Estimating greenhouse gas emissions from port vessel operations at the Lagos and Tin Can ports of Nigeria

Greenhouse gas (GHG) emission, the number one contributor to global warming is not just a product of in-land transportation, industries and other anthropogenic effect but also the maritime and shipping industries. This article estimates the amount of greenhouse gases emitted from port vessel operations in the Lagos and Tin Can ports of Nigeria. The emission estimate was carried out based on the type of the vessel and its movement from the moment of its arrival (400 km from the coast). The emission estimate was done using the bottom-up approach based on the characteristics of individual vessels and using data on vessels processed by both ports in the first and second quarter of the year 2017. Among various types of vessels, Premium Motor Spirit (PMS) carriers are the heaviest emitters, followed by the container vessels and general cargo vessels. Result for the first and second quarter of 2017 indicates that approximately 16,335 t and 773 t of CO2 were produced and emitted during anchorage and while passing through lock gates movement, respectively. Also, 644 t of CO2 was emitted through maneuvering to the dock movement. Consequently, these three movements account for 85% of the total CO

Involving young people in the care and support of people living with HIV/AIDS in Zambia

The Population Council, in collaboration with CARE International and Family Health Trust, conducted a study in Zambia to determine which care and support needs of people living with HIV and AIDS and their families could be met by trained youth, and to establish whether youth engaged in formalized care and support activities would increase their adoption of protective behaviors or reduce the stigma faced by members of AIDS-affected households. Discussions with caregivers and clients demonstrated that trained youth are able to meet a range of the needs of clients and orphans and vulnerable children, and that their efforts may be laying the foundation for decreased isolation and stigmatization of AIDS-affected families. This study also demonstrated that NGOs and youth clubs working in relatively isolated rural and semi-urban areas can meet with positive and enthusiastic responses and high levels of participation. A particular focus of the continuing study is to further strengthen local partnerships and expand network linkages in order to promote community ownership and sustainability

Facility-Based Treatment of Under Five Diarrhoea in Cross River State: A Clinical Audit

Introduction: Diarrhoea is the second leading cause of under-five mortality globally and ranks second among the top 10 priority child health problems in Nigeria. The World Health Organization (WHO) has recommended some cost-effective, evidence- based interventions for diarrhoea case management. It is needful to evaluate the current practice in the treatment of diarrhoea in under-fives in health facilities in the country.Objective: To determine the extent to which current treatment practice for diarrhoea in underfives conforms to the WHO recommendation.Method: A clinical audit was conducted between May and June 2013 in 32 health facilities in the Southern Senatorial district of Cross River State, Nigeria. Trained field workers extracted information from patients’ case records using a validated audit tool. Treatment was checked as appropriate, inappropriate, wrong or none, based on prescription on patients’ case records.Result: Of the 370 case records audited, prescription for diarrhoea was appropriate in 40 (10.8%), inappropriate in 231 (62.4%), wrong in 82 (22.2%) and no prescription was made in 17 (4.6%).Conclusion: Treatment of diarrhoea in under-fives in health facilities in the State is suboptimum. Retraining of health workers on the current WHO and UNICEF treatment guidelines is highly recommended.Keywords: Diarrhoea, Underfives, Health Facilities, Prescription, Clinical Audi

Assessing the consistency assumptions underlying network meta-regression using aggregate data

When numerous treatments exist for a disease (treatments 1, 2, 3 etc.), network meta-regression (NMR) examines whether each relative treatment effect (e.g. mean difference for 2 vs. 1, 3 vs. 1, 3 vs. 2 etc.) differs according to a covariate (e.g. disease severity). Two consistency assumptions underlie NMR: consistency of the treatment effects at the covariate value zero and consistency of the regression coefficients for the treatment by covariate interaction. The NMR results may be unreliable when the assumptions do not hold. Furthermore, interactions may exist but are not found because inconsistency of the coefficients is masking them; for example, when the treatment effect increases as the covariate increases using direct evidence but the effect decreases with the increasing covariate using indirect evidence.We outline existing NMR models that incorporate different types of treatment by covariate interaction. We then introduce models that can be used to assess the consistency assumptions underlying NMR for aggregate data. We extend existing node-splitting models, the unrelated mean effects inconsistency model and the design by treatment inconsistency model to incorporate covariate interactions. We propose models for assessing both consistency assumptions simultaneously and models for assessing each of the assumptions in turn to gain a more thorough understanding of consistency.We apply the methods in a Bayesian framework to trial-level data comparing anti-malarial treatments using the covariate average age, and to four fabricated datasets to demonstrate key scenarios.We discuss the pros and cons of the methods and important considerations when applying models to aggregated data

Cost-effectiveness analysis of an intervention project engaging traditional and religious leaders to improve uptake of childhood immunization in southern Nigeria

Vaccination is a cost-effective public health intervention, yet evidence abounds that vaccination uptake is still poor in many low- and middle-income countries. Traditional and Religious Leaders play a substantial role in improving the uptake of health services such as immunization. However, there is paucity of evidence on the cost-effectiveness of using such strategies. This study aimed to assess the cost-effectiveness of using a multi-faceted intervention that included traditional and religious leaders for community engagement to improve uptake of routine immunisation services in communities in Cross River State, Southern Nigeria. The target population for the intervention was traditional and religious leaders in randomly selected communities in Cross River State. The impact of the intervention on the uptake of routine vaccination among children 0 to 23 months was assessed using a cluster randomized trials. Outcome assessments were performed at the end of the project (36 months).The cost of the intervention was obtained from the accounting records for expenditures incurred in the course of implementing the intervention. Costs were assessed from the health provider perspective. The cost-effectiveness analysis showed that the incremental cost of the initial implementation of the intervention was US$19,357and that the incremental effect was 323 measles cases averted, resulting in an incremental cost-effectiveness ratio (ICER) of US$60/measles case averted. However, for subsequent scale-up of the interventions to new areas not requiring a repeat expenditure of some of the initial capital expenditure the ICER was estimated to be US$34 per measles case averted. Involving the traditional and religious leaders in vaccination is a cost-effective strategy for improving the uptake of childhood routine vaccinations

Effects of engaging communities in decision-making and action through traditional and religious leaders on vaccination coverage in Cross River State, Nigeria: a cluster-randomised control trial

BACKGROUND: Vaccination coverage levels fall short of the Global Vaccine and Action Plan 90% target in low- and middle- income countries (LMICs). Having identified traditional and religious leaders (TRLs) as potential public health change agents, this study aimed at assessing the effect of training them to support routine immunisation for the purpose of improving uptake of childhood vaccines in Cross River State, Nigeria. METHODS: A cluster-randomised controlled study was conducted between 2016 and 2019. Of the 18 Local Government Areas (LGA) in Cross River State, eight (four urban and four rural LGAs) were randomized into the intervention and control study arms. A multi-component intervention involving the training of traditional and religious leaders was implemented in the four intervention LGAs. Baseline, midline and endline surveys collected information on children aged 0-23 months. The effect of the intervention on outcomes including the proportion fully up-to-date with vaccination, timely vaccination for pentavalent and measles vaccines, and pentavalent 1-3 dropout rates were estimated using logistic regression models using random effects to account for the clustered data. RESULTS: A total of 2598 children at baseline, 2570 at midline, and 2550 at endline were included. The intervention was effective in increasing the proportion with at least one vaccine (OR 12.13 95% CI 6.03-24.41p<0.001). However, there was no evidence of an impact on the proportion of children up-to-date with vaccination (p = 0.69). It was effective in improving timeliness of Pentavalent 3 (OR 1.55; 95% CI: 1.14, 2.12; p = 0.005) and Measles (OR 2.81; 96% CI: 1.93-4.1; p<0.001) vaccination. The odds of completing Pentavalent vaccination increased (OR = 1.66 95% CI: 1.08,2.55). CONCLUSION: Informal training to enhance the traditional and religious leaders' knowledge of vaccination and their leadership role can empower them to be good influencers for childhood vaccination. They constitute untapped resources in the community to boost routine immunisation. Pan African Clinical Trial Registry (PACTR) PACTR202008784222254

BIOCHRONOLOGY OF SELECTED MAMMALS, MOLLUSCS AND OSTRACODS FROM THE MIDDLE PLIOCENE TO THE LATE PLEISTOCENE IN ITALY. THE STATE OF THE ART

The Authors have elaborated four range charts of mammalian (large and micro), molluscs and fresh-water and brackish ostracodes faunas, for the selected Plio-Pleistocene fossiliferous localities of the Italy. A new Mammal Age (Aurelian) correlatable to late Middle and Late Pleistocene has been defined. Inside this age two Faunal Units (Torre in Pietra and Vitinia) have been defined as characteristic for Early and Middle Aurelian, while no gisements have been chosen for the late Aurelian. Biochronological units are calibrated on magnetostratigraphic and isotopic scales and by radiometric datings.&nbsp;&nbsp; &nbsp

BIOCHRONOLOGY OF SELECTED MAMMALS, MOLLUSCS AND OSTRACODS FROM THE MIDDLE PLIOCENE TO THE LATE PLEISTOCENE IN ITALY. THE STATE OF THE ART

The Authors have elaborated four range charts of mammalian (large and micro), molluscs and fresh-water and brackish ostracodes faunas, for the selected Plio-Pleistocene fossiliferous localities of the Italy. A new Mammal Age (Aurelian) correlatable to late Middle and Late Pleistocene has been defined. Inside this age two Faunal Units (Torre in Pietra and Vitinia) have been defined as characteristic for Early and Middle Aurelian, while no gisements have been chosen for the late Aurelian. Biochronological units are calibrated on magnetostratigraphic and isotopic scales and by radiometric datings.&nbsp;&nbsp; &nbsp