Disasters in Nigeria: A Public Health Perspective

Background: Nigeria is the most populous black nation on earth with some fragile demographic, socio-economic and health indices. The country has been having its own share of both natural and man-made disasters. This paper discussed an overview of disasters and some socio-demographic characteristics of Nigeria, factors in vulnerability of disasters, public health impacts and issues in disaster management in Nigeria among others from a public health perspective and the way forward.Methods: The authors undertook full searches (September-November, 2012) of original research, reports and reviews using Medline, pubMed, Embase and World Health Organisation (WHO) database. Search words were disaster, disasters in Nigeria, and public health impacts. Part of the data used was personal communications and in-press publications.Results: The results revealed significant number of disasters in Nigeria, such as plane crashes, oil pipeline fire explosions, collapsed buildings, terrorist attacks, civil strife, and flood, among others. Some of the identified issues that hampered quick response and recovery included poor and ineffective search and rescue operations, poverty, poor public and community education on disaster management, among others.Conclusion: There is need for public and community education on disaster and its management, disaster preparedness, wellcoordinated and effective search and rescue operations, capacity building, tackling corruption and poverty reduction.Keywords: Disaster, Public Health, Public Education, Disaster Mitigation, Nigeri

Perception of Hazards Associated with Cooking Fuel in Building Indoor Environment

This study assessed perception of hazards from cooking fuels in building indoor environment. One hundred questionnaires were randomly administered to selected households in high density settlement of Zaria metropolis with 96% response rate received. Results showed that females are dominant (83%) users of cooking fuels, kerosene (48.1%) and firewood (29.2%) are common types of cooking fuel use by the households. Factors that determine the use of these fuels are cost (28.2%) and types of stove (19.8%). Awareness level of associated hazards is high (62.5%) and frequency of health problems associated with pollutants (39.6%) is alarming. Opening of windows (47.9%) and isolation of cooking area from living area (42.7%) were the common control measures adopted. It is recommended that public enlightenment on health issues relating to indoor air pollution should be emphasized, as well as implementing codes for control of pollution in the indoor environment

Social, economic and psychological burdens of sickle cell disease care among households of sufferers in a tertiary health facility in North Western Nigeria

The study assessed the social, economic and psychological burden of sickle cell disease (SCD) care among households of SCD patients attending sickle cell outpatient clinic in Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. Methods: It was a cross-sectional descriptive study conducted among 205 caregivers of SCD outpatients selected through systematic sampling. Data was collected using a structured interviewer-administered questionnaire, and analyzed using the IBM SPSS version 20.0 Results: The mean age of the SCD patients was 12.7±9.0 years and their mean duration since diagnosis was 10.9±8.7 years. In the last 12 months, 92 (44.9%) patients had been admitted at least once due to complications of SCD, 72 (35.1%) had been transfused with blood and 150 (73.1%) had experienced painful crises. Caring for SCD patients frequently reduces the amount of care that other household members were receiving 95 (46.3%), patient's illness frequently caused disagreement or quarrel among household members 150 (73.2%), and households experienced stigmatization by community members 33 (16.1%). Ninety-six (71.2%) of the households were experiencing catastrophic expenditure from providing medical care for the SCD patient. Conclusion: Households of SCD patients were experiencing various forms of psychological, social and economic burden. It is recommended that locally applicable methods of psychological, social and economic support be included in the routine care of SCD patients and their families

Factors influencing health seeking behaviour among residents of basawa community, sabon gari l.g.a. Kaduna state, Nigeria

The health of the citizenry is crucial to the growth and development of any nation. Nigeria is riddled with poor health indices ranging from maternal mortality to infant mortality rates. It has been established that health-seeking behaviour has a strong influence on health status, morbidity and mortality indices of a society. It also drives utilisation of health services and is affected by predisposing, enabling and need factors. This study assessed the factors influencing health-seeking behaviour among residents of Basawa community, Sabon Gari LGA, Kaduna State, Nigeria. Method: This was a descriptive cross-sectional study carried out in September 2017 among 125 residents of Basawa community selected by systematic sampling technique. Data was collected using asemi-structured interviewer-administered questionnaire and analysed with SPSS version 21. The results were presented as tables and charts among others. Level of statistical significance was set at p <0.05. Results: The mean age of the respondents was 42±10 years. Majority of the respondents were male (60.8%) and married (90.4%). About two-thirds of the respondents delayed for more than 24 hours before seeking healthcare. Long waiting time (55.2%), the attitude of health workers (22.4%) and the high cost of drugs (22.4%) were given as barriers to health care utilisation. High cost of services, type and severity of illness and attitude of health care workers are the main determinants of health-seeking behaviour. There was a statistically significant relationship between education, monthly income and delay in seeking health care. Conclusion: The study showed several factors that influence health care seeking behaviour. In view of the multifactorial determinants of health-care seeking behaviour, there is need for health workers to be trained and retrained to improve on their attitude, and the provision of community-based social health insurance scheme by the government among others

hospital waste management as a potential hazard in selected primary healthcare centres in zaria nigeria

The operations of health facilities generate waste; a common characteristic of hospitals and Primary Healthcare centres. However, improper handling of hospital waste constitutes potential risks to the environment and human health. Unfortunately, hospital waste management is not yet carried out with a satisfactory level of safety in many parts of the globe, especially in the underdeveloped world. This study was carried out with the aim of assessing hospital waste management practices among selected Primary Healthcare Centres (PHCs) in Zaria, Nigeria. A cross sectional descriptive study was carried out between October 2012 and March, 2013 using staff of the PHCs and an interviewer-administered questionnaire, checklist and participant observations. Majority of the staff of the PHCs were nurses (37%) and the knowledge score of all the staff was 5 out of 10 (50%). About 73% had training on hospital waste management 31% had reported injury by sharps. Also, 66% use protective hand gloves while doing their work. Wheel barrow was the commonest method of transporting waste and open burning was the final method of waste disposal by the PHCs. There is a need for safer means of waste disposal among the medical facilities visited. It was, therefore, recommended among others that funds should be made available to the PHCs. This is to ensure the acquisition of all facilities needed in hospital waste management and disposal. There should be training and re-training of health staff on current hospital waste management to meet global best practices. http://dx.doi.org/10.4314/njt.v33i2.1

Phenotypic covariance of longevity, immunity and stress resistance in the Caenorhabditis nematodes

Background \ud Ageing, immunity and stresstolerance are inherent characteristics of all organisms. In animals, these traits are regulated, at least in part, by forkhead transcription factors in response to upstream signals from the Insulin/Insulin– like growth factor signalling (IIS) pathway. In the nematode Caenorhabditis elegans, these phenotypes are molecularly linked such that activation of the forkhead transcription factor DAF-16 both extends lifespan and simultaneously increases immunity and stress resistance. It is known that lifespan varies significantly among the Caenorhabditis species but, although DAF-16 signalling is highly conserved, it is unclear whether this phenotypic linkage occurs in other species. Here we investigate this phenotypic covariance by comparing longevity, stress resistance and immunity in four \ud Caenorhabditis species. \ud \ud Methodology/Principal Findings \ud We show using phenotypic analysis of DAF-16 influenced phenotypes that among four closely related Caenorhabditis nematodes, the gonochoristic species (Caenorhabditis remanei and Caenorhabditis brenneri) have diverged \ud significantly with a longer lifespan, improved stress resistance and higher immunity than the hermaphroditic species (C. elegans and Caenorhabditis briggsae). Interestingly, we also observe significant differences in expression levels between the daf-16 homologues in these species using Real-Time PCR, which positively correlate with the observed phenotypes. Finally, we provide additional evidence in support of a role for DAF-16 in regulating phenotypic coupling by using a combination of wildtype isolates, constitutively active daf-16 mutants and bioinformatic analysis. \ud \ud Conclusions \ud The gonochoristic species display a significantly longer lifespan (p < 0.0001)and more robust immune and stress response (p<0.0001, thermal stress; p<0.01, heavy metal stress; p<0.0001, pathogenic stress) than the hermaphroditic species. Our data suggests that divergence in DAF-16 mediated phenotypes may underlie many of the differences observed between these four species of Caenorhabditis nematodes. These findings are further supported by the correlative higher daf-16 expression levels among the gonochoristic species and significantly higher lifespan, immunity and stress tolerance in the constitutively active daf-16 hermaphroditic mutants

Phenotypic covariance of Longevity, Immunity and Stress Resistance in the Caenorhabditis Nematodes

Background: Ageing, immunity and stresstolerance are inherent characteristics of all organisms. In animals, these traits are regulated, at least in part, by forkhead transcription factors in response to upstream signals from the Insulin/Insulin–like growth factor signalling (IIS) pathway. In the nematode Caenorhabditis elegans, these phenotypes are molecularly linked such that activation of the forkhead transcription factor DAF-16 both extends lifespan and simultaneously increases immunity and stress resistance. It is known that lifespan varies significantly among the Caenorhabditis species but, although DAF-16 signalling is highly conserved, it is unclear whether this phenotypic linkage occurs in other species. Here we investigate this phenotypic covariance by comparing longevity, stress resistance and immunity in four Caenorhabditis species. \ud \ud Methodology/Principal Findings: We show using phenotypic analysis of DAF-16 influenced phenotypes that among four closely related Caenorhabditis nematodes, the gonochoristic species (Caenorhabditis remanei and Caenorhabditis brenneri) have diverged significantly with a longer lifespan, improved stress resistance and higher immunity than the hermaphroditic species (C. elegans and Caenorhabditis briggsae). Interestingly, we also observe significant differences in expression levels between the daf-16 homologues in these species using Real-Time PCR, which positively correlate with the observed phenotypes. Finally, we provide additional evidence in support of a role for DAF-16 in regulating phenotypic coupling by using a combination of wildtype isolates, constitutively active daf-16 mutants and bioinformatic analysis. \ud \ud Conclusions: The gonochoristic species display a significantly longer lifespan (p<0.0001) and more robust immune and stress response (p<0.0001, thermal stress; p<0.01, heavy metal stress; p<0.0001, pathogenic stress) than the hermaphroditic species. Our data suggests that divergence in DAF-16 mediated phenotypes may underlie many of the differences observed between these four species of Caenorhabditis nematodes. These findings are further supported by the correlative higher daf-16 expression levels among the gonochoristic species and significantly higher lifespan, immunity and stress tolerance in the constitutively active daf-16 hermaphroditic mutants

The Effect of Organisational Factors in Motivating Healthcare Employees: A Systematic Review

Healthcare employee motivation is a key concept in the achievement of efficient,effective and good quality healthcare delivery. In this paper a systematic review of primary data from the UK, Europe, Africa and Asia was conducted to consolidate the available evidence on the effect of organisational factors on healthcare employee motivation. Because healthcare delivery is highly labour intensive, it must be acknowledged that human resources are extremely critical in the drive for healthcare organisations to deliver on their organisational goals. The organisational factors which were identified as having a great effect on healthcare employee motivation can be divided into financial and non-financial factors. Remuneration was identified as a strong extrinsic factor, while conducive working conditions, increased responsibilities and appreciation from the communities in which they serve were identified as strong intrinsic factors. Even though there is a cultural aspect to motivation, remuneration, managerial support and career advancement are core factors that affect all healthcare professionals irrespective of country. Many of the factors that were observed in the literature as affecting motivation can be addressed by an overhaul of the reward strategy of healthcare organisations

Hyperpolarized¹³C-Pyruvate Metabolism as a Surrogate for Tumor Grade and Poor Outcome in Renal Cell Carcinoma—A Proof of Principle Study

Differentiating aggressive clear cell renal cell carcinoma (ccRCC) from indolent lesions is challenging using conventional imaging. This work prospectively compared the metabolic imaging phenotype of renal tumors using carbon-13 MRI following injection of hyperpolarized [1-13C]pyruvate (HP-13C-MRI) and validated these findings with histopathology. Nine patients with treatment-naïve renal tumors (6 ccRCCs, 1 liposarcoma, 1 pheochromocytoma, 1 oncocytoma) underwent pre-operative HP-13C-MRI and conventional proton (1H) MRI. Multi-regional tissue samples were collected using patient-specific 3D-printed tumor molds for spatial registration between imaging and molecular analysis. The apparent exchange rate constant (kPL) between 13C-pyruvate and 13C-lactate was calculated. Immunohistochemistry for the pyruvate transporter (MCT1) from 44 multi-regional samples, as well as associations between MCT1 expression and outcome in the TCGA-KIRC dataset, were investigated. Increasing kPL in ccRCC was correlated with increasing overall tumor grade (ρ = 0.92, p = 0.009) and MCT1 expression (r = 0.89, p = 0.016), with similar results acquired from the multi-regional analysis. Conventional 1H-MRI parameters did not discriminate tumor grades. The correlation between MCT1 and ccRCC grade was confirmed within a TCGA dataset (p &lt; 0.001), where MCT1 expression was a predictor of overall and disease-free survival. In conclusion, metabolic imaging using HP-13C-MRI differentiates tumor aggressiveness in ccRCC and correlates with the expression of MCT1, a predictor of survival. HP-13C-MRI may non-invasively characterize metabolic phenotypes within renal cancer.</jats:p

Practices participating in a dental PBRN have substantial and advantageous diversity even though as a group they have much in common with dentists at large

<p>Abstract</p> <p>Background</p> <p>Practice-based research networks offer important opportunities to move recent advances into routine clinical practice. If their findings are not only generalizable to dental practices at large, but can also elucidate how practice characteristics are related to treatment outcome, their importance is even further elevated. Our objective was to determine whether we met a key objective for The Dental Practice-Based Research Network (DPBRN): to recruit a diverse range of practitioner-investigators interested in doing DPBRN studies.</p> <p>Methods</p> <p>DPBRN participants completed an enrollment questionnaire about their practices and themselves. To date, more than 1100 practitioners from the five participating regions have completed the questionnaire. The regions consist of: Alabama/Mississippi, Florida/Georgia, Minnesota, Permanente Dental Associates, and Scandinavia (Denmark, Norway, and Sweden). We tested the hypothesis that there are statistically significant differences in key characteristics among DPBRN practices, based on responses from dentists who participated in DPBRN's first network-wide study (n = 546).</p> <p>Results</p> <p>There were statistically significant, substantive regional differences among DPBRN-participating dentists, their practices, and their patient populations.</p> <p>Conclusion</p> <p>Although as a group, participants have much in common with practices at large; their substantial diversity offers important advantages, such as being able to evaluate how practice differences may affect treatment outcomes, while simultaneously offering generalizability to dentists at large. This should help foster knowledge transfer in both the research-to-practice and practice-to-research directions.</p