APOE E4 is associated with impaired self-declared cognition but not disease risk or age of onset in Nigerians with Parkinson's disease

The relationship between APOE polymorphisms and Parkinson's disease (PD) in black Africans has not been previously investigated. We evaluated the association between APOE polymorphic variability and self-declared cognition in 1100 Nigerians with PD and 1097 age-matched healthy controls. Cognition in PD was assessed using the single item cognition question (item 1.1) of the MDS-UPDRS. APOE genotype and allele frequencies did not differ between PD and controls (p > 0.05). No allelic or genotypic association was observed between APOE and age at onset of PD. In PD, APOE ε4/ε4 conferred a two-fold risk of cognitive impairment compared to one or no ε4 (HR: 2.09 (95% CI: 1.13-3.89; p = 0.02)), while APOE ε2 was associated with modest protection against cognitive impairment (HR: 0.41 (95% CI 0.19-0.99, p = 0.02)). Of 773 PD with motor phenotype and APOE characterized, tremor-dominant (TD) phenotype predominated significantly in ε2 carriers (87/135, 64.4%) compared to 22.2% in persons with postural instability/gait difficulty (PIGD) (30/135) and 13.3% in indeterminate (ID) (18/135, 13.3%) (p = 0.037). Although the frequency of the TD phenotype was highest in homozygous ε2 carriers (85.7%), the distribution of motor phenotypes across the six genotypes did not differ significantly (p = 0.18). Altogether, our findings support previous studies in other ethnicities, implying a role for APOE ε4 and ε2 as risk and protective factors, respectively, for cognitive impairment in PD

Stigmatizing attitude towards mental illness, disabilities, emotional and behavioural disorders, among healthcare students in a Tropical University College of Health Sciences

BACKGROUND: Stigma toward mental illness (MI), physical disability (DA), and emotional/behavioral disorders (EBD) has been identified as a form of violence and a cause of nontake-up of help by people in need. Stigmatization can aggravate an individual's feeling of rejection and incompetence and can be detrimental to treatment-seeking and adherence behaviors. This study evaluated the attitude of healthcare students toward MI, DA, and EBDs. MATERIALS AND METHODS: This study employed a cross-sectional survey method. A disproportionate stratified sampling technique was used to recruit participants. Sixty five consenting students who met the inclusion criteria were consecutively recruited from each clinical department of the college. The students were selected from the five clinical departments of the College (Nursing sciences, Medical Rehabilitation, Radiography, Medical laboratory science, and Medicine). The questionnaires on stigmatizing attitudes toward MI, EBD, and DA were self-administered. Descriptive statistics of frequency count, percentage, range, mean, and standard deviation were used to summarize participants' sociodemographic data and their questionnaire scores. Inferential statistics of Spearman rank order correlation was used to test for correlation; Mann-Whitney U test was used to test the influence of gender, religion, and family history; and Kruskal-Wallis test was used to test the influence of department of study and level of study. Alpha level was set at 0.05. RESULTS: Three hundred twenty seven students comprising 164 (50.2%) males and 163 (49.8%) females participated. Mean age of participants was 22.89 ± 2.05 years. 45.3% of the participants reported positive family history of one or a combination of MI, DA, and EBDs. The study observed poor attitude toward MI and fair attitude toward DA and EBD. There were significant correlations between attitudes toward MI and disability (r = 0.36, P = .000033), MI and EBD (r = 0.23, P = .000023), disability and EBD (r = 0.46, P = .000001), and age and attitude toward disability (r = 0.15, P = .009). Females had significantly more positive attitude toward disability (P = .03) and EBDs (P = .03). Nursing students also demonstrated the most positive attitudes toward MI (P = .03) and EBD (P = .000416), while final year students demonstrated the most positive attitudes toward MI (P = .00145) and EBDs (P = .03). CONCLUSIONS: There was a poor attitude toward MI and a fair attitude toward DA and EBD. Attitude toward MI, DA, and EBD correlated significantly with one another. Older students, females, and higher levels of training in the healthcare profession were associated with more positive attitudes toward MI, DA, and EBDs

Knowledge, Attitude and Practice Towards Hepatitis Virus Infection Prevention Among Healthcare Interns and Medical Students in A Tertiary Hospital, South-East Nigeria

Background: Hepatitis B and C viruses are common and preventable causes of liver disease. Health care workers are prone to infection by the hepatitis B and C viruses. In Nigeria there is no current guideline on vaccination of health care workers especially health care interns.Objective: To determine the knowledge, attitude and practice of health care interns and students towards hepatitis virus infection prevention.Methodology: This is a cross-sectional descriptive questionnaire-based study which was carried out among healthcare professional interns and medical students. Informed consent and ethical approval were obtained for this survey. Data entry and analysis was done using SPSS version 22 and appropriate descriptive statistics was applied.Results: A total of 253 interns of several healthcare professional groups and medical students took part in the survey. The healthcare interns were 115 (45.5%) and medical students were 138 (54.5%). They were 112 males (44.3%) and 141 females (55.7%), with age range 18-40 years and mean age of 22.9± 3.2 years. The respondents that knew that both hepatitis B and C were infective in nature were 225 accounting for 90.7% of respondents. The respondents with good knowledge on the modes of transmission of hepatitis were over 90% for known modes of transmission while those that knew of mother to child transmission accounted for 77.6% (n=180). Regarding the attitude of the respondents toward hepatitis B and C, only 60.4% (n=148) thinks that they are at risk of getting hepatitis infection. Those that have not received any form of hepatitis B vaccination were 163 accounting for 65.4% (n=163/253) of respondents. A high percentage of the respondents 97.8% (n=223/253) knew hepatitis B and C can cause liver disease.Conclusion: Despite a good knowledge of hepatitis B and C infectivity, attitude towards prevention of the infection was poor. The study reveals an urgent need for adequate and effective government and institutional policies towards prevention of viral hepatitis. Key words: Hepatitis B, Hepatitis C, Prevention, Interns, South- East Nigeria

Beyond the barrels: The impact of resource wealth on the energy-economy-climate targets in oil-rich economies

This study models the Kaya identity equation for carbon dioxide (CO2) emissions in a panel of 20 oil-rich countries from 1994 to 2019. The estimators used are robust to cross-sectional dependence and allow for heterogeneous slope coefficients. The results indicate that natural resource extraction hinders environmental sustainability in oil-rich countries by altering the structural composition of their consumption mix towards energy- and carbon-intensive technologies. However, this relationship is only significant after reaching a turning point level of resource extraction. This suggests that the carbon curse is only triggered at higher levels of resource dependence, supporting a U-shaped relationship between natural resource extraction and CO2 emissions. The threshold for the natural rents to GDP ratio, beyond which natural resource extraction triggers the carbon curse, is found to be 12.18 %. The vulnerability assessment reveals that 17 countries in the panel, including Algeria, Kazakhstan, the United Arab Emirates, Iran, Iraq, Kuwait, Qatar, Oman, Saudi Arabia, the Congo Republic, and Libya, are already within the carbon curse zone. From a policy perspective, promoting sustainable development in oil-rich economies requires a shift towards renewable energy sources, reducing reliance on fossil fuels, and widespread adoption of energy efficiency and conservation mechanisms

A community-based case–control study of prevalence and pattern of cognitive impairments in patients with epilepsy residing in South-Eastern Nigeria

Background: Epilepsy is the commonest neurological disorder encountered in Sub-Saharan Africa. The quality of life of patients with epilepsy (PWEs) is adversely affected by cognitive impairments. Aim: This study investigated the prevalence and pattern of cognitive impairments in PWE in Ukpo community located in a South-Eastern state in Nigeria using Community Screening Interview for Dementia (CSID) and a computer-assisted cognitive test battery (FePsy). Methods and Patients: Fifty-one PWEs were studied and compared with 51 age-, sex-and level of education-matched healthy controls. Diagnosis of epilepsy was confirmed clinically with eye-witness corroboration. Sociodemographic data and information on epilepsy variables were obtained with the aid of a questionnaire. Cognitive domains assessed include language, memory, orientation, attention, psychomotor speed and constructional praxis. Results: The prevalence rate of cognitive impairment using total CSID score was 19.6%. Analysis of CSID scores revealed significant impairment in language (17.6%), memory (29.4%), orientation (15.7%), attention (7.8%) and constructional praxis (15.7%) compared to healthy controls. A similar pattern was observed with FePsy but with better sensitivity indices for detecting cognitive impairment. Conclusion: This study indicated significant prevalence rate of cognitive impairment among treatment-naïve PWE with profound affectation of memory, mental speed and language. In addition, the FePsy was found to be more sensitive and specific in assessment of cognitive function in PWE