliver active pedagogies, in comparison with a third ‘usual practice’ control university. Results: There was a favourable intervention effect on the total teacher perceptions score among pre-service teachers in University 1 compared to the control group pre-service teachers. Further, there was a significant intervention effect on reduced perceived barriers to active strategies in University 1, and a significant increase in perceived effects of active strategies on Primary school student outcomes in University 2. Qualitative data suggested the program strengthened the connection between theory and practice (i.e., how pre-service teachers are educated in university and the way they teach in Primary schools). The program was motivating to both lecturers and pre-service teachers, resulted in them reflecting on their own teaching practice, and helped with pre-service teacher engagement. Discussion: Recommendations for improvement included stronger and more explicit alignment with the Australian Professional Standards for Teachers

A systematic review of tools designed for teacher proxy-report of children’s physical literacy or constituting elements

Abstract Background Physical literacy (PL) in childhood is essential for a healthy active lifestyle, with teachers playing a critical role in guiding its development. Teachers can assist children to acquire the skills, confidence, and creativity required to perform diverse movements and physical activities. However, to detect and directly intervene on the aspects of children’s PL that are suboptimal, teachers require valid and reliable measures. This systematic review critically evaluates the psychometric properties of teacher proxy-report instruments for assessing one or more of the 30 elements within the four domains (physical, psychological, cognitive, social) of the Australian Physical Literacy Framework (APLF), in children aged 5–12 years. Secondary aims were to: examine alignment of each measure (and relevant items) with the APLF and provide recommendations for teachers in assessing PL. Methods Seven electronic databases (Academic Search Complete, CINAHL Complete, Education Source, Global Health, MEDLINE Complete, PsycINFO, and SPORTDiscus) were systematically searched originally in October 2019, with an updated search in April 2021. Eligible studies were peer-reviewed English language publications that sampled a population of children with mean age between 5 and 12 years and focused on developing and evaluating at least one psychometric property of a teacher proxy-report instrument for assessing one or more of the 30 APLF elements. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance was followed for the conduct and reporting of this review. The methodological quality of included studies and quality of psychometric properties of identified tools were evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidance. Alignment of each measure (and relevant items) with the APLF domains and 30 elements was appraised. Results Database searches generated 61,412 citations; reduced to 41 studies that evaluated the psychometric properties of 24 teacher proxy-report tools. Six tools were classified as single domain measures (i.e. assessing a single domain of the APLF), eleven as dual-domain measures, and seven as tri-domain measures. No single tool captured all four domains and 30 elements of the APLF. Tools contained items that aligned with all physical, psychological, and social elements; however, four cognitive elements were not addressed by any measure. No tool was assessed for all nine psychometric properties outlined by COSMIN. Included studies reported a median of 3 out of nine psychometric properties. Most reported psychometric properties were construct validity (n = 32; 78% of studies), structural validity (n = 26; 63% of studies), and internal consistency (n = 25; 61% of studies). There was underreporting of content validity, cross-cultural validity, measurement error, and responsiveness. Psychometric data across tools were mostly indeterminate for construct validity, structural validity, and internal consistency. Conclusions There is limited evidence to fully support the use of a specific teacher proxy-report tool in practice. Further psychometric testing and detailed reporting of methodological aspects in future validity and reliability studies is needed. Tools have been designed to assess some elements of the framework. However, no comprehensive teacher proxy-report tool exists to assess all 30 elements of the APLF, demonstrating the need for a new tool. It is our recommendation that such tools be developed and psychometrically tested. Trial registration This systematic review was registered in the PROSPERO international prospective register of systematic reviews, with registration number CRD42019130936

The validity of the Physical Literacy in Children Questionnaire in children aged 4 to 12

Background: Given the growing evidence on the health benefits associated with physical literacy (PL), it is necessary to develop sound measures to assess the levels of PL in children. The Physical Literacy in Children Questionnaire (PL-C Quest) is the first self-report pictorial-based scale to assess children’s perceived PL. It has good validity and reliability in Australian children aged 7 to 12 years, but little is known in younger children and in other cultural contexts. The aim of this study was to examine the validity and reliability in an expanded age range. Methods: A total of 1,870 Chinese children (girls, n = 871; 46.6%), aged 4 to 12 years (M = 8.07 ± 2.42) participated in validity testing. Structural equation modeling with the Weighted Least Squares with Mean and Variance approach was used to assess construct validity. The hypothesized theoretical model used the 30 items and four hypothesized factors: physical, psychological, social and cognitive capabilities. Multigroup confirmatory factor analysis was used to assess sex and age group (4–6 years, 7–9 years and 10–12 years) measurement invariance. Internal consistency analyses were conducted using polychoric alpha. A random subsample (n = 262) was selected to determine test–retest reliability using Intra-Class Correlations (ICC). Results: All items except one (moving with equipment–skateboarding) loaded on sub-domains with λ > 0.45. The hypothesized model had a good fit (CFI = 0.954, TLI = 0.950, RMSEA = 0.042), with measurement equivalence across sex and age groups separately. Internal consistency values were good to excellent (overall: α = 0.94; physical: α = 0.86; psychological: α = 0.83; social: α = 0.81; cognitive: α = 0.86). Test–retest reliability was adequate to excellent (overall: ICC = 0.90, physical: ICC = 0.86, psychological: ICC = 0.75, social: ICC = 0.71, cognitive: ICC = 0.72).Conclusion: The Chinese version of the PL-C Quest is valid and reliable for testing the self-reported PL of Chinese children aged 4 to 12. This study provides the first evidence of validity for this tool in children aged 4–6 years and also evidence that the PL-C Quest would be a meaningful instrument to assess PL in Chinese children