Digitised audio questionnaire for assessment of informed consent comprehension in a low-literacy African research population: development and psychometric evaluation.

OBJECTIVE: To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants. SETTING: We conducted this study in the Gambia where a high illiteracy rate and absence of standardised writing formats of local languages pose major challenges for research participants to comprehend consent information. We developed a 34-item questionnaire to assess participants' comprehension of key elements of informed consent. The questionnaire was face validated and content validated by experienced researchers. To bypass the challenge of a lack of standardised writing formats, we audiorecorded the questionnaire in three major Gambian languages: Mandinka, Wolof and Fula. The questionnaire was further developed into an audio computer-assisted interview format. PARTICIPANTS: The digitised questionnaire was administered to 250 participants enrolled in two clinical trials in the urban and rural areas of the Gambia. One week after first administration, the questionnaire was readministered to half of the participants who were randomly selected. Participants were eligible if enrolled in the parent trials and could speak any of the three major Gambian languages. OUTCOME MEASURE: The primary outcome measure was reliability and validity of the questionnaire. RESULTS: Item reduction by factor analysis showed that 21 of the question items have strong factor loadings. These were retained along with five other items which were fundamental components of informed consent. The 26-item questionnaire has high internal consistency with a Cronbach's α of 0.73-0.79 and an intraclass correlation coefficient of 0.94 (95% CI 0.923 to 0.954). Hypotheses testing also showed that the questionnaire has a positive correlation with a similar questionnaire and discriminates between participants with and without education. CONCLUSIONS: We have developed a reliable and valid measure of comprehension of informed consent information for the Gambian context, which might be easily adapted to similar settings. This is a major step towards engendering comprehension of informed consent information among low-literacy participants

Presentation and Management of Uterine Fibroids at the Lagos University Teaching Hospital, Lagos.

To review the clinical presentation and management of uterine fibroids at the Lagos University Teaching Hospital, Idi-Araba, Lagos. women with uterine fibroids that presented at the Gynaecological outpatient clinic were followed up till surgery and data on sociodemographic profile, parity, presenting signs and symptoms, uterine size at presentation, associated infertility and modality of surgical management was obtained using a structured form. The mean age was 36.6±7.8years (range 20-55years). There were 219(81.4%) in the reproductive age group between 15-45years and of these, 141(52.6%) were nulliparous. 151(57.8%) presented with menorrhagia, 154(57.5%) had dysmenorrhea, 157(58.7%) presented with abdominal swelling and 101(37.6%) had associated abdominal pains at presentation. One hundred and twenty one (45%) of the women had infertility, with 94(77.7%) being secondary infertility and 27(22.3%) primary infertility. Majority of the women 191(71.3%) had myomectomy for fertility preservation while others had hysterectomy and vaginal polypectomy. Leiomyomata represent the most common gynaecologic tumour in this environment and nulliparity is an important risk factor as seen in this study. Treatment must be individualized based on such considerations as the presence and severity of symptoms, the patient's desire for definitive treatment, the desire to preserve childbearing capacity and the importance of uterine preservation.Keywords: fibroids, infertility, myomectom

Determinants of the disposition of patients attending a psychiatric emergency department in Nigeria

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Digitised audio questionnaire for assessment of informed consent comprehension in a low-literacy African research population: development and psychometric evaluation

To develop and psychometrically evaluate an audio digitised tool for assessment of comprehension of informed consent among low-literacy Gambian research participants.status: publishe

Running time of classification on the microarray database.

<p>Running time of classification on the microarray database.</p

Nucleolar Organizing Regions and α-Smooth Muscle Actin Expression in a Case of Ameloblastic Carcinoma

Ameloblastic carcinoma is a rare lesion of odontogenic origin. It is defined as a malignant epithelial odontogenic tumor that histologically has retained the features of ameloblastic differentiation and also exhibits cytologic features of malignancy, like atypia and mitotic activity. Although this lesion represents a separate entity, differentiating it from ameloblastoma has been often challenging to pathologists. In this case study reporting a case of ameloblastic carcinoma, we have attempted to verify the previous findings on the use of Argyrophilic nucleolar organizing regions (AgNORs) and immunohistochemical staining for the alpha-smooth muscle actin (alpha-SMA) in differentiating ameloblastic carcinoma from ameloblastoma. It was observed that AgNORs was found to be almost twice in ameloblastic carcinoma as it was in ameloblastoma. A difference between the two lesions in the pattern of expression of alpha-SMA was also observed, with alpha-SMA being expressed in the odontogenic epithelium and the stroma of ameloblastic carcinoma whereas, in the case of ameloblastoma, it was found only in the stromal part. These findings suggest that AgNORs and alpha-SMA expression may be used as adjuncts to the routine histopathologic examination to differentiate ameloblastic carcinoma and ameloblastoma

Are laws the appropriate solution: The need to adopt non-policy measures in aid of the implementation of sex discrimination laws in Nigeria

Gender inequality is a social problem facing women all over the world and is a barrier to human development. The United Nations commits to achieving gender equality and empowering women and girls and have adopted the Sustainable Development Goals to achieve gender equality by 2030. Nigeria, a Member State of the United Nations has ratified international and regional instruments which advocate for the protection and promotion of the rights of women and girls. Though some progress has been made to reduce inequality, discrimination remains a problem to women and is exacerbated by factors such as culture, religion, social practices and discriminatory laws. This study seeks to add to the discourse on gender inequality in Nigeria and examine the effectiveness of available domestic and international provisions against sex discrimination when considered against ingrained cultural attitudes, beliefs and discriminatory laws. The study found that amongst other determinants, culture and religion were constant features in the different forms of discrimination Nigerian women face and they were the primary reasons the proposals to pass gender equality laws were opposed and failed. The study proposes the need to adopt non-policy measures such as education and awareness-raising as additional measures to eliminating discrimination and promoting equalit