Cognitive and social predictors of generalized anxiety disorder symptoms among fresh undergraduates in Uganda

Background: Generalized anxiety disorder (GAD) is common. It accounts for about one out of four anxiety related clinic consultations. The prevalence of this common disorder and the associated factors in Ugandan students are unknown. The objectives of this study were to determine the prevalence of GAD symptoms, and to evaluate its association with intolerance of uncertainty and parental attachment among fresh undergraduates in Uganda.Methods: The research utilized a cross-sectional approach. Non-clinical participants from 8 colleges (mean age 21.24; 59.7% males, 40.3% females) completed self-report inventories measuring intolerance of uncertainty, parental attachment and GAD symptoms. Pearson’s correlations were run to test relationship between the independent and dependent variables, a stepwise regression analysis was used to identify predictors of GAD, while controlling for age.Results: A total of 401 students were involved in the study. The prevalence of GAD symptoms was 28.9%. There was a significant positive relationship between GAD symptoms and intolerance of uncertainty (r = 0.30, p = 0.001) and with parental attachment (r = 0.21, p = 0.001). Intolerance of uncertainty and parental attachment, predicted GAD symptoms (r = 0.30, 95% CI = 0.30 to 6.16, p = 0.001; r = 0.21, 95% CI = 0.21 to 4.19, p = 0.001, respectively).Conclusion:  The present research suggests that GAD symptoms are prevalent among fresh undergraduates and are associated with both intolerances of uncertainty and parental attachment. Psychological interventions for undergraduate students may be needed to target these factors

Dopamine Transporter Imaging in Psychogenic Parkinsonism and Neurodegenerative Parkinsonism with Psychogenic Overlay: A Report of Three Cases

Background: Differentiating psychogenic parkinsonism from neurodegenerative Parkinson's disease (PD) with psychogenic features is a diagnostic challenge. Case report: We report a detailed longitudinal clinical description of three cases presenting with suspected psychogenic parkinsonism. Dopamine transporter single-photon emission computed tomography (DAT-SPECT) was used as a supplemental diagnostic study and influenced clinical management. Discussion: DAT-SPECT quantified the integrity of the striatal dopaminergic system in these cases of clinically uncertain parkinsonism and supported clinical decision-making

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Dopamine Transporter Imaging in Psychogenic Parkinsonism and Neurodegenerative Parkinsonism with Psychogenic Overlay: A Report of Three Cases

Background:&nbsp;Differentiating psychogenic parkinsonism from neurodegenerative Parkinson's disease (PD) with psychogenic features is a diagnostic challenge.Case report:&nbsp;We report a detailed longitudinal clinical description of three cases presenting with suspected psychogenic parkinsonism. Dopamine transporter single-photon emission computed tomography (DAT-SPECT) was used as a supplemental diagnostic study and influenced clinical management.Discussion:&nbsp;DAT-SPECT quantified the integrity of the striatal dopaminergic system in these cases of clinically uncertain parkinsonism and supported clinical decision-making.<br /

Trends in contraceptive use among female adolescents in Nigeria: Evidence from the Nigeria Demographic and Health Survey

Available evidence indicates that only 2.1 percent and 1.2 percent of married (or in union) adolescents in Nigeria are using any method and modern method of contraceptives respectively. This has contributed to the estimated 1.2 million induced abortions done annually of which 60 percent were unsafe. The study examined data from the 2013 and 2018 Nigeria Demographic and Health Survey for trend on the knowledge and use of contraceptives by all women, currently married and sexually active unmarried women aged 15-19 years in between surveys. There was an increase of 144% (p&lt;0.05) in Family Planning (FP) discussion during health facility visit, 50% increase in FP utilization rate (p&lt;0.05), 97% increase in FP demand satisfied by modern methods (p&lt;0.05) and 7% reduction in total unmet need (p&gt;0.05) among currently married women 15-19 years. It also showed a 50% (p&lt;0.05) and 86% (p&lt;0.05) reduction in the current use of contraceptives and unmet need among sexually active unmarried women 15-19 years, respectively. None of the adolescents adopted Long-acting methods (LAM), Intrauterine device (IUD), and female sterilization contraceptive methods. We recommend an inclusive and youth-friendly, client-centered contraceptive services and information for adolescents notwithstanding their marital status. (Afr J Reprod Health 2021; 25[5]: 61-68)

Data from: Attitude and subjective well being of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria

Introduction: Attitude and subjective well-being are important factors in mothers accepting or rejecting Oral Polio Vaccine (OPV) supplemental immunization. The purpose of the study was to determine the role of mothers’ attitude and subjective wellbeing on non-compliance to OPV supplemental immunization in Northern Nigeria. Methods: The study utilized a cross-sectional design to assess attitude and subjective well-being of mothers using previously validated VACSATC (Vaccine Safety, Attitudes, Training and Communication-10 items) & SUBI (Subjective Well-being Inventory-40 items) measures. A total of 396 participants (equal number of non-compliant and compliant mothers) from 94 non-compliant settlements were interviewed, after informed consent. T-test was run to assess difference in mean scores between the non-compliant and compliant mothers on VACSATC and SUBI measures. Results: The research showed a significant difference in mean scores between the non-compliant and compliant groups on VACSATC measure of mothers’ attitude (M=18.9 non-compliant, compared to 26.5 compliant; p 0.05). Conclusion: The research has shown that negative attitude is more commonly present in non-compliant mothers and may be a factor in vaccine refusal in Northern Nigeria

Data from: Attitude and subjective well being of non-compliant mothers to childhood oral polio vaccine supplemental immunization in Northern Nigeria

Introduction: Attitude and subjective well-being are important factors in mothers accepting or rejecting Oral Polio Vaccine (OPV) supplemental immunization. The purpose of the study was to determine the role of mothers’ attitude and subjective wellbeing on non-compliance to OPV supplemental immunization in Northern Nigeria. Methods: The study utilized a cross-sectional design to assess attitude and subjective well-being of mothers using previously validated VACSATC (Vaccine Safety, Attitudes, Training and Communication-10 items) & SUBI (Subjective Well-being Inventory-40 items) measures. A total of 396 participants (equal number of non-compliant and compliant mothers) from 94 non-compliant settlements were interviewed, after informed consent. T-test was run to assess difference in mean scores between the non-compliant and compliant mothers on VACSATC and SUBI measures. Results: The research showed a significant difference in mean scores between the non-compliant and compliant groups on VACSATC measure of mothers’ attitude (M=18.9 non-compliant, compared to 26.5 compliant; p 0.05). Conclusion: The research has shown that negative attitude is more commonly present in non-compliant mothers and may be a factor in vaccine refusal in Northern Nigeria

Environmental, economic and socio-cultural risk factors of recurrent seasonal epidemics of cerebrospinal meningitis in Kebbi state, northwestern Nigeria: a qualitative approach

Abstract Background Kebbi State remains the epicentre of the seasonal epidemic meningitis in northwestern Nigeria despite interventions. In this setting, no previous study has been conducted to understand the risk factors of the recurrent meningitis epidemics using qualitative approach. Consequently, this study intends to explore and better understand the environmental, economic and socio-cultural factors of recurrent seasonal epidemic meninigitis using a qualitative approach. Methods We conducted in-depth interview (40 IDIs) and focus group discussions (6 FGDs) in two local government areas (LGAs) in Kebbi State, Northwestern Nigeria to understand the environmental, economic and socio-cultural factors of recurrent meningitis outbreaks. Routine surveillance data were used to guide the selection of settlements, wards and local government areas based on the frequency of re-occurrences and magnitude of the outbreaks. Results The discussions revealed certain elements capable of potentiating the recurrence of seasonal meningitis epidemics. These are environmental issues, such as poorly-designed built environment, crowded sleeping and poorly ventilated rooms, dry and dusty weather condition. Other elements were economic challenges, such as poor household living conditions, neighbourhood deprivation, and socio-cultural elements, such as poor healthcare seeking behaviour, social mixing patterns, inadequate vaccination and vaccine hesitancy. Conclusion As suggested by participants, there are potential environmental, socio-cultural and economic factors in the study area that might have been driving recurrent epidemics of cerebrospinal meningitis. In a bid to addressing this perennial challenge, governments at various levels supported by health development partners such as the World Health Organisation (WHO), United Nation Habitat, and United National Development Programme can use the findings of this study to design policies and programmes targeting these factors towards complementing other preventive and control strategies