Anthropometric parameter that best predict metabolic syndrome in South west Nigeria

AimThis study compared the ability of anthropometric parameters to predict Metabolic Syndrome (MetS).MethodsEleven anthropometric parameters: waist circumference (WC), body mass index (BMI), waist-to-height ratio (WHtR), a body shape index (ABSI), body roundness index (BRI), visceral adiposity index (VAI), abdominal volume index (AVI), Conicity Index (CI), body adiposity index (BAI), lipid accumulation product (LAP) and waist circumference-triglyceride index (WTI) were measured and calculated in apparently healthy subjects with and without MetS. A receiver operating characteristic (ROC) curve was applied to assess their ability to predict MetS.ResultsOf the 535 subjects recruited 23% had MetS. WC had the largest area under the curve (AUC) in both men (0.814 95% CI 0.721–0.907) and women (0.819 95%CI 0.771–0.867). This did not differ from the AUC of BMI, WHtR, BRI, CI, BAI, LAP in men and BMI, WHtR, BAI, LAP, VAI and WTI in women (P > 0.05). The cutoff point for WC was 89.5 cm and 91.8 cm in men and women respectively. The AUC of WC was the largest in the 40–49 and 60 years and above age groups while the AUC of LAP was the largest for age groups 30–39 and 50–59 years.ConclusionOf the 11 anthropometric parameters assessed, the WC was the best at predicting MetS in both men and women. There is need to ascertain the cutoff point and establish landmark for measuring WC especially for the sub Saharan region.     

Reported use of technology in stroke rehabilitation by physical and occupational therapists

Purpose: With the patient care experience being a healthcare priority, it is concerning that patients with stroke reported boredom and a desire for greater fostering of autonomy, when evaluating their rehabilitation experience. Technology has the potential to reduce these shortcomings by engaging patients through entertainment and objective feedback. Providing objective feedback has resulted in improved outcomes and may assist the patient in learning how to self-manage rehabilitation. Our goal was to examine the extent to which physical and occupational therapists use technology in clinical stroke rehabilitation home exercise programs.

Materials and methods: Surveys were sent via mail, email and online postings to over 500 therapists, 107 responded.

Results: Conventional equipment such as stopwatches are more frequently used compared to newer technology like Wii and Kinect games. Still, less than 25% of therapists’ report using a stopwatch five or more times per week. Notably, feedback to patients is based upon objective data less than 50% of the time by most therapists. At the end of clinical rehabilitation, patients typically receive a written home exercise program and non-technological equipment, like theraband and/or theraputty to continue rehabilitation efforts independently.

Conclusions: The use of technology is not pervasive in the continuum of stroke rehabilitation.

• Implications for Rehabilitation

• The patient care experience is a priority in healthcare, so when patients report feeling bored and desiring greater fostering of autonomy in stroke rehabilitation, it is troubling.

• Research examining the use of technology has shown positive results for improving motor performance and engaging patients through entertainment and use of objective feedback.

• Physical and occupational therapists do not widely use technology in stroke rehabilitation.

• Therapists should consider using technology in stroke rehabilitation to better meet the needs of the patient.

     

Consequences of HIV testing without consent

The objective of this study is to explore the HIV-infected individuals' experience with HIV testing, counselling, disclosure of diagnosis and subsequent life events following diagnosis.The method used is a questionnaire survey of 340 consecutive HIV-positive victims, seen in two health institutions in southeast Nigeria within a one-year-period, November 2003 to October 2004.Three hundred and twenty respondents answered the questionnaire, 121 were men and 199 women, with 79% in the age range 20-39 years. Most respondents had known their HIV status for 3.2 (+/-1.1) years and the majority are in the lower social class. About 80% reported that their consent for HIV test was not asked for, resulting in feelings of fear, disbelief, shock and embarrassment on learning about their HIV status. Despite the initial reaction to the diagnosis, majority (81.9%) expressed satisfaction with the pattern of disclosure of diagnosis. There was some reluctance to inform spouse/partner of the diagnosis especially among asymptomatic, unmarried, childless or divorced victims. A serodiscordant couple resulted in mistrust and increased incidence of abandonment. Apart from spouse/partner the respondents are more likely to inform their siblings of the diagnosis than parents, children or friends. Despite being supportive, the respondents are more likely to suffer more neglect from siblings than their spouse (P<0.05) but the risk of being abandoned was more with the spouse than with siblings (P<0.05). Only 32.6% of the 129 respondents on antiretroviral therapy are regular with it mainly because of cost and non-availability of drugs. Default in treatment was more evident among the unmarried, those with low educational status and treatment with antiretroviral drugs for more than two years.Proper pre- and post-test counselling, promotion of behavioural change among the society about HIV/AIDS and provision of support and cost-effective care for HIV victims is advocated.     

Induced abortion in Nigeria: findings from focus group discussion

Abortion is carried out daily in Nigeria despite the restrictive abortion law. This study was carried out to obtain information on societal attitude to the issues of family planning, unwanted pregnancy, abortion, adoption of children and laws relating to them. Focus group discussions were held in south-western Nigeria among 11 sub-groups. Participants felt that there was high prevalence of unwanted pregnancy and abortion particularly among youths. They had high level awareness of contraceptives and ascribed its low use to negative side effects, high cost and provider bias. Christians favoured planning of pregnancies while the Muslims did not. Majority of the respondents had negative perception of induced abortion. Some of them supported abortion if the education of the young girl would be disrupted, if paternity of pregnancy is in dispute, or if it would save the family from shame. Participants supported the enactment of laws that would make adoption of unwanted children easier.     

Fear of Falling and Quality of Life of Apparently-Healthy Elderly Individuals from a Nigerian Population

Ageing is associated with increased morbidity, increased fear of falling (FOF) and reduced activity. These may consequently impair the quality of life (QOL) of the elderly. Studies from Africa investigating FOF and its relationship with QOL among elderly individuals are rare. This study investigated the prevalence of FOF and QOL of apparently-healthy elderly residents of two Local Government Areas (LGAs) from Anambra State, Nigeria and also determined the relationship between the two variables. Two hundred and sixty-one (131 males and 130 females) volunteering elderly individuals, from three randomly-selected communities from each of the LGAs, participated in this cross-sectional survey. The Modified Fall Efficacy Scale (MFES) and the Short-Form Health Survey 36-item (SF-36) questionnaire were used to evaluate FOF and QOL respectively. Data were analysed using frequency, percentage, mean and standard deviation, Chi-square, Independent t-test, Pearson correlation and multivariate regression analysis statistics. Alpha level was set at 0.05. FOF was markedly prevalent in the population at 23.4 % and the QOL score of 55.27?±?17.28 was just modest. QOL was particularly low in the role limitations due to the physical and emotional problems domains but high in the mental health, social function and bodily pain domains. Significant relationship was found between FOF and all the QOL domains. FOF was present in nearly one of every four elderly individuals in the sample and was related to their QOL. FOF should be routinely investigated in community-dwelling elderly and strategies devised to combat it.