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Background: Vascular risk models can be quite informative in assisting the clinician to make a prediction of an individual's risk of cognitive impairment. Thus, a simple marker is a priority for low-capacity settings. This study examines the association of selected simple to deploy vascular markers with cognitive impairment in an elderly population. Method: This cross-sectional study assessed the cognitive functions of older persons 65 years and older in southwest Nigeria. Vascular parameters and risk factors were also measured. Analysis was done using SPSS, and logistic regression was used to explore the association between cognitive impairment and certain vascular risk factors such as elevated blood pressure, diabetes, and pulse pressure. Results: The study population comprised 623 participants (29.1% men) with mean age 73 ± 8.9 years. Having mean arterial pressure (MAP) and pulse pressure in the fourth quartiles (27% and 29.9%, respectively) was significantly associated with cognitive impairment (p = 0.001, p < 0.001). Predicted cardiovascular risks of 10% or more was significantly associated with cognitive impairment (p < 0.001). After adjusting for age, gender, educational level, and years of smoking, those with MAP in the fourth quartile were up to 3 times more likely to have cognitive impairment compared to those within the first quartile. Conclusion: Our study demonstrated that among elderly Nigerians, MAPs of 114 mmHg and more was an independent predictor of cognitive impairment. This is a simple measure that is available in low-capacity areas.

Background Physical activity is crucial to preventing noncommunicable diseases. This study aimed to provide up-to-date evidence on the epidemiology of insufficient physical activity across Nigeria to increase awareness and prompt relevant policy and public health response. Methods A systematic literature search of community-based studies on physical inactivity was conducted. We constructed a meta-regression epidemiologic model to determine the age-adjusted prevalence and number of physically inactive persons in Nigeria for 1995 and 2020. Results Fifteen studies covering a population of 13 814 adults met our selection criteria. The pooled crude prevalence of physically inactive persons in Nigeria was 52.0% (95% CI: 33.7–70.4), with prevalence in women higher at 55.8% (95% CI: 29.4–82.3) compared to men at 49.3% (95% CI: 24.7–73.9). Across settings, prevalence of physically inactive persons was significantly higher among urban dwellers (56.8%, 35.3–78.4) compared to rural dwellers (18.9%, 11.9–49.8). Among persons aged 20–79 years, the total number of physically inactive persons increased from 14.4 million to 48.6 million between 1995 and 2020, equivalent to a 240% increase over the 25-year period. Conclusions A comprehensive and robust strategy that addresses occupational policies, town planning, awareness and information, and sociocultural and contextual issues is crucial to improving physical activity levels in Nigeria. [ABSTRACT FROM AUTHOR]

The administration and governance of grant funding across global health organizations presents enormous challenges. Meeting these challenges is crucial to ensuring that funds are used in the most effective way to improve health outcomes, in line with the United Nations' Sustainable Development Goal 3, "Ensure healthy lives and promote well-being for all at all ages." The Good Financial Grant Practice (GFGP) Standard (ARS 1651) is the world's first and, currently, only international standard for the financial governance and management of grant funding. Through consensus building and global harmonization between both low- and middle-income and high-income country players, the GFGP Standard has achieved a leveling impact: GFGP applies equally to, and can be implemented by, all types of organization, regardless of location, size, or whether they predominantly give or receive funding. GFGP can be used as a tool for addressing some of the challenges of the current funding model. Here, we describe our experiences and lessons learned from implementing GFGP across 4 diverse research institutions in India, Nigeria, Colombia, and the Philippines as part of our National Institute for Health Research Global Health Research Unit on Genomic Surveillance of Antimicrobial Resistance. [ABSTRACT FROM AUTHOR]

Abstract Introduction Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents.

Background: Dementia is a chronic progressive disease that mostly affects the elderly. There is often a stigma surrounding dementia patients because of poor awareness about the disease. In Nigeria, this stigma and related attitudes have not been fully explored. In this study, we assessed the attitude of people towards demented individuals in a transitional community in Nigeria. Methods: The study used a mixed methods approach. Focused group discussions exploring the concept of dementia were conducted among six community groups, and quantitative data was obtained from an interviewer‐administered questionnaire. A total of 313 respondents were selected with a cluster sampling technique. Results: Only 212 respondents (67.7%) were aware of dementia. ‘Memory loss disease’, ‘ageing disease’, ‘disease of insanity’, ‘brain disorder’, ‘disease of forgetfulness’, and ‘dull brain’ are the common names used to describe dementia in the community. Enacted stigma was evident as 36% of respondents felt dementia was associated with shame and embarrassment in the community. Implied stigma was evident in another third that opined that demented individuals would prefer not to know or let others know that they have the disease. Also, 28% were of the opinion that people do not take those with dementia seriously. Of the 22 (10.4%) that reported having received structured information about dementia, 16 (72.7%) got the information from health facilities. Qualitative data revealed the presence of enacted stigma in the community as some referred to affected individuals by derogatory names such as ‘madman’. Some statements from the focus group discussion participants also gave useful insights into the scorn with which demented individuals are sometimes treated. Conclusion: The presence of enacted and implied stigma related to dementia within the community calls for concern. More research efforts are needed to unravel the burden of stigma within communities and best practice for stigma‐reducing interventions. [ABSTRACT FROM AUTHOR]

Background/ Objective: Child pedestrians have been identified as vulnerable road users. Although walking as a means of transport has health and other benefits, it exposes children to the risk of road traffic injuries. This study was conducted to assess the availability of road safety features around government-owned primary schools in Ibadan municipality. Materials and Methods: A multistage sampling technique was used to select 46 of the 74 schools in the study area. Some (11) of the selected schools were sited within the same premises and shared a common entrance; thus a total of 35 school premises were eventually observed. Trained research assistants observed the school environment around the selected schools for road safety features such as location of schools, presence of "school", "child crossing" and "speed limit" road signs, and presence of traffic calming devices (road bumps or zebra crossing). Results: Five (14%) of the schools were located on major roads and eight (23%) had road signs indicating that a school was nearby. Seven (20%) had road bumps close to the school, 15 (43%) had a warden who assisted children to cross, and none had a zebra crossing. Five (14%) schools had pedestrian sidewalks. Conclusions: The study revealed that the environment around a number of the observed schools in the municipality compromised the pupils' road safety. The local government, school authorities, parents, and road safety professionals need to institute definite measures to enhance the road safety environment around schools in the municipality. [ABSTRACT FROM AUTHOR]

Introduction: Out-of-school adolescents are often neglected when planning for tobacco prevention programmes whereas they are more vulnerable. Few studies exist in Nigeria about their pattern of tobacco use to serve as the basis for effective policy formulation. Method: A sub sample of 215 out of school adolescents was analyzed from a descriptive cross sectional study on psychoactive substance use amongst youths in two communities in a Local Government Area in Nigeria which used a multi-stage sampling technique. Results: Males were 53% and females 47%. Only 20.5% had ever used tobacco while 11.6% were current users. Males accounted for 60% of current users compared to 40% amongst females. Of current users, 84% believed that tobacco is not harmful to health. In addition, the two important sources of introduction to tobacco use were friends 72% and relatives 20%. Use of tobacco amongst significant others were: friends 27%, fathers 8.0%, relatives 4.2% and mothers 0.5%. The most common sources of supply were motor parks 52% and friends 16%. Conclusion: The study showed that peer influence is an important source of introduction to tobacco use while selling of tobacco to adolescents in youth aggregation areas is common. We advocate for a theory based approach to designing an appropriate health education intervention targeted at assisting adolescents in appreciating the harmful nature of tobacco use in this locality. A point-of-sale restriction to prevent adolescent access to tobacco in youth aggregation areas within the context of a comprehensive tobacco control policy is also suggested. However, more research would be needed for an in-depth understanding of the tobacco use vulnerability of this group of adolescents. [ABSTRACT FROM AUTHOR]

We conducted a multi-ancestry genome-wide association study of prostate-specific antigen (PSA) levels in 296,754 men (211,342 European ancestry; 58,236 African ancestry; 23,546 Hispanic/Latino; 3,630 Asian ancestry; 96.5% of participants were from the Million Veteran Program). We identified 318 independent genome-wide significant (p≤5e-8) variants, 184 of which were novel. Most demonstrated evidence of replication in an independent cohort (n=95,768). Meta-analyzing discovery and replication (n=392,522) identified 447 variants, of which a further 111 were novel. Out-of-sample variance in PSA explained by our genome-wide polygenic risk scores ranged from 11.6%-16.6% in European ancestry, 5.5%-9.5% in African ancestry, 13.5%-18.2% in Hispanic/Latino, and 8.6%-15.3% in Asian ancestry, and decreased with increasing age. Mid-life genetically-adjusted PSA levels were more strongly associated with overall and aggressive prostate cancer than unadjusted PSA. Our study highlights how including proportionally more participants from underrepresented populations improves genetic prediction of PSA levels, offering potential to personalize prostate cancer screening.

Introduction: Tobacco control strategies have not incorporated retailers, despite being the focus by the tobacco industry to promote its products. Few studies exist on their possible roles in tobacco control. This study, therefore, assessed retailer awareness of tobacco control laws and willingness to be involved in control activities., Methods: A cross sectional study was carried out on all 218 tobacco retailers in Ibarapa Central and Ibarapa East Local Government Areas of Oyo State. The willingness of tobacco retailers to participate in tobacco-use control was evaluated using a questionnaire., Results: The majority of the respondents were females (95%), and 30-39 years old with respect to age. Almost two-thirds (65%) of the respondents reported the sale of tobacco as a profitable business, and a third reported that their income would decrease if they stopped tobacco sales. Up to 35% of retailers were aware of laws restricting smoking in public places and 45% aware of a ban on the sale of tobacco products to minors. Retailers were willing to: support anti-tobacco legislations (84%), counsel smokers to quit smoking (84%), and display anti-tobacco messages in their shops (77%)., Conclusions: The sale of tobacco products is a profitable venture for retailers. Willingness to participate in tobacco control was high among the retailers. There is a need to raise awareness and co-opt tobacco retailers as change agents in tobacco control efforts., Competing Interests: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported., (© 2018 Uchendu O.)

Background: Tobacco industry's undermining of tobacco control goes on unabated in sub-Saharan African countries, especially in Kenya, Nigeria, and Uganda. The Framework Convention on Tobacco Control (FCTC) contains provisions aimed at curbing these activities. However, the level to which FCTC is implemented and the strength of each country's tobacco control law will determine its usefulness in this regard. We determined the implementation status and strength of tobacco control laws in Kenya, Nigeria, and Uganda., Materials and Methods: The World Health Organization and Campaign for Tobacco-Free Kids websites were queried for secondary data related to tobacco control. Sources and data were disambiguated and reported as tables. Composite scores for implementation were computed based on the number of indicators of the articles of the FCTC reported on by each country. Strength of tobacco control law (SoTCL) was computed based on the total number of domains of the laws meeting a defined acceptable standard. Total obtainable score for implementation and SoTCL were 148 and 38, respectively., Results: On the FCTC, Kenya, Nigeria, and Uganda achieved 75, 61.5, and 46.6% implementation, respectively. SoTCL was weakest in the smoke-free domain for Kenya, tobacco advertisement promotion and sponsorship domain for Nigeria, and packaging and labeling domain for Uganda. SoTCL scores were 18 (47.4%), 20 (52.6%), and 34 (89.5%) for Nigeria, Kenya, and Uganda, respectively., Conclusion: Kenya, Nigeria, and Uganda will need to strengthen their tobacco control laws through appropriate amendment as well as regulatory mechanisms that guarantee alignment with FCTC and the implementation thereof.