Oil and conflicts in the Niger Delta region, Nigeria: facing the facts

THE NIGER DELTA Region of Nigeria is the storehouse of Nigeria’s crude oil, which accounts for approximately 90% of the country’s revenue, providing more than 90% of total exports. Despite this, the people remain poor, marginalized and restive. Resort to conflicts has been taken as the only way of expressing grievances in oil-rich communities in the region. The conflict situation has been cause for alarm since 1999 with kidnapping of oil company workers, bombing of oil facilities and confrontation with state law enforcement agents, being common occurrences. These happenings have had serious implications for the economy. The paper reports on the results of a study employed interviews, stakeholder meetings and consulted news reports to assess issues central to the persistent conflicts in the region. The results indicated that both the government of Nigeria and the oil multinationals have failed to recognize communities in the Niger Delta as the third stakeholder in the oil industry The relationship has been characterized by unfavorable state policies, politicking’ and lack of standard practices. The study thus noted that the government of Nigeria has not approached the question of the Niger Delta in an open manner, and hence it recommends that stakeholder participation/partnership predicated on transparency is a key to the solution of the Niger Delta problem.KEYWORDS: Oil exploitation. stakeholder relationship. conflicts. Niger Delta. Nigeria, multinational

Inhaled Corticosteroids and the Occurrence of Oral Candidiasis:A Prescription Sequence Symmetry Analysis

<p>The primary aim of the study was to gain insight into the relative risk of clinically relevant oral candidiasis following inhaled corticosteroid (ICS) initiation over time. A secondary aim was to analyse the influence of patient characteristics and co-medication on the occurrence of this adverse effect.</p><p>Drug prescription data from 1994 to 2011 were retrieved from the IADB.nl database. To study the influence of ICS use on occurrence of oral candidiasis, a prescription symmetry analysis was used, including patients using medication for oral candidiasis up to 1 year before or after ICS initiation. The relative risk was calculated by dividing the number of patients receiving medication for oral candidiasis after ICS initiation by the number of patients receiving the same medication before ICS initiation. Sub-analyses were conducted to compare the relative risks at several time points after ICS initiation and to account for therapy persistence by only including chronic users of ICS. A multivariate logistic regression model was used to identify predictive factors.</p><p>A total of 52,279 incident users of ICS therapy were identified, of which 1,081 received medication for oral candidiasis up to 1 year before or after ICS initiation. A total of 701 patients received medication for oral candidiasis after ICS initiation, while 361 received these medications in the reversed sequence, resulting in a sequence ratio (SR) of 1.94 (95 % CI 1.71-2.21). In the first 3 months after ICS initiation, the SR was 2.72 (95 % CI 2.19-3.38) and then decreased to 1.47 (95 % CI 1.11-1.95) 9-12 months after ICS initiation. Predictive factors were higher daily dose of ICS and concomitant use of oral corticosteroids.</p><p>This study found a significant and clinically relevant increased number of patients receiving medication for oral candidiasis in the first year after therapy initiation with ICS. Relative risk is highest in the first 3 months, but remains increased up to at least 1 year after ICS initiation. This study stresses the need for patient education and inhalation instruction.</p>