Gender variations in specialties among medical doctors working in public healthcare institutions in Bayelsa State, Nigeria

Background: Gender variations exist in the choice of specialties among doctors globally. This variation is of public health importance as it affects the distribution of doctors in public health institutions and patient care. In Bayelsa, Nigeria,no such study had been undertaken.This study aimed to examine gender variations in specialties among medical doctors working in public healthcare institutions in Bayelsa State.Methods: Cross-sectional study design was adopted for this study. Information about doctors working in public healthcare institutions in Bayelsa were collected via data extraction from the register of doctors at Niger Delta University Teaching Hospital (NDUTH) and at Hospital Management Board (HMB) of State Ministry of Health, and with self-completed questionnaires from doctors at Federal Medical Centre (FMC). In this paper, statistical analyses were restricted to data from FMC (n=91) and NDUTH (n=100) because they have multiple specialties. All available data were analyzed by gender and data analyses were carried out using SPSS statistical software.Results: Out of the191 doctors included in the analysis, 135(70.7%) were males. The median age was 32 years for male doctors and 29 years for female doctors.The top three specialty choices for males were obstetrics and gynaecology (14.8%),internal medicine (11.1%) and surgery (8.9%). For female doctors,pediatrics was the topmost specialty (25%) followed by obstetrics and gynaecology (10.7%) and internal medicine (8.9%). There were no female doctors in 14 specialties. Female doctors had higher proportions of house officers compared to males (45.5% versus 32.3% respectively). Conversely, male doctors had higher proportions of consultants/specialists than females (24.1% versus 9.1% respectively).Conclusion: Specialty distribution of doctors in Bayelsa is gendered and some specialties appear not to attract female doctors. These findings call for further studies to investigate the factors responsible for this gender variation, and to identify and address any barriers.Keywords: Gender variation,Specialties,Doctors,Public healthcare,Health workforc

Characteristics of medical doctors working in public healthcare institutions in a southern Nigerian state

Objective: This study assessed the characteristics of medical doctors working in public healthcare institutions and examined differences in some of the characteristics by geographical (urban versus rural) location.Methods: A cross-sectional study of doctors working in public healthcare institutions using data obtained from 3 centres in Bayelsa, Nigeria.Results: Three-quarters (75.4%) of the 280 medical doctors were males. Most of the doctors (68.6%) were working at tertiary healthcare level, 16.1% at primary and 15.4% at secondary healthcare levels. In terms of their professional positions, there were more medical officers (34.5%) relative to the other cadres while 17.2% were consultants. When their places of practice were dichotomised into rural and urban settings, 88.2% were practising in urban settings. A higher proportion of the 69 female doctors were practising in urban settings compared to rural settings (26.7% versus 9.1% respectively, P=0.027). There was a statistically significant relationship between residency status and place of practice (P=0.001). Specialists  (i.e. doctors who have completed residency training) were more likely to practice in urban (19.2%) than in rural settings (3.3%).Conclusion: Only a quarter of doctors in this study were females. There seemed to be more doctors at tertiary level of care and in urban areas. These findings suggest that there may be a shortage of female doctors, and that there may be unmet personnel needs at primary and secondary healthcare levels and in rural areas.Keywords: Health services, Human resources for heath, Health workforce, Geographical Distribution, Medical Doctor

Splenotoxic effect of radiographic developer effluent on Wistar rats

Background: Histological changes associated with toxicity of radiographic developer effluents on spleen tissues have not been previously studied. The present study therefore aimed at demonstrating the histopathological changes in splenic tissues of Wistar rats following exposure to developer effluent.Methods: Eighteen young Wistar rats weighing 140-220g were used for the study. The animals were divided randomly into three groups of 6 rats each based on the dose of developer effluent administered to them – i.e. control group I (0 dose) and experimental groups II (lower dose, 200 mg/kg) and III (higher dose, 400 mg/kg) respectively. The groups were further classified as either A or B sub-groups of three rats each, depending on the duration (14 or 28 days) of effluent administration. The effluent administration was done by oral gavages.Results: Normal spleen histology was observed in the control group. In contrast, tissue degeneration and necrosis; lymphocytic infiltration as well as reduction of splenic follicles were observed in some of the test groups (IIA, IIB and IIIA). Interestingly, the toxic effects of the developer effluent on group IIIB administered with higher dose for a longer period of 28 days were not as severe as observed in the other test groups.Conclusions: The present study which indicated adverse effects of exposures to sub-lethal doses of developer effluent on Wistar rats’ spleen tissues suggests the need for proper management and disposal of radiographic effluents.

Assessment of background ionizing radiation exposure levels in industrial buildings in Nnewi, Anambra State, Nigeria

Background: Increased exposure from background radiations and the attendant health effects have in recent times drawn the attention of researchers. This study aimed to assess the indoor and outdoor background radiation levels in selected offices/industrial buildings in Nnewi, Anambra State, Nigeria. Methods: Forty buildings in the four villages of Nnewi were surveyed using a calibrated international medicom CRM 100 radiation monitor. Radiation readings were obtained in counts per minute and converted to micro-sieverts per hour (µSv h-1). The indoor annual effective dose rate (IAEDR), outdoor annual effective dose rate, excess lifetime cancer risk, and organ doses were calculated using recommended occupancy and conversion factors.Results: The mean IAEDR and OAEDR were respectively 0.8060±0.056 mSv y-1 and 0.2281±0.020 mSv y-1 with estimated ELCR of 2.822x10-3 and 0. 799x10-3 respectively. The testes received the highest dose (0.843 mSv y-1) followed by bone marrow (0.710 mSv y-1).Conclusions: The study revealed that the mean background radiation exposures in and outside offices in Nnewi, Anambra State were below the UNSCEAR and ICRP recommended doses for the general public

Project OPUS: Development and evaluation of an electronic platform for pain management education of medical undergraduates in resource-limited settings

Introduction Pain is a very frequent symptom that is reported by patients when they present to health professionals but remains undertreated or untreated, particularly in low-resource settings including Nigeria. Lack of training in pain management remains the most significant obstacle to pain treatment alongside an inadequate emphasis on pain education in undergraduate medical curricula, negatively impacting on subsequent care of patients. This study aimed to determine the effect of a 12-week structured e-Learning course on the knowledge of pain management among Nigerian undergraduate medical students. Methods Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z = 11.3, p<0.001, effect size = 1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible. Methods: Prospective, multisite, pre-post study conducted across five medical colleges in Nigeria. Structured modules covering aspects of pain management were delivered on an e-Learning platform. Pre- and post-test self-assessments were carried out in the 12-week duration of the study. User experience questionnaires and qualitative interviews were conducted via instant messaging to evaluate user experiences of the platform. User experience data was analysed using the UEQ Data Analysis Tool and Framework Analysis. Results: A total of 216 of 659 eligible students completed all sections of the e-Learning course. Participant mean age was 23.52 years, with a slight female predominance (55.3%). Across all participants, an increase in median pre- and post-test scores occurred, from 40 to 60 (Z=11.3, p<0.001, effect size=1.3), suggestive of increased knowledge acquisition relating to pain management. Participants suggested e-Learning is a valuable approach to delivering pain education alongside identifying factors to address in future iterations. Conclusion: e-Learning approaches to pain management education can enhance traditional learning methods and may increase students’ knowledge. Future iterations of e-Learning approaches will need to consider facilitating the download of data and content for the platform to increase user uptake and engagement. The platform was piloted as an optional adjunct to existing curricula. Future efforts to advocate and support integration of e-Learning for pain education should be two-fold; both to include pain education in the curricula of medical colleges across Nigeria and the use of e-Learning approaches to enhance teaching where feasible

Shepherding sub-Saharan Africa's wildlife through peak anthropogenic pressure toward a green anthropocene

Sub-Saharan Africa’s (SSA’s) iconic biodiversity is of immense potential global value but is jeopardized by increasing anthropogenic pressures. Elevated consumption in wealthier countries and the demands of international corporations manifest in significant resource extraction from SSA. Biodiversity in SSA also faces increasing domestic pressures, including rapidly growing human populations. The demographic transition to lower fertility rates is occurring later and slower in SSA than elsewhere, and the continent’s human population may quadruple by 2100. SSA’s biodiversity will therefore pass through a bottleneck of growing anthropogenic pressures, while also experiencing intensifying effects of climate change. SSA’s biodiversity could be severely diminished over the coming decades and numerous species pushed to extinction. However, the prospects for nature conservation in SSA should improve in the long term, and we predict that the region will eventually enter a Green Anthropocene. Here, we outline critical steps needed to shepherd SSA’s biodiversity into the Green Anthropocene epoch.http://www.annualreviews.orgam2023Mammal Research InstituteZoology and Entomolog

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake