Pollution risk and life insurance decisions: Microgeographic evidence from the United Kingdom.

Recent research documents that exposure to air pollution can trigger various behavioral reactions. This article presents novel empirical evidence on the causal effect of pollution risk on life insurance decisions. We create a unique dataset by linking microgeographic air quality information to the confidential UK Wealth and Assets Survey. We identify an inverse N-shape relationship between pollution risk and life insurance adoption by exploiting the orthogonal variations in meteorological conditions. Over a given range above a threshold of exposure, rising pollution is associated with rising demand for life insurance, whereas at lower than the threshold levels of pollution, higher exposure risk reduces demand for insurance. Our findings indicate-for the first time-a nonlinear relationship between local pollution risk and life insurance demand.

Environmental sustainability and prevention of heavy metal pollution of some geo-materials within a city in southwestern Nigeria.

Increased anthropogenic activities may cause the release of potentially hazardous metals into the environment. This is a major public health concern. The study was aimed at accessing ways by which pollution can be prevented with enhanced environmental sustainability in Ibadan, Southwestern, Nigeria. Geo-materials (groundwater, soil and stream sediment) were collected, analyzed for heavy metals using inductively coupled plasma-mass spectrometry. Results of acidity (pH), electrical conductivity (EC), total dissolved solid (TDS) and heavy metals (Zn, As, and Cd) obtained in water were compared with WHO permissible limits. All parameters were found within WHO permissible limits except TDS (624.35 mg/L). Risk index showed dangerous to extremely dangerous. High TDS can be attributed to weathering while high Cd, Zn and Pb in stream sediment and soil are due to anthropogenic effect. Provision of adequate disposal facilities should be created by private and government agencies and the use of it must be enforced.

Mind the gap: what explains the rural-nonrural inequality in diarrhoea among under-five children in low and medium-income countries? A decomposition analysis.

BACKGROUND: Diarrhoea poses serious health problems among under-five children (U5C) in Low-and Medium-Income Countries (LMIC) with a higher prevalence in rural areas. A gap exists in knowledge on factors driving rural-non-rural inequalities in diarrhoea development among U5C in LMIC. This study investigates the magnitude of rural-non-rural inequalities in diarrhoea and the roles of individual-level and neighbourhood-level factors in explaining these inequalities. METHODS: Data of 796,150 U5C, from 63,378 neighbourhoods across 57 LMIC from the most recent Demographic and Health Survey (2010-2018) was analysed. The outcome variable was the recent experience of diarrhoea while independent variables consist of the individual- and neighbourhood-level factors. Data were analysed using multivariable Fairlie decomposition at p < 0.05 in Stata Version 16 while visualization was implemented in R Statistical Package. RESULTS: Two-thirds (68.0%) of the children are from rural areas. The overall prevalence of diarrhoea was 14.2, 14.6% vs 13.4% among rural and non-rural children respectively (p < 0.001). From the analysis, the following 20 countries showed a statistically significant pro-rural inequalities with higher odds of diarrhoea in rural areas than in nonrural areas at 5% alpha level: Albania (OR = 1.769; p = 0.001), Benin (OR = 1.209; p = 0.002), Burundi (OR = 1.399; p < 0.001), Cambodia (OR = 1.201; p < 0.031), Cameroon (OR = 1.377; p < 0.001), Comoros (OR = 1.266; p = 0.029), Egypt (OR = 1.331; p < 0.001), Honduras (OR = 1.127; p = 0.027), India (OR = 1.059; p < 0.001), Indonesia (OR = 1.219; p < 0.001), Liberia (OR = 1.158; p = 0.017), Mali (OR = 1.240; p = 0.001), Myanmar (OR = 1.422; p = 0.004), Namibia (OR = 1.451; p < 0.001), Nigeria (OR = 1.492; p < 0.001), Rwanda (OR = 1.261; p = 0.010), South Africa (OR = 1.420; p = 0.002), Togo (OR = 1.729; p < 0.001), Uganda (OR = 1.214; p < 0.001), and Yemen (OR = 1.249; p < 0.001); and pro-non-rural inequalities in 9 countries. Variations exist in factors associated with pro-rural inequalities across the 20 countries. Overall main contributors to pro-rural inequality were neighbourhood socioeconomic status, household wealth status, media access, toilet types, maternal age and education. CONCLUSIONS: The gaps in the odds of diarrhoea among rural children than nonrural children were explained by individual-level and neighbourhood-level factors. Sustainable intervention measures that are tailored to country-specific needs could offer a better approach to closing rural-non-rural gaps in having diarrhoea among U5C in LMIC.

Repellency and larvicidal activities of Azadirachta indica seed oil on Anopheles gambiae in Nigeria.

Despite the recent decline in the global prevalence of malaria, the disease continues to be one of the major causes of morbidity and mortality among pregnant women and under-five children in Nigeria. The adoption of an integrated approach to malaria control including the use of bio-insecticide will further reduce the burden of malaria. This study determined the repellency and bio-insecticidal effects of Azadirachta indica oil on Anopheles gambiae in Ibadan, Nigeria. The study was experimental in design. Oil was extracted from the ground seed kernel of Azadirachta indica plants using N-hexane as a solvent. Larvicidal tests were carried out on 600 third and fourth instar stages of Anopheles gambiae using an aliquot of extracted oil emulsified with a surfactant (Tween 80) at concentrations ranging from 100 to 500 ppm. Mortality was recorded every 24 h for five days. Repellency tests were carried out by exposing Guinea pigs that were previously treated with the oil mixed with paraffin at 10-40%v/v concentrations, to 70 adult female Anopheles gambiae in netted cages. Data were analysed using descriptive statistics and ANOVA. The oil yield accounted for 40.0% weight of the ground seed kernel. The larvicidal effect was significant across the concentration of the emulsified Azadirachta oil ranging from 91.6-100.0%, compared to the control experiment ranging from 5-15% (LC50 and LC90: -1666.86 ppm and -2880.94 ppm respectively). A 100.0% larval mortality of Anopheles gambiae was recorded within three days at 500 ppm. All the concentrations of the oil solution also caused 100% inhibition of pupae formation. The repellent effect of adult Anopheles was significant (p < 0.05) across the concentrations but with varying degrees of protection. The highest repellent effect was observed at 40.0% (v/v). The possibility of using Azadirachta indica as bio-insecticide against Anopheles gambiae was established in this study.

Comparative effect of slow and rapid freezing on sperm functional attributes and oxidative stress parameters of goat spermatozoa cryopreserved with tiger nut milk extender.

Comparative effect of slow and rapid freezing on sperm functional attributes and oxidative stress parameters of goat spermatozoa cryopreserved with tiger nut milk (TNM) extender was examined in this study. Pooled semen samples obtained from West African Dwarf (WAD) goat bucks were diluted with Tris-based extenders containing different levels of TNM (0, 5, 10, 15 and 20 ml/100 ml extender). The diluted semen samples were subjected to slow and rapid freezing for a period of 7 days and thereafter evaluated for sperm functional attributes (percentage motility, acrosome integrity, membrane integrity, abnormality and livability) and oxidative stress (malondialdehyde [MDA] concentration and acrosin activity) parameters. Results showed that higher (p < 0.05) motility, livability, membrane and acrosome integrities in semen cryopreserved with slow freezing compared to rapid freezing. These parameters (motility, livability and membrane integrity) were higher (p < 0.05) in semen cryopreserved with 15% TNM in both slow and rapid freezing protocols. The results revealed that semen cryopreserved in slow freezing had lower (p < 0.05) abnormality compared to rapid freezing. Acrosin activity was higher in slow freezing compared to rapid freezing. Acrosin activity was higher at 15% TNM in both slow and rapid freezing. Lower (p < 0.05) MDA concentration was observed in semen cryopreserved using slow freezing compared to rapid freezing. The findings revealed improved post-thaw sperm functional attributes and oxidative stress parameters of WAD goat spermatozoa cryopreserved with 15% TNM using slow freezing.

Prevalence and Correlates of Missed First Appointments among Outpatients at a Psychiatric Hospital in Nigeria.

BACKGROUND: Missed appointments are common in psychiatric practice. It compromises quality of care, results in poor treatment outcomes and drains financial resources. In Nigeria, where mental health services are poorly organized, missed appointments and its resultant consequences may be burdensome. AIM: This study sought to determine the prevalence and factors (sociodemographic and clinical) associated with missed clinic appointments at a regional psychiatric hospital. SUBJECTS AND METHODS: A study on a cohort of patients attending the Outpatient Clinics for the first time between June and September 2011 was conducted. We interviewed each participant at their first presentation then tracked through case records to determine adherence to scheduled first clinic appointments after 4 weeks. A questionnaire was used in eliciting sociodemographic characteristics, clinical variables, and patient/caregiver satisfaction with treatment. Descriptive statistics were used to summarize the data and inferential statistics to test associations using the SPSS 16. RESULTS: Three hundred and ten patients were recruited over the study period. The prevalence of missed first appointment was 32.6% (101/310). Participants who were single (P = 0.04), living alone (P < 0.01) or aggressive (P < 0.01) were more likely to miss their first appointment. However, having received previous treatment for a psychiatric illness (P = 0.02) and having comorbidity (P = 0.05) was associated with less likelihood to miss a first appointment. A binary logistic regression analysis showed that having received previous treatment independently predicted a less likelihood to miss first appointment (P = 0.03). CONCLUSION: Quite a proportion (32.6%) of patients attending outpatient clinics miss scheduled clinic appointments. Receiving previous psychiatric care predicted adherence to scheduled appointment.

Culture-bound syndromes and the neglect of cultural factors in psychopathologies among Africans.

One of the major problems in psychiatric practice worldwide is inability to reach a consensus as regards a globally acceptable classificatory system for the different psychopathologies. Consequently, apart from the WHO's International Classification of Diseases (ICD) that is expected to be universally applicable there are regional-based classificatory systems in some parts of the world. In Africa, a number of culture bound syndromes (CBS) have been described which have not been given international recognition. The possible consequences of this non-recognition are highlighted in this paper. Unfortunately there are serious constraints such as the relatively small number of psychiatrists on the continent, and inadequate funding for mental health research, which militate against producing an African classificatory system. Nevertheless, it is proposed that reports of African psychiatrists emanating from their research and clinical experience should be accorded adequate recognition in the WHO so as to assign these CBS their rightful placement in the International classificatory system.

Prevalence and perceived health effect of alcohol use among male undergraduate students in Owerri, South-East Nigeria: a descriptive cross-sectional study.

BACKGROUND: Alcohol use during adolescence and young adulthood remains a prominent public health problem. Despite growing problems of global alcohol abuse, accurate information on the prevalence and pattern of use in Nigeria remain sparse. This study examines the prevalence and perceived health effects of alcohol use among undergraduate students in Owerri, Nigeria. METHOD: The prevalence and perceived health effects of alcohol was estimated for 482 male undergraduates of four higher institutions in Owerri, South-East Nigeria between October 2008 and March 2009. Information was obtained using a semi-structured, self-administered questionnaire. RESULT: The mean age of the students was 24.7 years. Majority of the respondents confirmed they were current users of alcohol given a prevalence of 78.4%, with twenty-seven percent of them being heavy drinkers (≥ 4 drinks per day). Reasons given by respondents for alcohol drinking include: makes them feel high (24.4%); makes them belong to the group of "most happening guys" on campus (6.6%); makes them feel relaxed (52.6%) while (16.4%) drinks it because their best friends do. Perceived health impacts of alcohol use among current users include: it enhances pleasure during moment of sex (51.1%), causes drowsiness and weakness (63.8%), may precipitate defective memory and impaired perception (64.3%) and serves as risk factor for most chronic diseases (68.5%). CONCLUSION: High prevalence of alcohol use was established among study groups. Evaluation of full-scale community-level intervention, including community mobilisation and media advocacy aimed at supporting changes in policies on drinking, access and sales of alcohol to young people, could be helpful in reducing the trend.

Perceptions on the use of insecticide treated nets in parts of the Imo River Basin, Nigeria: implications for preventing malaria in pregnancy.

This study aimed at assessing perceptions on use of ITNs in parts of the Imo River Basin, Nigeria and its implications in preventing malaria in pregnancy. Data was collected using focus group discussions, key informant interviews and structured questionnaires. Results showed high awareness on the benefits of ITNs. Factors affecting use of ITNs included its high cost, perceptions of chemicals used to treat them as having dangerous effects on pregnancy, low utilization of antenatal care, husband's lack of interest in malaria prevention and perceptions that adolescent girls are at low risk of getting malaria. The implications of these findings include demystifying the negative perceptions on the chemicals used for net treatment and subsidizing the cost of ITNs to increase access. These findings provide important lessons for malaria programmes that aim at increasing access to ITNs by pregnant women in developing countries.

Stimulant use among secondary school students in Osogbo, Nigeria.

OBJECTIVES: The objectives of this study were to determine the prevalence and pattern of stimulant use and its association with 'brain fag syndrome' among secondary school students in Osogbo, Osun State. The study also aimed to determine the association of socio-demographic variables (of the students and their parents) with stimulant use. MATERIALS AND METHODS: A questionnaire consisting of sociodemographic variables, the stimulant use section of the WHO Student Drug Use Questionnaire and the Brain Fag Syndrome Scale (BFSS) was administered on randomly selected students of the two Local Government Areas of Osogbo. The prevalence rates of stimulant use were calculated and the association of stimulant use with Brain Fag Syndrome (BFS) and socio-demographic variables was determined. RESULTS: The 30-day prevalence rate of stimulant use was 20.3%. Users engaged more in the use of common and cheap stimulants (coffee and kola nut). Majority of users started at age 13 years or below. There was a very high relationship between stimulant use and the symptoms of the BFS (p<0.001). Stimulant use was associated with lower age group, poor school attendance, polygamous background, low education of mother, high education of father and the description of mother as being too permissive. CONCLUSION: The findings suggest the need to increase the awareness of the dangers of stimulant use among students. Control programmes are urgently needed to prevent student wastage.

Brain Fag Syndrome - a myth or a reality.

The Brain Fag Syndrome (BFS) is defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as a culture bound syndrome. BFS is a tetrad of somatic complaints; cognitive impairments; sleep related complaints; and other somatic impairments. Prince first described this psychiatric illness associated with study among African students in 1960. There have been questions relating to the nosological status of the syndrome as to whether: BFS is an objective or subjective phenomenon; it is one phenomenon or a variant of other known disorders; it is a mental illness? These three questions pose challenges to the culture bound/depressive or anxiety equivalent approach to the condition. The scope of this paper is the scope of BFS history from its first reference in the psychological medicine to the most contemporary descriptions in transcultural psychiatry. The conceptual history of BFS is divided into four major perspectives: Traditional medicine, Psychoanalysis, Biopsychological and Transcultural psychiatry. This helps to outline some of the key issues, helps to clarify its nosological status, its present status and helps to set the stage for the future progress. From its conceptual history, BFS as a phenomenon, with its distinct presentations, is subjectively real and is best classified with the framework of psychiatry, psychology and or sociology. The existence of BFS is evidenced by case as well as epidemiological reports of the condition in different locations. However, its course, response to treatment and outcome deserve more attention than has been given.

Management of perceived mental health problems by spiritual healers: a Nigerian study.

OBJECTIVE: Anecdotal reports and research findings have suggested that religious healers are widely consulted by many Nigerians in time of mental health crisis.The study aimed at examining the knowledge, attitude and practice of mental health care among a syncretic Church's healers, and their readiness to cooperate with Psychiatrists. METHOD: A modified, pilot-tested, selfcompleted questionnaire was used to obtain information from consenting spiritual healers who satisfy the inclusion criteria. Focus group discussions (FGDs), Participatory Observation (PO) and Key Informant Interviews (KII) were used to corroborate or refute the findings. RESULTS: The respondents' knowledge of mental disorders was limited to psychotic disorders; their explanatory model was similar to beliefs of the populace. In practice, they combined some modern medical approach, some native methodology and some eclectic religious practices such as prophecy, trance and dream. Only 6% of them ever referred their clients to medical practitioners. CONCLUSION: Religious healers still constitute an important route to access mental health care providers to some Nigerians.

Management of perceived mental health problems by spiritual healers : a Nigerian study

Objective : Anecdotal reports and research findings have suggested that religious healers are widely consulted by many Nigerians in time of mental health crisis. The study aimed at examining the knowledge; attitude and practice of mental health care among a syncretic Church's healers; and their readiness to cooperate with Psychiatrists. Method : A modified; pilot-tested; self-completed questionnaire was used to obtain information from consenting spiritual healers who satisfy the inclusion criteria. Focus group discussions (FGDs); Participatory Observation (PO) and Key Informant Interviews (KII) were used to corroborate or refute the findings. Results : The respondents' knowledge of mental disorders was limited to psychotic disorders; their explanatory model was similar to beliefs of the populace. In practice; they combined some modern medical approach; some native methodology and some eclectic religious practices such as prophecy; trance and dream. Only 6of them ever referred their clients to medical practitioners. Conclusion : Religious healers still constitute an important route to access mental health care providers to some Nigerians

Risk factors of postpartum depression and EPDS scores in a group of Nigerian women.

A sample of 252 women was studied for postpartum depression (PPD) in a 68-bed maternity hospital in Lagos, Nigeria. After obtaining consent, they were assessed using: (1) a questionnaire on socio-demographic profile and risk factors of PPD; (2) the Edinburgh Postnatal Depression Scale (EPDS), and when necessary with (3) the depressive module of International Classification of Diseases, 10th edition (ICD-10). The cohort was predominantly young (mean age 28.5 +/- 5.26 years). About one-quarter (23%) scored > or =12, (the cut-off score) on EPDS assessment; with majority of these depressed on further evaluation with ICD-10. The risk factors for PPD were found to be mainly psychosocial, including unwanted pregnancy, unemployment and marital conflict. It is concluded that PPD is a major complication of childbirth in Nigeria, which can be minimized by improving both the citizens' socioeconomic condition and providing cheaper and more efficient health-care services.

Normative data on mental and motor development in Nigerian children.

BACKGROUND: In Nigeria and sub-Saharan Africa at large, there has been heavy reliance on the "Caucasian data" in the developmental assessment of children. Hence, this study set out to establish normative data for psychomotor development on Nigerian children. STUDY DESIGN: One hundred and twenty eight children distributed equally to eight different integrative age groups between 8 weeks and 30 months were included in the cross-sectional study. The subjects were assessed for the five fields of development using Developmental Screening Inventory (DSI) and Bayley Scales of Infant Development (BSID): a screening and performance instruments respectively. A trained research assistant administered the DSI on each of the subjects, and the scores made blind to the researchers until after the subject's assessment with the BSID within maximum of 24 hours interval. RESULTS: The subjects scored above the normal values in the five fields of development for each of the instruments. Furthermore, from the normative data derived, there were high scores in the motor and personal -social fields, especially among subjects in the lower age groups of 8,16,and 32 weeks when compared to data from the western world. CONCLUSION: It is concluded that this normative data will be of much clinical value to practitioners in Nigeria, especially the pediatricians, psychiatrists, clinical psychologists, etc.

Postpartum depression in a maternity hospital in Nigeria.

OBJECTIVE: To explore the recognition and management of postpartum depression (PPD) by the obstetric team in a maternity hospital concomitantly, was to find the rate of PPD in the centre. DESIGN: A descriptive cross-sectional study. SETTING: Island Maternity Hospital, Lagos, Nigeria; a moderately large obstetric facility with 68 beds and 42 paediatric cots. SUBJECTS: The medical staff including doctors and nurse midwives in the study centre. Concomitantly, a sample of women that delivered in the hospital during the study period. RESULTS: Seventy two (65.5%) of the total 110 obstetric staff in the hospital consented to the study; made up of 10 doctors and 62 midwives of varying cadres. 43.1% of them admitted their difficulty to recognise PPD with X2 of 25.8, while 19.4% expressed doubt in the obstetric team's ability to manage PPD. 86.1% would rather refer PPD cases to the psychiatrists, but saw stigma as a militating factor. Hence 77.8% with X2 of 65.3 would want consultation-liaison psychiatric services established in the centre. Concomitantly, of the 252 women assessed with EPDS, 23% were depressed with scores >12. CONCLUSION: It is concluded that there is need to update the obstetric team's knowledge on the management of PPD through Continuous Medical Education (CME) to which 97.2% of them agreed.

Psychopathology among senior secondary school students in Ilesa, south western Nigeria.

The prevalence rate of psychopathology and the relationship between psychopathology and some socio-demographic variables and consolidated current drug use were studied in 600 randomly selected senior secondary school students in Ilesa, south-western Nigeria. The 30-item version of the General Health Questionnaire and the WHO student drug use questionnaire were administered for the study. The findings revealed that the prevalence of psychopathology among the study population was 39.5%. There were significant positive associations between psychopathology and belonging to low socio-economic status, coming from a polygamous family and self-rated poor academic performance. The results also showed that although psychopathology was commoner amongst respondents who were engaged in current use of psychoactive substances than those who were not, the difference was not significant. The implications of these findings within the context of the limitations of the study and the importance of effective preventive and therapeutic student mental health services are discussed.

Landau-Kleffner syndrome (acquired epileptic aphasia) in a Nigerian child.

Epilepsy is one of the commonest disorders presenting the neurological clinics in developing countries. There are attendant complications especially in untreated or poorly treated cases. In this article, we report an uncommon complication known as Landau-Kleffner syndrome in a Nigerian girl. The syndrome, typically seen in children consists of an acquired aphasia frequently associated with clinical seizures and paroxysmal electroencephalographic (EEG) accompaniment. There had been no adequate neuropathlogical correlations to explain the symptomatology; thus, various forms of pathogenesis have been ascribed to the syndrome. The clinical seizure is easily controlled by an antiepileptic; but speech recovery is variable, and this is usually poor in cases presenting one or two years after onset.