CLIMATE CHANGE VARIABILITY AND ASSOCIATED HEALTH EFFECTS AMONG FARMING HOUSEHOLDS IN ONDO STATE, NIGERIA

Objectives: The study examined climate change variability and associated health effects among farming households in Ondo State, Nigeria. It specifically described the socioeconomic characteristics of the farming households, identified the health issues experienced as a result of climate change, and analyzed the determinants of health effect of climate change and other socioeconomic variables among farming households in the study area. Methods: One hundred and twenty respondents selected through multistage sampling technique were used for the study. Data were collected with the aid of questionnaire and analyzed using descriptive and logit regression model. Results: Majority (92.9%) of the respondents were male, married (82.1%) with a mean household size of six people and a mean age of 49 years. Headache (95.5%), dizziness (95%), malaria (92%), body weakness (91.1%), cough (81.3%), typhoid fever (67.9%), skin rashes (58%), and rheumatic pain (48.2%) were the major health problems experienced by the farming households as a result of climate change in the study area. The significant variables determining the health effects of climate change among farming households in the study area were temperature (p<0.01), relative humidity (p<0.01), rainfall (p<0.01), sunshine (p<0.01), pressure (p<0.10), sex (p<0.10), marital status (p<0.01), household size (p<0.10), farming experience (p<0.01), and income (p<0.05). Conclusion: The health and well-being of the farming households were compromised by the vagaries in climatic condition in the study area. Hence, agricultural extension workers should be empowered to accommodate health education and preparedness measures that take into account, differences in the level of exposure, perceptivity, and acclimation capacity of different households may help to alleviate health effects of climate change on farming households in the study area

Long stay patients in a psychiatric hospital in Lagos, Nigeria

Objective: In the face of recently introduced government health reform and the dwindling number of available beds for acutely ill patients, a cross sectional study was carried out on long-stay patients at the 100 years old psychiatric hospital Yaba, Lagos, Nigeria with a view to discharging most of them. Method: Necessary consent was obtained from the Hospital Research and Ethical Committee. All the long-stay patients were evaluated with a specially designed proforma to elicit socio-demographic, clinical and long-stay variables. Further more, each of them had clinical assessment to make diagnosis in accordance with ICD - 10 and finally, the subjects were also assessed with the Brief Psychiatric Rating Scale (BPRS). Results: Fifty-one (51) subjects; that is, occupying 10.7% of the hospital functional beds fulfilled the criteria of long-stay. They included 36 (70.6%) males and 15(24.4%) females. The mean age was 47.3±16.5 years with age range of 18-92 years. The average length of stay was 11.4±15.0 years and range of 0.5 to 57 years; with significant gender difference (males higher than females) (t =3.51,

New research directions on disparities in obesity and type 2 diabetes

Obesity and type 2 diabetes disproportionately impact U.S. racial and ethnic minority communities and lowâ income populations. Improvements in implementing efficacious interventions to reduce the incidence of type 2 diabetes are underway (i.e., the National Diabetes Prevention Program), but challenges in effectively scalingâ up successful interventions and reaching atâ risk populations remain. In October 2017, the National Institutes of Health convened a workshop to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases. Common features of guiding frameworks to understand and address disparities and promote health equity were described. Promising research directions were identified in numerous areas, including study design, methodology, and core metrics; program implementation and scalability; the integration of medical care and social services; strategies to enhance patient empowerment; and understanding and addressing the impact of psychosocial stress on disease onset and progression in addition to factors that support resiliency and health.This report discusses a workshop convened by the National Institutes of Health to understand how to (1) address socioeconomic and other environmental conditions that perpetuate disparities in the burden of obesity and type 2 diabetes; (2) design effective prevention and treatment strategies that are accessible, feasible, culturally relevant, and acceptable to diverse population groups; and (3) achieve sustainable health improvement approaches in communities with the greatest burden of these diseases.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/154507/1/nyas14270_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/154507/2/nyas14270.pd

Clinical applications of cardiac CT angiography

ECG-gated multislice CT provides a cost-effective, non-invasive technology for evaluation of the coronary arteries, as well as for additional clinical applications, which require morphological assessment of the heart and adjacent structures with simultaneous evaluation of the coronary circulation

Comparative and Joint Analysis of Two Metagenomic Datasets from a Biogas Fermenter Obtained by 454-Pyrosequencing

Biogas production from renewable resources is attracting increased attention as an alternative energy source due to the limited availability of traditional fossil fuels. Many countries are promoting the use of alternative energy sources for sustainable energy production. In this study, a metagenome from a production-scale biogas fermenter was analysed employing Roche's GS FLX Titanium technology and compared to a previous dataset obtained from the same community DNA sample that was sequenced on the GS FLX platform. Taxonomic profiling based on 16S rRNA-specific sequences and an Environmental Gene Tag (EGT) analysis employing CARMA demonstrated that both approaches benefit from the longer read lengths obtained on the Titanium platform. Results confirmed Clostridia as the most prevalent taxonomic class, whereas species of the order Methanomicrobiales are dominant among methanogenic Archaea. However, the analyses also identified additional taxa that were missed by the previous study, including members of the genera Streptococcus, Acetivibrio, Garciella, Tissierella, and Gelria, which might also play a role in the fermentation process leading to the formation of methane. Taking advantage of the CARMA feature to correlate taxonomic information of sequences with their assigned functions, it appeared that Firmicutes, followed by Bacteroidetes and Proteobacteria, dominate within the functional context of polysaccharide degradation whereas Methanomicrobiales represent the most abundant taxonomic group responsible for methane production. Clostridia is the most important class involved in the reductive CoA pathway (Wood-Ljungdahl pathway) that is characteristic for acetogenesis. Based on binning of 16S rRNA-specific sequences allocated to the dominant genus Methanoculleus, it could be shown that this genus is represented by several different species. Phylogenetic analysis of these sequences placed them in close proximity to the hydrogenotrophic methanogen Methanoculleus bourgensis. While rarefaction analyses still indicate incomplete coverage, examination of the GS FLX Titanium dataset resulted in the identification of additional genera and functional elements, providing a far more complete coverage of the community involved in anaerobic fermentative pathways leading to methane formation

Measuring Health Utilities in Children and Adolescents: A Systematic Review of the Literature.

BACKGROUND: The objective of this review was to evaluate the use of all direct and indirect methods used to estimate health utilities in both children and adolescents. Utilities measured pre- and post-intervention are combined with the time over which health states are experienced to calculate quality-adjusted life years (QALYs). Cost-utility analyses (CUAs) estimate the cost-effectiveness of health technologies based on their costs and benefits using QALYs as a measure of benefit. The accurate measurement of QALYs is dependent on using appropriate methods to elicit health utilities. OBJECTIVE: We sought studies that measured health utilities directly from patients or their proxies. We did not exclude those studies that also included adults in the analysis, but excluded those studies focused only on adults. METHODS AND FINDINGS: We evaluated 90 studies from a total of 1,780 selected from the databases. 47 (52%) studies were CUAs incorporated into randomised clinical trials; 23 (26%) were health-state utility assessments; 8 (9%) validated methods and 12 (13%) compared existing or new methods. 22 unique direct or indirect calculation methods were used a total of 137 times. Direct calculation through standard gamble, time trade-off and visual analogue scale was used 32 times. The EuroQol EQ-5D was the most frequently-used single method, selected for 41 studies. 15 of the methods used were generic methods and the remaining 7 were disease-specific. 48 of the 90 studies (53%) used some form of proxy, with 26 (29%) using proxies exclusively to estimate health utilities. CONCLUSIONS: Several child- and adolescent-specific methods are still being developed and validated, leaving many studies using methods that have not been designed or validated for use in children or adolescents. Several studies failed to justify using proxy respondents rather than administering the methods directly to the patients. Only two studies examined missing responses to the methods administered with respect to the patients' ages

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Multifaceted highly targeted sequential multidrug treatment of early ambulatory high-risk SARS-CoV-2 infection (COVID-19)

The SARS-CoV-2 virus spreading across the world has led to surges of COVID-19 illness, hospitalizations, and death. The complex and multifaceted pathophysiology of life-threatening COVID-19 illness including viral mediated organ damage, cytokine storm, and thrombosis warrants early interventions to address all components of the devastating illness. In countries where therapeutic nihilism is prevalent, patients endure escalating symptoms and without early treatment can succumb to delayed in-hospital care and death. Prompt early initiation of sequenced multidrug therapy (SMDT) is a widely and currently available solution to stem the tide of hospitalizations and death. A multipronged therapeutic approach includes 1) adjuvant nutraceuticals, 2) combination intracellular anti-infective therapy, 3) inhaled/oral corticosteroids, 4) antiplatelet agents/anticoagulants, 5) supportive care including supplemental oxygen, monitoring, and telemedicine. Randomized trials of individual, novel oral therapies have not delivered tools for physicians to combat the pandemic in practice. No single therapeutic option thus far has been entirely effective and therefore a combination is required at this time. An urgent immediate pivot from single drug to SMDT regimens should be employed as a critical strategy to deal with the large numbers of acute COVID-19 patients with the aim of reducing the intensity and duration of symptoms and avoiding hospitalization and death

Psychological interventions for coronary heart disease

A meta-analysis was conducted on 35 trials involving 10,703 individuals who had experienced a myocardial infarction and were randomised to an intervention involving some form of psychological therapy. Ten of these studies involved individuals with confirmed psychiatric diagnoses. Moderate quality evidence found no reduction of risk for total mortality or revascularisation procedures in comparison to usual care. Low quality evidence found no risk reduction for non-fatal MI although there was a 21% reduction in cardiac mortality. There was also some evidence of benefit on measures of psychological morbidity including anxiety, depression, and stress. It is concluded that psychological interventions may reduce cardiac mortality, although stronger evidence is required before this can be definitively concluded. It is also not clear who benefits most from psychological interventions

Community-oriented services in a psychiatric hospital. Effort to reduce stigmatization

Mental illnesses are highly stigmatized worldwide;in Nigeria, the psychiatric institutions and the mental health personnel are additionally stigmatized. From its inception as an asylum about a century ago, Psychiatric Hospital, Yaba Lagos has had its own share of stigmatization. For instance the observed fear of the citizenry to enter into the hospital premises, as well as its being derogatorily labeled as “Ogba were” (lunatic asylum) and “Yaba apa osi” (Yaba to the left side). Consequently, in the year 2000 the hospital stepped up its efforts on destigmatization through public enlightenment programmes and provision of commercial /social as well as general health care services in the institution that would bring or attract the citizenry to its facilities We carried out an audit study of the utilization of general health care services provided within the hospital partly aimed at attracting the citizenry to the hospital premises such as Harvey Road Community Clinic (HRCC): a general health care practice and Electroencephalograph(EEG)unit. Furthermore, the statistics of patients\' flow to the hospital 5 years before the year 2000 (when destigmatization programme was reorganized in the hospital) and five years after was done. Necessary consent was obtained from the Research and Ethical Committee of the hospital to carry out the study. The records of the patients\' flow into the hospital for the period of 1995 to 2005 were obtained from the Medical Records department. Furthermore, the necessary records of services utilisation were also retrieved from the HRCC and EEG units; and an audit evaluation was carried out on the obtained records. Observation of services rendered in these units (HRCC and EEG) was also carried out by three recruited research assistants. In the first year of the EEG unit in the hospital, 560 patients had EEG recording done in the centre; 44% of them were from outside the institution. The figure rose to 1326 patients in the fifth year, with 57.7% from outside the institution. Similarly, for HRCC, the number of patients\' attendances in the clinic rose from 3033 in 2001 (91.7% hospital staff attendances and 8.3% attendances from the community) to 5013 in 2005 (76.0% hospital staff attendances and 24.0% from the community). For psychiatrically ill patients, the total number seen in the facility rose from 23488 in 1995 (5 years before the reorganization of the destigmatization programme and the establishment of general healthcare services) to 40513 in 2005 but with a peak of 41116 in the year 2003. Although expediency (especially for EEG) may partly explain the citizenry\'s patronisation of the services provided in the study centre; it is concluded that the subjects, especially the non-psychiatrically ill ones would most probably disregard perceived psychiatric stigma and not mind to utilise the general health services provided within the premises of the psychiatric facility when the need arose. Nigerian Journal of Psychiatry Vol. 5 (1) 2007: pp. 19-2