Evaluation of Extension Agents’ Communication Strategies in Promoting the New Rice for Africa Technology Among Rice Farmers in Ofada, Ogun State, Nigeria

This study focused on evaluating the effectiveness of extension agents’ communication strategies in promoting the New Rice for Africa Technology among farmers in Ofada, Ogun State, Nigeria. Hinged on the Diffusion of Innovations Theory, the study adopted the survey research design using structured questionnaire and focused group discussion sessions to elicit data from extension workers and rice farmers respectively. Findings from the study revealed that extension agents employed communication strategies such as one-to-one, group gatherings, radio jingles, short sms, and video demonstrations among others to promote NERICA among rice farmers in Ofada. It was also gathered that these communication strategies were effective in passing across required information however; the farmers prefer the one-to-one than the group gathering communication strategy which was more often used by the extension workers. This preference was premised on the inherent advantage of interactivity which the adoption of the one-to-one technique could provide. In the light of these findings, it was recommended that, more needed to be done by the extension agents and the government to ensure adoption of NERICA technology. With the right seedlings, good preservation techniques, and other backup supports such as availability of pesticides, herbicides and fertilizers, adopting NERICA technology would be easier for farmers. The study recommended use of the one-to-one communication strategy and periodic evaluation of the extension worker’s activities by government. Keywords: Communication; Communication Strategies; Agricultural Extension Agents, NERICA, Rice Farmers DOI: 10.7176/DCS/9-6-06 Publication date:June 30th 201

Who speaks for the poor? Poverty, Human Rights, Social Justice and Access to Media in Nigeria

Nigeria faces a major poverty crisis with more than half of the population living in extreme poverty. This conceptual paper delves into the critical issues surrounding the rights of the poor in Nigeria especially in regard their access to media, freedom of expression, and the broader implications for social justice and poverty alleviation. The central question explored in this study is whether the right to freedom of expression and the right to be heard by the poor are recognized and upheld within the Nigerian media landscape as a fundamental human right. Furthermore, this paper examines the extent to which the media has contributed to addressing poverty prevalence in Nigeria and the impactful ways in which this contribution has manifested. Relying on the analytical and critical methodology of study, the paper argues that access to information is a fundamental human right, and the poor, who face multifaceted inequalities, must have their rights protected. Doing so, the paper contends will enhance their capacity to escape poverty, since information and knowledge play pivotal roles in poverty reduction. Emphasis is laid on the importance of granting the poor adequate access to information through available and relevant media, to enable them make informed decisions and choices that can lead to their emancipation from poverty. Keywords: Human Rights, Media Access, Poverty Reduction, Social Justice, Freedom of Expression DOI: 10.7176/JPID/63-04 Publication date: April 30th 2024

The Law of Privacy: Appraising the Practice of Professional Journalism in a Democratic 21st Century Nigeria

The issue of the invasion of privacy in the practice of professional journalism is not a strange phenomenon to those following happenings in Nigeria. Although there is a law guarding against such practice, it appears journalists derive great pleasure from reporting matters that relate to individuals’ personal lives as long as such news is sensational. This paper attempts a synthesis of some of the principles that should inform the development and implementation of the right to individuals’ privacy in a democratic state like Nigeria. Since a chapter of the country’s constitution makes provision for guaranteed and protected rights to certain aspects of citizen’s personal lives, homes, correspondences and several other situations, the paper argues that there is no better time to take the implementation and enforcement of such rights to the next level as now.  The research relied on the analytical and critical methodology of study. It made several recommendations which includes the necessity for a re-appraisal of the current laws of Nigeria relating to citizen’s right to privacy viz-a-vis the duty of journalists to publish and reconcile the gaps where any in the legal regime of protection of persons’ privacy. Doing this, the paper concludes, will help significantly in upholding the dignity and integrity of human beings in Nigeria, thereby fostering the protection of fundamental human rights of citizens, and as well help in strengthening and deepening of our democratic values. Keywords: Fundamental Right to Privacy, Constitutional Right to Publish, and Liabilities in Defamatio

Civil society leadership in the struggle for AIDS treatment in South Africa and Uganda

Includes abstract.Includes bibliographical references.This thesis is an attempt to theorise and operationalise empirically the notion of ‘civil society leadership’ in Sub-Saharan Africa. ‘AIDS leadership,’ which is associated with the intergovernmental institutions charged with coordinating the global response to HIV/AIDS, is both under-theorised and highly context-specific. In this study I therefore opt for an inclusive framework that draws on a range of approaches, including the literature on ‘leadership’, institutions, social movements and the ‘network’ perspective on civil society mobilisation. This framework is employed in rich and detailed empirical descriptions (‘thick description’) of civil society mobilisation around AIDS, including contentious AIDS activism, in the key case studies of South Africa and Uganda. South Africa and Uganda are widely considered key examples of poor and good leadership (from national political leaders) respectively, while the Treatment Action Campaign (TAC) and The AIDS Support Organisation (TASO) are both seen as highly effective civil society movements. These descriptions emphasise ‘transnational networks of influence’ in which civil society leaders participated (and at times actively constructed) in order to mobilise both symbolic and material resources aimed at exerting influence at the transnational, national and local levels

Initial Impact of the Affordable Care Act on an Ohio Level I Trauma Center

BACKGROUND Hospital financial pressures and inadequate reimbursement contribute to the closure of trauma centers. Uninsured patients contribute significantly to the burden of trauma center costs. The Affordable Care Act implemented changes in 2014 to provide health care coverage for all Americans. This study analyzes the impact of the recent health care changes on an Ohio Level I trauma center financials. METHODS We conducted an analysis of trauma charges, reimbursement, and supplemental payments at an Ohio Level I trauma center. A 3-year trauma patient cohort (2012–2014) was selected and grouped by reimbursement source (Medicare, Medicaid, other government, commercial, and self-pay/charity). A total of 9,655 patients were reviewed. Data were collected with the Transition Systems Inc. accounting system and analyzed with IBM SPSS Statistics 22.0. RESULTS For trauma cases, the percentage of self-pay/charity patients decreased during the 2012 to 2014 period (15.1%, 15%, to 6.4%, respectively), while the percentage of Medicaid decreased from 2012 to 2013 followed by a large increase in 2014 (15.4%, 13.9%, to 24.3%, respectively). The percentage of commercially insured patients decreased slightly from 2012 to 2014 (34.2%, 32.3%, to 30.7%, respectively). Uninsured charges decreased notably (approximately $22.5 million and$21 million for 2012–2013 to approximately $8.6 million in 2014). Medicaid charges decreased from 2012 to 2013, followed by a rebound in 2014 ($50.7 million in 2012 to $37.3 million in 2013 to$54.3 million in 2014). The percentage of total charges for self-pay/charity decreased (9.5%, 10.1%, to 4.1%). The percentage of total charges for Medicaid increased (21.4%, 18.0%, to 25.9%). Mean Medicaid reimbursement per patient decreased ($19,000,$14,000, to $13,000). Mean reimbursement per uninsured patient did not vary significantly among years. Total hospital supplemental payments (trauma and nontrauma combined) decreased ($47.6 million, $49 million, to$39.2 million). CONCLUSION In the first year following the changes implemented by the Affordable Care Act, our hospital saw self-pay/charity charges decrease, Medicaid charges increase, and total hospital supplemental payments decrease. In addition, there was a small, yet noteworthy, downward trend in the number of commercially insured patients. Although more data collection and analysis are needed, this initial financial evaluation of a Level I trauma center following the Affordable Care Act provides insight into insurance trends

Initial Impact of the Affordable Care Act on an Ohio Level I Trauma Center

BACKGROUND Hospital financial pressures and inadequate reimbursement contribute to the closure of trauma centers. Uninsured patients contribute significantly to the burden of trauma center costs. The Affordable Care Act implemented changes in 2014 to provide health care coverage for all Americans. This study analyzes the impact of the recent health care changes on an Ohio Level I trauma center financials. METHODS We conducted an analysis of trauma charges, reimbursement, and supplemental payments at an Ohio Level I trauma center. A 3-year trauma patient cohort (2012–2014) was selected and grouped by reimbursement source (Medicare, Medicaid, other government, commercial, and self-pay/charity). A total of 9,655 patients were reviewed. Data were collected with the Transition Systems Inc. accounting system and analyzed with IBM SPSS Statistics 22.0. RESULTS For trauma cases, the percentage of self-pay/charity patients decreased during the 2012 to 2014 period (15.1%, 15%, to 6.4%, respectively), while the percentage of Medicaid decreased from 2012 to 2013 followed by a large increase in 2014 (15.4%, 13.9%, to 24.3%, respectively). The percentage of commercially insured patients decreased slightly from 2012 to 2014 (34.2%, 32.3%, to 30.7%, respectively). Uninsured charges decreased notably (approximately $22.5 million and$21 million for 2012–2013 to approximately $8.6 million in 2014). Medicaid charges decreased from 2012 to 2013, followed by a rebound in 2014 ($50.7 million in 2012 to $37.3 million in 2013 to$54.3 million in 2014). The percentage of total charges for self-pay/charity decreased (9.5%, 10.1%, to 4.1%). The percentage of total charges for Medicaid increased (21.4%, 18.0%, to 25.9%). Mean Medicaid reimbursement per patient decreased ($19,000,$14,000, to $13,000). Mean reimbursement per uninsured patient did not vary significantly among years. Total hospital supplemental payments (trauma and nontrauma combined) decreased ($47.6 million, $49 million, to$39.2 million). CONCLUSION In the first year following the changes implemented by the Affordable Care Act, our hospital saw self-pay/charity charges decrease, Medicaid charges increase, and total hospital supplemental payments decrease. In addition, there was a small, yet noteworthy, downward trend in the number of commercially insured patients. Although more data collection and analysis are needed, this initial financial evaluation of a Level I trauma center following the Affordable Care Act provides insight into insurance trends

Initial Impact of the Affordable Care Act on an Ohio Level I Trauma Center

BACKGROUND Hospital financial pressures and inadequate reimbursement contribute to the closure of trauma centers. Uninsured patients contribute significantly to the burden of trauma center costs. The Affordable Care Act implemented changes in 2014 to provide health care coverage for all Americans. This study analyzes the impact of the recent health care changes on an Ohio Level I trauma center financials. METHODS We conducted an analysis of trauma charges, reimbursement, and supplemental payments at an Ohio Level I trauma center. A 3-year trauma patient cohort (2012–2014) was selected and grouped by reimbursement source (Medicare, Medicaid, other government, commercial, and self-pay/charity). A total of 9,655 patients were reviewed. Data were collected with the Transition Systems Inc. accounting system and analyzed with IBM SPSS Statistics 22.0. RESULTS For trauma cases, the percentage of self-pay/charity patients decreased during the 2012 to 2014 period (15.1%, 15%, to 6.4%, respectively), while the percentage of Medicaid decreased from 2012 to 2013 followed by a large increase in 2014 (15.4%, 13.9%, to 24.3%, respectively). The percentage of commercially insured patients decreased slightly from 2012 to 2014 (34.2%, 32.3%, to 30.7%, respectively). Uninsured charges decreased notably (approximately $22.5 million and$21 million for 2012–2013 to approximately $8.6 million in 2014). Medicaid charges decreased from 2012 to 2013, followed by a rebound in 2014 ($50.7 million in 2012 to $37.3 million in 2013 to$54.3 million in 2014). The percentage of total charges for self-pay/charity decreased (9.5%, 10.1%, to 4.1%). The percentage of total charges for Medicaid increased (21.4%, 18.0%, to 25.9%). Mean Medicaid reimbursement per patient decreased ($19,000,$14,000, to $13,000). Mean reimbursement per uninsured patient did not vary significantly among years. Total hospital supplemental payments (trauma and nontrauma combined) decreased ($47.6 million, $49 million, to$39.2 million). CONCLUSION In the first year following the changes implemented by the Affordable Care Act, our hospital saw self-pay/charity charges decrease, Medicaid charges increase, and total hospital supplemental payments decrease. In addition, there was a small, yet noteworthy, downward trend in the number of commercially insured patients. Although more data collection and analysis are needed, this initial financial evaluation of a Level I trauma center following the Affordable Care Act provides insight into insurance trends

Initial Impact of the Affordable Care Act on an Ohio Level I Trauma Center

BACKGROUND Hospital financial pressures and inadequate reimbursement contribute to the closure of trauma centers. Uninsured patients contribute significantly to the burden of trauma center costs. The Affordable Care Act implemented changes in 2014 to provide health care coverage for all Americans. This study analyzes the impact of the recent health care changes on an Ohio Level I trauma center financials. METHODS We conducted an analysis of trauma charges, reimbursement, and supplemental payments at an Ohio Level I trauma center. A 3-year trauma patient cohort (2012–2014) was selected and grouped by reimbursement source (Medicare, Medicaid, other government, commercial, and self-pay/charity). A total of 9,655 patients were reviewed. Data were collected with the Transition Systems Inc. accounting system and analyzed with IBM SPSS Statistics 22.0. RESULTS For trauma cases, the percentage of self-pay/charity patients decreased during the 2012 to 2014 period (15.1%, 15%, to 6.4%, respectively), while the percentage of Medicaid decreased from 2012 to 2013 followed by a large increase in 2014 (15.4%, 13.9%, to 24.3%, respectively). The percentage of commercially insured patients decreased slightly from 2012 to 2014 (34.2%, 32.3%, to 30.7%, respectively). Uninsured charges decreased notably (approximately $22.5 million and$21 million for 2012–2013 to approximately $8.6 million in 2014). Medicaid charges decreased from 2012 to 2013, followed by a rebound in 2014 ($50.7 million in 2012 to $37.3 million in 2013 to$54.3 million in 2014). The percentage of total charges for self-pay/charity decreased (9.5%, 10.1%, to 4.1%). The percentage of total charges for Medicaid increased (21.4%, 18.0%, to 25.9%). Mean Medicaid reimbursement per patient decreased ($19,000,$14,000, to $13,000). Mean reimbursement per uninsured patient did not vary significantly among years. Total hospital supplemental payments (trauma and nontrauma combined) decreased ($47.6 million, $49 million, to$39.2 million). CONCLUSION In the first year following the changes implemented by the Affordable Care Act, our hospital saw self-pay/charity charges decrease, Medicaid charges increase, and total hospital supplemental payments decrease. In addition, there was a small, yet noteworthy, downward trend in the number of commercially insured patients. Although more data collection and analysis are needed, this initial financial evaluation of a Level I trauma center following the Affordable Care Act provides insight into insurance trends

HSV-2 prevalence and association with inflammatory cytokines among sexual and gender minorities (SGM) living with and without HIV-1 from Lagos, Nigeria

Herpes simplex virus type 2 (HSV-2) is common globally and contributes significantly to the risk of acquiring HIV-1, yet these two sexually transmitted infections (STIs) have not been sufficiently characterized for sexual and gender minorities (SGM) across sub-Saharan Africa. To help fill this gap, we performed a retrospective study using plasma and serum samples from 183 SGM enrolled at the Lagos site of the TRUST/RV368 cohort in Nigeria, assayed them for HSV-2 antibodies with the Kalon ELISA and plasma cytokines and chemokines with Luminex, and correlated the findings with HIV-1 viral loads and CD4 counts. We found an overall HSV-2 prevalence of 36.6% (49.5% and 23.9% among SGM with and without HIV-1, respectively, p \u3c 0.001). Moreover, HSV-2 positive status was associated with high circulating concentrations of CCL11 among antiretroviral therapy (ART) treated (p = 0.031) and untreated (p = 0.015) participants, and with high concentrations of CCL2 in the untreated group (p = 0.004), independent of VL. Principal component analysis revealed a strong association of cytokines with HIV-1 viral load independent of HSV-2 status. In conclusion, our study finds that HSV-2 prevalence among SGM with HIV-1 is twice as high than HSV-2 prevalence among SGM without HIV-1 in Lagos and suggests that this is associated with higher levels of certain systemic cytokines. Additional work is needed to further characterize the relationship between HSV-2 and HIV-1 in SGM and help develop targeted therapies for co-infected individuals

Association of age with healthcare needs and engagement among Nigerian men who have sex with men and transgender women: Cross‐sectional and longitudinal analyses from an observational cohort

Introduction: Young men who have sex with men (MSM) and transgender women (TGW) face stigmas that hinder access to healthcare. The aim of the study was to understand age‐related determinants of healthcare needs and engagement among MSM and TGW. Methods: The TRUST/RV368 cohort provides integrated prevention and treatment services for HIV and other sexually transmitted infections (STIs) tailored to the needs of sexual and gender minorities. MSM and TGW aged ≥ 16 years in Abuja and ≥ 18 years Lagos, Nigeria, completed standardized behavioural questionnaires and were tested for HIV, Neisseria gonorrhoeae (NG) and Chlamydia trachomatis (CT) every three months for up to 18 months. Logistic regression was used to estimate adjusted odds ratios (aORs) for associations of age and other factors with outcomes of interest upon enrolment, including HIV care continuum steps – HIV testing, ART initiation and viral suppression \u3c 1000 copies/mL. Cox proportional hazards models were used to calculate adjusted hazard ratios (aHRs) for associations with incident infections. Results: Between March 2013 and February 2019, 2123 participants were enrolled with median age 23 (interquartile range 21 to 27) years. Of 1745 tested, 865 (49.6%) were living with HIV. HIV incidence was 11.6/100 person‐years [PY], including 23.1/100PY (95% CI 15.5 to 33.1) among participants aged 16 to 19 years and 23.8/100 PY (95% CI 13.6 to 39.1) among TGW. Compared to participants aged ≥ 25 years, those aged 16 to 19 years had decreased odds of prior HIV testing (aOR 0.40 [95% CI 0.11 to 0.92]), disclosing same‐sex sexual practices to healthcare workers (aOR 0.53 [95% CI 0.36 to 0.77]) and receiving HIV prevention information (aOR 0.60 [95% CI 0.41 to 0.87]). They had increased odds of avoiding healthcare (aOR 1.94 [95% CI 1.3 to 2.83]) and engaging in transactional sex (aOR 2.76 [95% CI 1.92 to 3.71]). Age 16 to 19 years was independently associated with increased incidence of HIV (aHR 4.09 [95% CI 2.33 to 7.49]), NG (aHR 3.91 [95% CI 1.90 to 8.11]) and CT (aHR 2.74 [95% CI 1.48 to 5.81]). Conclusions: Young MSM and TGW demonstrated decreased healthcare engagement and higher incidence of HIV and other STIs as compared to older participants in this Nigerian cohort. Interventions to address unique obstacles to healthcare engagement by adolescents and young adults are needed to curb the spread of HIV and other STIs among MSM and TGW in Nigeria