Digital health interventions for all? Examining inclusivity across all stages of the digital health intervention research process.

Digital interventions offer many possibilities for improving health, as remote interventions can enhance reach and access to underserved groups of society. However, research evaluating digital health interventions demonstrates that such technologies do not equally benefit all and that some in fact seem to reinforce a "digital health divide." By better understanding these potential pitfalls, we may contribute to narrowing the digital divide in health promotion. The aim of this article is to highlight and reflect upon study design decisions that might unintentionally enhance inequities across key research stages-recruitment, enrollment, engagement, efficacy/effectiveness, and retention. To address the concerns highlighted, we propose strategies including (1) the standard definition of "effectiveness" should be revised to include a measure of inclusivity; (2) studies should report a broad range of potential inequity indicators of participants recruited, randomized, and retained and should conduct sensitivity analyses examining potential sociodemographic differences for both the effect and engagement of the digital interventions; (3) participants from historically marginalized groups should be involved in the design of study procedures, including those related to recruitment, consent, intervention implementation and engagement, assessment, and retention; (4) eligibility criteria should be minimized and carefully selected and the screening process should be streamlined; (5) preregistration of trials should include recruitment benchmarks for sample diversity and comprehensive lists of sociodemographic characteristics assessed; and (6) studies within trials should be embedded to systematically test recruitment and retention strategies to improve inclusivity. The implementation of these strategies would enhance the ability of digital health trials to recruit, randomize, engage, and retain a broader and more representative population in trials, ultimately minimizing the digital divide and broadly improving population health.

Purification and biochemical characterization of pullulanase produced from Bacillus sp. modified by ethyl-methyl sulfonate for improved applications.

Strain improvement via chemical mutagen could impart traits with better enzyme production or improved characteristics. The present study sought to investigate the physicochemical properties of pullulanase produced from the wild Bacillus sp and the mutant. The pullulanases produced from the wild and the mutant Bacillus sp. (obtained via induction with ethyl methyl sulfonate) were purified in a-three step purification procedure and were also characterized. The wild and mutant pullulanases, which have molecular masses of 40 and 43.23 kDa, showed yields of 2.3% with 6.0-fold purification and 2.0% with 5.0-fold purification, respectively, and were most active at 50 and 40 °C and pH 7 and 8, respectively. The highest stability of the wild and mutant was between 40 and 50 °C after 1 h, although the mutant retained greater enzymatic activity between pH 6 and 9 than the wild. The mutant had a decreased Km of 0.03 mM as opposed to the wild type of 1.6 mM. In comparison to the wild, the mutant demonstrated a better capacity for tolerating metal ions and chelating agents. These exceptional characteristics of the mutant pullulanase may have been caused by a single mutation, which could improve its utility in industrial and commercial applications.

Reducing intervention- and research-induced inequalities to tackle the digital divide in health promotion.

Social inequalities are an important contributor to the global burden of disease within and between countries. Using digital technology in health promotion and healthcare is seen by some as a potential lever to reduce these inequalities; however, research suggests that digital technology risks re-enacting or evening widening disparities. Most research on this digital health divide focuses on a small number of social inequality indicators and stems from Western, educated, industrialized, rich, and democratic (WEIRD) countries. There is a need for systematic, international, and interdisciplinary contextualized research on the impact of social inequality indicators in digital health as well as the underlying mechanisms of this digital divide across the globe to reduce health disparities. In June 2023, eighteen multi-disciplinary researchers representing thirteen countries from six continents came together to discuss current issues in the field of digital health promotion and healthcare contributing to the digital divide. Ways that current practices in research contribute to the digital health divide were explored, including intervention development, testing, and implementation. Based on the dialogue, we provide suggestions for overcoming barriers and improving practices across disciplines, countries, and sectors. The research community must actively advocate for system-level changes regarding policy and research to reduce the digital divide and so improve digital health for all.

Association between Socioeconomic Status and the Utilization of Maternal Health Services in Nigeria.

Background: Maternal health is the mother's state of well-being before, during, and after conception. Studies have suggested that the increasing maternal mortality rate is preventable provided maternal health services are accessible during pregnancy. This study explored the association between socioeconomic status and the utilization of maternal health services in the Federal Medical Centre (FMC), Abeokuta, Ogun State. Materials and Methods: This study is a cross-sectional survey. One hundred and eighty-eight pregnant women from the antenatal unit of a tertiary hospital in Southwestern Nigeria were selected using a convenience sampling technique. Data were collected via a pretested, self-designed questionnaire. The descriptive statistics were used to analyze the resulting data, and the hypotheses were tested using the Pearson product-moment correlation at 0.05 level of significance. Result: From the study, 72 (38.30%) and 58 (30.90%) agreed that their income and occupation influence their maternal health services utilization. Significant relationship (p < 0.05) existed between maternal health service utilization and age and between socioeconomic factors (occupation and income level) and utilization of maternal health services of pregnant women. Conclusions: Overall, this study revealed that the level of utilization of maternal health services among expectant women attending FMC is moderate. As this study has shown that socioeconomic factors influence the utilization of maternal health services, we recommend that interventions by health workers targeted at improving the utilization of maternal health services should consider these factors when designing such interventions. It is hoped that this will contribute to reducing maternal mortality and morbidity in this state.

Tissue-specific DNA methylation variability and its potential clinical value.

Complex diseases have multifactorial etiologies making actionable diagnostic biomarkers difficult to identify. Diagnostic research must expand beyond single or a handful of genetic or epigenetic targets for complex disease and explore a broader system of biological pathways. With the objective to develop a diagnostic tool designed to analyze a comprehensive network of epigenetic profiles in complex diseases, we used publicly available DNA methylation data from over 2,400 samples representing 20 cell types and various diseases. This tool, rather than detecting differentially methylated regions at specific genes, measures the intra-individual methylation variability within gene promoters to identify global shifts away from healthy regulatory states. To assess this new approach, we explored three distinct questions: 1) Are profiles of epigenetic variability tissue-specific? 2) Do diseased tissues exhibit altered epigenetic variability compared to normal tissue? 3) Can epigenetic variability be detected in complex disease? Unsupervised clustering established that global epigenetic variability in promoter regions is tissue-specific and promoter regions that are the most epigenetically stable in a specific tissue are associated with genes known to be essential for its function. Furthermore, analysis of epigenetic variability in these most stable regions distinguishes between diseased and normal tissue in multiple complex diseases. Finally, we demonstrate the clinical utility of this new tool in the assessment of a multifactorial condition, male infertility. We show that epigenetic variability in purified sperm is correlated with live birth outcomes in couples undergoing intrauterine insemination (IUI), a common fertility procedure. Men with the least epigenetically variable promoters were almost twice as likely to father a child than men with the greatest number of epigenetically variable promoters. Interestingly, no such difference was identified in men undergoing in vitro fertilization (IVF), another common fertility procedure, suggesting this as a treatment to overcome higher levels of epigenetic variability when trying to conceive.

Satisfaction and perceived impact of virtual learning during COVID-19 lockdown: A case study of an online nursing research conference.

AIM: This study aimed to assess nurses' satisfaction and perceptions of the impact of virtual learning. DESIGN: A descriptive cross-sectional survey. METHOD: 236 nurses attending an online conference from several parts of Nigeria participated in the study. Analysed data were summarized and presented in tables and graphs, while linear regression was used to measure the associations. RESULTS: Most of the respondents perceived the programme as highly impactful. All three domains: learner-content interaction (p = 0.020), learner-instructor interaction (p = 0.000) and learner-learner interaction (p = 0.000), were found to be statistically significantly associated with the perceived impact of the programme, and thus statistically significant predictors of the effects of online learning (p = 0.02), (F = 5.471). Conclusively, the Interaction of learners with learning content, lecturers and other learners was seen as determinants of an effective and impactful online education. It is recommended that nursing training institutions embrace online learning either as the leading platform or as an adjunct to a face-to-face method.

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria.

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statementWhat is already known on this subject? Psychiatric morbidity has immense effects on a woman's quality of life, social functioning, obstetric outcome, and economic productivity.What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression.What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability.

Experiences of community tuberculosis volunteers in Ibadan north local government: A qualitative study.

BACKGROUND: Although several efforts have gone into combating tuberculosis (TB) in Nigeria, the country remains one of the worst hit with TB globally. Community Tuberculosis Care (CTBC) which refers to community TB efforts taken beyond the confines of the hospital facilities, has been suggested as a means to reach TB cases not reported or diagnosed. However, CTBC is in the formative stage in Nigeria, and the experiences of Community Tuberculosis Volunteers (CTVs) remain unclear. Hence, the study was conducted to explore the experiences of CTVs in Ibadan North Local Government. METHODS: A qualitative descriptive design with focus group discussion was adopted. CTVs in the Ibadan-north Local Government were recruited, and data were collected using a semi-structured interview guide. The discussions were audio-recorded. Qualitative content analysis method was used for data analysis. RESULTS: All the CTVs (10) in the local government were interviewed. Four themes emerged which include: CTVs' activities, the need of the patient living with TB, success stories, and challenges faced by CTVs. CTBC activities by the CTVs include case finding, awareness rallies, community education. The needs of the patient living with TB include finances, love, attention and support. Challenges encountered by them include myths, poor family and governmental support. CONCLUSION: CTBC was progressing well in this community as the CTVs have many success stories to share. However, the CTVs needed more support from the government in terms of finances, free and adequate drug supply, and assistance with media advert.

Prevalence and Factors Associated With Alcohol Use in Selected Urban Communities in Ibadan, Nigeria.

Nigeria is ranked high among African countries in the consumption of alcohol and the national adult per capita consumption was estimated at 12.3litres. Harmful alcohol use is the sixth leading cause of disability and deaths in Nigeria. This study assessed the prevalence and factors associated with alcohol use in selected urban communities in Ibadan, Nigeria. This community-based cross sectional study was conducted among 500 respondents in two selected urban communities in Ibadan, Nigeria. The World Health Organization STEPS tool was used to collect data on socio-demographic characteristics of respondents and the history of alcohol use. Alcohol users were categorized into ever consumed, current consumers, consumers within last 12 months, and frequent consumers within 30 days (low, medium, and high consumers).Chi-square analysis was used to identify factors associated with the different categories of alcohol consumption. The mean age of the respondents was 35.36 ± 12.24 years. Almost one third of the participants (29.0%) reported they had ever consumed alcohol and (13.6%) had consumed alcohol within 30 days prior to the study. Factors significantly associated with the ever-use of alcohol were gender (p = 0.000), and income (p = 0.000). Current use of alcohol had a statistically significant relationship with male gender (p = 0.000). The prevalence of high alcohol use is low in the sample of urban communities studied, and factors influencing include sex, marital status, level of education, income. These results should inform policy decisions to address the alcohol use in urban communities in Southwest Nigeria.

Intention and Concerns about HPV Vaccination among In-School Adolescents in Ibadan, Oyo State, Nigeria.

Background: Human papillomavirus (HPV) is a very common sexually transmitted infection responsible for some cancers including cervical cancer. Despite nearly half of the Nigerian population being at risk (women <25), vaccination uptake against the infection is still less than 5%. Methodology: This cross-sectional descriptive survey was conducted using a multi-stage sampling technique. A semi-structured questionnaire was administered to 300 in-school adolescents aged 15-19 years, across 15 private and public secondary schools in Ibadan-North and Ibadan North-West of Oyo State, whose parents gave consent. The data was analysed using descriptive and inferential statistics in SPSS v21. Cronbach's alpha coefficient was used to measure internal consistency reliability while categorical tables were compared using chi-square and regression analysis with a p-value <0.05. Results: The mean age of respondents was 15.8 ± 0.84 years. Half of them were females (52.3%) and also attended private schools (56.3%). Very few of the respondents had heard about HPV (21.0%) and HPV vaccine (12.7%), however, more than half had heard about cervical cancer (55.3%). Few respondents had good knowledge (11.0%) and positive perception (27.0%) of HPV, cervical cancer and HPV vaccine. The major source of information was social media (46.2%). Half of the respondents reported intention to take the vaccine if recommended by their family doctor (56.3%) and if given parental approval (52.0%), however, many (60.7%) were concerned about the vaccine's side effects. Conclusion: Findings show that parents and health workers influence adolescents' HPV vaccination uptake. The study thus recommends the prioritization of parental involvement in HPV vaccination. Parents and health workers should therefore be targeted as key stakeholders in driving the awareness of HPV and uptake of HPV vaccine among adolescents.

Cervical cancer awareness and risk factors among women residing in an urban slum in Lagos, Southwest Nigeria.

Background: Poor awareness of cervical cancer and high prevalence of its risk factors may be responsible for the large burden of cervical cancer in low-income countries. This study assessed awareness of cervical cancer and prevalence of risk factors among women residing in a slum in Lagos, Nigeria. Methods: This was a descriptive cross-sectional study carried out amongst 305 women of reproductive age (15-49 years) in Idi-Araba, a slum in Urban Lagos. Data were collected using interviewer administered questionnaires. Analysis was done with SPSS 20 software. Results: Mean age of respondents was 33.5(9.0) years. Only 12.8% of the respondents had heard of cervical cancer. Ninety-five percent of respondents were sexually active and 56.2% had more than one lifetime sexual partner. Close to half (47.3%) of respondents had their first sexual intercourse before the age of 20. One in five (22.2%) had 5 or more children. Half of the respondents (54.8%) had had abnormal vaginal discharge. Conclusion: Awareness of cervical cancer among the women was poor and prevalence of risk factors of cervical cancer was high. Campaigns aimed at increasing awareness of cervical cancer, and screening should be carried out by governmental and charitable organizations for women residing in slums.

Cervical Cancer and Human Papillomavirus Vaccine Knowledge, Utilisation, Prevention Educational Interventions and Policy Response in Nigeria: A Scoping Review.

PURPOSE: This review evaluated the knowledge, utilisation, prevention education, and policy response across the six geopolitical regions of Nigeria to inform national efforts for the prevention and control of cervical cancer. METHODS: A keyword-based systematic search was conducted in PubMed/MEDLINE (NCBI), Google Scholar, and AJOL electronic databases, including a manual scan of papers, journals and websites to identify relevant peer-reviewed studies. Articles were screened and assessed for eligibility. RESULTS: Many (158) articles were downloaded and after duplicates were removed, 110 articles were included in the final analysis. These were made up of qualitative, quantitative (cross-sectional), intervention and policy studies. Studies have generally reported poor knowledge and awareness of cervical cancer screening but those carried out in urban areas demonstrated a slightly higher level of awareness of Human Papilloma Virus (HPV) vaccine, HPV vaccination uptake and utilization of cervical cancer preventive services than the rural studies. The studies did not show strong government support or policies in relation to cervical cancer control. CONCLUSION: Knowledge and uptake of cervical cancer preventive services across diverse groups in Nigeria remain poor. These could be linked to socio-cultural factors, the lack of an organised cervical cancer screening programme and low financial resource pool for cervical cancer prevention. Therefore, it is necessary to increase government, donor prioritisation and political support in order to ensure increased investment and commitment to cervical cancer elimination in Nigeria.

Strategies to Improve Women's Leadership Preparation for Early Career Global Health Professionals: Suggestions from Two Working Groups.

Background: Despite advances in gender equality, women still experience inequitable gaps in global health leadership, and barriers to women's advancement as leaders in global health have been well described in the literature. In 2021, the Johns Hopkins Center for Global Health conducted two virtual working groups for emerging women leaders to share challenges and suggest solutions to advance women's leadership in global health. In this paper, we present emerging themes from the working groups, provide a framework for the results, and discuss strategies for advancing women's leadership in global health. Objectives: The objective of this paper is to synthesize and share the themes of the two working group sessions to provide strategies for improving women's leadership training and opportunities in the field of global health. Methods: Approximately 182 women in the global health field participated in two virtual working group sessions hosted by the Johns Hopkins Center for Global Health using the Zoom platform. Participants were divided into virtual breakout rooms and discussed pre-assigned topics related to women's leadership in global health. The participants then returned to share their ideas in a plenary session. Notes from the breakout rooms and transcripts from the plenary session were analyzed through a participatory and iterative thematic analysis approach. Findings: We found that the working group participants identified two overarching themes that were critical for emerging women leaders to find success in global health leadership. First, the acquisition of individual essential skills is necessary to advance in their careers. Second, the institutional environments should be setup to encourage and enable women to enter and succeed in leadership roles. The participants also shared suggestions for improving women's leadership opportunities such as including the use of virtual technologies to increase training and networking opportunities, intersectionality in mentorship and sponsorship, combatting impostor syndrome, and the importance of work-life balance. Conclusions: Investing in women and their leadership potential has the promise to improve health and wealth at the individual, institutional, and community levels. This manuscript offers lessons and proposes solutions for increasing women's leadership through improving individual level essential skills and fostering environments in which women leaders can emerge and thrive.

Endoscopic Findings in Patients With Upper Gastrointestinal Bleeding in Ogun State, Nigeria.

Introduction Although the global incidence of upper gastrointestinal bleeding (UGIB) appears to have reduced substantially in the past few decades, acute UGIB still carries significant morbidity and mortality worldwide. There are currently no published data on UGIB in Ogun State, Nigeria. This study examined the endoscopic findings in patients with UGIB in Ogun State.  Methodology The study was a retrospective cross-sectional survey of patients with UGIB who had upper gastrointestinal endoscopy at three endoscopy centers in Ogun State, Southwest Nigeria, from January 2015 to December 2021. Patients' data, which included age, gender, and endoscopic findings, were extracted from the endoscopy registers into a spreadsheet and analyzed statistically. Summary statistics included means ± standard deviation for continuous variables and frequencies and percentages for categorical variables. Categorical variables were compared for differences by chi-square test or Fisher's exact test as appropriate. The statistical significance cutoff was p-value <0.05. Results A total of 171 had endoscopy for UGIB during the period under review but 168 had complete data. Out of the 168, 113 (67.3%) were males, giving a male-to-female ratio of 2:1. The mean age of the patients was 52.4 ± 18.1 years, with an age range of 7-85 years. The modal age group was ≥60 years (75; 39.9%). The most common endoscopic finding was peptic ulcer disease (77; 45.8%), followed by esophagogastric varices (27; 16.1%), erosive mucosal disease (25; 14.9 %), portal hypertensive gastropathy (15; 8.9%), suspected malignancies (11; 6.6%), hemorrhagic gastritis (7; 4.2%), gastric antral vascular ectasia (2; 1.2%), and Mallory-Weiss tear (1; 0.6%), respectively. Forty-four patients (26.2%) had no lesion that could explain UGIB.  Conclusion Peptic ulcer disease was the most common cause of UGIB among our patient population, and the elderly male patients were the most affected.

Indepth Interviews' on Acceptability and Concerns for Human Papilloma Virus Vaccine Uptake among Mothers of Adolescent Girls in Community Settings in Ibadan, Nigeria.

Human papillomavirus (HPV) vaccine offers protection of between 80 and 100% for anogenital warts and 60-80% in reducing the incidence of pre-malignant lesions from cervical cancer. However, uptake remains low in Nigeria among adolescent girls. This study was a qualitative study that assessed mothers' acceptability and concerns regarding uptake of HPV vaccine by their adolescent daughters. In-depth interviews were conducted with 20 mothers of adolescents girls aged 9-15 years. A snowballing sampling technique was adopted to select the mothers within the community. Consent was obtained for the use of audiotapes, which were transcribed verbatim with thematic analysis of data. Mothers were between the ages of 30-49 years and most of them were traders. Almost all of the women have heard about cervical cancer, but their knowledge about cervical cancer and HPV vaccine was low. Despite their low knowledge, most of the mothers accepted that the vaccine is good and was willing for their adolescent daughters to take the HPV vaccine for the prevention of HPV. However, cost of the vaccine, side effects, and potential exposure of their daughters to promiscuity after taking the vaccine for protection were the major concerns expressed by the mothers as regards to HPV vaccine uptake by their daughters. Findings highlight the need for health promotion and education programs about cervical cancer, HPV, and HPV vaccine to increase awareness and knowledge among mothers of adolescent girls. Also, HPV vaccination should be included as part of routine immunization for female adolescents.

Perceptions of participation in school and association with health and wellbeing: comparison among Nigerian and Irish pupils.

School participation among pupils is considered a key value of the health promoting school approach. However, few studies have documented the relationship between the school participation of pupils and health and wellbeing outcomes in different geographical contexts, especially looking at developing and developed country contexts. This study investigated the perceptions of Nigerian and Irish pupils on participation in school and reported health and wellbeing. Data was collected using self-completed questionnaires among 333 and 231 primary school pupils in 4th, 5th and 6th classes across 17 schools in Nigeria and Ireland. Logistic regression analysis was used to analyse the data from both countries. There was no statistically significant difference in the mean scores for participation in school activities (NIG mean = 22.8, SD 3.5; IRE mean = 22.3, SD 3.4) and school events (NIG mean = 18.8, SD 3.7; IRE mean = 17.1, SD 3.6). However, participation in school decisions and rules (NIG mean = 17.3, SD 4.7; IRE mean = 15.8, SD 3.6) and health and wellbeing (NIG mean = 16.9, SD 1.7; IRE mean = 15.3, SD 2.4) scores were significantly higher among Nigerian pupils, while positive perception of school participation (NIG mean = 24.2, SD 4.1; IRE mean = 26.2, SD 3.4) was significantly higher among Irish pupils. The findings suggest that Irish and Nigerian pupils have positive perceptions of their schools irrespective of their location and levels of development. However, further research using qualitative approaches might be needed to better clarify dimensions of pupils' perceptions of school life and school participation among Nigerian pupils in order to substantiate these claims.

Critically Ill Patient with Multidrug-Resistant Acinetobacter baumannii Respiratory Infection Successfully Treated with Intravenous and Nebulized Bacteriophage Therapy.

Hospitalized patients are at risk of developing serious multidrug resistant bacterial infections. This risk is heightened in patients who are on mechanical ventilation, are immunocompromised, and/or have chronic comorbidities. We report the case of a 52-year-old critically ill patient with a multidrug resistant Acinetobacter baumannii (MDR-A) respiratory infection who was successfully treated with antibiotics and intravenous and nebulized bacteriophage therapy.

Urban Poor Community Settings' Knowledge and Screening Practices for Cervical Cancer in Ibadan, Nigeria.

PURPOSE: This study investigated knowledge and screening practices for cervical cancer among two urban poor community settings in Ibadan, Nigeria. METHODS: A cross-sectional design was used. ODK tool was used to collect quantitative data among a sample size of 500 respondents. Data were analyzed using IBM SPSS version 21 for descriptive and inferential statistics. Scores for knowledge were on a scale of 0-39 points (0-18 low, 19-23 fair, and 24-39 high knowledge). RESULTS: A majority of respondents (77.2%) had low knowledge of cervical cancer and were not aware (93.6%) of the Papanicolaou test (Pap smear test) or cervical cancer screening (91.2%). Very few women (10%) were aware of the human papillomavirus vaccine for the prevention of cervical cancer, 4% had been screened with the Papanicolaou test, and one woman (0.3%) with visual inspection with acetic acid. Four (1.1%) women had taken human papillomavirus vaccine before. CONCLUSION: The findings of this study have underscored a necessity for increased awareness creation through health promotion interventions and strategies to alleviate low knowledge, prevention, and screening practices for cervical cancer in poor community settings in Nigeria.

Knowledge and risk perception of e-cigarettes and hookah amongst youths in Lagos State, Nigeria: An exploratory study.

INTRODUCTION: Limited research exists describing young people's knowledge and risk perception of e-cigarettes and hookah in Nigeria. This qualitative study explored the knowledge and risk perception of e-cigarettes and hookah amongst young people in Lagos, Nigeria. METHODS: Participants (n = 20), aged 15-24 years who had used e-cigarettes or hookah at least once in the past 12 months, participated in three focus group (FG) discussions in January 2020. Each FG session consisted of 6-7 participants, was facilitated by a trained moderator and lasted approximately 60 min. Sessions were recorded, and notes were taken after informed consent. Recordings were transcribed verbatim and analysed using NVIVO 10 software. RESULTS: An essential element of our findings was that the majority of the participants seemed to be more aware of hookah and used hookah compared to e-cigarettes. The participants mentioned they used these tobacco products mainly to reduce stress, for pleasure and for social acceptance. Most of the study participants reported that they were aware of some adverse health effects associated with e-cigarette or hookah use. Although some participants felt that the use of e-cigarettes or hookah could transform to cigarette smoking, many felt that e-cigarette was a harm reduction tool. CONCLUSION: Young users of e-cigarettes and hookah continue to use these products though they are aware of some associated adverse health effects. These products are used primarily for relieving stress and for social reasons. Raising awareness of the risks associated with the use of these tobacco products may help to reduce the acceptability of these products amongst youths.

Experience of Stress and Coping Mechanism Among Police Officers in South Western Nigeria.

Prior research on stress among police officers in Nigeria is limited. Most researchers have focused on the predictors of workplace stress among the police officer, and fewer still have examined their coping mechanisms. This study assessed the stress experienced and coping mechanism among police officers in Ibadan Metropolis, Oyo State, Nigeria. The study was a descriptive cross-sectional study, which utilized a pretested self-administered questionnaire. The study population included 342 selected respondents using a multistage sampling technique from police stations in Ibadan North Local Government, Oyo State, Nigeria. The data were analyzed using descriptive statistics, χ2 test, and Fisher's exact test at p = .05. Results revealed that majority (92.5%) of the respondents had poor knowledge of stress with a mean knowledge of 5.4 ± 1.7. Majority (80.1%) of the respondents reported experience of stress such as feeling depressed sometimes at work, while 60.5% said that they usually have headache and body ache. In addition, 36.9% had good coping mechanism and more than half (58.8%) had a fair coping mechanism with a mean coping score of 5.0 ± 3.0. This study showed that knowledge of stressors was poor and respondents perceived that they experienced stress and its symptoms. Strategies such as training using teaching, discussion, and explanation to educate the police officers about stress and its coping mechanism and policy interventions to facilitate the construction of standard stress management centers would be appropriate strategies to reduce stress, increase the knowledge of police officers on stressors, and enhance their coping mechanism.