Bodily Pain in Physical Function and the Role of Physical Activity Among Community-Dwelling Adults Aged 50-69 Years in Ghana.

BACKGROUND: Older adults who experience pain are likely to report higher functional limitations (FL) and lower physical activity (PA) levels. However, the extent to which PA explains the association of pain with FL is largely unknown, particularly in low- and middle-income countries. This study estimates whether and how much pain in FL is mediated by PA engagement. METHODS: We used cross-sectional data from 770 adults aged 50-69 years who participated in the Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana. FL and pain characteristics were defined using the Medical Outcomes Study Short Form-36. PA was assessed by the International Physical Activity Questionnaire-Short Form. Bootstrapped mediation analyses estimated the direct and indirect hypothesized associations. The control variables included age, sex, residential type, level of education, monthly income, social isolation, emotional distress, multimorbidity, and self-rated health. RESULTS: After adjusting for potential confounders, higher pain interference (ß = 0.091, p < .05) and higher pain severity (ß = 0.075, p < .05) were associated with greater FL. The bootstrapping analyses showed that PA mediated the pain interference-FL association, accounting for approximately 58% (ß = 0.124, Boots 95% confidence interval (CI): 0.078-0.175) of the total effect (ß = 0.215, Boots 95% CI: 0.095-0.335). Similarly, PA mediated the association between pain severity with FL, accounting for approximately 37% (ß = 0.044, Boots 95% CI: 0.001-0.094) of the overall effect (ß = 0.119, Boots 95% CI: -0.011 to 0.249). CONCLUSIONS: Our data suggest that the higher pain severity and pain interference may lead to higher FL in middle and old age, and the associations are partially explained by PA. Effective and low-cost PA participation could be targeted in efforts to reduce the effect of pain on physical functioning among middle-aged and older adults.

Acceptability, appropriateness and feasibility of webinar in strengthening research capacity in COVID-19 era in Nigeria.

Introduction: The challenges posed by the COVID-19 pandemic have necessitated the increasing use of online virtual training platforms. The objectives of the study were to assess the acceptability, appropriateness and feasibility of virtual space in strengthening the research capacity in Nigeria. Materials and Methods: Data were collected through an adapted online questionnaire from participants following a 2-day webinar. Both descriptive and inferential (bivariate and multivariate) analyses were done. Results: The findings of the study revealed that 55.2% of participants (n = 424) were males and 66.0% (n = 424) were early career researchers. Two hundred and thirty-six participants (55.7%) (n = 424) reported very good acceptability, 67.9% (n = 424) reported very good appropriateness while 54.7% (n = 424) reported good feasibility of webinar for research capacity strengthening. The rating of knowledge obtained from the webinar as 'excellent' increased the odds of acceptability (odd ratio [OR] = 38.30; P < 0.001), appropriateness (OR = 15.65; P < 0.05), and feasibility (OR = 20.85; P < 0.05). Furthermore, the preference for zoom and other online platforms for learning increased odds of acceptability of the webinar (OR = 2.29; confidence interval [CI]: 0.97-57.39; P < 0.05), appropriateness (OR = 2.55; CI: 1.10-5.91; P < 0.05) and feasibility (OR = 2.34; CI: 0.96-5.74; P < 0.05). Conclusion: The study concluded that webinar was acceptable, appropriate and feasible for strengthening research capacity, although poor internet connectivity and cost of data were the major challenges in Nigeria. However, a learner-centred approach in contents' delivery that ensures optimal learning has the potential of enhancing research capacity strengthening via virtual space.

Suicide Ideation and Its Correlates Among University Undergraduates in South Western Nigeria.

Suicide is one of the leading causes of death among young people aged 15 to 29 years of age. Ideation or suicidal thoughts , which precedes suicide is sometimes normalized and excused thereby missing avertable deaths within a given context. Understanding suicide ideation and the associated social correlates within contexts can provide cues on how to mitigate suicide. This paper examines the potential social factors that are shaping suicidal ideation among young people in two universities in Nigeria. Based on a mixed-method design, a survey was conducted among a proportionate sample of 500 young people (18-25years that are undergraduates). Four Focus Group Discussion sessions were also held among the same group and six semi-structured interviews with social workers at both universities. Quantitative evidence associated irregular financial support (OR = 0.60; p < 0.05) and broken intimate relationship (OR = 1.57; P < 0.05) with suicide ideation. Findings from the qualitative component also considered undergraduates that have academic challenges, engage in substance abuse, and have parents with marital problems to be prone to suicidal ideation. Suicidal ideation among these young people is embedded in their network of relationships, which can be mitigated when the quality of support systems is responsive and adequately accessed.

Institutionalizing research capacity strengthening in LMICs: A systematic review and meta-synthesis.

Background: Evidence on effective strategies to ensure sustainability of research capacity strengthening interventions in low- and middle-income country (LMIC) institutions is lacking. This systematic review identified publications describing research capacity building programs and noted their effect, their contexts, and the mechanisms, processes and social actors employed in them. Methods: We searched online databases for the period 2011-2018. Inclusion criteria were that the publications 1) described the intervention; 2) were implemented in LMICs; 3) were based in, or relevant to, university staff or post docs; 4) aimed to improve research capacity; 5) aimed to effect change at the institutional level. Two reviewers screened titles, abstracts and full text in consecutive rounds, a third resolved disagreements. Two people extracted the data of each full text using a data extraction tool covering data relevant to our question. Results: In total 4052 citations were identified and 19 papers were included, which referred to 14 interventions. Only three interventions mentioned using a conceptual framework to develop their approach and none described using a theory of change to assess outcomes. The most frequent inputs described were some method of formal training, promotion of a research-conducive environment and establishment of research support systems. A range of outcomes were reported, most frequently an increased number of publications and proportion of staff with PhDs. When factors of success were discussed, this was attributed to a rigorous approach to implementation, adequate funding, and local buy-in. Those who mentioned sustainability linked it to availability of funds and local buy-in. The lack of a common lexicon and a framework against which to report outcomes made comparison between initiatives difficult. Conclusions: The reduced number of interventions that met the inclusion criteria suggests that programs should be well-described, evaluated systematically, and findings published so that the research capacity strengthening community can extract important lessons.

"The night comes early for a woman": Menopause and sexual activities among urban older Yoruba men and women in Ibadan, Nigeria.

This article explores older peoples' perceptions of menopause and sexuality in old age. The research was exploratory, consisting of 12 vignette-based focus group discussions and 18 face-to-face semistructured interviews among older Yoruba men and women (60+). Findings revealed menopause as a biopsychosocial marker of aging that provides gendered spaces for women to abstain from or suppress their sexual desires and avoid a folk pregnancy- oyun iju(folk fibroid). Older men construe menopause and sexual refusals from their wives as opportunities for extramarital relations. Thus, both older men and women have differentiated perceptions and dispositions toward menopause, which have implications for their sexual health and well-being.

Explanations around physical abuse, neglect and preventive strategies among older Yoruba people (60+) in urban Ibadan Southwest Nigeria: A qualitative study.

Older people's views, experiences and explanations on abuse and neglect in later life is marginal in the literature. With more cases of physical abuse and neglect in old age in sub-Saharan Africa, this study explored the views and positions of older people and community stakeholders like religious leaders on why physical elder abuse and neglect and preventive measures within community settings in Nigeria. An exploratory research design that consisted of two focus group discussions with older Yoruba men and women (60+) and six semi-structured interviews with religious leaders (Christianity, Islam, and Traditional) guided the study. Based on thematic analysis, the findings revealed that older persons and religious leaders have multiple interpretations of physical elder abuse and neglect. Social ills, poor economic situation, evil machinations, and stereotypes and misconceptions of old age and spirituality are possible explanations for physical abuse and neglect. The intersecting nature of the factors promoting vulnerability to physical abuse and neglect in later life also emerged in the preventive measures suggested by older persons and community members. As such, the participants affirmed that most older persons are becoming conscious of vulnerability to abuse and do contest actions, relationships, and contexts that can reduce their vulnerability and earn more social acceptance. Nonetheless, the participants expressed worries over the absence of policies and legal frameworks that can protect older people against physical abuse and neglect. More worrisome was the growing spread of social ills, stereotypes around old age, poverty in old age, witchcraft accusations and ageism. These developments are compounding ageing experiences, including physical abuse and neglect in urban spaces in Nigeria.

'No Sweet in Sex': Perceptions of Condom Usefulness among Elderly Yoruba People in Ibadan Nigeria.

Emerging evidence has shown a gradual increase in sexually transmitted infections among elderly. This study explores the views of elderly Yoruba men and women (60+) on condoms use and its suitability against sexual infections. The research design was a sequential exploratory mixed method that consisted of vignettes based focus group discussion and a structured questionnaire. Twelve vignettes based Focus Group Discussion and a survey of 252 elderly Yoruba people (aged 60+) were carried out. The findings revealed limited awareness and experience with condoms. Few of the male (20.4%) and 2.8% of the female respondents felt condom use can prevent sexually transmitted infections. A marginally proportion of the females (29.2%) than the males (25.0%) perceived condom as more useful for younger people. Condom use as a preventive measure against sexual infections varies by gender and marital status (p = .000). Gender and marital status also had an influence on whether condom use could reduce sexual pleasures (p = 0.000). These findings offer strong support of the sexual pleasure hypothesis which is often invoked to explain attitude toward condom use in a variety of social and cultural contexts. Social marketing of condoms is urgently required to address misconceptions around condom use and encourage uptake among sexually active elderly people.

Adolescent mothers' subjective well-being and mothering challenges in a Yoruba community, southwest Nigeria.

Well-being varies within cultures and context. Studies on the well-being and mothering challenges of adolescents in Nigeria have focused on the general poor well-being of adolescent mothers rather than exploring their agency and subjective well-being within specific context. This study explores adolescent mothers' (13-20 years) subjective well-being by focusing on their childbirth, mothering experiences, and available network of supports. Thirty face-to-face in-depth interviews were conducted through the support of four informants and peer referrals. Content analysis was used to identify salient themes and patterns. Findings showed that a high proportion of the adolescent mothers had stigmatizing experiences among which include dropping out of school, and lack of supports from families, friends, and the society. Where available, supports were perceived as inadequate in contributing to their well-being and that of their children. Some of the adolescent mothers were apprehensive of losing their children to ill health while emphasizing that their present challenges could affect their children's future. However, the adolescent mothers invoked their agency by subtly using strategies such as petty trading and apprenticeship to reduce the social consequences of unintended pregnancy and earn a living. Recognizing adolescent mothers' agency in policies targeted toward their empowerment would be of benefit.

Ageing, sexuality and enhancement among Yoruba people in south western Nigeria.

Sexual health across the life course is influenced by biological and psychosocial factors. The paper explores sexuality and associated practices among older Yoruba people with a view to identifying the implications of cultural beliefs and practices for sexual health in later life. A total of 64 vignette-based in-depth interviews and 12 focus-group discussions were held with older adults (50-75 years) in two Yoruba communities in south western Nigeria. Findings portray sexuality as an important aspect of old age, with sexual intercourse being construed as having physical and spiritual consequences. This same perspective also emerged as participants' attributed factors affecting sexual desire in old age to religious beliefs, poverty, ill health and the non-availability of a partner. Gender differences were dominant on sexual desire and pleasure in old age. Participants' views on causes of sexual dysfunction identified biological, psychosocial and spiritual factors. Sexual decline in old age was considered redeemable with the support of biomedical and traditional medicines. However, only traditional medicine was considered beneficial in addressing sexual dysfunctions that had spiritual dimensions.

Constraints to exclusive breastfeeding practice among breastfeeding mothers in Southwest Nigeria: implications for scaling up.

BACKGROUND: The practice of exclusive breastfeeding is still low despite the associated benefits. Improving the uptake and appropriating the benefits will require an understanding of breastfeeding as an embodied experience within a social context. This study investigates breastfeeding practices and experiences of nursing mothers and the roles of grandmothers, as well as the work-related constraints affecting nurses in providing quality support for breastfeeding mothers in Southwest Nigeria. METHODS: Using a concurrent mixed method approach, a structured questionnaire was administered to 200 breastfeeding mothers. In-depth interviews were also held with breastfeeding mothers (11), nurses (10) and a focus group discussion session with grandmothers. RESULTS: Breastfeeding was perceived as essential to baby's health. It strengthens the physical and spiritual bond between mothers and their children. Exclusive breastfeeding was considered essential but demanding. Only a small proportion (19%) of the nursing mothers practiced exclusive breastfeeding. The survey showed the major constraints to exclusive breastfeeding to be: the perception that babies continued to be hungry after breastfeeding (29%); maternal health problems (26%); fear of babies becoming addicted to breast milk (26%); pressure from mother-in-law (25%); pains in the breast (25%); and the need to return to work (24%). In addition, the qualitative findings showed that significant others played dual roles with consequences on breastfeeding practices. The desire to practice exclusive breastfeeding was often compromised shortly after child delivery. Poor feeding, inadequate support from husband and conflicting positions from the significant others were dominant constraints. The nurses decried the effects of their workload on providing quality supports for nursing mothers. CONCLUSION: Breastfeeding mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Thus, scaling up of exclusive breastfeeding among mothers requires concerted efforts at the macro, meso and micro levels of the Nigerian society.

Maternal age at birth and under-5 mortality in Nigeria.

OBJECTIVE: The paper examined the impact of maternal age at birth on under-5 death in Nigeria. METHOD: Secondary data were generated from the 2003 Nigeria Demographic and Health Surveys in examining the relationship between maternal age at birth and under-5 mortality risk. Relationships between variables were tested through bivariate and logistic analyses. RESULTS: Out of 7620 sampled women for the study, almost 60% were less than 30 years old, the median age was 26 years- a youthful population. Analyses of the data revealed a high under-5 mortality rate (45.4%), a general high home delivery (62.4%) among Nigerian women, which dictates a low rate at which assistance by health professional is being sought during childbirth . Furthermore, mothers' median age at first birth was less than 19, while under-5 death was significantly pronounced among younger (less than 20 years) mothers and older women (above 35 years) (p<0.05). Maternal education which was significantly low among younger mothers was a predictor of under-5 mortality. CONCLUSION: Under -5 mortality is still high especially among younger mothers. Thus resolving this challenge in Nigeria will be inadequate if early childbearing issues are not addressed using a tailored framework alongside with the need to improve maternal education in Nigeria.