Assessment of tobacco smoking status and in luence of health care professionals on tobacco cessation among outpatients in different clinics of the Department of Medicine of Lagos University Teaching Hospital (LUTH), Idi Araba, Lagos, Nigeria

Background: As a risk factor for six out of the world's eight leading causes of death, tobacco smoking has been dubbed the single most preventable cause of death. Healthcare professionals have a prominent role to play in tobacco control. Studies have shown that even a brief interven on by a health professional significantly increases the cessa on rate. Purpose: The objec ves of the study were to assess the smoking status and iden fy the influence of health professionals on smoking cessa on of outpa ents in different clinics at the department of Medicine, Lagos University Teaching Hospital (LUTH), Nigeria

Does training with amplitude modulated tones affect tone-vocoded speech perception?

Temporal-envelope cues are essential for successful speech perception. We asked here whether training on stimuli containing temporal-envelope cues without speech content can improve the perception of spectrally-degraded (vocoded) speech in which the temporal-envelope (but not the temporal fine structure) is mainly preserved. Two groups of listeners were trained on different amplitude-modulation (AM) based tasks, either AM detection or AM-rate discrimination (21 blocks of 60 trials during two days, 1260 trials; frequency range: 4Hz, 8Hz, and 16Hz), while an additional control group did not undertake any training. Consonant identification in vocoded vowel-consonant-vowel stimuli was tested before and after training on the AM tasks (or at an equivalent time interval for the control group). Following training, only the trained groups showed a significant improvement in the perception of vocoded speech, but the improvement did not significantly differ from that observed for controls. Thus, we do not find convincing evidence that this amount of training with temporal-envelope cues without speech content provide significant benefit for vocoded speech intelligibility. Alternative training regimens using vocoded speech along the linguistic hierarchy should be explored

Reintegration of child soldiers in Burundi: A tracer study

Background Substantial attention and resources are aimed at the reintegration of child soldiers, yet rigorous evaluations are rare. Methods This tracer study was conducted among former child soldiers (N=452) and never-recruited peers (N=191) who participated in an economic support program in Burundi. Socio-economic outcome indicators were measured retrospectively for the period before receiving support (T1; 2005–06); immediately afterwards (T2; 2006–07); and at present (T3; 2010). Participants also rated present functional impairment and mental health indicators. Results Participants reported improvement on all indicators, especially economic opportunity and social integration. At present no difference existed between both groups on any of the outcome indicators. Socio-economic functioning was negatively related with depression- and, health complaints and positively with intervention satisfaction. Conclusion The present study demonstrates promising reintegration trajectories of former child soldiers after participating in a support program

Holiness and Patronage in the Hispanic World in the Modern Age

On March 23, 1630 the Congregation of rites issued a decree on the patron saints that limited their choice to the canonized. In this way direct control was granted to the Holy See. The choice of the cities of their patron saints in the modern age was determined by the interests of their ruling classes, the popular devotion and by the possession of the relics of the proposed saints. Concerning to the homeland of the Saints, martyrs, bishops and hermits, and the control of their relics were published many controversial writings that generated intense debates during the 17th century. In the election of the of the patron saints the Vatican regulation will not always be respected; in the case of Pedro Regalado and Rosa de Lima there were express authorization for the beginning of the canonization processes, his cult and their appointment

Care-seeking behaviour for malaria treatment among community primary school teachers ( a cross sectional study)

Background: The identification of sex from the skeleton is of great medico-legal and anthropological importance. The hip bone is commonly used. The ischio-pubic index is one of the parameters used for sex determination because of its reliability. Aim: To determine from radiographs, ischio-pubic index of Nigerians. This will help to establish a baseline anthropometric data and to define standard values for the local population. Methods: Standard anterio-posterior (AP) pelvic radiographs of 100 normal adults comprising 54 females and 46 males were employed in this study. Radiographs were randomly selected from the Radiology departments of University of Port Harcourt Teaching Hospital and Braithwaite Memorial Specialist Hospital, Port Harcourt. The pubic lengths and ischial lengths were measured using the method adopted by Washburn and the ischio-pubic index was calculated. Results: The mean ischio-pubic index was greater in females (102.7±5.7). This difference between the sexes was statistically significant (P less than 0.05). The pubic bone was longer in females but the Ischium was longer in males. Conclusion: The result of this study confirmed previous reports that irrespective of race, the ischio-pubic index for females is significantly greater than that of males and that ischio-pubic index can be accurately used for sex determination in this environment. Ischio-pubic index greater than 90 will most probably be that of a female and less than 90 will most probably be that of a male Nigerian in Port Harcourt.   Key words: Ischio-pubic index, Sex determination, Anthropometry, Pelvic radiograph, Nigerians in Port Harcour

Pharmacists’ participation in the documentation of medication history in a developing setting: An exploratory assessment with new criteria

Objective: To assess the impact of pharmacists’ participation on the frequency and depth of medication history information documented in a developing setting like Nigeria Method: The study consisted of two phases. The first phase was a baseline cross-sectional assessment of the frequency and depth of medication history information documented by physicians in case notes of systematic samples of 900 patients that were stratified over 9 Medical outpatients Units at a premier teaching hospital in south western Nigeria. The second phase was an exploratory study involving 10 pharmacists who conducted cross-sectional medication history interview for 324 randomly selected patients. Results: 49.2% of patients, whose medication history were documented at the baseline, by physicians, were males; while 50.3% of patient interviewed by pharmacists were male. Mean age (SD) of males and females whose medication histories were documented by physicians and pharmacists were 43.2 (SD=18.6), 43.1 (SD=17.9) years and 51.5 (SD=17.6), 52.1 (SD=17.4) years respectively. The frequency of medication history information documented by pharmacists was significantly higher for twelve of the thirteen medication history components (P < 0.0001). These include prescription medicines; over the counter medicines; source of medicines; adverse drug reactions; allergy to drugs, allergy to foods, allergy to chemicals; patient adherence; alcohol use; cigarette smoking; dietary restrictions and herbal medicine use. The depth of medication history information acquired and documented by pharmacist was significantly better for all the thirteen medication history components (P<0.0001). Conclusion: Pharmacists’ participation resulted in significant increase in frequency and depth of medication history information documented in a developing setting like Nigeria. The new medication history evaluation criteria proved useful in assessing the impact of pharmacists’ participation

Undergraduate Students’ Knowledge and Practice of Gonorrhea and other Sexually Transmitted Infections

Background: Sexually transmitted infections (STIs) are a major public  health issue. Adolescents and youth (15-24 years) are the age groups at the greater risk for acquiring them. Also a large percentage of new STIs occur in this age group with 7000 young people worldwide acquiring theinfection every day. Sexually transmitted infections (STIs) are poorly recognized and inadequately treated in Nigeria despite the fact that they constitute a major risk factor for sexual transmission of HIV infection. The shortage of trained human resources is among the most important obstacles to strengthening health systems in low-income countries.Objective: This study is to document the knowledge and practice of undergraduate students about gonorrhoea and other STIs as a baseline survey for future intervention work.Methods: It was a questionnaire-based, cross sectional descriptive study of the knowledge and practice of STIs among students in the seven public tertiary academic institutions in Lagos State using list obtained from theLagos State Ministry of Education. Thirty (30) students who agreed to be surveyed were conveniently selected from each school. Pre-tested,  semi-structured, validated questionnaires were administered and collected back. Data was entered into Microsoft Excel and analysed using EPI Info, SPSS version 15 and Microsoft Excel. Results were considered to be  statistically significant if p &lt; 0.05.Results: Majority of the respondents were of the 21 - 25 year age range (48%) and were mainly single (95%), Christian (61%) and Yoruba (81%). About 51% of the respondents had at least good knowledge of gonorrhoeaand other STIs. Knowledge about symptoms and transmission was higher than knowledge of prevention, consequences and drugs. Among those that are sexually active 24% do not use condom while 10% reuse condom.Use of both modern and traditional medical practitioners (TMP) was documented among the students.Conclusions: Awareness programs with key messages about gonorrhoea and other STIs should be developed and circulated widely in tertiary institutions in the state to improve students' practice. Also strategies to embrace TMP for STI management should be evolved.Key Words: Gonorrhea, Undergraduate Students, STIs, Knowledge, Practice

Management of acute diarrhea in children by community pharmacists in Lagos, Nigeria

Background: Acute diarrhea in children leads to dehydration and death if not appropriately managed. World Health Organization (WHO) recommends treating diarrhea with oral rehydration therapy (ORT), fluids and foods. Proper management is hinged on accurate assessment of patients to identify the acute watery diarrhea. Objective: To compare the knowledge and attitude of community pharmacists in the management of acute diarrhea in children with their observed practice. Methods: This study was carried out using two instruments: structured self-administered questionnaire to assess knowledge and attitude of community pharmacists in the management of acute diarrhea in children and simulated patient visits to evaluate assessment of patients, recommendation of products and instructions on feeding and fluid intake. The simulated patient visits were done in 186 pharmacies in the city of Lagos, Nigeria. Results: The study reveals that the knowledge and attitude of community pharmacists in the management of acute diarrhea in children was different from their observed practice. The difference was statistically significant (p<0.05). During the simulations, 23% carried out appropriate assessment before recommending any products, and 15% recommended ORT alone. Although information to the pharmacists indicated non-dysentery, non-cholera, acute watery diarrhea, antibiotics and antidiarrheals were irrationally recommended and these were the mainstay of symptoms’ management in practice. Questionnaire data revealed that 24% of pharmacists knew the correct instructions to give on food and fluid intake during diarrhea, whereas 8% followed WHO guideline on food and fluid intake during the visits. Conclusions: Assessment of patients to determine acute diarrhea was inadequate. Observed practice in managing acute diarrhea in children was inappropriate and significantly different from their claims in the questionnaire. The recommendation of ORT was scanty and advice on food and fluid intake was inadequate and sometimes inappropriate. This study shows that only 15% of community pharmacists managed acute diarrhea in children according to the WHO guidelines

Tobacco related knowledge and support for smoke-free policies among community pharmacists in Lagos state, Nigeria

Background: There are no safe levels of exposure to second hand smoke and smoke-free policies are effective in reducing the burden of tobacco-related diseases and death. Pharmacists, as a unique group of health professionals, might be able to play a role in the promotion of smoke-free policies. Objective: To determine the tobacco-related knowledge of community pharmacists and assess their support for smoke-free policies in Lagos state, Nigeria. Methods: A cross-sectional descriptive study design using both quantitative and qualitative methods was employed. Two hundred and twelve randomly selected community pharmacists were surveyed using a pre-tested self-administered questionnaire. In addition, one focus group discussion was conducted with ten members of the Lagos state branch of the Association of Community Pharmacists of Nigeria. Results: The quantitative survey revealed that the majority (72.1%) of the respondents were aged between 20 and 40 years, predominantly male (60.8%), Yoruba (50.2%) or Igbo (40.3%) ethnicity and had been practicing pharmacy for ten years or less (72.2%). A majority (90.1%) of respondents were aware that tobacco is harmful to health. Slightly less (75.8%) were aware that second hand smoke is harmful to health. Among the listed diseases, pharmacists responded that lung (84.4%) and esophageal (68.9%) cancers were the most common diseases associated with tobacco use. Less than half of those surveyed associated tobacco use with heart disease (46.9%), chronic obstructive pulmonary disease (27.8%), bladder cancer (47.2%), peripheral vascular disease (35.8%) and sudden death (31.1%). Only 51.9% had heard of the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). A little over half of the respondents (53.8%) were aware of any law in Nigeria controlling tobacco use. The majority of respondents supported a ban on smoking in homes (83.5%), in public places (79.2%), and in restaurants, nightclubs and bars (73.6%). For every additional client attended to daily, knowledge scores increased by 0.022 points. Current smokers were 1.3 times less likely to support smoke-free policies compared with non-smokers. The findings emanating from the focus group discussion reinforced the fact that the pharmacists were in support of smoke-free policies particularly in homes and public places. It also demonstrated that most of them were aware of the health risks associated with tobacco use and second hand smoke however some misconceptions seemed to exist. Conclusion: The pharmacists surveyed expressed support of smoke-free policies and most of them were aware of the health risks associated with tobacco use. However, awareness of WHO FCTC and country-level tobacco legislation was low. Current smokers were less likely to support smoke-free policies. Community pharmacists should therefore be considered worth engaging for the promotion of smoke-free policies. Efforts should also be made to educate pharmacists about country level smoke-free laws