4,239 research outputs found
Trends and drivers of skilled birth attendant use in Nigeria (1990–2013): policy implications for child and maternal health
No full textAdeniyi F Fagbamigbe,1,2 Elizabeth O Hurricane-Ike,3 Oyindamola B Yusuf,1 Erhabor S Idemudia2 1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Nigeria; 2School of Research and Postgraduate Studies, Faculty of Human and Social Sciences, North West University, Mafikeng, South Africa; 3Department of Demography and Social Statistics, Obafemi Awolowo University, Ile Ife, Nigeria Introduction: While Nigeria accounts for only 2% of the world population, it regrettably shares 14% of global maternal death burden. Whether its reported increase in antenatal care utilization is accompanied by increased use of skilled birth attendants (SBAs) is not known. This study assessed trends in utilization of SBAs in Nigeria between 1990 and 2013 and identified its determinants.Methods: Data from four consecutive Nigerian Demographic and Health Survey reports between 1990 and 2013 were pooled. We used basic descriptive statistics, test of association, and logistic regression to assess the prevalence, relative change, and determinants of SBA use at 5% significance level. Sample weights were applied, and adjustment was made for survey design and sampling errors.Results: Nearly half (46.7%) of the respondents were aged 25–34 years, while half (50.3%) of the respondents had no formal education. The prevalence of SBA use increased only marginally across the years and characteristics studied, from 32.4% in 1990 to 38.5% in 2013, an insignificant 6% increase. Educated women used SBA more than women with no education (92.4% vs 13.1%), and their odds ratio of using SBA were thrice that of uneducated women (odds ratio =3.09, 95% confidence interval =2.17–4.38). Women involved in decisions regarding their use of health facility were 12% more likely to use SBAs than others who do not. Educational attainment, religion, tribe, rural/urban residence, and zone of residence were significant to the use of SBA.Conclusion: The use of SBA was very low throughout the study period, barely at one third usage with insignificant changes over the studied period. Women empowerment, including decision-making power and residence, were the strongest determinants of SBA use. To overturn poor child and maternal health outcomes in Nigeria through SBA use, efforts should be targeted at educating girls, sexual and reproductive health education, and accessible and improved health care facility services. Keywords: antenatal care, utilization, women education, Nigeria, women empowerment, DH
Modeling association between times to recurrence of the different polarities in bipolar disorder among service seekers in urban Nigeria: a survival analysis approach
No full textAdeniyi Francis Fagbamigbe,1 Victor Adesola Makanjuola2 1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Nigeria; 2Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan Nigeria Introduction: Bipolar disorder (BD) remains both a clinical and public health challenge worldwide, especially in developing countries such as Nigeria. Many studies have focused on prevalence and recurrences among BD service seekers but little has been documented on the nature, strength, direction, existence, and estimation of association between times to recurrence of the two possible polarities or mood episodes in BD. In this study, we explored the association between durations before recurrence of depression and manic episodes among people seeking treatment for BD.Methods: This analytical study used retrospective data of 467 persons who sought treatment for BD at the psychiatric clinic of University College Hospital, Ibadan, Nigeria between 2005 and 2014. Descriptive statistics were used to explore the data. We right-censored the data and obtained Kaplan–Meier estimates of the time to recurrence of the outcomes and transformed the estimates to standardized binormal data using quantile-quantile transformation. The likelihood was maximized to obtain the maximum likelihood estimate of the association parameter at 5% significance level.Results: The mean (± standard deviation) age of the respondents was 32.9±12.9 years, this was lower among service seekers who were initially diagnosed with mania than among those initially diagnosed with depression (31.3±11.6, 33.2±11.9, respectively). The median survival time to recurrence of mania and depression among the patients was 1,120 and 745 days, respectively, whereas association between times to recurrence of mania and depression was maximized at 0.67 (95% confidence interval: 0.62–0.71).Conclusion: There exists a strong and positive association between times to recurrence of depression and mania in BD. The longer the time to recurrence of mania, the longer the time to recurrence of depression and vice versa. Keywords: bipolar disorder, time to recurrence, depression, bivariate censored outcomes, maximum likelihood estimates, mania 
Survivorship of patients with head and neck cancer receiving care in a tertiary health facility in Nigeria
No full textVitalis C Okwor,1,2 Adeniyi F Fagbamigbe,1 Olufunmilayo I Fawole1 1Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan, Ibadan, Oyo State, Nigeria; 2Department of Radiation Medicine, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria Background: Head and neck cancer (HNC) is a major clinical and public health concern worldwide which impairs the vital functions of life. The treatment of metastatic HNCs is mainly palliative. This study examined the survival patterns and treatment outcomes in patients with HNCs in a tertiary hospital in Nigeria.Materials and methods: A review of the case files and treatment cards of patients with histological diagnosis of HNCs seen between January 2002 and December 2011 at the Radiotherapy Department, University College Hospital, Ibadan, was conducted. A total of 494 cases were identified, of which 481 had valid records. Analyses were done using Kaplan–Meier survival function and Cox proportional hazard regression techniques at 5% significance level.Results: The median age of patients was 42 years with a male-to-female ratio of 2:1. Most patients presented at stages 3 (50.7%) and 4 (36.8%). Nasopharyngeal carcinoma was the most common (42.6%) HNC, followed by paranasal sinus (17.7%) and laryngeal cancer (11.6%). The lung was the most common site of metastasis (25.5%). Patients who presented at stages 1 and 4 disease had a median survival of 7.8 years and 1.9 years, respectively. Patients treated with a combination of chemotherapy and radiotherapy had a median survival of 8.0 years compared with those who had a single modality of treatment (~6.3 years).Conclusion: Patient survival was inversely proportional to the stage of the disease. To encourage the early presentation of HNC cases, health education of the population on routine medical check-ups and on the symptoms suggestive of HNC is recommended. Health care providers should be trained to refer suspected cases promptly to tertiary health facilities for management. Keywords: head and neck cancer, treatment outcome, survivorship patterns 
Isrogrogidda Falka Af-soomaaliga: Aragti ku aadan Midaynta Qoraalkiisa
No full textQoraagu wuxuu diraasad ku sameeyey sidii loo midayn lahaa af Soomaaliga qoraaal ahaan loo adeegsada. Gaar ahaan wuxuu diiradda saarayaa sidii loo midayn lahaa qaababka isrogrogga falalka oo haatan loo adeegsado siyaabo aan midaysanayn.In questo articolo, l'autore analizza e avanza una proposta relativamente alla standardizzazione del somalo scritto, in particolar modo delle forme di coniugazione dei verbi somali che attualmente non sono scritte in modo omogenea.In this article, the author analyzes and provides a proposal about the standardization of written Somali, in particular relating to verb conjugation forms whose orthography still differs today.Cabdirashid M. Ismaaciil, Cabdalla C. Mansuur, Saynab A. Sharci (eds.
Coastal Research and its Economic Justification
No full textProper and thorough planning of coastal engineering projects is discussed and the economie justification of research work indicated. Examples are given concerning navigational problems, coastal protection problems, and harbor sediment problems.KWP-collectio
Midaynta iyo Horumarinta Af-soomaaliga
No full textQoraagu wuxuu maqaalkan ku falanqaynayaa arrimo ku saabsan midaynta af Soomaaliga qoran, oo dadka qaarkood ay ku doodaan in ay dhibaato ka taagantahay, iyagoo u aanaynaya kala duwanaanta lahjadaha Soomaaliyeed iyo farta af Soomaaliga oo aan xasillayn. Qoraha oo soo bandhigayaa in arrimahaasu aanu sax ahayn, wuxuuna muujinayaa caqabadaha dhabta ah ee hortaagan houmarinta af Soomaaliga: afku wuxuu la'yahay dawlad si rasmi ah u adeegsato, weerar ba'anna waxaa ku haya af Ingiriisiga, xagga ereyadana nabaadguur xooggan ayaa ku dhacaya, gaar ahaan ereyada la xiriira dhaqanka Soomaaliyeed.L'autore, in questo articolo, analizzando la questione della lingua somala scritta, cerca di illustrare che la situazione del somalo standard non è cosi problematica come a detta di alcuni somali, specialmente, nell'ortografia e nella differenza tra i dialetti, ma il problema somalo è bensì riscontrabile in altri fattori: la mancanza di un stato che continui ad adottare il somalo come lingua ufficiale, l'estinzione di tantissimi vocaboli in disuso, nonché la forte influenza dalla lingua inglese.The author in this article, in analysing the written somali language, wants to show the somali standard situation is not so bad, like some Somalis say, especially in orthography and in vernaculars difference. In spite of, the somali language problem is recognisable in some others factors: lack of state that usually chooses somali language as official language, extinction of many terms in disuse and also the strong influence of English.Cabdirashid M. Ismaaciil, Cabdalla C. Mansuur, Saynab A. Sharci (eds.
Are the timings and risk factors changing? Survival analysis of timing of first antenatal care visit among pregnant women in Nigeria (2003–2013)
No full textAdeniyi Francis Fagbamigbe,1,2 Baitshephi Mashabe,1 Lornah Lepetu,1 Clearance Abel1 1Department of Mathematics and Statistical Sciences, Botswana International University of Science and Technology, Palapye, Botswana; 2Department of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Nigeria Background: Child and maternal mortality and morbidity remain among the top global health challenges despite various efforts and multitude of resources directed to improving this situation over time. This study assessed trend of the timings of first antenatal care (ANC) visit in Nigeria and also identified the risk factors associated with it.Methods: The data obtained from three consecutive Nigerian Demographic and Health Surveys in 2003, 2008, and 2013 were pooled. We focused on the ANC attendance history during the current pregnancies or the last pregnancies within 5 years preceding the survey irrespective of how the pregnancy ended. The gestational age at time of first ANC visit was computed as the survival time, while others who did not attend ANC were censored. Basic descriptive statistics and survival analysis methods were used to analyze the data.Results: A total of 45,690 pregnancies were studied, of which 70% were from rural areas. Mothers were mostly (45%) aged 25–34 years and 47.1% had no formal education, while only 37.9% were involved in decisions on the use of health care facility. Prevalence of ANC use was 60.5% in 2008 and 65.8% in both 2003 and 2013. Less than one-third (32.3%) of the women accessed ANC within first 3 months of pregnancy, with highest rate (41.7%) among women with higher education and those from North Central Nigeria (42.7%). The hazard of the timing of first ANC visit was higher in years 2003 and 2013 than in 2008.Conclusion: Initiation of ANC visit in Nigeria is generally late with most women making first visit during second trimester, with significant variations across the years studied. The increase in coverage of ANC recorded in 2003 and 2013 was not accompanied by earlier commencement of ANC visit. Maternal health stakeholders should do more to ensure that all pregnant women start ANC visit earlier. Keywords: antenatal care, timing of first ANC visit, Nigeria, women autonomy, maternal healt
Om inloppet ifrån Östersjön : till SöderTelje eller Egelsta wiken
No full textAuthor: Nathanael Gerhard af Schultén.Dated: "Carlberg den 12 Januari 1806."Digital reproduction, The National Library of Finland, Centre for Preservation and Digitisation, MikkeliA description of the Baltic Sea.TravelEuropeanaSchultén, Nathanael Gerhard af (1750-1825
Dwing als gebiedsontwikkelaar een duidelijke opdracht af
No full textTerwijl de context waarin gebiedsontwikkelaars werken alleen maar complexer wordt, ziet Co Verdaas, hoogleraar gebiedsontwikkeling, een aanhoudende neiging om keuzes vooruit te schuiven of te verhullen. Hij geeft zes tips om gebiedsontwikkelaars in hun kracht te zetten. “Zonder escalatie geen resultaat zou het devies moeten zijn.”Practice Chair Urban Area Developmen
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