Adverse health outcomes among people who inject drugs who engaged in recent sex work: findings from a national survey.

OBJECTIVES: This study explores trends in sex work among people who inject drugs (PWID) by gender and the relationship between sex work and adverse health outcomes including overdose, injection-site, and blood-borne virus (BBV) infections. STUDY DESIGN: The Unlinked Anonymous Monitoring Survey of PWID is an annual cross-sectional survey that monitors BBV prevalence and behaviours, including transactional sex, among PWID recruited through specialist services in England, Wales, and Northern Ireland. METHODS: Trends in sex work among PWID (2011-2021) were described. Data were analysed to assess differences between PWID who engaged in sex work in the past year (sex workers [SWs]) and those who did not (non-SWs) by gender (Pearson Chi2 tests) (2018-2021). Associations between sex work in the past year and adverse health outcomes were investigated using logistic regression. RESULTS: Between 2011 and 2021, sex work among PWID remained stable, with 31% of women and 6.3% of men who inject, reporting having ever engaged in sex work, and 14% of women and 2.2% of men engaging in sex work in the past year. Between 2018 and 2021, SWs had greater odds of reporting symptoms of an injection-site infection (adjusted odds ratio (aOR): 1.68 [95% confidence interval {CI}: 1.31-2.16], P < 0.001) and reporting overdose (aOR: 2.21 [CI: 1.74-2.80], P < 0.001) than non-SWs had in the past year. Among men, SWs had 243% greater odds of having HIV than non-SWs (aOR: 3.43 [CI: 1.03-11.33], P = 0.043). CONCLUSIONS: Our findings highlight disproportionate vulnerability and intersection of overlapping risk factors experienced by PWID SWs and a need for tailored interventions which are inclusive and low-threshold.

Preliminary indications of the burden of COVID-19 among people who inject drugs in England and Northern Ireland and the impact on access to health and harm reduction services.

OBJECTIVE: The aim of the study was to describe the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic on people who inject drugs (PWID) in England, Wales and Northern Ireland. STUDY DESIGN: This is a cross-sectional Unlinked Anonymous Monitoring (UAM) Survey of PWID. METHODS: People who had ever injected psychoactive drugs were recruited to the UAM Survey by specialist drug/alcohol services in England, Wales and Northern Ireland. From June 2020, in addition to providing a dried blood spot sample and completing the UAM behavioural questionnaire, participants were asked to complete an enhanced coronavirus disease 2019 (COVID-19) questionnaire. Preliminary data are presented to the end of October and were compared with data from the 2019 UAM Survey, where possible. RESULTS: Between June and October, 288 PWID were recruited from England and Northern Ireland. One in nine (11%; 29/260) PWID reported testing positive for SARS-CoV-2 or experiencing COVID-19 symptoms. Fifteen percent (26/169) reported injecting more frequently in 2020 than in 2019; cocaine injection in the preceding four weeks increased from 17% (242/1456) to 25% (33/130). One in five PWID (19%; 35/188) reported difficulties in accessing HIV and hepatitis testing, and one in four (26%; 47/179) reported difficulties in accessing equipment for safer injecting. CONCLUSIONS: Our preliminary findings suggest that PWID have experienced negative impacts on health, behaviours and access to essential harm reduction, testing and treatment services owing to the COVID-19 pandemic. Continued monitoring through surveillance and research is needed to understand the subsequent impact of COVID-19 on blood-borne virus transmission in this population and on health inequalities.

PATIENT'S PERCEPTION ON THE QUALITY OF RADIOTHERAPY SERVICES IN TWO TEACHING HOSPITALS IN NIGERIA.

OBJECTIVE: Patient satisfaction is an important and commonly used indicator for measuring the quality in health care. Patient satisfaction affects clinical outcomes, patient retention, and medical malpractice claims. It affects the timely, efficient, and patient-centered delivery of quality health care. A review of quality of services from the patient's perspective could be a method of assessing in order to improve services and achieve total quality management. This study was designed to assess patients' perception on the quality of Radiotherapy services in Lagos University Teaching Hospital (LUTH) Lagos and University College Hospital (UCH) Ibadan. METHODOLOGY: This study is a cross-sectional study. This research lasted for a period of two months and all patients receiving radiotherapy within is period were included in this study. A total of 246 questionnaires were completed (152 and 94 in LUTH and UCH respectively) and the data collection was by semi-structured questionnaire. Data obtained were collected and analyzed using SPSS statistics [Social Sciences Statistical Package] 17.0 version. RESULTS: The findings of this research indicated that 68.4% in LUTH and 53.2% in UCH of the patients experienced good care. It also revealed that there is good interaction between the staff and the patient. Most of the patients spent more than 3 hours before receiving treatment and also the reason for such delay were not explained to them. The rate of preferential treatment was noted to be high. CONCLUSION: This study will contribute positively towards achieving effective and qualitative radiotherapy services by creating awareness for the need to minimize patient waiting time as well as the need to explain the reason for such delays. The department should adopt better ways of appointment system so that treatment will be on first come first serve basis. This study will contribute positively towards achieving effective and qualitative radiotherapy services by creating awareness for the need to minimize patient waiting time as well as the need to explain the reason for such delays. The department should adopt better ways of appointment system so that treatment will be on first come first serve basis.

Occupational stress among radiographers in Lagos, Nigeria.

BACKGROUND: Occupational stress induced injuries occur in various professions that require repetitive motion or physical exertion, such as Radiography. The injuries may involve body parts such as the neck, the upper back, mid back, low back (waist), knee, elbow, wrist and hand and eyes. OBJECTIVE: To assess work related injuries medical radiographers are prone to, during practice of the profession in relation to their working conditions. METHODS: This study was conducted among registered practicing radiographers in Lagos State, South-West, Nigeria. Lagos is one of Nigeria's most populated states and economic nerve centre of Nigeria. Due to its population, there are many hospitals with radiodiagnostic facilities and radiodiagnostic centres which are either government or privately owned. Eighty registered radiographers in 21 hospitals and diagnostic centres participated in the study. They include three federal government owned institutions, three State government owned institutions and fifteen privately owned diagnostic centres. The respondents' status were made up of 38 males and 42 females where 37 of them were between 20-30 years, 11 were between 41-50 years and those above 51 years were 12. RESULTS: The results revealed that a majority (91.2%) of respondents stand during the course of their work. Waist, neck, heel, wrist and shoulder pains were common among the respondents. Some respondents frequently manifest frustration (78.7 %), insomnia (52.5 %), difficulty in concentration (56.2%), poor appetite (50.0%), irritation (67.5 %) and tension (63.8%) while lesser percentages experience such. CONCLUSION: This study showed that occupational stress sites susceptible to work induced stress injury. Musculoskeletal strain was the most common type. Waist/ low back, plantar/heel and wrist pains were also common among radiographers in Lagos, Nigeria.

Simulation of motorcycle crashes with w-beam guardrail: injury patterns and analysis.

This study uses computer simulations to study the impact of a motorcycle with the conventional w-beam guardrail. A three-dimensional computer simulation of a scaled hybrid III 50th-percentile male dummy mounted on a motorcycle and colliding with a w-beam guardrail is carried out. A multi-body model of the motorcycle and finite element model of the guardrail are developed using commercially available software. The simulation model is validated with a physical crash test conducted with same initial impact configurations. Impacts at speeds of 32, 48, and 60 km/h at an impact angle at 45 degrees are considered. The predicted forces and accelerations are compared with the biomechanical limits for each body part and the risk of injury to the rider are evaluated. Speed was found to have a significant influence on the level of injury to the head, neck, chest, and femur. A significant reduction of the severity of injuries was found when the impact speed was reduced from 60 to 32km/h. The accelerations experienced by the head and chest are found to be higher than safe levels for impact speeds of 48 and 60 km/h. The biomechanical limit for the right femur is exceeded at all three considered impact speeds. Neck injuries are also a concern, with the predicted tension values and neck bending extent being higher than the biomechanical limit for the 60 km/h impact speed. In light of these results, it is suggested that the design of guardrails should be reviewed with a focus on the safety of motorcyclists.

Potential health risks due to telecommunications radiofrequency radiation exposures in Lagos State Nigeria.

BACKGROUND: The global system mobile telecommunications system (GSM) which was recently introduced in Nigeria is now being used by over 40 million people in Nigeria. The use of GSM is accompanied with exposure of the users to radiofrequency radiation (RFR), which if significant, may produce health hazards. This is the reason why many relevant national and international organizations recommended exposure limits to RFR and why it is made compulsory for GSM handsets to indicate the maximum power output as a guide to potential consumers. OBJECTIVE: This study was conducted to measure the RFR output power densities (S) from the most commonly used GSM handsets used in Lagos State and compare with the limit recommended for safety assessment. METHODS: Over 1100 most commonly used handsets of different makes and models as well as wireless phones were sampled and studied in all over the local government areas of the State. An RFR meter, Electrosmog from LESSEMF USA was used for the measurements. The handsets were assessed for health risks using the reference value of 9 Wm(-2) as recommended by the International Commission on Non-Ionizing Radiation Protection (ICNIRP). RESULTS: The range of the S-values obtained varied from a minimum of 1.294 0.101 Wm(-2) with Siemens model R228 to a maximum of 16.813 +/- 0.094 Wm(-2) with Samsung model C140*. The results from wireless telephones showed very low S-values ranging from a minimum of 0.024 +/- 0.001 Wm(-2) with HUAWEI and ST CDMA 1 to a maximum of 0.093 +/- 0.002 Wm(-2) with HISENSE. CONCLUSION: The results showed that the population in Lagos State may be at risk due to significant RFR exposures resulting principally from the use of GSM. Quite a number of handsets emit power above the ICNIRP recommended value. Measured RFR power close to Radio and Television masts and transmitters are within tolerable limits in most cases, only that the public should not reside or work close to RFR installations. Phone calls with GSM should be restricted to essential ones while youths and children that are more susceptible to RFR hazards should be supervised in their use of GSM. Wireless phones are quite safe.