Health trends in Canada 1990-2019: An analysis for the Global Burden of Disease Study.

OBJECTIVE: Monitoring trends in key population health indicators is important for informing health policies. The aim of this study was to examine population health trends in Canada over the past 30 years in relation to other countries. METHODS: We used data on disability-adjusted life years (DALYs), years of life lost (YLL), years lived with disability, life expectancy (LE), and child mortality for Canada and other countries between 1990 and 2019 provided by the Global Burden of Disease Study. RESULTS: Life expectancy, age-standardized YLL, and age-standardized DALYs all improved in Canada between 1990 and 2019, although the rate of improvement has leveled off since 2011. The top five causes of all-age DALYs in Canada in 2019 were neoplasms, cardiovascular diseases, musculoskeletal disorders, neurological disorders, and mental disorders. The greatest increases in all-age DALYs since 1990 were observed for substance use, diabetes and chronic kidney disease, and sense organ disorders. Age-standardized DALYs declined for most conditions, except for substance use, diabetes and chronic kidney disease, and musculoskeletal disorders, which increased by 94.6%, 14.6%, and 7.3% respectively since 1990. Canada's world ranking for age-standardized DALYs declined from 9th place in 1990 to 24th in 2019. CONCLUSION: Canadians are healthier today than in 1990, but progress has slowed in Canada in recent years in comparison with other high-income countries. The growing burden of substance abuse, diabetes/chronic kidney disease, and musculoskeletal diseases will require continued action to improve population health.

RéSUMé: OBJECTIF: La surveillance des tendances des indicateurs clés de la santé de la population est importante pour éclairer les politiques de santé. Dans cette étude, nous avons examiné les tendances de la santé de la population au Canada au cours des 30 dernières années par rapport à d'autres pays. MéTHODES: Nous avons utilisé des données sur les années de vie ajustées en fonction de l'incapacité (DALY), les années de vie perdues (YLL), les années vécues avec un handicap, l'espérance de vie (LE) et la mortalité infantile pour le Canada et d'autres pays entre 1990 et 2019, fournies par l'Étude mondiale sur le fardeau de la maladie. RéSULTATS: L'espérance de vie, les YLL ajustées selon l'âge et les DALY ajustées selon l'âge ont tous connu une amélioration au Canada entre 1990 et 2019, bien que le taux d'amélioration se soit stabilisé depuis 2011. Les cinq principales causes des DALY pour tous les âges au Canada en 2019 étaient les néoplasmes, les maladies cardiovasculaires, les affections musculosquelettiques, les affections neurologiques et les troubles mentaux. Les plus fortes augmentations des DALY pour tous les âges depuis 1990 ont été observées pour l'usage de substances, le diabète et les maladies rénales chroniques, ainsi que les troubles des organes sensoriels. Les DALY ajustées selon l'âge ont diminué pour la plupart des conditions, à l'exception de l'usage de substances, du diabète et des maladies rénales chroniques, ainsi que des troubles musculosquelettiques, qui ont augmenté de 94,6 %, 14,6 % et 7,3 % respectivement depuis 1990. Le classement mondial du Canada pour les DALY ajustées selon l'âge est diminué de la 9ième place en 1990 à la 24ième place en 2019. CONCLUSION: Les Canadiens sont en meilleure santé aujourd'hui qu'en 1990, mais les progrès se sont ralentis ces dernières années par rapport à d'autres pays à revenu élevé. La croissance du fardeau lié à l'abus de substances, au diabète/maladies rénales chroniques et aux affections musculosquelettiques exigera des actions continues pour améliorer la santé de la population.

Luminescence dosimetry for evaluation of the external exposure in Metlino, upper Techa River valley, Southern Urals, Russia: Analysis of new results.

Luminescence dosimetry was applied in the former settlement of Metlino, Southern Urals, Russia as part of a full-scale study to validate the Techa River Dosimetry System (TRDS) 2016 for the upper Techa River region. The village, which was evacuated in 1956, was located 7 km downstream of the release point of liquid radioactive waste by the Mayak plutonium facility. Several brick samples were taken from north-eastern and south-eastern walls of the granary, facing the former Techa river shoreline and floodplain. Samples were all taken at the same height and measured at different depths into the brick. For the majority of brick samples, good Optically Stimulated Luminescence properties of the quartz grains were observed. In some cases, however, strong levels of sensitization and/or signal recuperation were encountered which necessitated adjustment in the measurement protocols. Anthropogenic doses in bricks varied from 1.5 to 6.6 Gy and the horizontal profiles along both walls showed significant variation, which is explained on a qualitative basis. A dose depth profile is observed for selected samples, which is different from the dose depth profile measured and simulated for samples from the north-western wall of the granary in previous studies. This is qualitatively explained by the differences in source configuration.

Heart failure in Nigeria: protocol for a systematic review and meta-analysis.

Background: Heart failure is now a significant contributor to the burden of non-communicable diseases in developing countries like Nigeria which is experiencing epidemiologic and demographic transition. The epidemiology of heart failure in this country is poorly characterized. The aim of the review is to determine the prevalence of heart failure, the associated risk factors, the aetiology, management, and outcomes of the condition in the country. Methods: Relevant databases such as PubMed /Medline, EMBASE, Web of Science, Google Scholar, African Index Medicus, and African journal online would be searched for articles published in English from January 2000 to December 2021. The analysis will include observational studies conducted among Nigerian adults aged 12 years and above. Article selection shall be conducted by pairs of independent reviewers. Data extraction shall be done by 2 independent reviewers. Results: The primary outcome would be the pooled prevalence of heart failure while the secondary outcomes would be to identify the risk factors and management of heart failure in Nigeria. Conclusion: This will be the first systematic review and meta-analysis of heart failure epidemiology in Nigeria which will hopefully identify gaps for future research and guidance for policy interventions.

Utilization of Uterine and Umbilical Artery Doppler in the Second and Third Trimesters to Predict Adverse Pregnancy Outcomes: A Nigerian Experience.

Objective: To assess the utility of uterine and umbilical artery Doppler in the second and third-trimester in predicting adverse pregnancy outcomes. Methodology: In a prospective longitudinal study, the demographic, clinical, Doppler ultrasound parameters of the uterine and umbilical arteries of 84 consecutive women attending the antenatal clinic at 22-24 weeks and 116 women at 30-34 weeks gestation and pregnancy outcomes were documented and analyzed. Results: Pregnant women with adverse pregnancy outcomes had significantly higher second-trimester mean uterine systolic/diastolic (S/D) ratio (p = 0.001), pulsatility index (PI; p = 0.003), umbilical artery S/D (p = 0.016), and resistivity index (RI; p = 0.041) as well as higher third-trimester uterine S/D and PI. While pregnancies with adverse fetal outcomes showed significantly higher uterine artery S/D and PI at the second trimester, third-trimester uterine showed higher S/D, RI, and PI and umbilical artery PI than in women with normal fetal outcomes. The combination of uterine PI and early diastolic notch were predictors of maternal outcomes and correctly predicted 73% (p < 0.001) in the second trimester. By the third trimester, the uterine PI alone was the best predictor and accurately predicted about 62% of maternal outcomes (p = 0.028). In addition, the second-trimester uterine S/D and early diastolic notch and uterine PI in the third trimester correctly predicted 79% and 78% of fetal outcomes, respectively. Conclusion: Among unselected pregnant women population, the second-trimester Doppler parameters are better predictors of maternal adverse pregnancy outcomes, while adverse fetal outcome prediction by uterine and umbilical Doppler at the second- and the third-trimester parameters are comparable.

Central Retinal and Ophthalmic Artery Doppler Velocimetry among Hypertensives and Normotensive Adults at a Nigerian Tertiary Health Facility.

Background: Haemodynamic alterations of the retrobulbar circulation are sequelae of untreated, long-standing hypertension. Early evaluation of the retrobulbar blood flow is very crucial to prevent irreversible ocular complications. The objective of this study was to evaluate the differences in central retinal artery (CRA) and ophthalmic artery (OA) haemodynamics in adult hypertensive and non-hypertensive subjects. Methodology: This prospective, comparative cross-sectional study was conducted among 63 hypertensives and 75 normotensive controls. Using Doppler ultrasonography, the CRA and OA Doppler velocimetry parameters among cases and controls were evaluated and analysed. Results: The CRA Peak Systolic Velocity (PSV) and End-diastolic velocity (EDV) was 7.54 ± 2.60cm/s and 2.99 ± 1.15cm/s (p<0.001) in hypertensives but 10.8 ± 2.51cm/s and 4.50 ± 1.25cm/s) p<0.001 in controls. The systolic/diastolic ratio (S/D) in cases was 2.64 ± 0.75 and 2.44 ± 0.38 p=0.045 in controls. The CRA's Pulsatility Index (PI) between cases and controls was not statistically significant, p =0.082. Furthermore, the CRA's PSV, PI, Resistivity index (RI) and S/D, were higher among subjects with stage 1 compared to stage 2 hypertension (p=0.004; p=0.027; p<0.001 and p=0.001 respectively). The OA mean EDV in hypertensives was 4.57 ± 1.97 and in controls= 5.31 ± 1.79 (p=0.022), while the OA mean RI and Peak Ratio, p=0.009 and 0.003, respectively, were higher in stage 1 hypertension. Conclusion: The Central retinal and ophthalmic artery blood flow parameters were significantly lower among hypertensive cases. Also, hypertensive stage 2 cases had significantly lower blood flow and vascular impedance parameters in the CRA and both Central retinal and ophthalmic artery, respectively.

Sexual Abuse among Female Adolescent Hawkers in Selected Markets in Ibadan, Nigeria.

Involvement of a child or adolescent in a sexual activity is a global public health challenge. This cross-sectional study documented experiences of sexual abuse (SA) among Female Adolescent Hawkers (FAHs) in selected markets in Ibadan, Nigeria. Data were collected from 410 FAHs using interviewer-administered questionnaire. Descriptive statistics, chi-square and logistic regression were used to analyze the data at p < .05 significance level. Mean age of respondents was 14.4 ± 1.76 years. The majority (69.0%) have ever experienced at least a form of SA, of which 68.3% occurred 3 months preceding the study. Having had sex and boyfriends were predictors of SA. Male customers (98.6%), traders (98.2%) and peers (69.4%) were major perpetrators. About 67.5% of victims of SA did not seek help. Sexual abuse is a major problem among FAHs. Age-appropriate sexuality education and life-building skills interventions should be targeted at FAHs while advocacy is recommended for caregivers and market stakeholders.

Effects of Training on HIV Risk Perception, Knowledge and Sexual Behaviour Among Fisherfolks in Two Communities in North Central Nigeria.

Fisherfolks participate in unsafe sexual behaviors which can predispose them to HIV infection. This research was designed to assess the effects of training on HIV/AIDS-related knowledge and sexual behavior among fisherfolks in two fishing communities in Nigeria. Respondents were allocated into Experimental Group (EG, n = 103) and Control Group (CG, n = 105). Data were collected at baseline using a questionnaire which included questions on socio-demographic characteristics, sexual behavior among others. A 3-day HIV/AIDS training was conducted for EG. Fisherfolks in EG and CG with good knowledge were 16.5% and 54.3%, respectively at baseline. The number increased to 100.0% in EG than CG (60%) at follow-up. At baseline, fisherfolks in EG and CG with high riskperception scores were 26.2% and 59.0%, respectively; corresponding figures at post intervention for EG and CG were 100.0% and 70.0% respectively. Training increased HIV/AIDS knowledge, improved risk perception and reduced risky sexual practices among fisherfolks.

Soil-to-cassava plant transfer factor of natural radionuclides on a mining impacted soil in a tropical ecosystem of Nigeria.

The transfer factors (TFs) of naturally occurring radionuclides, 238U and 232Th from soil to different cassava plant compartments were calculated. Cassava is widely cultivated in Nigeria and contributes significantly to the food supply of the nation. There is sparsity of data on the TFs in Nigeria, and no TF data from any African country were included in the International Atomic Energy Agency's compilation of TFs for the tropical ecosystem. Samples of tin tailings and soil samples from virgin land were used to formulate three soil groups; group-A (soil from virgin land only), group-B (tailings only) and group-C (equal dry mass combination of tailings and soil from virgin land). Pot experiments were set up to determine the TFs of 238U and 232Th. The activity concentrations of 238U and 232Th in the dried samples of the soil and plant compartments were determined using a sodium iodide detector. The TF of 238U ranged from below detection limit (BDL) to 0.01 in the tuber samples, BDL to 0.23 in the stem samples and BDL to 0.90 in the leaf samples, while the TF of 232Th ranged between 0.006 and 0.49 for tuber samples, 0.03 and 0.65 in stem samples and 0.03 and 1.54 in the leaf samples. There were significant difference in the TF of 238U and 232Th between the soil groups. The leaf compartment generally had most of the highest TF values while the tuber samples had most of the lowest TF values for both radionuclides.

The Value of Ultrasonography in the Diagnosis of a Rare Congenital Dermoid Cyst of the Anterior Fontanelle in an Infant.

A dermoid cyst is a benign lesion that may occur in different parts of the body. A dermoid cyst of the subgaleal space over the anterior fontanelle is rather uncommon. We present a case of congenital dermoid cyst of the anterior fontanelle in a 3-month-old male infant, underscoring the value of ultrasonography in the diagnosis and highlighting the classical clinical, sonographic, surgical, and pathological findings.

Un kyste dermoïde est une lésion bénigne qui peut survenir dans différentes parties du corps. Un kyste dermoïde de l'espace sous-galéal au-dessus de la fontanelle antérieure est plutôt rare. Nous présentons un cas de kyste dermoïde congénital de la fontanelle antérieure chez un nourrisson de sexe masculin de 3 mois, soulignant l'intérêt de l'échographie dans le diagnostic et mettant en évidence les résultats cliniques, échographiques, chirurgicaux et pathologiques classiques.

Risk factors for perinatal transmission of HIV among women attending prevention of mother-to-child transmission clinics in Northwest Nigeria.

Despite the effectiveness of antiretroviral therapy (ART) in the prevention of mother-to-child transmission of HIV (PMTCT), some HIV-infected women in PMTCT care are at risk of transmitting HIV to their babies. Using a 1:1 unmatched case-control study design, we assessed the risk factors for perinatal transmission among women who received ART for PMTCT in Sokoto State, Nigeria. Data were abstracted from medical records of cases (94 HIV-infected babies) and controls (94 HIV-uninfected babies) and their mothers who accessed PMTCT services in three purposefully selected secondary health facilities. We conducted univariate and multivariate logistic regressions to determine if sociodemographic characteristics, time of enrolment, type of maternal ART, receipt of infant antiretroviral (ARV) prophylaxis, place of delivery, or feeding practice were associated with HIV infection among HIV-exposed babies. Sixteen percent of the mothers of babies in the case group had early enrolment while 90% of those in the control group enrolled early. Infant prophylaxis was received in 54% of cases and 95% of controls. In both groups, 99% of the mothers practiced mixed feeding. In the univariate analysis, factors that were significantly associated with HIV infection were religion (islam), rural residence, late⁠ enrolment, and non-receipt of infant ARV prophylaxis. In the multivariate analysis, rural residence (Adjusted odds ratio (aOR) = 8.01, 95% CI = 1.79-35.78), late enrolment (aOR = 41.72, 95% CI = 15.16-114.79), and non-receipt of infant ARV prophylaxis (aOR = 4.1, 95% CI = 1.18-14.33) remained statistically significant. Findings from this study indicate that eliminating MTCT in Nigeria requires interventions that will enhance timely access of ART by mother-baby dyads.

Youths and non-consensual sex: exploring the experiences of rape and attempted rape survivors in a tertiary institution in Ibadan, Nigeria.

BACKGROUND: Non-consensual Sex (NCS) is a worldwide problem with far reaching effects on the survivors. This study explored the experiences of rape and attempted rape (AR) survivors in a tertiary institution in Nigeria. METHODS: In-depth interviews with fourteen survivors of rape and AR were used to explore the context of experience of NCS, its consequences and help-seeking. Interviewees consisted two males and five females for each form of NCS who were identified during the quantitative aspect of the study. Interviews were subjected to content analysis. RESULTS: Mean age of the respondents was 22.3±2.5 years. Context of non-consensual sexual experiences varied with sex. Female survivors reported use of physical violence on them by their perpetrators while males reported verbal threats, nudity, forceful hugging and kissing. Means of escape adopted by survivors of AR varied between the sexes. Female AR survivors used physical force as a means of escape while males employed deception/plea. Perpetrators were majorly acquaintances of the survivors. Consequences of the experiences reported include physical injuries and pregnancy among females and psychological disturbances among males. Majority, both males and females did not report, nor seek help due to shame and did not know appropriate methods of preventing future experience. CONCLUSION: Although both males and females reported they have experienced rape and AR, the context of the experiences and consequences reported varied between both sexes and most did not know how to prevent future experience. This call for urgent development of gender sensitive sexual violence prevention programmes to address this phenomenon. FUNDING: The study received grant support from The Gates Institute, John Hopkins University Baltimore, USA through The Centre for Population and Reproductive Health, College of Medicine, University of Ibadan, Nigeria.

Instant messaging and nursing students' clinical learning experience.

BACKGROUND: Although learning in clinical settings is a key element of nursing education, for many learners these are challenging developmental contexts often marked by isolation and a lack of belongingness. Despite the massive appropriation of mobile instant messaging (MIM) platforms and the connective properties attendant to them, very little is known about their role in and impact on nursing students' clinical learning experiences. APPROACH AND METHODS: To address this gap, the study, which was part of a multinational research project on the use of mobile social media in health professions education in developing countries, examined the use of the instant messaging platform WhatsApp by nursing students during placements and potential associations with socio-professional indicators. The survey involved a total number of 196 nursing students from 5 schools in Oyo State, Nigeria. RESULTS: The findings suggest that students used WhatsApp relatively frequently and they perceived that this platform strongly enhanced their communication with other students and nurses. WhatsApp use during placements was positively associated with students' maintained social capital with peer students, the development of a professional identity, placement satisfaction and with reduced feelings of isolation from professional communities. The determinants that influenced WhatsApp use during placements were perceived usefulness and perceived ease of use. No associations were found between WhatsApp use during placement and age, attitude, subjective norms and placement duration. CONCLUSION: This study is one of the first of its kind that points to the relevance of mobile instant messaging as part of nursing students' (inter)personal learning environments in clinical settings and, particularly, in the development setting under investigation. Further research is needed to corroborate these findings, to enhance the understanding of the impact mechanisms, and to evaluate a more systematic use of MIM in clinical learning contexts.

Intracranial Arterial Calcification in Black Africans with Acute Ischaemic Stroke.

BACKGROUND: Intracranial arterial calcification (IAC), a recognized marker of atherosclerosis on cranial computed tomography (CT), is an independent risk factor for ischaemic stroke. This study aimed to determine the prevalence, distribution, severity, and associations of IAC in adults with acute ischaemic stroke (AIS) at the University College Hospital, Ibadan, Nigeria. METHODS: Cranial CT images of 130 consecutive adults who presented with AIS were acquired on a 64-slice multi-detector Toshiba Aquilion scanner and evaluated for IAC in bone window on Vitrea® software using a semi-quantitative scoring method for extent, thickness, and length of calcifications in the large intracranial arteries. Associations of IAC with clinical and laboratory data were determined by statistical analysis at p < 0.05. RESULTS: There were 71 males (54.6%), and the mean age of all patients was 63.0 ± 13.2 years. Hypertension was the most common risk factor (83.1%). IAC was found in 121 patients (93.1%), predominantly in the carotid siphon (86.1%) followed by the intracranial vertebral arteries (9.3%), middle cerebral arteries (2.4%), basilar artery (1.2%), and the anterior cerebral arteries (1%). The burden of IAC ranged from mild (17.4%) to moderate (52.1%) to severe (30.6%). Age (p < 0.001), diastolic blood pressure (p = 0.037), and alcohol use (0.046) were significantly different among the patients with mild, moderate, and severe degrees of IAC. IAC was associated with age (p < 0.001), hypertension (p = 0.03), diabetes mellitus (p = 0.02), hyperlipidaemia (p = 0.04), and alcohol use (p < 0.001) but not with sex (p = 0.35). CONCLUSIONS: The burden of IAC is very high among native African patients with AIS and preferentially involves proximal inflow arteries. Therefore, the role of large vessel atherosclerosis in ischaemic stroke in native Africans should be explored in future multinational, multimodality studies.

Maternal depression and child psychopathology among Attendees at a Child Neuropsychiatric Clinic in Abeokuta, Nigeria: a cross sectional study.

BACKGROUND: Children with recognized, diagnosable mental and neurological disorders are in addition prone to emotional and behavioral problems which transcend their specific diagnostic labels. In accessing care, these children are almost invariably accompanied by caregivers (usually mothers) who may also have mental health problems, notably depression. The relationship between child and maternal psychopathology has however not been sufficiently researched especially in low and middle income countries. METHODS: Mothers (n = 100) of children receiving care at the Child and Adolescent Clinic of a Neuropsychiatric Hospital in Abeokuta, Nigeria took part in the study. To each consenting mother was administered a sociodemographic questionnaire and the Patient Health Questionnaire, while information regarding their children (n = 100) was obtained using the Strengths and Difficulties Questionnaire. Data analysis was done with the Statistical Package for Social Sciences (SPSS) version 16. RESULTS: The mean ages of the mothers and children were 40.4 years (SD 4.7) and 11.6 years (SD 4.1), respectively. Among the children, 63 % had a main diagnosis of seizure disorder. Regardless of main diagnosis, 40 % of all the children had a comorbid diagnosis. Among the mothers, 23 % had major depressive disorder. A quarter (25 %) of the children had abnormal total SDQ scores. A diagnosis of major depressive disorder in mothers was associated with poor total SDQ scores and poor scores in all SDQ domains except the emotional domain for the children. Major depressive disorder among the mothers was associated with not being married (p = 0.004; OR = 0.142, 95 % CI 0.037-0.546) and longer duration of the child's illness (p = 0.039, OR = 1.165, 95 % CI 1.007-1.346). CONCLUSION: The study showed notable rates of depressive illness among mothers of children with neuropsychiatric disorders. Marked rates of emotional and behavioral disorders were also found among the children. Associations were found between maternal and child psychopathology. Mothers of children with neuropsychiatric disorders should be screened for depressive illness.

Effects of problem-solving interventions on aggressive behaviours among primary school pupils in Ibadan, Nigeria.

BACKGROUND: Aggressive patterns of behavior often start early in childhood, and tend to remain stable into adulthood. The negative consequences include poor academic performance, disciplinary problems and encounters with the juvenile justice system. Early school intervention programs can alter this trajectory for aggressive children. However, there are no studies evaluating the feasibility of such interventions in Africa. This study therefore, assessed the effect of group-based problem-solving interventions on aggressive behaviors among primary school pupils in Ibadan, Nigeria. METHODS: This was an intervention study with treatment and wait-list control groups. Two public primary schools in Ibadan Nigeria were randomly allocated to an intervention group and a waiting list control group. Teachers rated male Primary five pupils in the two schools on aggressive behaviors and the top 20 highest scorers in each school were selected. Pupils in the intervention school received 6 twice-weekly sessions of group-based intervention, which included problem-solving skills, calming techniques and attribution retraining. Outcome measures were; teacher rated aggressive behaviour (TRAB), self-rated aggression scale (SRAS), strengths and difficulties questionnaire (SDQ), attitude towards aggression questionnaire (ATAQ), and social cognition and attribution scale (SCAS). RESULTS: The participants were aged 12 years (SD = 1.2, range 9-14 years). Both groups had similar socio-demographic backgrounds and baseline measures of aggressive behaviors. Controlling for baseline scores, the intervention group had significantly lower scores on TRAB and SRAS 1-week post intervention with large Cohen's effect sizes of 1.2 and 0.9 respectively. The other outcome measures were not significantly different between the groups post-intervention. CONCLUSIONS: Group-based problem solving intervention for aggressive behaviors among primary school students showed significant reductions in both teachers' and students' rated aggressive behaviours with large effect sizes. However, this was a small exploratory trial whose findings may not be generalizable, but it demonstrates that psychological interventions for children with high levels of aggressive behaviour are feasible and potentially effective in Nigeria.

Associations between Forced Sexual Initiation, HIV Status, Sexual Risk Behavior, Life Stressors, and Coping Strategies among Adolescents in Nigeria.

OBJECTIVES: Some individuals experience their first sexual intercourse through physically forced sex, which affects the way they experience and cope with stress. We examined differences in sexual risk behavior, experience of stressors, and use of stress-coping strategies among adolescents in Nigeria based on their history of forced sexual initiation and HIV status. METHODS: We analyzed data from 436 sexually active 10-19-year-old adolescents recruited through a population-based survey from 12 Nigerian states. Using Lazarus and Folkman's conceptual framework of stress and coping, we assessed if adolescents who reported forced sexual initiation were more likely to report HIV sexual risk practices, to report as stressors events related to social expectations, medical care and body images, and loss and grief, and to use more avoidance than adaptive coping strategies to manage stress. We also assessed if HIV status affected experience of stressors and use of coping strategies. RESULTS: Eighty-one adolescents (18.6%) reported a history of forced sexual initiation; these participants were significantly more likely to report anal sex practices (OR: 5.04; 95% CI: 2.14-11.87), and transactional sex (OR: 2.80; 95% CI: 1.56-4.95). Adolescents with no history of forced sexual initiation were more likely to identify as stressors, life events related to social expectations (OR: 1.03; 95% CI: 0.96-1.11) and loss and grief (OR: 1.34; 95% CI: 0.73-2.65), but not those related to medical care and body images (OR: 0.63; 95% CI: 0.34-1.18). They were also more likely to use adaptive responses (OR: 1.48; 95% CI: 0.62-3.50) than avoidance responses (OR: 0.90; 95% CI: 0.49-1.64) to cope with stress, though these differences were not significant. More adolescents with a history of forced sexual initiation who were HIV positive identified as stressors, life events related to medical care and body images (p = 0.03) and loss and grief (p = 0.009). Adolescents reporting forced sexual initiation and HIV-negative status were significantly less likely to use religion as a coping strategy (OR: 0.28; 95% CI: 0.09-0.83). CONCLUSION: History of forced sexual initiation and HIV status affected perception of events as stressors and use of specific coping strategies. Our study findings could inform best practice interventions and policies to prevent and address forced sexual initiation among adolescents in Nigeria and other countries.

Sexual and Reproductive Health Research and Research Capacity Strengthening in Africa: Perspectives from the region.

Developing the capacity to effectively carry out public health research is an integral part of health systems at both the national and global levels and strengthening research capacity is recognized as an approach to better health and development in low- and middle-income countries (LMICs). Especially fields such as sexual and reproductive health (SRH) would require inter-disciplinary teams of researchers equipped with a range of methodologies to achieve this. In November 2013, as part of the International Family Planning Conference in Addis Ababa, Ethiopia, a group of African researchers came together to discuss the gaps and strategies to improve sexual and reproductive health research and research capacity strengthening in Africa. This commentary summarizes the three broad areas where the issues and proposed solutions have concentrated around: 1) Addressing research gaps that are most relevant to policies and programmes in SRH, 2) Carrying out high quality and collaborative research, and 3) Translating research findings into SRH policies and programmes. Even though the focus of the discussions was Africa, the issues and proposed solutions can also be applied to other regions facing a high burden of disease with limited resources. The time is now and these can be achieved through synergistic commitment of African and global researchers, funders and organizations.

Influence of Exposure to Sexually Explicit Films on the Sexual Behavior of Secondary School Students in Ibadan, Nigeria.

Young people in secondary schools who are prone to engage in risky sexual behaviors spend considerable time watching Television (TV) which often presents sex scenes. The influence of exposure to sex scenes on TV (SSTV) has been little researched in Nigeria. This study was therefore designed to determine the perceived influence of exposure to SSTV on the sexual behavior of secondary school students in Ibadan North Local Government Area. A total of 489 randomly selected students were surveyed. Mean age of respondents was 14.1 ± 1.9 years and 53.8% were females. About 91% had ever been exposed to sex scenes. The type of TV program from which most respondents reported exposure to sexual scenes was movies (86.9%). Majority reported exposure to all forms of SSTV from secondary storage devices. Students whose TV watching behavior was not monitored had heavier exposures to SSTV compared with those who were. About 56.3% of females and 26.5% of males affirmed that watching SSTV had affected their sexual behavior. Predictor of sex-related activities was exposure to heavy sex scenes. Peer education and school-based programs should include topics to teach young people on how to evaluate presentations of TV programs.