Predictors of Female Health Care Providers’ Knowledge on Symptoms and Risk Factors of Ovarian Cancer: A Tertiary Health Care Institutional Based Cross-sectional Study

Context: Ovarian cancer is responsible for more deaths per year than all other gynaecological cancers combined, and its overall mortality is high because of late presentation. Aims: To evaluate the predictors of knowledge of the symptoms and the risk factors of ovarian cancer among female healthcare providers in Enugu, Nigeria. Settings and Design: Cross‑sectional survey conducted at the University of Nigeria Teaching Hospital (UNTH), Enugu from June to August 2018. Subjects and Methods: A self‑administered, structured questionnaire on symptoms and risk factors of ovarian cancer was given to 422 randomly selected female healthcare providers working at UNTH. Statistical Analysis: Data were analysed using SPSS version 22.0 for  Windows (Chicago, IL, USA). Predictors of knowledge level were determined using logistic regression. P < 0.05 was considered statistically significant. Results: Mean age of the respondents was 39.22 ± 7.89 years. Less than 50% of participants know the other symptoms of ovarian cancer outside increased abdominal size (n = 268, [63.5%]). Also, <50% of participants know the other risk factors of ovarian cancer outside family history of cancer (n = 288, [68.2%]) and genetic predisposition (n = 251, [59.5%]). Female doctors are less likely not to know about the symptoms (odds ratio [OR] = 0.011, 95% confidence interval [CI] = 0.004–0.024, P < 0.001) and risk factors (OR = 0.005, 95% CI = 0.002–0.013, P < 0.001) of ovarian cancer. Conclusions: Female healthcare providers had a reduced level of awareness of the risk factors and symptoms of ovarian cancer, while  female doctors are less likely not to know about the symptoms and the risk factors. Keywords: Female health care workers, knowledge, ovarian cancer, predictors, risk factors, symptom

Prediction of Self-Concept and Anxiety on the Tendency of Postgraduate Students with Learning Disabilities (LD) to Acquire Research Skills in Two Public Universities of Cross River State, Nigeria: Implications for Counseling

Background: Acquisition of research skills provide the forum for incorporating Nigerian graduate students with disabilities and university lecturers into the international scientific culture and the developing knowledge economy. Aim: This study investigated the prediction of self-concept and anxiety on the tendency of postgraduate students with Learning Disabilities (LD) to acquire research skills in two Public Universities of Cross River State, Nigeria: Implications for counseling. Two objectives of the study were stated to guide the study and to achieve the purpose of the study. Two research questions were formulated, which were converted to two statements of hypotheses. A literature review was carried out based on the variables under study. Method: The survey research design was considered most suitable for the study. A stratified random sampling technique was adopted in selecting the 49 respondents sampled for the study. A validated 20 items four-point modified Likert scale questionnaire was the instrument used for data collection. The face and content validity of the instrument was established by experts in Test and Measurement. The reliability estimates of 0.81 of the instruments were established using the Cronbach Alpha method. A simple Linear regression statistical tool was used to test the hypotheses formulated for the study. The hypotheses were tested at a 0.05 level of significance. Results: The results obtained from the data analysis revealed a significant prediction of self-concept and anxiety on the tendency of postgraduate students with Learning Disabilities (LD) to acquire research skills in the study area. Conclusion: Based on the findings of the study, it was therefore recommended, among others, that internal seminars and workshops should be organized by Graduate schools every quarter of the year, where each postgraduate student delivers a standard paper, and this should be made compulsory. This will encourage sharing knowledge and increase skills and zeal for using knowledge and more research publications

COVID-19 mortality rate and its associated factors during the first and second waves in Nigeria

COVID-19 mortality rate has not been formally assessed in Nigeria. Thus, we aimed to address this gap and identify associated mortality risk factors during the first and second waves in Nigeria. This was a retrospective analysis of national surveillance data from all 37 States in Nigeria between February 27, 2020, and April 3, 2021. The outcome variable was mortality amongst persons who tested positive for SARS-CoV-2 by Reverse-Transcriptase Polymerase Chain Reaction. Incidence rates of COVID-19 mortality was calculated by dividing the number of deaths by total person-time (in days) contributed by the entire study population and presented per 100,000 person-days with 95% Confidence Intervals (95% CI). Adjusted negative binomial regression was used to identify factors associated with COVID-19 mortality. Findings are presented as adjusted Incidence Rate Ratios (aIRR) with 95% CI. The first wave included 65,790 COVID-19 patients, of whom 994 (1∙51%) died; the second wave included 91,089 patients, of whom 513 (0∙56%) died. The incidence rate of COVID-19 mortality was higher in the first wave [54∙25 (95% CI: 50∙98–57∙73)] than in the second wave [19∙19 (17∙60–20∙93)]. Factors independently associated with increased risk of COVID-19 mortality in both waves were: age ≥45 years, male gender [first wave aIRR 1∙65 (1∙35–2∙02) and second wave 1∙52 (1∙11–2∙06)], being symptomatic [aIRR 3∙17 (2∙59–3∙89) and 3∙04 (2∙20–4∙21)], and being hospitalised [aIRR 4∙19 (3∙26–5∙39) and 7∙84 (4∙90–12∙54)]. Relative to South-West, residency in the South-South and North-West was associated with an increased risk of COVID-19 mortality in both waves. In conclusion, the rate of COVID-19 mortality in Nigeria was higher in the first wave than in the second wave, suggesting an improvement in public health response and clinical care in the second wave. However, this needs to be interpreted with caution given the inherent limitations of the country’s surveillance system during the study

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Humoral and cellular immune responses to Lassa fever virus in Lassa fever survivors and their exposed contacts in Southern Nigeria.

Funder: National Institute of Allergy and Infectious DiseasesFunder: Science for Africa FoundationElucidating the adaptive immune characteristics of natural protection to Lassa fever (LF) is vital in designing and selecting optimal vaccine candidates. With rejuvenated interest in LF and a call for accelerated research on the Lassa virus (LASV) vaccine, there is a need to define the correlates of natural protective immune responses to LF. Here, we describe cellular and antibody immune responses present in survivors of LF (N = 370) and their exposed contacts (N = 170) in a LASV endemic region in Nigeria. Interestingly, our data showed comparable T cell and binding antibody responses from both survivors and their contacts, while neutralizing antibody responses were primarily seen in the LF survivors and not their contacts. Neutralizing antibody responses were found to be cross-reactive against all five lineages of LASV with a strong bias to Lineage II, the prevalent strain in southern Nigeria. We demonstrated that both T cell and antibody responses were not detectable in peripheral blood after a decade in LF survivors. Notably LF survivors maintained high levels of detectable binding antibody response for six months while their contacts did not. Lastly, as potential vaccine targets, we identified the regions of the LASV Glycoprotein (GP) and Nucleoprotein (NP) that induced the broadest peptide-specific T cell responses. Taken together this data informs immunological readouts and potential benchmarks for clinical trials evaluating LASV vaccine candidates