Housing Quality and Risk Factors Associated with Respiratory Health Conditions in Nigeria

This chapter presents an overview of the condition and quality of housing in Nigeria and its implication on respiratory health. Addressing housing issues offers public health practitioners an opportunity to assess an important social determinant of health. This chapter detailed the housing characteristics in Nigeria and revealed that respiratory health conditions, especially among children is associated with certain environmental factors that perturb the composition of the indoor air, and thus the housing quality. Drawing on this perspective, this chapter pursues the following questions: (1) What are the factors that affect the quality of housing where people spend most of their time daily? and (2) Given the housing condition in Nigeria, what housing-related factors influence the prevalence of respiratory health conditions especially among children? In the course of the discussion, we described the meteorological conditions of houses in relation to respiratory conditions, established a link between indoor air and housing quality, and elucidated the indicators for evaluating housing quality. Drawing on the associated risk factors, it argues that the quality of housing, including the external and internal structures, as well as the internal environment has a selective force on the respiratory health status of its occupants

Pilot Study Assessing Water Sanitation and Hygiene (WaSH) Program in Public Secondary Schools in South-Western Nigeria.

The provision of safe water, sanitation and hygiene in schools has been established to improve health, boost educational achievement, and promote gender equity which has a positive impact on the society. The aim of this study is to ascertain the state of WASH program in public secondary schools in South-Western Nigeria. A total of twelve schools which span across three Cities in two States (Lagos and Ogun), in South-Western Nigeria were selected. The standard for WASH in schools by UNICEF was used as the guiding principles to evaluate the adequacy of the various WASH components. Out of the 12 public secondary schools visited, only 3 (25%) had drinking water points (boreholes) and 40% of the schools do not have separate latrines for boys and girls. Only 1 (10%) of the schools had hand washing points but without soap and there is no program in the schools for promoting privacy of older girls. This study reveals that the present WASH practice in many of the schools is not satisfactory. Therefore, to maximize the potential of students as the most persuasive advocates of good WASH practices in the society, it is necessary to integrate WASH program into national education policy

Mechanical cough augmentation techniques in amyotrophic lateral sclerosis/motor neuron disease

© 2016 The Cochrane Collaboration.This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: To assess the effects of mechanical insufflator/exsufflator (MI-E) and the breath-stacking technique for reducing morbidity and mortality and enhancing quality of life in people with amyotrophic lateral sclerosis (ALS)/motor neuron disease (MND)

A consensus review on the development of palliative care for patients with chronic and progressive neurological disease

BACKGROUND AND PURPOSE: The European Association of Palliative Care Taskforce, in collaboration with the Scientific Panel on Palliative Care in Neurology of the European Federation of Neurological Societies (now the European Academy of Neurology), aimed to undertake a review of the literature to establish an evidence-based consensus for palliative and end of life care for patients with progressive neurological disease, and their families. METHODS: A search of the literature yielded 942 articles on this area. These were reviewed by two investigators to determine the main areas and the subsections. A draft list of papers supporting the evidence for each area was circulated to the other authors in an iterative process leading to the agreed recommendations. RESULTS: Overall there is limited evidence to support the recommendations but there is increasing evidence that palliative care and a multidisciplinary approach to care do lead to improved symptoms (Level B) and quality of life of patients and their families (Level C). The main areas in which consensus was found and recommendations could be made are in the early integration of palliative care (Level C), involvement of the wider multidisciplinary team (Level B), communication with patients and families including advance care planning (Level C), symptom management (Level B), end of life care (Level C), carer support and training (Level C), and education for all professionals involved in the care of these patients and families (Good Practice Point). CONCLUSIONS: The care of patients with progressive neurological disease and their families continues to improve and develop. There is a pressing need for increased collaboration between neurology and palliative care

Prevalence and Prognostic Features of ECG Abnormalities in Acute Stroke: Findings From the SIREN Study Among Africans

Background Africa has a growing burden of stroke with associated high morbidity and a 3-year fatality rate of 84%. Cardiac disease contributes to stroke occurrence and outcomes, but the precise relationship of abnormalities as noted on a cheap and widely available test, the electrocardiogram (ECG), and acute stroke outcomes have not been previously characterized in Africans. Objectives The study assessed the prevalence and prognoses of various ECG abnormalities among African acute stroke patients encountered in a multisite, cross-national epidemiologic study. Methods We included 890 patients from Nigeria and Ghana with acute stroke who had 12-lead ECG recording within first 24 h of admission and stroke classified based on brain computed tomography scan or magnetic resonance imaging. Stroke severity at baseline was assessed using the Stroke Levity Scale (SLS), whereas 1-month outcome was assessed using the modified Rankin Scale (mRS). Results Patients\u27 mean age was 58.4 ± 13.4 years, 490 were men (55%) and 400 were women (45%), 65.5% had ischemic stroke, and 85.4% had at least 1 ECG abnormality. Women were significantly more likely to have atrial fibrillation, or left ventricular hypertrophy with or without strain pattern. Compared to ischemic stroke patients, hemorrhagic stroke patients were less likely to have atrial fibrillation (1.0% vs. 6.7%; p = 0.002), but more likely to have left ventricular hypertrophy (64.4% vs. 51.4%; p = 0.004). Odds of severe disability or death at 1 month were higher with severe stroke (AOR: 2.25; 95% confidence interval: 1.44 to 3.50), or atrial enlargement (AOR: 1.45; 95% confidence interval: 1.04 to 2.02). Conclusions About 4 in 5 acute stroke patients in this African cohort had evidence of a baseline ECG abnormality, but presence of any atrial enlargement was the only independent ECG predictor of death or disability

Supportive and symptomatic management of amyotrophic lateral sclerosis

The main aims in the care of individuals with amyotrophic lateral sclerosis (ALS) are to minimize morbidity and maximize quality of life. Although no cure exists for ALS, supportive and symptomatic care provided by a specialist multidisciplinary team can improve survival. The basis for supportive management is shifting from expert consensus guidelines towards an evidence-based approach, which encourages the use of effective treatments and could reduce the risk of harm caused by ineffective or unsafe interventions. For example, respiratory support using noninvasive ventilation has been demonstrated to improve survival and quality of life, whereas evidence supporting other respiratory interventions is insufficient. Increasing evidence implicates a causal role for metabolic dysfunction in ALS, suggesting that optimizing nutrition could improve quality of life and survival. The high incidence of cognitive dysfunction and its impact on prognosis is increasingly recognized, although evidence for effective treatments is lacking. A variety of strategies are used to manage the other physical and psychological symptoms, the majority of which have yet to be thoroughly evaluated. The need for specialist palliative care throughout the disease is increasingly recognized. This Review describes the current approaches to symptomatic and supportive care in ALS and outlines the current guidance and evidence for these strategies

Location and Time Aware Multitask Allocation in Mobile Crowd-Sensing Based on Genetic Algorithm

Mobile crowd-sensing (MCS) is a well-known paradigm used for obtaining sensed data by using sensors found in smart devices. With the rise of more sensing tasks and workers in the MCS system, it is now essential to design an efficient approach for task allocation. Moreover, to ensure the completion of the tasks, it is necessary to incentivise the workers by rewarding them for participating in performing the sensing tasks. In this paper, we aim to assist workers in selecting multiple tasks while considering the time constraint of the worker and the requirements of the task. Furthermore, a pricing mechanism is adopted to determine each task budget, which is then used to determine the payment for the workers based on their willingness factor. This paper proves that the task-allocation is a non-deterministic polynomial (NP)-complete problem, which is difficult to solve by conventional optimization techniques. A worker multitask allocation-genetic algorithm (WMTA-GA) is proposed to solve this problem to maximize the workers welfare. Finally, theoretical analysis demonstrates the effectiveness of the proposed WMTA-GA. We observed that it performs better than the state-of-the-art algorithms in terms of average performance, workers welfare, and the number of assigned tasks

Rehabilitation medicine in palliative care of chronic neurological conditions

Background: People living with long-term neurological conditions (LTNC) often require palliative care. Rehabilitation medicine specialists often coordinate the long-term care of these patients. Objective: The aim of the present review was to undertake systematic literature searches to identify the evidence on palliative care for people with LTNC to guide rehabilitation medicine specialists caring for these patients in the UK. Methods: We searched for evidence for (1) discussion of end of life, (2) planning for end-of-life care, (3) brief specialist palliative care interventions, (4) support for family and carers, (5) training of rehabilitation medicine specialists in palliative care, and (6) commissioning of services. The databases searched were MEDLINE, EMBASE, CINAHL, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, NHS Economic Evaluation Database and Health Technology Assessment Database. Evidence was assimilated using a simplified version of the Grading of Recommendations Assessment, Development and Evaluation method. Results: We identified 2961 records through database searching for neurological conditions and 1261 additional records through database searches for specific symptoms. We removed duplicate records and conference presentations. We screened 3234 titles and identified 330 potentially relevant abstracts. After reading the abstracts we selected 34 studies for inclusion in the evidence synthesis. Conclusions: From the evidence reviewed we would like to recommend that we move forward by establishing a closer working relationship with specialists in palliative care and rehabilitation medicine and explore the implications for cross-specialty training