Perception and Utilization of Primary Health Care Services in a Semi-Urban Community in South-Western Nigeria

Objective: The health status of most people living in developing countries of the world remains poor. Linked to this are some factors, of which low utilization of PHC facilities remain a major issue. This study therefore aimed to determine the utilization of PHC services in a sub-urban community in a developing country in West Africa.Design: The study was a descriptive cross sectional study conducted in Olorunda Local Government Area of Osun State, Nigeria. A multistage sampling technique was used to recruit adults above the age of 18 years, normally resident in the community. Three hundred and ninety five individuals were involved in this community-based study. Interview was conducted using semi-structured pre-tested questionnaire to obtain relevant information.Result: Most (71.7%) of respondents were aware of PHC facilities in their communities and the most frequently mentioned health service provided was the immunization service. Three quarters of respondents felt that PHC services were accessible while over half (57.2%) felt it could address the disease burden in the community. Only 44.1% of them had ever-utilized any PHC health facility within the district. Respondents' age, sex, marital status, educational level and occupation are all significantly related to utilization status.Conclusion: The study demonstrates high awareness level of the PHC system in the population studied; however, utilization of the facilities is still very low. We hereby recommend that managers of this health institution put in place programs and schemes that will facilitate more effective service delivery especially in relation to the workers in this health sector. In addition, orientation programs lauding the benefits of the PHC facilities to correct wrong opinions about PHC among local communities and creation of good access routes that link primary health centers to the communities should be on the priority list of the managers of PHC to enhance utilization of services.Keywords: Perception, Utilization, Primary Health Care, Developing Countrie

Subjective assessment of childhood fever by mothers utilizing primary health care facilities in Osogbo, Osun state, Nigeria.

To assess the accuracy of tactile examination bymothers as amethod of fever determination in their children and thus determine the reliability of mothers' history about the presence or absence of fever in their children. A descriptive cross-sectional study conducted in four health centers randomly selected in Osogbometropolis.Three hundredmotherswere studied, a semi-structured questionnairewas utilized. The study found the sensitivity and specificity of tactile examination for mothers as a means of detecting fever in their children to be 82.3% and 54.1% respectively. Mother's socio-demographic characteristics and the age of child did not affectmother's subjective assessment of childhood fever (p>0.05). Mothers are able to provide accurate information about the presence or absence of fever in their children by palpation without the use of a thermometer. Tactile examination was found to be adequate for mothers as ameans of detecting fever in their children. Physicians should accept as reliablemothers' history of fever and give promptmanagement.Keywords: Subjective assessment, childhood fever, tactile examination,mothers, sensitivity, specificit

Prevalence of hepatitis B surface antigen, hepatitis C and Human Immunodeficiency Virus antibodies in a population of students of tertiary institution in Nigeria

Objective: Human immunodeficiency virus (HIV), hepatitis B virus, and hepatitis C viruses (HCV) are major causes of mortality and morbidity worldwide. They are also among the commonest transfusiontransmissible infectious agents. Students of higher institutions are often used as voluntary unpaid donors by many hospitals in Nigeria. In this study, the prevalence of HIV and HCV and HBsAg is determined in a population of students attending Ladoke Akintola University of Technology in south west Nigeria, to provide background information on the burden of these infections in this population. Materials and Methods: Serum samples were obtained from students of the Pre-degree Science programme of Ladoke Akintola University of Technology, Ogbomosho and tested for antibodies to HIV, HCV and HBsAg using the ELISA procedure. Results: The prevalence rates of antibodies to HIV and HCV in the student population were 0% and 4.8%, respectively and that of HBsAg was 9.5%. Conclusion: The findings of this study which showed that the prevalence of antibodies to HIV and of HBsAg in this group of students is somewhat similar to those carried out in similar populations. This strongly suggests that the viral burden amongst this population of students is similar and that probably similar factors (demographic) are responsible for maintaining this level of viral load. Further studies would be needed to elucidate the reasons why this is the case. Also it would be necessary to reemphasize the methods of prevention of transmission of these viruses, and to ensure their implementation in order to reduce the viral levels and therefore avoid the long term sequalae.Key words: Transfusion, Infection, Blood Donatio

Users’ Perception for Quality Service Delivery in Albert Ilesanmi Ilemobode Library, Federal University Of Technology Akure (FUTA)

Abstract The study investigated Users’ perception for quality service delivery in Albert Ilesanmi Ilemobode Library, Federal University of Technology Akure (FUTA). The descriptive survey research design was adopted for the study; the major instrument for generating data collection was the questionnaires. In carrying out the research, a case study research method was adopted while the researchers made use of random sampling techniques. The Sampling size for this research consists of 10% of registered post graduate students of Albert Ilesanmi Ilemobode Library; hence 200 respondents were selected for the study. However, only 192 respondents completed and returned the questionnaires. The data collected were analyzed using frequency tables, and percentages. The findings of the study showed that the library was used more frequently by students. The perceptions of the quality of library services were found to be satisfactory in the library. The library environment and information resources were considered adequate by Albert Ilesanmi Ilemobode Library users, the most valued aspects of the library were the library collections, and the friendliness and willingness of library staff to assist users. It was also found that users derived a number of benefits from using the library. In the view of above findings the research recommended that the academic library should have a specific guideline for measuring their value. The research work considers the nature of library value and made recommendations for improving library services. Keywords: Academic libraries; User Satisfaction, Library Services, Service Quality, Valu

The effect of moving to East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village, on physical activity and adiposity (ENABLE London): a cohort study

Background The built environment can affect health behaviours, but longitudinal evidence is limited. We aimed to examine the effect of moving into East Village, the former London 2012 Olympic and Paralympic Games Athletes' Village that was repurposed on active design principles, on adult physical activity and adiposity. Methods In this cohort study, we recruited adults seeking new accommodation in East Village and compared physical activity and built environment measures with these data in control participants who had not moved to East Village. At baseline and after 2 years, we objectively measured physical activity with accelerometry and adiposity with body-mass index and bioimpedance, and we assessed objective measures of and participants' perceptions of change in their built environment. We examined the change in physical activity and adiposity between the East Village and control groups, after adjusting for sex, age group, ethnicity, housing tenure, and household (as a random effect). Findings We recruited participants for baseline assessment between Jan 24, 2013, and Jan 7, 2016, and we followed up the cohort after 2 years, between Feb 24, 2015, and Oct 24, 2017. At baseline, 1819 households (one adult per household) consented to initial contact by the study team. 1278 adults (16 years and older) from 1006 (55%) households participated at baseline; of these participants, 877 (69%) adults from 710 (71%) households were assessed after 2 years, of whom 441 (50%) participants from 343 (48%) households had moved to East Village. We found no effect associated with moving to East Village on daily steps, the time spent doing moderate-to-vigorous physical activity (either in total or in 10-min bouts or more), daily sedentary time, body-mass index, or fat mass percentage between participants who had moved to East Village and those in the control group, despite sizeable improvements in walkability and neighbourhood perceptions of crime and quality among the East Village group relative to their original neighbourhood at baseline. Interpretation Despite large improvements in neighbourhood perceptions and walkability, we found no clear evidence that moving to East Village was associated with increased physical activity. Improving the built environment on its own might be insufficient to increase physical activity

The risks and rewards of covariate adjustment in randomized trials: an assessment of 12 outcomes from 8 studies

Adjustment for prognostic covariates can lead to increased power in the analysis of randomized trials. However, adjusted analyses are not often performed in practice

Efficacy of high-intensity, low-volume interval training compared to continuous aerobic training on insulin resistance, skeletal muscle structure and function in adults with metabolic syndrome: study protocol for a randomized controlled clinical trial (Intraining-MET)

ABSTRACT: Evidence of the efficacy of high-intensity, low-volume interval training (HIIT-low volume) in treating insulin resistance (IR) in patients with metabolic disorders is contradictory. In addition, it is unknown whether this effect is mediated through muscle endocrine function, which in turn depends on muscle mass and fiber type composition. Our aims were to assess the efficacy of HIIT-low volume compared to continuous aerobic exercise (CAE) in treating IR in adults with metabolic syndrome (MS) and to establish whether musclin, apelin, muscle mass and muscle composition are mediators of the effect. Methods: This is a controlled, randomized, clinical trial using the minimization method, with blinding of those who will evaluate the outcomes and two parallel groups for the purpose of showing superiority. Sixty patients with MS and IR with ages between 40 and 60 years will be included. A clinical evaluation will be carried out, along with laboratory tests to evaluate IR (homeostatic model assessment (HOMA)), muscle endocrine function (serum levels of musclin and apelin), thigh muscle mass (by dual energy x-ray absorptiometry (DXA) and thigh muscle composition (by carnosine measurement with proton magnetic resonance spectroscopy (H–MRS)), before and after 12 weeks of a treadmill exercise program three times a week. Participants assigned to the intervention (n = 30) will receive HIIT-low volume in 22-min sessions that will include six intervals at a load of 90% of maximum oxygen consumption (VO2 max) for 1 min followed by 2 min at 50% of VO2 max. The control group (n = 30) will receive CAE at an intensity of 60% of VO2 max for 36 min. A theoretical model based on structural equations will be proposed to estimate the total, direct and indirect effects of training on IR and the proportion explained by the mediators. Discussion: Compared with CAE, HIIT-low volume can be effective and efficient at improving physical capacity and decreasing cardiovascular risk factors, such as IR, in patients with metabolic disorders. Studies that evaluate mediating variables of the effect of HIIT-low volume on IR, such as endocrine function and skeletal muscle structure, are necessary to understand the role of skeletal muscle in the pathophysiology of MS and their regulation by exercise. Trial registration: NCT03087721. High-intensity Interval, Low Volume Training in Metabolic Syndrome (Intraining-MET). Registered on 22 March 2017, retrospectively registered

Supporting recovery in patients with psychosis through care by community-based adult mental health teams (REFOCUS): a multisite, cluster, randomised, controlled trial

Background: Mental health policy in many countries is oriented around recovery. The evidence base for service-level pro-recovery interventions is lacking. Methods: Two-site cluster randomised controlled trial in England (ISRCTN02507940). REFOCUS is a one-year team-level intervention targeting staff behaviour (increasing focus on patient values, preferences, strengths, goal-striving) and staff-patient relationships (coaching, partnership). 27 community-based adult mental health teams were randomly allocated to treatment-as-usual (n=13) or treatment-as-usual plus REFOCUS (n=14). Baseline (n=403) and one-year follow-up (n=297) outcomes were assessed for randomly selected patients with psychosis, representing 88% of target recruitment. Primary outcome was recovery, assessed using Questionnaire about Processes of Recovery (QPR). Findings: Intention-to-treat analysis using multiple imputation found no difference in QPR Total (control 40·0 (s.d.10·2), intervention 40·6 (s.d.10·1), adjusted difference 0·68, 95%CI: 1·7 to 3·1, p=·58), or sub-scales. Secondary outcomes which improved in the intervention group were functioning (adjusted difference 6·96, 95%CI 2·8 to 9·2, p<·001) and staff-rated unmet need (adjusted difference 0·80, 95%CI 0·2 to 1·4, p=·01). This pattern remained after covariate adjustment and completer analysis (n=275). Higherparticipating teams had higher staff-rated pro-recovery behaviour change (adjusted difference -0·4, 95%CI -0·7 to -0·2, p=·001) and patients had higher QPR Interpersonal scores (adjusted difference -1·6, 95%CI -2·7 to -0·5, p=·005) at follow-up. Interventiongroup patients incurred £1,062 (95%CI -£1,103 to £3,017) lower adjusted costs. Interpretation: Supporting recovery may, from the staff perspective, improve functioning and reduce needs. Overcoming implementation barriers may increase staff pro-recovery behaviours and interpersonal aspects of patient-rated recovery

Biodegradation of polycyclic aromatic hydrocarbons (PAHs) in spent and fresh cutting fluids contaminated soils by Pleurotus pulmonarius (Fries). Quelet and Pleurotus ostreatus (Jacq.) Fr. P. Kumm

The potential of Pleurotus pulmonarius and Pleurotus ostreatus on the degradation of PAHs in spent and fresh cutting fluids (SCF and FCF) contaminated soils was investigated. Different weights of soil samples were contaminated with varying composition (10, 20 or 30%) of spent and fresh cutting fluids separately then inoculated each sample with P. pulmonarius and P. ostreatus separately and incubated at 28 ± 2°C for two months. The samples were analyzed in triplicates for 16 priority polycyclic aromatic hydrocarbons (PAHs) by gas chromatography after extracting with hexane and dichloromethane (3:1). The initial PAHs in the cutting fluids were mainly composed of 2 to 6 fused benzene rings. Significant reductions in PAHs concentrations for SCF and FCF were observed after two months of incubation. The percentage total PAHs remaining in FCF soil ranged from 71.7 to 73.6% when inoculated with P. pulmonarius and 0.93 to 31.0% when inoculated with P. ostreatus. Similarly, the percentage total PAHs remaining in SCF soil ranged from 42.6 to 72.6% when inoculated with P. pulmonarius and 54.9 to 62.2% when inoculated with P. ostreatus. Overall range of PAHs degradation by P. pulmonarius inoculated on FCF contaminated soil was 17.3 to 27.3%, while for P. ostreatus inoculated soil was 69.0 to 99.07% at different contamination levels. In contrast, overall PAHs degradation for P. pulmonarius and P. ostreatus inoculated on SCF ranged from 27.4 to 57.4% and from 37.8 to 45.2%, respectively. Thus, P. ostreatus is found more effective as a biodegradation agent for PAHs in contaminated soils when compared with P. pulmonarius. Key words: Biodegradation, polycyclic aromatic hydrocarbons (PAHs), cutting fluids, Pleurotus ostreatus, Pleurotus pulmonarius