Prevalence of mental illness and its impact on the use of home care and nursing homes: a population-based study of older adults in Manitoba.

OBJECTIVES: To determine the prevalence of mental illness in older adults and its effect on home care and personal care home (PCH) use. METHODS: Using nonidentifying administrative records (fiscal years 1997-1998 to 2001-2002) from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy, we determined the 5-year period prevalence for individuals aged 55 years and over (119 539 men and 145 752 women) for 3 mental illness categories: cumulative mental disorders (those having a diagnosis of depression, anxiety disorder, personality disorder, schizophrenia, and [or] substance abuse), any mental illness, and dementia. We calculated age-specific and age-adjusted rates of home care and PCH use and the prevalence of mental illness in PCH residents. RESULTS: From the group aged 55 to 59 years to the group aged 90 years or older, the prevalence of mental illness increased with the population's age. The prevalence of any mental illness rose from 32.4% to 45.0% in men and from 42.6% to 51.9% in women, and dementia prevalence rose from 2.0% to 33.6% in men and from 1.3% to 40.3% in women. The age-adjusted annual rates of open home care cases per 1000 population aged 55 and older varied by mental illness grouping (no mental disorder, 57 for men and 91 for women; cumulative mental disorders, 162 for men and 191 for women; dementia, 300 for men and 338 for women). The age-adjusted rates of PCH use per 1000 population aged 75 years and older also varied by mental illness grouping (no mental disorder, 53 for men and 78 for women; cumulative mental disorders, 305 for men and 373 for women; dementia, 542 for men and 669 for women). Among patients admitted to (or resident in) a PCH in 2002-2003, 74.6% (87.1%) had a mental illness, and 46.0% (69.0%) had dementia. CONCLUSIONS: Mental illness affects the use of home care and nursing homes profoundly. Individuals with dementia used home care at 3 times the rate of those having no mental illness diagnosis, and they used PCHs at 8 times the rate.     

Effects of some common additives on the antimicrobial activities of alcohol-based hand sanitizers

Objective: To study the effects of some common additives on the antimicrobial activities of alcohol-based hand sanitizers. Methods: The antibacterial activities of varying aqueous concentrations of ethanol and isopropyl alcohol were tested by the agar well diffusion method. The influences of different concentrations of glycerin was similarly tested. Finally, isopropyl alcohol and benzalkonium chloride were combined in different ratios within the sate use concentrations of each, and the effects of these combinations were compared with values obtained for the two agents used alone. Statistical methods, such as student t test and one-way ANOVA were used when appropriate to evaluate the differences in activity. Results: The activities of the alcohols showed marked concentration dependence, and both showed peak activity at 85%-95% concentration range. Over the concentration range of 60%-100%, isopropyl alcohol inhibited more bacterial and fungal organisms than ethanol, though the inhibition zone diameters it produced were not statistically different from those of ethanol for organisms which were sensitive to both of them.Addition of glycerin reduced the antimicrobial activities of the isopropyl alcohol, as shown by reduction in the inhibition zone diameters produced in vitro, which may be due to reduced drug diffusion with increase in viscosity. Addition of benzalkonium to isopropyl alcohol systems improved the activity of the alcohol, but the overall activity of the combination was not superior to that seen in the use of benzalkonium alone. Conclusion: Alcohol-based hand sanitizers should not be used outside the concentration range of 85%-95% and isopropyl alcohol inhibits more bacterial and fungal organisms than ethanol for most concentrations. Inclusion of benzalkonium improves the antimicrobial spectrum and activity of isopropyl alcohol, and the combination may justifiably be used to achieve both immediate and long lasting effect. Glycerin may adversely affect the antimicrobial activities of isopropyl alcohol-based hand sanitizers and should be used with caution.     

Prevalence and factors associated with anthropometric failure,vitamin A and iron deficiency among adolescents in a Nigerian urban community

BackgroundUnder nutrition is a problem of severe magnitude in low income countries like Nigeria. Adolescent school children might also be vulnerable. The dearth of data hinders planning of school health and nutrition programmes for school children.ObjectiveTo determine the prevalence of stunting, thinness; vitamin A and iron deficiencies among adolescent students in Nsukka urban, Nigeria and to determine factors that are associated with these nutritional problems.MethodsA total of 400 participants were randomly selected from 717 students aged 12 – 18 years in 3 randomly selected secondary schools. Questionnaires, anthropometric measurements, and blood analyses were the data collection methods employed.ResultsThe prevalence of stunting was 33.3% and thinness 31.0%. Neither overweight nor obesity was observed. While 64.0% were anaemic; 44.0% had vitamin A deficiency (VAD). A total of 48.0% had both anaemia and stunting, 42% had VAD + thinness; while 40% had anaemia + VAD. Household income was a predictor of vitamin A status. Children from medium/high income households had higher odds of having VAD than those from low income households (AOR=0.14; 95% CI=0.031, 0.607; P=0.009). Household income (AOR=0.12; 95% CI=0.021, 0.671; P=0.016), and age (AOR=0.09; 95% CI=0.014, 0.587; P=0.012) were independent determinants of height-for-age status.ConclusionAmong urban adolescent students in Nigeria, stunting, thinness, anaemia and VAD were problems of public health significance. Age and household monthly income played major roles.     

Azadirachta indica extract–artesunic acid combination produces an increased cure rate of Plasmodium berghei-infected mice

Context: Available artemisinin-combination therapies (ACTs) are expensive. Various traditional herbal remedies for malaria involve plants, proven scientifically to have antiplasmodial effects, e.g., Azadirachta indica A. Juss. (Meliaceae).

Objective: Combination of an artemisinin-based compound and a medicinal herb extract will provide an indigenous alternative/herb-based ACT.

Materials and methods: The in vivo schizontocidal activity of the crude aqueous extract of 100, 500, and 1000?mg/kg of A. indica fresh leaves (NCE) and 6, 15, and 20?mg/kg of artesunic acid were determined, alone and in combination, while keeping the dose of artesunic acid constant at 15?mg/kg, using the Peter’s 4-day suppressive test and Swiss albino mice. The ED₅₀ was calculated from the dose-response relationships. Percentage survival and cure were also determined.

Results: The average yield of two extractions of NCE was 8.33?±?1.67%. Combination of 1000?mg/kg of NCE and 15?mg/kg of artesunic acid, produced a significant reduction of parasitemia (96.87%), compared to 20?mg/kg of artesunic acid alone (68.14%). The combination had an ED₅₀ of 0.58?mg/kg while that of artesunic acid alone was 8.814?mg/kg. The combinations of NCE with artesunic acid produced a cure, although the artesunic acid did not produce a cure in 30?d.

Discussion: NCE increased the activity of artesunic acid in terms of reduction in parasitemia, and increased survival time and cure rate.

Conclusion: The combination of an artemisinin and aqueous extract of neem leaf is possible, providing a potentiated reduction of parasitemia, and increased cure rate.     

Blood pressure,prevalence of hypertension and hypertension related complications in Nigerian Africans:A review

To review studies on hypertension in Nigeria over the past five decades in terms of prevalence,awareness and treatment and complications.Following our search on Pubmed,African Journals Online and the World Health Organization Global cardiovascular infobase,1060 related references were identified out of which 43 were found to be relevant for this review.The overall prevalence of hypertension in Nigeria ranges from 8%-46.4% depending on the study target population,type of measurement and cut-off value used for defining hypertension.The prevalence is similar in men and women(7.9%-50.2% vs 3.5%-68.8%,respectively) and in the urban(8.1%-42.0%) and rural setting(13.5%-46.4%).The pooled prevalence increased from 8.6% from the only study during the period from 1970-1979 to 22.5%(2000-2011).Awareness,treatment and control of hypertension were generally low with attendant high burden of hypertension related complications.In order to improve outcomes of cardiovascular disease in Africans,public health education to improve awareness of hypertension is required.Further epidemiological studies on hypertension are required to adequately understand and characterize the impact of hypertension in society.     

Evaluation of the anti-candidal activity of methanolic leaf extract of cleistopholis patens (fam. Annonaceae) on candida species isolated from stage II HIV patients

BackgroundCandida species (sp) is implicated in causing opportunistic disseminated mycotic complications in stage II HIV patients. Cleistopholis patens is a West African medicinal tree reported to have significant antifungal activity against C. albicans.ObjectivesThis study aimed to determine the anti-candidal activity of methanolic leaf extract of Cleistopholis patens against Candida species isolated from stage II HIV patients.MethodsThe minimum inhibitory concentration (MIC) of the extract and Nystatin®® was determined by agar dilution method. The killing rate studies of the plant extract and Nystatin® were also determined.ResultsThe extract had activity against all Candida isolates, with the MIC against the five isolates ranging from 6.0 – 9.8 mg/ml. Nystatin® also demonstrated plausible activity against the isolates with MICs ranging from 0.3125 — 25 mg/ml. Candida albicans strain 2 was the most sensitive to both extract and Nystatin® with MIC values of 6 and 0.3125 mg/ml respectively. Candida krusei was the least sensitive with MIC values of 9.8 and 25 mg/ml for the extract and Nystatin® respectively. The killing rate values for the extract ranged from −0.029 to −0.091 min⁻¹ and that of Nystatin® ranged from −0.076 to −0.112¹⁶ min⁻¹.ConclusionsThe results indicate that the methanolic extract of Cleistopholis patens is a promising clinical alternative besides Nystatin® in the treatment of infections caused by Candida species in stage II HIV patients.     

Sexual activity and function in women with and without pelvic floor disorders

Introduction and hypothesis

We describe differences in sexual activity and function in women with and without pelvic floor disorders (PFDs).

Methods

Heterosexual women ≥40 years of age who presented to either urogynecology or general gynecology clinics at 11 clinical sites were recruited. Women were asked if they were sexually active with a male partner. Validated questionnaires and Pelvic Organ Prolapse Quantification (POP-Q) examinations assessed urinary incontinence (UI), fecal incontinence (FI), and/or pelvic organ prolapse (POP). Sexual activity and function was measured by the Female Sexual Function Index (FSFI). Student’s t test was used to assess continuous variables; categorical variables were assessed with Fisher’s exact test and logistic regression. Univariate and multivariate analyses were used to assess the impact of pelvic floor disorders (PFDs) on FSFI total and domain scores.

Results

Five hundred and five women met eligibility requirements and gave consent for participation. Women with and without PFDs did not differ in race, body mass index (BMI), comorbid medical conditions, or hormone use. Women with PFDs were slightly older than women without PFDs (55.6?+?10.8 vs. 51.6?+?8.3 years, P <0.001); all analyses were controlled for age. Women with PFDs were as likely to be sexually active as women without PFDs (61.6 vs. 75.5 %, P?=?0.09). There was no difference in total FSFI scores between cohorts (23.2?+?8.5 vs. 24.4?+?9.2, P?=?0.23) or FSFI domain scores (all P?=?NS).

Conclusion

Rates of sexual activity and function are not different between women with and without PFDs.     

Impact of the Out-of-School Nutrition and Physical Activity (OSNAP) Group Randomized Controlled Trial on Children’s Food,Beverage, and Calorie Consumption among Snacks Served

Background

Afterschool interventions have been found to improve the nutritional quality of snacks served. However, there is limited evidence on how these interventions affect children’s snacking behaviors.

Induction of a single dose of streptozotocin (50 mg) in rat model causes insulin resistance with type 2 diabetes mellitus

Streptozotocin (STZ) is a broad-spectrum antibiotic that is toxic to the insulin-producing beta cells of the pancreatic islets. STZ is currently used clinically for the treatment of metastatic islet cell carcinoma of the pancreas and the induction of diabetes mellitus (DM) in rodents. So far, there has been no previous research to show that STZ injection in rodents causes insulin resistance in type 2 diabetes mellitus (T2DM). The purpose of this study was to determine if rats (Sprague–Dawley) developed type 2 diabetes mellitus (insulin resistance) after 72 h of intraperitoneal administration of 50 mg/kg STZ. Rats with fasting blood glucose levels above 11.0 mM, 72 h post-STZ induction, were used. The body weight and plasma glucose levels were measured every week throughout the 60-day treatment period. The plasma, liver, kidney, pancreas, and smooth muscle cells were harvested for antioxidant, biochemical analysis, histology, and gene expression studies. The results revealed that STZ was able to destroy the pancreatic insulin-producing beta cell, as evidenced by an increase in plasma glucose level, insulin resistance, and oxidative stress. Biochemical investigation indicates that STZ can generate diabetes complications through hepatocellular damage, elevated HbA1c, kidney damage, hyperlipidemia, cardiovascular damage, and impairment of the insulin-signaling pathway.