REFLECTIVE PERSPECTIVE ON THE DEVELOPMENT OF THE COSMOSES IN THE INDIGENOUS PSYCHOTHERAPY MODEL, HARMONY RESTORATION THERAPY

African indigenous psychotherapy methods have largely been undocumented because almost everything an African does, including greeting, attending social rites and settling disputes, is psychotherapeutic. Hence, attempting to percolate habitual practices into coherent wholes to form an organized system of treatment procedures is arduous. This article examines an indigenous psychotherapy model, Harmony Restoration Theory and its therapy, the Harmony Restoration Therapy, and some of its applications. The Harmony Restoration Therapy is a treatment method of African origin based on the existential tradition of Africans.  The Harmony Restoration Therapy hinges on the fact that health or ill-health for an African depends on the individual’s level of harmony or disharmony with the components of their cosmos (world).  In Harmony Restoration Therapy, the individual’s cosmos is compartmentalised, the endocosmos, mesocosmos, and exocosmos representing the relationship between the individual and him/herself, their significant others and the higher beings/things that they revere. The article begins with a synopsis of the concepts and why restoring harmony in African clients is necessary. Major Concepts in Harmony Restoration Therapy were highlighted. The author’s reflective perspective on the development of the Endocosmos, Mesocosmos and Exocosmos were examined. The Concept of Cosmos Incorporation and the Concept of Cosmos Information Incorporation were discussed. The article concludes with an introduction to the process of measuring an individual’s level of harmony or disharmony with the Harmony – Disharmony (H-D) Scale.&nbsp

EXAMINING THE INDIGENOUS PSYCHOTHERAPY MODEL MESERON THERAPY AND SOME OF ITS THERAPEUTIC IMPLICATIONS

This article examines the indigenous psychotherapy model Meseron Therapy and chronicles some of its applications. The Meseron Therapy was developed by Professor Alfred Awaritefe in 1995. Meseron means “I refuse” in the Urhobo language. The therapy focuses on the power of the spoken word and how it is able to effectively change a person and a person’s condition by encouraging the person to think, say, and do things that will cause a change in the person’s condition. The origin of Meseron therapy was discussed, Meseron as a motivational theory and cognitive therapy was examined. The Practice of Meseron Therapy, the basic assumptions, aims and goals, therapeutic implications, and the techniques and tools of Meseron therapy were highlighted, with the therapeutic implications of Meseron Therapy further discussed. The article concluded with a call for clinical and counselling psychologists to integrate indigenous psychotherapy methods into their practice. Research endeavors and publications in indigenous psychotherapy methods were also encouraged

REFLECTIVE PERSPECTIVE ON THE DEVELOPMENT OF THE COSMOSES IN THE INDIGENOUS PSYCHOTHERAPY MODEL, HARMONY RESTORATION THERAPY

African indigenous psychotherapy methods have largely been undocumented because almost everything an African does, including greeting, attending social rites and settling disputes, is psychotherapeutic. Hence, attempting to percolate habitual practices into coherent wholes to form an organized system of treatment procedures is arduous. This article examines an indigenous psychotherapy model, Harmony Restoration Theory and its therapy, the Harmony Restoration Therapy, and some of its applications. The Harmony Restoration Therapy is a treatment method of African origin based on the existential tradition of Africans.  The Harmony Restoration Therapy hinges on the fact that health or ill-health for an African depends on the individual’s level of harmony or disharmony with the components of their cosmos (world).  In Harmony Restoration Therapy, the individual’s cosmos is compartmentalised, the endocosmos, mesocosmos, and exocosmos representing the relationship between the individual and him/herself, their significant others and the higher beings/things that they revere. The article begins with a synopsis of the concepts and why restoring harmony in African clients is necessary. Major Concepts in Harmony Restoration Therapy were highlighted. The author’s reflective perspective on the development of the Endocosmos, Mesocosmos and Exocosmos were examined. The Concept of Cosmos Incorporation and the Concept of Cosmos Information Incorporation were discussed. The article concludes with an introduction to the process of measuring an individual’s level of harmony or disharmony with the Harmony – Disharmony (H-D) Scale.&nbsp

Harmony-Disharmony Scale: Development and Initial Factorial Validation

The Harmony Restoration Theory (HRTheory) propounded by Ebigbo (1995, 2001a) is an African psychodiagnostic theory of health. It is a theory of harmony-disharmony, psychopathology, psychotherapy and a useful attempt to account for the aetiology of psychopathology in the African. Central to the theory is the notion that psychopathology arises from the disharmony in the cosmos of an individual. The objective of this study was to develop and validate a measuring scale, harmonydisharmony scale (HD Scale), for determining the areas of the cosmos which an individual needs harmony restoration before the initiation of harmony restoration therapy. Method - Based on the harmony restoration theory of health and Harmony restoration therapy, 120 items with 40 items per subscale were generated focusing on the three aspects of an individual‟s cosmos viz: endocosmos, mesocosmos and exocosmos needing harmony restoration. The outcome, a 120 likert-type scale, was administered to a cross-section of University undergraduates. The 258 responses obtained from the respondents (124 males and 128 females) aged 16 to 29 years (21.02 ± 4.083, mean ± s.d.) were subjected to factor analysis. Results - The data was examined to assess the suitability for factor analysis and was found suitable with good R-matrix, Bartlett‟s test of Sphericity and Kaiser-Meyer-Olkin (KMO) sample sufficiency. A 3-factor model emerged from the result of the factor analysis with 59 pure and valid items loading on factor 1, 23 items loading on factor 2 and 16 items loading on factor 3. The factors retained their original theoretical names viz: endocosmos, mesocosmos and exocosmos. Conclusion - The finding of this study is consistent with the harmony restoration theory on the African personality consisting of three components. Suggestions on ways to advance this area of research were made and a short version of the harmonydisharmony scale was proposed

Parental Marital Status as Predictor of Undergraduates’ Mental Health Status

Parenting plays a major role in the development and transformation of young adults. However, in recent years, the aptness of parents has been greatly reduced. Considering the increase of broken marriages and single parenting in Nigeria, young adults may be at risk of depreciating mental health due to unexpected emotional challenges with respect to the immediate family. This cross-sectional survey examined the mental health status of undergraduates as a function of parent’s marital status. One hundred and fifty-six undergraduates selected from three higher institutions responded to the Awaritefe Psychological Index (API), measuring mental health status. Two hypotheses were tested at p=0.05 level of significance and the results revealed that parent’s marital status did not significantly predict undergraduates’ mental health status (β=-0.076, t=0.951, p>0.05); however, the type of higher institution significantly predicted undergraduates’ mental health status (β=0.159, t= -1.985, p<0.05). Since this study revealed that the institution of learning is an effective predictor of undergraduates’ mental health status, it is recommended that institutions of learning should be made more academically conducive for undergraduates to foster better mental health

Renal cell carcinoma in a semi-urban population of south-western Nigeria

Objective: To describe the demographic features, treatment challenges and  prognosis of renal cell carcinoma (RCC) in a semi-urban population of south-western NigeriaDesign: A retrospective review of RCC managed between January 2007 and  December 2014Setting: Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife,  southwestern NigeriaSubjects: Fifty-one patients with histologically confirmed RCC Interventions: Radical nephrectomy, ImmunotherapyMain outcome measures: Surgical outcomesResults: A total of 51 cases were reviewed, representing 46.8/100,000 of all new  patients. Age range was 21 to 83 years, with peak in third decade and male to female ratio of 1:1.5. Identified risk factors were systemic hypertension (15.7%), smoking  (11.8%) and obesity (3.9%). Triad of haematuria, loin pain and loin mass was found in 13.7% while 5.9% were discovered  incidentally. The right and left kidneys were involved in 41.2% and 58.8% respectively. Radical nephrectomy was the most  common procedure done (78.4%). Surgical complications included  excessive primary haemorrhage (8.5%), surgical site  infection (6.4%) and duodenal injury (2.1%) while mortality was (2.1%). Adjuvant immunotherapy with  sunitinib/sorafenib was given in 7.8% of patients. The histologic types were clear cell (60.8%), chromophobe (17.6%), papillary (13.7%), sarcomatoid (3.9%), mixed (1.9%) and multilocular cystic RCC (1.9%). Clear cell variant were low grade with good prognosis. Poor prognostic factors were sarcomatoid histology and late presentationConclusion: RCC is more common in females mainly of the younger age group in our environment. Radical nephrectomy remains the mainstay of management, including in advanced cases

Trends, Determinants and Health Risks of Adolescent Fatherhood in Sub-Saharan Africa

BACKGROUND: This study examined the trends, determinants and health risks of adolescent fatherhood in three selected African countries where adolescent-girl pregnancy/motherhood are decried but with permissive male sexual latitude.METHODS: Adolescent male data were extracted from the malerecodedatasets of Demographic Health Survey (2000-2014) for Nigeria, Ethiopia and Zambia. The surveys were grouped into 3-Waves: (2000-2004); (2005-2008) and (2011-2014). The study employed descriptive and binary logistics that tested the log-odds of adolescent fatherhood with respect to selected sexual behaviour indices, and individual and shared demographic variables.RESULTS: The results revealed that the number of lifetimesexual-partners among the boys is ≥2. The likelihood of adolescent fatherhood is positively associated with increasing age at first cohabitation and multiple sexual partnerships (≥2) having OR=1.673 and OR=1.769 in 2005/2008 and 2011/2014 respectively. Adolescents who had attained tertiary education, and engaged in professional and skilled jobs were 0.313, 0.213 and 0.403 times (respectively) less likely to have ever-fathered a child. The positive association between rural place of residence and adolescent fatherhood in the past shifted to urban residents in 2011/2014.CONCLUSION: The study concludes that early sexual activities and cohabitation are common among male adolescents among the countries of study. The authors recommend discouragement of boy-girl cohabitation, increasing access to higher education and job opportunities in order to stem boy-fatherhood incidence in the study locations and, by extension, other countries in sub-Saharan Africa.KEYWORDS: Adolescent fatherhood, sexual behaviour, trends, determinants, health risks, lifetime-sexual-partner

Unusual presentation of advanced prostate cancer in a black population of South-Western Nigeria

There are growing concerns on the varying pattern of advanced prostate cancer (PCa) presentation across the world. We report some of the unusual presentations of PCa at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, South-Western Nigeria. A review of all patients with histologically confirmed PCa who had unusual presentations between January 2014 and December 2015 was done. Unusual presentation was defined as an atypical feature in the absence of lower urinary tract symptoms (LUTS), with the diagnosis of PCa only suspected after abnormal digital rectal examination (DRE) and/or elevated prostate specific antigen (PSA) assay. Thirteen patients had an unusual presentation in OAUTHC during the study period. Five (38.5%) had left supraclavicular swellings while four (30.8%) had haematochyzia and tenesmus. Other unusual presentations include large bowel obstruction requiring emergency colostomy (2;15.4%) and a scalp mass (1;7.7%). All patients had appropriate treatment for stage of CaP and are being followed up in the out-patient clinic. The change in presentations of PCa may suggest the need for DRE and serum PSA assay among all middle-aged and elderly men presenting at health facilities. Large scale studies on PCa across different population groups may also help at identifying related clinical, demographic and epidemiological factors as well as possible validation of some of these unusual presentations

TRENDS, DRIVERS AND HEALTH RISKS OF ADOLESCENT FATHERHOOD IN SUB-SAHARAN AFRICA

The study examined the trends, determinants and health risks of adolescent fatherhood in countries where adolescent-girl pregnancy/motherhood are decried but with permissive male sexual latitude. Male-recode datasets of Demographic Health Survey (2000-2014) for Nigeria, Ethiopia and Zambia were used. The surveys were grouped into 3-Waves: Wave 1 (2000 and 2004); Wave 2 (2005 to 2009) and waves 3 (2010 to 2014). Ethiopia data consisted of 2000, 2005 and 2011 datasets; Nigeria‘s datasets included 2003, 2008 and 2013 while Zambia set of data featured 2002, 2007 and 2014. Wave-1 consists of 2000, 2002 and 2003 datasets; Wave-2 has 2005, 2007 and 2008 datasets while 2011, 2013 and 2014 data were used for Wave- 3. These files in each wave were grouped together and then combined into a single file. All data were weighted to ensure representation and analyses were split by countries and by waves to show the trends across .the years and for different countries. The study employed univariate, bivariate analysis and binary logistics that tested the log-odds of adolescent fatherhood with respect to selected sexual behaviour indices, individual and shared demographic variables. The results, among others, indicated that more than one out of every five adolescents has had two or more sexual partners. The likelihood of adolescent fatherhood is inversely related to condom use, but positively associated with increasing age at first cohabitation and higher number of multiple sexual partnerships (≥ 2) at odd-ratio of 1.673 and 1.769 in 2005/2009 and 2010/2014, respectively. Adolescents that have attained primary and tertiary education, and who are professionals and skilled labourers were 0.379, 0.313, 0.213 and 0.403 times (respectively) less likely to father a child as adolescent. The positive association between rural place of residence and adolescent fatherhood in the past shifted to urban residents in 2010/2014. The study concludes that enlightenment on the use of condom and testing for STIs/HIV and AIDS should be intensified. Increasing access to higher formal education including job opportunities is crucial to interventions towards boys’ vulnerability to fatherhood. The authors recommend support from policy-takers, governments and other stakeholders towards male adolescent access to higher education, skills acquisition, and campaigns against boys and girls cohabitations in the study locations and by extension sub-Saharan Africa in general

Histomorphological pattern of urologic malignancies in Ile-Ife, south-western Nigeria

Introduction: The last decade witnessed a remarkable rise in the prevalence of several malignant diseases in Nigeria. Whether&nbsp; Urologic malignancies (UM) have followed the same trend remains to be studied. The pattern of UM diagnosed in a Nigerian tertiary hospital is hereby presented. Our aim was to determine the pattern and prevalence of histologically diagnosed UM in Obafemi Awolowo University Teaching Hospitals Complex. Ile-Ife, Nigeria.Materials and Methods: A 10-year retrospective review of all patients diagnosed with UM was carried out between January 2005 and December 2014. Data was obtained from the patients’ case files and the Ife-Ijesha Cancer registry. Information obtained included demographic characteristics, site of origin and histology. Data was analysed with Statistical package for Social sciences (SPSS) Version 20.Results: A total of 4675 malignancies were histologically confirmed during the study period. UM accounted for 420 (8.9%) of totalmalignancies. Prostate cancer was the commonest UM with 315 (75%) cases. Others include renal tumours 62(14.8%), bladder&nbsp; tumours 29 (6.9%), testicular tumours 13(3.1%) and scrotal tumour 1(0.2%). UM were commoner in males (348, 88.8%) than females (47, 11.2%) and accounted for 13.8% and 2.18% of all tumours in males and females respectively.Conclusion: This study revealed a rising prevalence of UM most especially Prostate and Renal Cancers among other malignancies in Ile-Ife. Keywords: Pattern, Urologic malignancies, Ile-Ife