Disparities in Current Cigarette Smoking Prevalence by Type of Disability, 2009–2011

Objectives

Smoking, the leading cause of disease and death in the United States, has been linked to a number of health conditions including cancer and cardiovascular disease. While people with a disability have been shown to be more likely to report smoking, little is known about the prevalence of smoking by type of disability, particularly for adults younger than 50 years of age.

Methods

We used data from the 2009–2011 National Health Interview Survey to estimate the prevalence of smoking by type of disability and to examine the association of functional disability type and smoking among adults aged 18–49 years.

Results

Adults with a disability were more likely than adults without a disability to be current smokers (38.8% vs. 20.7%, p<0.001). Among adults with disabilities, the prevalence of smoking ranged from 32.4% (self-care difficulty) to 43.8% (cognitive limitation). When controlling for sociodemographic characteristics, having a disability was associated with statistically significantly higher odds of current smoking (adjusted odds ratio = 1.57, 95% confidence interval 1.40, 1.77).

Conclusions

The prevalence of current smoking for adults was higher for every functional disability type than for adults without a disability. By understanding the association between smoking and disability type among adults younger than 50 years of age, resources for cessation services can be better targeted during the ages when increased time for health improvement can occur.Smoking is the leading cause of disease and death in the United States.¹ It is estimated to cause 443,000 deaths per year in the U.S.,² and average annual health-care-related expenditures are estimated at $96 billion during 2000–2004.² Smoking has been linked to a number of adverse health conditions, including cancer, cardiovascular disease, pulmonary disease, and reproductive health issues.^3,4Disability affects more than 56 million Americans,⁵ with annual health-care expenditures associated with disability approaching $400 billion as of 2006.⁶ Among older adults, disability is often associated with the development or worsening of chronic conditions; as a consequence, disability is often equated with ill health. While this perception may be reinforced given that adults with a disability have been shown to have a lower self-rated health status than adults without disabilities,⁷ a Surgeon General''s report provided ample evidence arguing that this disparity in health is largely preventable. People with disabilities can and should lead as healthy a life as people without disabilities.⁸People with disabilities report a higher prevalence of smoking than do those without disabilities.^9,10 Medicare enrollees with a disability who smoke have been shown to have lower mental and physical function than those who never smoked.¹¹ People with rheumatoid arthritis, which is a leading disabling condition,¹² are more likely to be current smokers than those without rheumatoid arthritis.¹³ In addition, cardiovascular disease and pulmonary disease, both of which are associated with smoking,^3,4 are the third and fourth most commonly reported causes of disability, respectively.¹²Despite condition-specific information and state-level surveillance reports, there is little nationally representative information on the prevalence of smoking by functional type of disability. Such information is critical for understanding how the prevalence of smoking may differ among people with disabilities. A better understanding of any differences that may exist can be used to explore how best to tailor cessation intervention efforts toward people with a disability. Using data from the 2009–2011 National Health Interview Survey (NHIS),¹⁴ we estimated smoking prevalence by disability type among adults aged 18–49 years.     

Obstetric quality assurance to reduce maternal and fetal mortality in Kano and Kaduna State hospitals in Nigeria

Objective

To achieve Millennium Development Goals 4 and 5 in Nigeria, a quality assurance project in obstetrics in 10 hospitals in northern Nigeria was established to improve maternal and fetal outcome.

Methods

The project commenced in January 2008 with assessment and improvement of the structure of the 10 hospitals. Continuous maternal and fetal data collection and analysis were conducted from 2008 to 2009 by means of a maternity record book and structured monthly summary form. The quality of hospital infrastructure and equipment was also assessed.

Results

The mean maternal mortality ratio (MMR) was reduced from 1790 per 100 000 births in the first half of 2008 to 940 per 100 000 births in the second half of 2009. The average fetal mortality ratio (FMR) decreased slightly from 84.9 to 83.5 per 1000 births. There was an inversely proportional relationship between the total number of deliveries in a hospital and MMR and FMR. There was a close correlation between the MMR and the equipment status and hygiene conditions of the hospitals.

Conclusion

Continuous monitoring of quality assurance in maternity units raised the awareness of the quality of obstetric performance and improved the quality of care provided, thereby improving MMR.     

The general surgeon in inter-disciplinary gynaecological cancer care

Gynaecological cancers pose a significant cancer burden globally. In 2008 cancers of the cervix, uterus and ovaries accounted for 529000(4.2%), 287000(2.3%) and 225000(1.8%) cancers, respectively, and together were responsible for 486400 deaths. Inter-disciplinary gynaecological care is an emerging concept aimed at providing more effective care by integrating different disciplines into a team working together to perform the various aspects of management at one time. This model has both advantages and potential shortcomings. In advanced healthcare systems there appears to be little role for the general surgeon. However in developing world, the general surgeon has a valuable, but complementary role in inter-disciplinary gynaecological cancer care. This role depends on the available workforce and includes, but is not limited to, the establishment of a diagnosis and treatment, including the management of complications. There is however little evidence-based research to provide guidance on the general surgeon's role in inter-disciplinary gynecologic cancer care and more research is needed.     

Evaluation of extraction protocols for anti-diabetic phytochemical substances from medicinal plants

AIM To examine the efficacy of three extraction techniques: Soxhlet-extraction(SE), cold-maceration(CM) and microwave-assisted-extraction(MAE) using 80% methanol as solvent. METHODS The study was performed on each of 50 g of Vernonia amygdalina(VA) and Occimum gratissimum(OG) leaves respectively. The percentage yield, duration of extraction, volume of solvent used, qualitative and quantitative phytoconstituents present was compared. The biological activities(hypoglycemic effect) were investigated using albino wistar rat model of diabetes mellitus(n = 36) with a combined dose(1:1) of the two plants leaf extracts(250 mg/kg b.w.) from the three methods. Theextracts were administered orally, once daily for 21 d.RESULTS In this report, the percentage VA extract yield from MAE was highest(20.9% ± 1.05%) within 39 min using 250 m L of solvent, when compared to the CM(14.35% ± 0.28%) within 4320 min using 900 m L of solvent and SE(15.75% ± 0.71%) within 265 min using 500 m L of solvent. The percentage differences in OG extract yield between: MAE vs SE was 41.05%; MAE vs CM was 46.81% and SE vs CM was 9.77%. The qualitative chemical analysis of the two plants showed no difference in the various phytoconstituents tested, but differs quantitatively in the amount of the individual phytoconstituents, as MAE had significantly high yield(P 0.05) on phenolics, saponins and tannins. SE technique gave significantly high yield(P 0.05) on alkaloid, while CM gave significant high yield on flavonoids. The extracts from CM exhibited a significantly(P 0.05) better hypoglycemic activity within the first 14-d of treatment(43.3% ± 3.62%) when compared to MAE(36.5% ± 0.08%) and SE methods(33.3% ± 1.60%). However, the percentage hypoglycemic activity, 21 d post-treatment with 250 mg/kg b.w. extract from MAE was 72.6% ± 1.03% and it was more comparable to 10 mg/kg b.w. glibenclamide treated group(75.0% ± 0.73%), unlike the SE(69.5% ± 0.71%) and CM(69.1% ± 1.03%). CONCLUSION CM technique produces extract with better hypoglycemic activity, whereas; MAE is a better option for high yield of phytoconstituents using less solvent within a short time.     

Redesign and Validation of a Real-Time RT-PCR to Improve Surveillance for Avian Influenza Viruses of the H9 Subtype

Avian influenza viruses of the H9 subtype cause significant losses to poultry production in endemic regions of Asia, Africa and the Middle East and pose a risk to human health. The availability of reliable and updated diagnostic tools for H9 surveillance is thus paramount to ensure the prompt identification of this subtype. The genetic variability of H9 represents a challenge for molecular-based diagnostic methods and was the cause for suboptimal detection and false negatives during routine diagnostic monitoring. Starting from a dataset of sequences related to viruses of different origins and clades (Y439, Y280, G1), a bioinformatics workflow was optimized to extract relevant sequence data preparatory for oligonucleotides design. Analytical and diagnostic performances were assessed according to the OIE standards. To facilitate assay deployment, amplification conditions were optimized with different nucleic extraction systems and amplification kits. Performance of the new real-time RT-PCR was also evaluated in comparison to existing H9-detection methods, highlighting a significant improvement of sensitivity and inclusivity, in particular for G1 viruses. Data obtained suggest that the new assay has the potential to be employed under different settings and geographic areas for a sensitive detection of H9 viruses.     

Characterization of a Novel Thermostable Nuclease Homolog (NucM) in a Highly Divergent Staphylococcus aureus Clade

A thermostable nuclease homologue (Nuc_M) in an animal-associated divergent clade of Staphylococcus aureus in sub-Saharan Africa has a highly divergent nucleotide sequence compared to those of the classical nuc1 and nuc2 genes of S. aureus. Its deduced amino acid sequences, tertiary structures, and nuclease activities, however, are similar.     

Intestinal ameliorative effects of traditional Ogi-tutu,Vernonia amygdalina and Psidium guajava in mice infected with Vibrio cholera

BackgroundCholera, a severe acute watery diarrhea caused by Vibrio cholerae is endemic in Nigeria with most cases occurring in the rural areas. In South West Nigeria, some individuals resort to alternative treatments such as Ogi-tutu, Psidium guajava and Vernonia amygdalina during infections. The effectiveness of these alternatives in the prevention and treatment of V. cholerae infection requires experimental investigation.ObjectiveThis study was designed to investigate the ameliorative effects of Ogi-tutu, Vernonia amygdalina and Psidium guajava on intestinal histopathology of experimental mice infected with V. cholerae.MethodsPreliminary investigation of in vitro vibriocidal activities of these alternatives were carried out using agar cup diffusion assay. For ameliorative effects, adult mice were inoculated with 100 µl (106 cells) of Vibrio cholerae and dosed at 0 h (immediate prevention) and 4 h (treatment of infection) and their intestines were histopathologically evaluated.ResultsThe histopathological changes were the same irrespective of the treated groups, but the lesions varied in extent and severity. The ameliorative effects in decreasing order were V. amygdalina > P. guajava > Ogi-tutu.ConclusionV. amygdalina gave the best ameliorative effects in the prevention and treatment of V. cholerae infection.     

Serum and seminal plasma prolactin levels in male attenders of an infertility clinic in Ibadan.

Serum and seminal plasma prolactin and testosterone were studied in 51 healthy-looking men who presented at the infertility clinic. They included 20 men with normospermia, 20 with oligospermia and 11 with azoospermia. The mean serum prolactin and gonadotrophin levels of the oligospermics and azoospermics were similar but significantly higher than those of the normospermics. The mean seminal plasma prolactin levels in the three groups were similar. The mean serum testosterone of the azoospermics was significantly higher than those of the oligospermics and normospermics who had similar levels. The seminal plasma testosterone of the oligospermics was similar to that of the azoospermics but significantly higher than that of the normospermics. A significant correlation occurred between serum prolactin and sperm motility. No correlation occurred between the serum and seminal plasma prolactin levels, and seminal plasma testosterone or between serum and seminal plasma testosterone. Seminal prolactin has no correlation with any biophysical parameters. It was concluded that poor spermatogenesis is associated with high serum prolactin in patients with infertility. Serum but not seminal plasma prolactin assay is useful in assessing male infertility.