Children on the Streets of Ibadan Nigeria: Neglect of Children's Rights.

BACKGROUND: The Nigerian Convention on the Rights of the Child (CRC) 2008 enacted prohibitive laws against child streetism. However, in metropolises like Ibadan, there is a growing epidemic of street children, particularly the category with existing family ties known as "children on the streets". Children on the street come from home daily to engage in economic-oriented activities on the streets and return home to their families at night time. OBJECTIVE: We focused on perceptions of formal responses to the problem of child streetism in Ibadan. METHODS: This was qualitative research. Participants were selected from each of the five urban LGA of Ibadan, purposively and by snowball technique. In-depth Interviews (IDI) were conducted, audio-recorded and transcribed. Framework analysis of data was supported by ATLASTi version 22. RESULTS: Fifty-three (53) interviews were conducted including IDI with ten (10) child-welfare officers, ten (10) street shop owners, eleven (11) children on the street, and ten (10) pairs of parent-child dyads. Two themes emerged including governmental shortcomings with six subthemes and suboptimal governmental interventions with four subthemes. Child streetism in Ibadan is a consequence of the State's failed education systems, inadequate children's vocational and rehabilitation programs, lax child welfare laws, lack of empowerment of skilled children, and poor implementation of the policy on ideal family size. Interventions that were existing but sub-optimal included communitybased child welfare programs, parental poverty alleviation, public sensitisation and child welfare monitoring programmes. CONCLUSION: There is an urgent need to update, enforce laws, and amalgamate efforts against child streetism in Ibadan.

CONTEXTE: La Convention nigériane relative aux droits de l'enfant (CRC) de 2008 a promulgué des lois interdisant le travail des enfants dans la rue. Cependant, dans des métropoles comme Ibadan, il existe une épidémie croissante d'enfants des rues, en particulier la catégorie ayant des liens familiaux existants connue sous le nom d'"enfants des rues". Les enfants des rues viennent de chez eux tous les jours pour participer à des activités orientées vers l'économie dans les rues et rentrent chez eux auprès de leurs familles le soir. OBJECTIF: Nous nous sommes concentrés sur les perceptions des réponses formelles au problème du travail des enfants dans la rue à Ibadan. MÉTHODES: Il s'agissait d'une recherche qualitative. Les participants ont été sélectionnés dans chacun des cinq LGA urbains d'Ibadan, de manière délibérée et par la technique de la boule de neige. Des entretiens approfondis (IDI) ont été réalisés, enregistrés et retranscrits. L'analyse thématique des données a été soutenue par ATLAS-Ti version 22. RÉSULTATS: Cinquante-trois (53) entretiens ont été menés, comprenant des IDI avec dix (10) agents de protection de l'enfance, dix (10) propriétaires de magasins de rue, onze (11) enfants des rues et dix (10) paires de dyades parent-enfant. Deux thèmes ont émergé, comprenant des lacunes gouvernementales avec six sous-thèmes et des interventions gouvernementales suboptimales avec quatre sous-thèmes. Le travail des enfants dans la rue à Ibadan est une conséquence des systèmes éducatifs défaillants de l'État, des programmes de formation et de réadaptation insuffisants pour les enfants, des lois laxistes sur la protection de l'enfance, du manque d'autonomisation des enfants qualifiés et de la mauvaise mise en œuvre de la politique sur la taille idéale de la famille. Les interventions existantes mais suboptimales comprenaient des programmes communautaires de protection de l'enfance, l'alleviation de la pauvreté des parents, la sensibilisation du public et les programmes de suivi de la protection de l'enfance. CONCLUSION: Il est urgent de mettre à jour, d'appliquer les lois et de regrouper les efforts contre le travail des enfants dans la rue à Ibadan. MOTS-CLÉS: Travail des enfants dans la rue, Protection sociale, Droits de l'enfant, Lois, Famille.

EFFECT OF WORKPLACE STRESS ON THE PERCEIVED HEALTH OF RESIDENT DOCTORS IN NIGERIA.

Background: Resident doctors' health and wellbeing has recently become the focus of international concern, as they are very important members of the healthcare system. The medical workplace is a complex environment where the doctors respond differently. Objective: The objective of this study was to assess workplace stress among the resident doctors, examine their perceived health status, and determine the effect of workplace stress on their perceived health status. Methods: The study was a cross-sectional study conducted among resident doctors at University College Hospital (UCH), Ibadan, Nigeria across all the specialties over a three-month period, from 1st March to 31st May, 2019. Two hundred and thirty-two eligible and consenting resident doctors were selected by stratified random sampling and data was collected using interviewer-guided selfadministered questionnaire. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 23. Results: The result showed that 144 (62.1%) of the resident doctors experienced workplace stress and 108 (46.6%) resident doctors perceived their health as poor. Workplace stress, years in residency program, designation, and work hours on least busy day at work were all significantly associated with perceived health status of the resident doctors, however, only workplace stress could independently predict poor perceived health status of the resident doctors. Conclusion: It is therefore important to prevent and manage workplace stress in order to improve the perceived health status of resident doctors.

Work-related psychological distress among teachers in southwest Nigeria: a rural and urban comparison

Background: The jobs of teachers involve high demand and low control, which predisposes them to psychological distress. Differences in the basic infrastructure in rural and urban areas may influence the psychological health status of teachers. Objectives: We assessed the prevalence of psychological distress and associated work-related factors among secondary school teachers in rural and urban areas of southwest Nigeria. Methods: A cross-sectional analytical study design was utilised. Teachers from rural (n = 578) and urban (n = 596) areas were selected using multistage sampling. Sociodemographic and occupational characteristics were recorded, and the 12-item General Health Questionnaire (GHQ-12) was used to assess psychological distress, using a cut-off score of ≥ 3 to indicate distress. Data were analysed using SPSS version 23. Chi-square analysis was used to test for differences between categorical variables and Student's t-test was used to check for differences in means. Logistic regression analysis was conducted to determine predictors of psychological distress. Statistical significance was set at 5%. Results: Rural-based teachers were significantly younger than those in urban locations (p = 0.013), had fewer mean years of work experience (p = 0.043), taught larger class sizes (p < 0.000), had more financial dependants (p = 0.001), and spent less time at work each day (p < 0.000). More rural- than urban-based teachers had other jobs in addition to teaching (p = 0.023). Overall, 38.1% of the teachers were psychologically distressed: 42.7% in rural and 33.6% in urban schools (p = 0.001). Factors associated with psychological distress were being married (p = 0.007), teaching in a public school (p = 0.007), and teaching > 5 subjects (p < 0.001). The adjusted odds of psychological distress were higher in teachers in rural schools (AOR 1.30, 95% CI 1.02­1.67), and in public schools (AOR 1.58, 95% CI 1.19­2.11). The adjusted odds increased by 19% for every additional subject taught, and by 2% for every hour spent teaching. Conclusion: Teachers in rural schools had more psychological distress than those in urban ones. Distress was associated with both individual and workrelated characteristics. Teachers' work conditions in rural schools need to be improved to provide an incentive for them to work and remain in remote

Knowledge and perception of family medicine among medical students at University of Ibadan, Nigeria

Background: Postgraduate training in Family Medicine in Nigeria began over three decades ago, but it was not until recently that the National University Commission (NUC) made it a policy for all Nigerian universities to include undergraduate Family Medicine training in their curriculum. This study aimed to assess the awareness and perception of Family Medicine among medical students at the University College Hospital (UCH), Ibadan. Method: A descriptive cross-sectional study was conducted over a period of four weeks (June 11­July 6, 2018) among 131 fourth-year, 118 fifth-year and 163 sixth-year medical students at UCH, Ibadan. Data were obtained using a self-administered questionnaire. Results: Data were collected from 309 (75% of the target population). The mean age of the respondents was 22.3 ± 2.3 years. The majority (74.4%) did not have a family member who was a doctor and only 2.3% had a family member who was specialising in Family Medicine. Most of the participants (68.9%) had good knowledge of Family Medicine, while 57.3% had good perception of Family Medicine as a specialty. Importantly, an increase in year of clerkship was associated with an increase in the knowledge of Family Medicine among the respondents. Conclusion: It was observed that with increase in length of exposure to Family Medicine as a specialty, knowledge and perception of the specialty improved among the medical students. It is imperative that all the medical schools in Nigeria implement the NUC directive and start undergraduate Family Medicine training

Parenting styles and socio-demographic dynamics associated with mental health of in-school adolescents in Ibadan, south-west Nigeria

Background: Positive parenting and enabling socio-demography, engenders good conduct in adolescence. Balanced parental demandingness and emotional responsiveness, deployed by authoritative parents, supports adolescents' mental health. Parental emotional responsiveness deters peer-pressured risky behaviours; while parental negligence, permissiveness, or demandingness encourages mental health problems. This is especially in the context of unfavourable socio-demographic setting.Aim: We aimed to evaluate parenting styles and socio-demographic factors associated with adolescents' mental health.Method: A cross-sectional multistage study was conducted with 286 in-school adolescents in Ibadan, Nigeria. Data were collected with questionnaires. The questionnaires evaluated socio-demography, mental health, and perceived parenting styles using the Strength and Difficulty Questionnaire (SDQ) and Scale of Parenting Styles (SPS) questionnaires. Data analysis was conducted using SPSS 21.Results: Some of the adolescents in this study, experienced peer problems (4.9%), conduct problems (9.4%), hyperactivity problems (0.7%), emotional problems (14.3%), and they lacked pro-social behaviours (11.1%). In comparison to adolescents who perceived fathers as authoritative, adolescents who perceived fathers as less demanding experienced emotional (p = 0.01) and peer (p = 0.02) problems. Perceived maternal negligence and authoritarian parenting was associated with more peer problems (1.5±2.3 and 1.3±2.2) in comparison to perceived maternal authoritative style (0.6±1.5). Most adolescents from lower social class experienced conduct (88.8%; p = 0.07) and emotional problems (73.2%; p = 0.20).Conclusion: Competent parenting style and socio-economic resources supports resilience to mental health problems in adolescents

SYMPTOMATOLOGY AND COMORBIDITY OF SOMATIZATION DISORDER AMONGST GENERAL OUTPATIENTS ATTENDING A FAMILY MEDICINE CLINIC IN SOUTH WEST NIGERIA.

BACKGROUND: Individuals with somatization may be the most difficult to manage because of the diverse and frequent complaints across many organ systems. They often use impressionistic language to describe circumstantial symptoms which though bizarre, may resemble genuine diseases. The disorder is best understood in the context "illness" behaviour, masking underlying mental disorder, manifesting solely as somatic symptoms or with comorbidity. OBJECTIVE: To evaluate somatization symptoms and explore its comorbidity in order to improve the management of these patients. METHODS: A cross-sectional survey of 60 somatizing patients who were part of a case-control study, selected by consecutive sampling of 2668 patients who presented at the Family Medicine Clinic of University College Hospital Ibadan, Nigeria between May-August 2009. Data was collected using the ICPC-2, WHO- Screener and Diagnostic Schedule and analysed with SPSS 16. RESULTS: There were at least 5 symptoms of somatization in 93.3% of the patients who were mostly females. Majority had crawling sensation, "headache", unexplained limb ache, pounding heart, lump in the throat and insomnia. The mean age at onset was 35yrs with 90% having recurrence of at least 10yrs.Approximately 54% had comorbidity with cardiovascular disease being the most prevalent. CONCLUSIONS: The study revealed that somatization is not a specific disease but one with a spectrum of expression. This supports proposition that features for the diagnosis of somatization could be presence of three or more vague symptoms and a chronic course lasting over two years. It is important to be conversant with pattern of symptoms and possible comorbidity for effective management of these patients.

Role of Patients' Demographic Characteristics and Spatial Orientation in Predicting Operative Difficulty of Impacted Mandibular Third Molar

Background: The influence of patient factors such as age; sex; weight; body mass index (BMI) and spatial orientation on operative difficulty of impacted mandibular third molar (M3) surgery is a subject of controversy in the literature. Aim: To assess the risk indicators of operative difficulty of mandibular third molar surgery at our institution. Subjects and Methods: A descriptive cross.sectional study involving patients that presented for wisdom tooth extraction between January 2010 and December 2011. The correlation between patientsf factors such as age; sex; weight; height; BMI; radiographic spatial relationship of the impacted tooth and operation time was determined with Spearmanfs rank correlation coefficient. Statistically significant variables were selected for multiple regression analysis to determine which factors contribute most to operative difficulty of M3. P value was set at 0.05. Statistical analysis used SPSS 17.0. Results: Only patientsf age and radiographic spatial relationship showed a statistically significant correlation with operation time (P = 0.038 and 0.008; respectively). Linear regression analysis of patientsf age and angulation of M3 showed that both contribute 44.8 risk of increased operation time (regression coefficient = 0.448); with M3 angulation contributing more significantly to increase in operation time (P = 0.001) than increasing age of the patient (P = 0.005). Conclusions: Findings from this study have shown that increasing age of the patient and the angulation of M3 impaction increases the risk of operative difficulty of the impacted M3 significantly