Theory-driven development of a mobile phone supported intervention for adolescents with perinatal depression

Purpose

This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria.

Methods

We conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains.

Results

FGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, “as need arises” phone calls, and the involvement of "neighborhood mothers”. In the inner settings, care providers’ behaviour is addressed with training to increase their capacity to engage young mothers in treatment.

Conclusion

A theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.

     

Decoupling the Contribution of Surface Energy and Surface Area on the Cohesion of Pharmaceutical Powders

Pharmaceutical Research - Surface area and surface energy of pharmaceutical powders are affected by milling and may influence formulation, performance and handling. This study aims to decouple the...     

Rural-urban disparities in maternal immunization knowledge and childhood health-seeking behavior in Nigeria: a mixed method study

Background

Immunization and appropriate health-seeking behavior are effective strategies to reduce child deaths.

Objectives

To compare maternal knowledge about immunization, use of growth chart and childhood health-seeking behavior in rural and urban areas.

Methods

A cross-sectional comparative study done in Lagos, Nigeria. Questionnaire survey and focus group discussions were done. 300 respondents were selected by multi-stage sampling while discussants were purposively selected.

Results

Awareness of immunization was high but knowledge of vaccine preventable diseases (VPDs) was poor in both areas. Urban women utilized preventive services more; growth monitoring (p<0.001) and immunization (p<0.001) while higher proportions of rural women utilized nutritional counseling (p=0.005) and treatment of illness (p<0.001). Growth chart utilization was better in the urban areas (p<0.001). Increasing maternal education increased use of growth chart in both areas. Both groups of women use multiple treatment sources for children (more in urban), determined by cost, time, perceived severity of illness and type of ailment (urban) and peculiarity of illness (rural). There is a preference for orthodox care in the rural area.

Conclusions

Knowledge of VPDs was poor and multiple treatment sources were common among rural and urban women. Education is vital to improve immunization knowledge and health-seeking behavior in both areas.     

The effects of rooibos (Aspalathus linearis), green tea (Camellia sinensis) and commercial rooibos and green tea supplements on epididymal sperm in oxidative stress-induced rats

Reactive oxygen species (ROS) are involved in many physiological functions of mammalian sperm. Numerous endogenous antioxidants belonging to both enzymatic and non‐enzymatic groups can remove excess ROS and prevent oxidative stress (OS). This study compares the modulation of OS by rooibos, Chinese green tea and commercial rooibos and green tea supplements in rat sperm. Male Wistar rats (n = 60) were supplemented with fermented rooibos, ‘green’ rooibos, Chinese green tea, rooibos supplement, green tea supplement or water for 10 weeks while OS was induced during the last 2 weeks. Sperm count and motility were significantly higher for rats consuming fermented rooibos and ‘green’ rooibos when compared with the other groups. Catalase activity was significantly higher in the sperm of rats consuming fermented rooibos, ‘green’ rooibos and both the rooibos and green tea supplements. Superoxide dismutase concentration in the sperm of rats supplemented with fermented rooibos, ‘green’ rooibos and green tea was higher. Sperm glutathione levels of rats consuming the fermented and ‘green’ rooibos were also significantly higher. Rooibos fermented and ‘green’ rooibos showed a tendency to lower the levels of ROS and lipid peroxidation when compared with the control group. In conclusion, both rooibos extracts could offer a measure of protection against induced oxidative damage by increasing the antioxidant defence mechanisms and thereby improving the sperm quality and function. Copyright © 2012 John Wiley & Sons, Ltd.     

A radiographic study of third molar crown development in a group of Nigerian children

The present study assessed developmental stages of third molar crowns in a group of Nigerian children and compared development across arches in relation to chronological age and sex.MethodologyPanoramic radiographs of 560 healthy Nigerian children aged 5 to 15 years were reviewed. The stages of development of third molar crowns across arches were assessed and determined using the criteria defined in Gravely's classification of crown formation. A score was recorded in each quadrant for each child. Data was analyzed using Epi-info 6 version for windows. Statistical significance was inferred at P < 0.05.ResultsMales 267 (47.7%), females 293 (52.3%). Mean age 10.4 years (SD52.5). Earliest evidence of crypt formation was observed at age 5.0. Mean age for stage 1 of crown calcification was 7.55, 7.75, 8.24 and 8.88 for the lower right, lower left, upper right and upper left quadrant of the jaws respectively. Differences observed between males and females were significant for stage 1 upper right molar crown development, (P = 0.03). In children 12 years and above, approximately 75% of the crowns visible on radiographs were at least half formed. Mean age for stage 5 of crown formation and initiation of root formation was between 13.10 and 13.43 years. The proportion of agenesis among children aged 12 years and above was 0.7.ConclusionsThe first sign of third molar crown development was observed as early as age 5. A positive correlation was observed between third molar development and chronological age. Proportion of agenesis in children aged 12 years and above was 0.7.     

Synthesis and cytotoxic activities of some 2-Arylnaphtho[2,3-d]oxazole-4,9-dione derivatives on androgen-dependent (LNCaP) and androgen-independent (PC3) human prostate cancer cell lines

The synthesis of five 2-arylnaphtho[2,3-d]oxazole-4,9-dione derivatives was accomplished by refluxing 2-amino-3-bromo-1,4-naphthoquinone with appropriate benzoyl chloride analogs at elevated temperatures. In vitro anticancer evaluation of these compounds was performed on androgen-dependent, LNCaP, and androgen-independent, PC3, human prostate cancer cell lines. In general, these compounds displayed slightly stronger cytotoxicity on the androgen-dependent LNCaP than on the androgen-independent PC3 prostate cancer cell lines. The meta-substituted 2-(3-Chloro-phenyl)-naphtho[2,3-d]oxazole-4,9-dione (10) appear to display the best cytotoxicity on both cell lines with an IC(50) of 0.03 μM on LNCaP and 0.08 μM on PC3 after 5 days of exposure.