Beliefs about hypertension among Nigerian immigrants to the United Kingdom: A qualitative study

OBJECTIVE: The aim of the study was to elicit beliefs about hypertension among Nigerian immigrants in the United Kingdom. BACKGROUND: The distributions of cardiovascular risk factors and diseases are not shared equally across ethnic and economic groups in the United Kingdom. Its burden is more clustered among minority ethnic populations and migrant groups including black African Nigerian migrants. Similar patterns have been reported across Europe, Australia, Canada, Nordic countries and the United States of America. There are about 300 distinct ethnic groups in Nigeria and reliable information about their beliefs about hypertension is not available. Given that the United Kingdom has a large community of Nigerian immigrants from these different ethno-cultural backgrounds, understanding their unique beliefs about hypertension may help promote appropriate care for this population in the United Kingdom and Nigeria. SETTING: A single Pentecostal church community in West London PARTICIPANTS: Twenty-seven Nigerian migrant members of the church entered and completed the study METHODS AND OUTCOME MEASURE: A qualitative interview study was conducted. The interviews were analysed using thematic framework analysis. The outcome measures were emerging themes from the thematic framework analysis. RESULTS: Participants expressed beliefs in four major areas related to hypertension: (1) The Meaning of the term hypertension, (2) Perceptions of causation, (3) Effects of hypertension, and (4) Perceptions of treatment. The study revealed a diversity of beliefs about hypertension which incorporated both orthodox and culturally framed ideas. CONCLUSIONS: This study identified important beliefs among Nigerian migrants about hypertension that can contribute to our understanding of the management of hypertension in this group and suggests the need for further research to determine whether these beliefs may be representative of this group

The Economic Role of Nigeria’s Subsistence Agriculture in the Transition Process: Implications for Rural Development

This study examined the role of subsistence-oriented agriculture in Nigeria in the 1990s to 2000s. The start out by discussing the diverging economic effects of the growth of subsistence agriculture in Nigeria since the transition process started. The quantitative analysis of this sector’s role is carried out by means of an applied Computable General Equilibrium (CGE) model applying a 1994 Social Accounting Matrix (SAM) as base year data. The innovation of the article is to disaggregate primary agricultural production not by products but by farm types, which enables us to distinguish their institutional and economic characteristics. The study simulates two Structural Adjustment Programme (SAP) of the government. The results of the post SAP period highlight that Nigeria’s subsistence agriculture was an important shock absorber against further agricultural output declines during transition. A simulation, which looks into the effects of a devaluation of the Nigeria Naira, shows that the financial crisis should have increased the relative competitiveness particularly of large-scale crop farms versus small-scale farms. The reforms of successive governments show that efficiency enhancing institutional change would benefit both large-scale and small-scale farms. However, within small-scale agriculture, a shift from subsistence to commercial agriculture would take place.Subsistence agriculture, CGE model, Exchange rate, Institutional Development, Structural Constraints, Nigeria, Community/Rural/Urban Development,

An exploration of the risk factors, beliefs and management of hypertension in primary care in Nigeria - a mixed methods study

Objective: To explore ways to improve care of hypertension at the primary care level in Nigeria Background: Although the burden of communicable diseases is still present in Africa, the burden of non-communicable diseases is rapidly increasing. Chronic conditions like hypertension are common among both rural and urban populations in Nigeria. In many regions of Nigeria, the primary health care (PHC) facility is usually the only source of formal health care available. Many clients who use PHC facilities in Nigeria may have hypertension yet they often go undetected and untreated. Setting: Twenty (20) rural (N=10) and urban (N=10) primary health care centres in the Federal Capital Territory Nigeria Methods: A multi-level triangulation mixed method design was used. Participants: Forty-one (41) primary health care clients and forty-one (41) primary health care workers participated in the qualitative study while 650 clients participated in the quantitative study which investigated the prevalence of hypertension and cardiovascular risk factors. Results: Overall, the study revealed a substantial unmet need for hypertension in primary care in Nigeria. The sample population for this study is very young with about 90% of the population aged between 18-44 years old. Overall, among those 40years and older, 94.4% (95%CI: 88.9-97.7) had 10-year risk of cardiovascular event less than 10%. Most participants had 1-2 risk factors (58.4% [95%CI: 54.5-62.3]) while 32.3% [95%CI: 28.7-36.1]) had 3-5 risk factors for cardiovascular diseases. The overall hypertension service readiness and availability of the 20 primary care facilities was very low. The overall prevalence of hypertension was 27.9% (95%CI: 24.5- 31.6). The qualitative study identified important ethnic differences and similarities in beliefs about meaning, risk factors, symptoms and treatment of hypertension between PHC clients and workers. It also revealed that non-physician PHC workers were enthusiastic to take on additional roles in managing hypertension which is currently beyond their scope of duty. Conclusions: This study provides important information for improving care of hypertension in primary care in Nigeria by first highlighting the burden of hypertension and risk factors among primary care clients. Then it identifies differences and similarities in beliefs between PHC clients and PHC workers as well as current experiences of PHC workers with managing hypertension which could help inform appropriate hypertension management program in Nigeria

Reproductive Hormones and Fibroid Cases in Nigerian Women

Investigations were carried out on the association between some reproductive hormones (Progesterone, oestrogen, leutenizing and follicle stimulating hormones), and fibroid cases in Nigerian women.  The levels of these hormones were determined in 30 patients with chronic fibroid cases and another 30 patients with non chronic fibroid cases. The mean values of these hormones in non-chronic fibroid cases (14.50±0.20, 98.01±0.67, 0.51±0.05, 4.02±0.74 respectively), were found  to be significantly higher than corresponding values in non fibroid cases. Also the values obtained in chronic fibroid cases were also significantly higher (P<0.05) than that of the non chronic fibroid cases. Our finding indicates that the alteration in these reproductive hormone levels might be related with the pathogenesis of fibroid in Nigerian women. Keywords: reproductive hormones, progesterone, oestrogen, leuteinizing hormones, follicle stimulating hormones, fibroid, pathogenesis

Biochemical Changes in Fibroid Patients

Some biochemical parameters were determined in sixty fibroid patients in University Teaching Hospital. Mean value for plasma total cholesterol (5.56±3.25mmol/L), Triglycerides (1.14±0.61mmol/L, Sodium(Na+) (140±3.0mmol/L), Chloride(CI-)(106±4.2mmol/L) Calcium(Ca2+)(2.5±0.17mmol/L), and Phosphorus(P)(1,40±0.3mmol/L) showed an increase when compared with the control. Analysis of the result showed a decrease in the mean value of total protein(6.01±0,15g/dL), Albumin(4.01± 6.25g/dL), Potassium(K)(3.64±o.32mmol/L) when compared with the control. The mean value of  bicarbonate(HCO3) (24.0±2.3mmol/L) was significantly higher (P<0.05) when compared with the control. The raised level of cholesterol and triglycerides in fibroid patient reveal a possible link between fibroid and hypertension while increase concentration of Ca2+,Mg²+ and low concentration of K+ characterise increase oestrogen level which has been implicated in fibroid growth. Keywords: Total cholesterol, triglycerides, total protein, Albumin, fibroid

Chemical Weathering and Mobility of Inorganic Species in Dry Disposed Ash: An Insight from Geochemical Fractionation and Physicochemical Analysis

The burning of low-grade coal produces vast amounts of ash and other solid by-products. In South Africa, coal combustion by-products undergo disposal on land as dry heaps or slurried to dams. In this study, the geochemical partitioning, transport, and mobility of elements in dry disposed ash dumps were investigated using a modified sequential extraction scheme. The chemical and mineralogical compositions of 50 drilled core samples were investigated by X-ray fluorescence (XRF), X-ray diffraction (XRD), and inductively coupled plasma mass spectrometry. Ternary plots of major elements as determined by XRF showed that the 15-year-old and 2-week-old dry disposed ashes are sialic, and the 4-year-old ash cores are sialic and ferrocalsialic. The relationship between SiO2 and the chemical index of alteration showed a moderate to high degree of weathering. The variation in chemical compositions and degree of chemical weathering are ascribed to differences in the chemistry of feedstock coals and ash/water/CO2 interaction chemistry. Multivariate statistical analysis revealed the subtle chemical alteration differences and disparity in dissolution of major components of fly ash. The pH profile of the cores indicates that contact with atmosphere and consequent ingress of CO2, leaching by rainwater, and point of saturation have a great effect on the chemical weathering of the dry disposed fly ash. XRD analysis of two weathered drilled core samples taken from 4-m depth intervals showed the presence of calcite. The chemical interaction of fly ash with ingressed CO2 from the atmosphere will ultimately lead to a reaction with buffering components such as CaO and the subsequent conversion into calcite. The modified geochemical partitioning scheme revealed that relative enrichment and depletion in the inorganic elements at various depth sections of the ash dump are governed by chemical interaction of fly ash with ingressed CO2 from the atmosphere, porewater pH, leaching by percolating rainwater, fluctuation in water level (i.e., weathering over time), heterogeneity in fly ash, continuous irrigation of fly ash by high saline effluents, and fresh water

Chemical Partitioning and Mobility of Trace Elements in Dry Disposed Weathered Ash Conditioned with High-Saline Effluents

Weinvestigated the mobility of inorganic elements in the ash dump due to chemical interaction of weathered dry disposed ash conditioned with high-saline effluents and ingressed CO2 from atmosphere and percolating rainwater. Drilled ash core samples collected from dry disposed ash dump at a South African coal-burning power station were characterized using X-ray diffraction (XRD) and X-ray fluorescence (XRF) analyses. A modified sequential extraction procedure was selected to determine the mineralogical association of the investigated elements in the 1-year-old drilled ash cores. Major mineral phases are quartz and mullite and other minor phases included hematite, lime, calcite, anorthite, mica, and enstatite. Mica and calcite in the ash cores is attributed to carbonation process, which led to long-term reduction in pore water pH. The 2-week-old ash cores are sialic but the 1-year-old ash cores were both sialic and ferrocalsialic in chemical composition. The ferrocalsialic nature of 1-year-old ash cores could be attributed to drastic changes in feed coal in the power station. The chemical index of alteration (CIA) and chemical index of weathering (CIW) values suggest a relatively high degree of weathering. The changes in CIA and CIW values in the ash cores depend on the pore water pH, leaching rate, carbonation process, and possibly the conversion of the alkali and alkali earth metals into carbonates. Multivariate analysis results suggest that the major oxides and carbon percent show differences and have a greater contribution to the differentiation in the 1-year-old ash cores. Trace elements such as Mo, Cr, and Se show high mobility but As, B, and Pb exhibit fairly low mobility in the water-soluble fraction. Aconsiderable mobility of trace elements in the exchangeable and carbonate fractions is attributed to the alkaline nature and pore water pH. A decreasing response of As, Mo, Cr, and Pb in the reducible fraction with depth suggests immobility attributed to coprecipitation with the Fe- and Mn-oxide phases. On the contrary, the increasing response of Pb, Mo, and B in the carbonate fraction with depth implies mobility due to dissolution and flushing of soluble major chemical phases, as evident in the pore water pH. A considerable amount of B and Pb are concentrated in the residual fraction of 1-year-old ash cores. This suggests that, under natural settings, these elements will not be released in solution over a long time; therefore, they are not considered to be an environmental risk

A Geochemical Analytical Scheme for the Appraisal of Partitioning and Mobility of Major elements in Weathered Dry Disposed Coal Fly Ash

South Africa is endowed with significant deposits of coal which is utilized in electricity generation to meet the nation’s energy demand. A large volume of waste solid residue from the combustion of pulverized feed coal in power stations is dry disposed in stock piles or dumps. Chemical interactions of dry disposed fly ash with ingressed CO2 from the atmosphere and infiltrating rain water would cause dissolution of the soluble components in the fly ash matrix. Chemical partitioning and mobility of major elements in samples from cores drilled into serially stacked weathered dry disposed fly ash were investigated using a modified five steps sequential extraction scheme. A total acid digestion was carried out on the original ash core samples prior to extraction to validate the extraction procedure. The geochemical distribution of the investigated major elements in 59 drilled core samples was determined by x-ray fluorescence and inductively coupled plasma mass spectrometry. The relationship between SiO2 and chemical index of alteration (CIA) showed 8 year and 20-year-old core samples have a moderate to high degree of weathering. Conversely, 1-year-old cores samples showed characteristics between low and moderate-high degrees of weathering. A cluster and discriminant analysis of the major elements was also able to reveal the subtle chemical alteration differences of the core samples. Functional analysis revealed the disparities in the dissolution patterns of major soluble components in the matrix of the drilled core samples. Modified sequential extractions revealed high concentration of the major species in the leachates for every mineralogical fraction; although the bulk of the major elements are locked up in the insoluble phase of the core samples (i.e. residual fraction) which would not be released under normal environmental conditions. It is noteworthy that the concentration of major elements in the labile fractions (water soluble + exchangeable + carbonate) was high and this has implications for the long-term durability of residual mineral phases. Relative enrichment and depletion trends of major elements are promoted by heterogeneity in the ash dump (i.e. moisture content), gradual reduction of pore water pH and continuous brine and water irrigation.Key words: Coal fly ash; Weathering; Sequential extraction scheme; Cluster analysis; Factor Analysis

Mobility and Transport of Inorganic Species in Weathered Hydraulic Disposed Coal Fly Ash: An Insight from Geochemical Fractionation and Statistical Evaluation

A large volume of coal fly ash generated through combustion process has raised environmental concerns due to possible release of potentially toxic species to the surface and groundwater systems. The chemical partitioning and mobility of elements in the hydraulic disposed ash dump was investigated using modified sequential extraction scheme. The geochemical distribution of the investigated elements in 33 drilled core samples was determined by x-ray fluorescence and inductively coupled plasma mass spectrometry. The ternary plot of major elements as determined by XRF showed that hydraulic disposed ash cores are sialic, ferrosialic and ferrocalsialic in chemical composition. The relationship between SiO2 and chemical index of alteration (CIA) showed low, moderate to high degree of weathering. These chemical compositions and degree of chemical weathering depend on the ash sampling point and ash interaction chemistry. The Na+ and K+ soluble salts showed evidence of leaching and downward migration in the water soluble fraction indicating that the hydraulic disposed ash dump is not a sustainable salt sink. The geochemical partitioning reveals that mobility and transport of potentially toxic metal species are governed by the pore water pH, ash interaction chemistry and the sampling point of the ash cores.  The chemical interaction of drilled core ash with the ingress CO2 and percolating rain water led to dissolution and co-precipitation of soluble major components in fly ash. This had led to incoherent patterns of elements in carbonate fraction of the ash cores.Key words: Modified sequential extraction; Hydraulic disposed ash; Chemical index of alteration; Pore water pH; Ash interaction chemistry; Moisture content; Chemical weatherin