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BACKGROUND: Rapid corona virus disease 2019 (COVID-19) vaccination drives aimed to immunize primary school-aged youth have a potential for health safety and supportive academic attainment. This study aimed to identify the potential factors influencing childhood COVID-19 vaccine confidence among the primary school's stakeholders in Bangladesh and assess the effects of health education on vaccine confidence and receptivity. MATERIALS AND METHODS: This cross-sectional study used a bilingual, multi-item, closed-ended, anonymous questionnaire adopted from the extant literature studies on the topic. Data were collected purposively by the face-to-face interview approach. In total, 627 primary school's stakeholders participated in this study. The binary logistic regressions and Chi-square tests were employed to investigate and rationalize the study-outlined objectives where 0.05) in the Chi-squared test. Hence, there was no vaccine-hesitant risky recipient group identified in implementing upcoming childhood COVID-19 vaccination programs. CONCLUSIONS: This study confirms the importance of a positive perception of vaccine safety, efficacy, effectiveness, and health education for vaccine confidence under any circumstances. Childhood COVID-19 vaccine confidence is Improved if vaccination data become more available to the guardians and school community. Public health education would be considered a preferred approach for building trust and fostering childhood vaccine confidence against COVID-19 in Bangladesh.

Cardiac rehabilitation (CR) is a standard model of care, and an established component of comprehensive care that has been proven to reduce mortality and morbidity in patients with cardiac diseases. International clinical practice guidelines routinely recommend that cardiac patients participate in CR programs for comprehensive secondary prevention. However, there is scant guidance on how to deliver these programs in low-resourced settings. This dearth of clinical practice guidelines may be an indication of low emphasis placed on CR as a component of cardiac health services in low-income countries, especially in Africa. Indeed, CR programs are almost non-existent in Africa despite the unmet need for CR in patients with ischemic heart disease in Africa reported to be about one million. This figure represents the highest unmet need of any World Health Organization region, and is colossal given the projected accelerated increases in incidence of cardiovascular diseases (CVD) in the region. This narrative review explored the availability of CR programs, potential barriers to CR and strategies that can mitigate such barriers in Africa., (© 2023. Italian Society of Hypertension.)

Background: Regular physical activity (PA) improves general health and quality of life (QoL) of the general population. It is however not known if leisure-time PA (LTPA) behaviour will reduce co-morbidity and adiposity, and improve cardiorespiratory fitness and QoL in midlife men. This study explored the impacts of regular LTPA behaviour on co-morbidity, adiposity, cardiorespiratory fitness and QoL among male midlife sports club members in a Nigerian population., Methods: This cross-sectional study involved 174 age-matched male midlife adults: 87 engaging in LTPA (LTPA group) and 87 not engaging in LTPA (non-LTPA group). Information on age, body mass index (BMI), waist circumference (WC), maximal oxygen uptake (VO 2 max) , resting heart rate (RHR), QoL and co-morbidity level was collected using standardized procedures. Data were summarized using mean and standard deviation, and explored using frequency and proportion. Independent t-test, Chi Square and Mann-Whitney U test were employed to determine the impacts of LTPA at 0.05 significance level., Results: The LTPA group had lower co-morbidity score (p = 0.05) and RHR (p = 0.004), and higher QoL (p = 0.01) and VO 2 max (p = 0.003) than non-LTPA group. While heart disease (χ 2  = 10.99; p = 0.01) and hypertension (χ 2  = 15.24; p = 0.004) severity levels were associated with LTPA behaviour, hypertension (p = 0.01) was the only co-morbid condition that had a significantly lower score in the LTPA group than in the non-LTPA group., Conclusions: Regular LTPA improves cardiovascular health, physical work capacity and QoL in the sample of Nigerian mid-life men. Regular LTPA behaviour is recommended for cardiovascular health promotion, and improved physical work capacity and life satisfaction in midlife men., (© 2023. The Author(s).)

Detection of somatic mutation in whole-exome sequencing data can help elucidate the mechanism of tumor progression. Most computational approaches require exome sequencing for both tumor and normal samples. However, it is more common to sequence exomes for tumor samples only without the paired normal samples. To include these types of data for extensive studies on the process of tumorigenesis, it is necessary to develop an approach for identifying somatic mutations using tumor exome sequencing data only. In this study, we designed a machine learning approach using Deep Neural Network (DNN) and XGBoost to identify somatic mutations in tumor-only exome sequencing data and we integrated this into a pipeline called DNN-Boost. The XGBoost algorithm is used to extract the features from the results of variant callers and these features are then fed into the DNN model as input. The XGBoost algorithm resolves issues of missing values and overfitting. We evaluated our proposed model and compared its performance with other existing benchmark methods. We noted that the DNN-Boost classification model outperformed the benchmark method in classifying somatic mutations from paired tumor-normal exome data and tumor-only exome data.

Objectives: To cross-culturally adapt and validate the Physical Activity Scale for the Elderly (PASE) into Igbo culture., Methods: The English version of the PASE (E-PASE) was translated into Igbo, harmonized, back-translated, subjected to expert panel review, and pretested. The final Igbo version of PASE (I-PASE), the E-PASE, and the International Physical Activity Questionnaire were then administered to consecutively recruited 109 consenting Igbo older adults. Data were analyzed using frequency, percentage, mean, standard deviation, Mann-Whitney U test, Spearman rank-order correlation, and Cronbach's alpha at .05 level of significance., Results: All items on the E-PASE were retained on the I-PASE but some modifications were made. The I-PASE had poor internal consistency coefficient (α = .66), poor-to-excellent item, and total score known-group validity (ρ = .24-1.00) and moderate convergent validity (ρ = .50)., Conclusion: The I-PASE is a valid, reliable, and culturally specific tool for assessing PA among Igbo older adults.

Background: Falls and fear of falling (FOF) have serious adverse effects for older adults. Culturally-specific and environmentally-tailored interventions may help address the problems of falls and FOF. No such interventions are however available for use in the African context., Objective: To explore falls and FOF among older adults in an assisted-living facility, as a foundation for developing interventions to address falls and FOF., Methods: This qualitative study involved purposefully recruiting nine older adults and four caregivers at an assisted-living facility in Southeast Nigeria. Focus group discussions were conducted separately for older adults and the caregivers. Data were analysed using an Inductive Approach., Results: Four themes emerged: incidence of falls and fear of falling; factors associated with falls and fear of falling; health implications of falls and fear of falling; and coping strategies to deal with falls and fear of falling. Older adults were experiencing a high prevalence of falls and FOF perceived to be caused by both cultural/environmental/institutional-related factors (poorly lit environment at night; poor ambulatory surfaces; unwillingness to accept age-related changes in physical capacity; poor disposition towards walking aids; poor treatment of injuries; misconceptions; poor physical activity participation; and external perturbation) and intrinsic factors (psychological/emotional, concentration/attention, socio-demographic and morbidity-related)., Conclusion: The older adults were experiencing a high prevalence of falls and FOF which has a multifactorial origin of common and cultural/societal/institutional/environmental-related factors. The need for a multicomponent and culturally and environmentally-specific interventions to address falls and FOF in this sample is thus highlighted., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Tele-physiotherapy has been shown to be valuable to improve clinical outcomes after stroke. Yet, home-based interventions for stroke survivors (SSVs) who speak indigenous African languages are sparse. This study developed a video-based home exercise programme (VHEP) for SSV speakers of Yoruba. A qualitative descriptive pilot study was conducted in two phases: development and feasibility testing. VHEP development followed the American Stroke Association's recommendations to include demonstrations of task-specific mobility-task and postural training; trunk exercises, and overground walking. The exercise instructions were presented in the Yoruba language. Each exercise was demonstrated for five minutes on video for a total of 30 minutes. The feasibility testing involved ten consenting chronic SSVs. Each imitated the VHEP twice per week for two weeks and thereafter completed a feasibility questionnaire. Criteria for feasibility were: cost of using VHEP, recruitment rate, retention of participants, adherence to the exercises, and intervention delivery. The ten SSVs were recruited within one week, had prior home access to a video player at no-cost, adhered to the exercises as recorded, completed the 30 minute-duration for two weeks, and confirmed intervention delivery of VHEP. Most participants liked the novel use of Yoruba as the language of instruction on VHEP. The VHEP was feasible and acceptable among the studied sample of SSVs. Video based home telerehabilitation for SSVs therefore has the potential to meet the growing need for tele-physiotherapy in resource limited settings., (Copyright © 2020 Marufat O. Odetunde, Overcomer T. Binuyo, Fatai A. Maruf, Sunday O. Ayenowowon, Adaobi M. Okonji, Nurain A. Odetunde, Chidozie E. Mbada.)

Background: Fear of falling (FOF) is a very pervasive problem among older adults. Consequently, many scales have been developed for its assessment. The Modified Falls Efficacy Scale (MFES) is one of the most popular FOF scales. The MFES was originally developed for use in developed countries, and thus may not be entirely suitable for use in developing countries due to cultural and environmental differences between the two country categories. This study was therefore designed to cross-culturally adapt and validate the MFES to Igbo culture and environment among community-dwelling older adults in Nnewi community using established guidelines., Methods: The original English version of the MFES (E-MFES) was translated, synthesized, back-translated, subjected to expert panel review, and pretested before producing the final Igbo version of the MFES (I-MFES). The I-MFES and the Short Falls Efficacy Scale International were randomly administered to consecutively recruited 109 consenting older adult residents of Nnewi (43.1% males; mean age = 74.45 ± 8.78 years). Convergent and structural validities and internal consistency of the I-MFES were assessed at 0.05 level of significance., Results: All the 14 items on the E-MFES were retained on the I-MFES. The I-MFES exhibited the same structure as the E-MFES. The correlation between the total scores on the I-MFES and the Short Falls Efficacy Scale International was excellent (rho = - 0.93) indicating evidence of convergent validity of the I-MFES. The Cronbach's alpha value of the I-MFES was 0.97 showing evidence of excellent internal consistency of the items on the I-MFES., Conclusion: This study provides evidence of some aspects of validity and reliability of the I-MFES.

Background: Stroke results in varying levels of physical disabilities that may adversely impact balance with increased tendency to falls. This may intensify with cognitive impairments (CI), and impede functional recovery. Therefore, task-specific balance training (TSBT), which presents versatile task-specific training options that matches varied individual needs, was explored as a beneficial rehabilitation regime for stroke survivors with and without CI. It was hypothesized that there will be no significant difference in the balance control measures in stroke survivors with and without CI after a 12-month TSBT., Objective: To determine if TSBT will have comparable beneficial effects on the balance control status of sub-acute ischemic stroke survivors with CI and without CI., Methods: One hundred of 143 available sub-acute first ever ischemic stroke survivors were recruited using convenience sampling technique in a quasi-experimental study. They were later assigned into the cognitive impaired group (CIG) and non-cognitive impaired group (NCIG), respectively, based on the baseline presence or absence of CI, after screening with the mini-mental examination (MMSE) tool. With the help of four trained research assistants, TSBT was applied to each group, thrice times a week, 60 mins per session, for 12 months. Their balance was measured as Bergs Balance scores (BBS) at baseline, 4th, 8th, and 12th month intervals. Data were analyzed statistically using Kruskal Wallis test, and repeated measure ANOVA, at p < 0.05., Results: There was significant improvement across time points in the balance control of CIG with large effect size of 0.69 after 12 months of TSBT. There was also significant improvement across time points in the balance control of NCIG with large effect size of 0.544 after 12 months of TSBT. There was no significant difference between the improvement in CIG and NCIG after 8th and 12th months of TSBT., Conclusions: Within the groups, a 12-month TSBT intervention significantly improved balance control, respectively, but with broader effects in the CIG than NCIG. Importantly, though between-group comparison at baseline revealed significantly impaired balance control in the CIG than NCIG, these differences were not significant at the 8th month and non-existent at the 12th month of TSBT intervention. These results underscore the robustness of TSBT to evenly address specific balance deficits of stroke survivors with and without CI within a long-term rehabilitation plan as was hypothesized.

Introduction: Understanding lifestyle behavior among individuals with hypertension is important for achieving hypertension control., Aim: This study explored perception, knowledge, attitude and participation in physical activity (PA) among individuals with hypertension attending tertiary hospitals in a south-eastern Nigerian state., Methods: This cross-sectional survey involved 200 individuals with hypertension from the Out-Patient Departments of the two teaching hospitals in Anambra State, Nigeria. Information on age, education level, gender, height, sleep duration, perception of PA, knowledge about PA, attitude towards PA, and participation in PA was collected using a self-developed and pilot-tested questionnaire. Blood pressure (BP), height, body weight, and waist circumference were measured using standardized procedures. PA level was assessed using 7-Day International PA Questionnaire., Results: Majority of participants reported good perceptions of PA behavior, in terms of not being discouraged by relations and friends, and of its benefits. They reported good knowledge about PA behavior. The participants demonstrated positive attitude in terms of benefits, importance, and involved risk of PA, and reported high level of participation in PA. There were significant correlations among knowledge about PA, attitude towards PA and participation in PA. PA level generally correlated significantly with attitude and participation in PA CONCLUSIONS: Perceived high level of participation in PA in this study sample can be attributed to their much knowledge and positive attitude towards PA. Increasing the knowledge about PA among individuals with hypertension by creating awareness about benefits and utilization of PA will improve their attitudes towards PA, and thereby fosters their participation in PA.

Background: Ageing is associated with increased morbidity, depression and decline in function. These may consequently impair the quality of life (QoL) of older adults., Purpose: This study was used to investigate the prevalence of functional disability, depression, and level of quality of life of older adults residing in Uyo metropolis and its environs, Nigeria., Method: This cross sectional survey involved 206 (116 females and 90 males) older adults with mean age of 69.8±6.7. The World Health Organization Quality of Life-OLD, Functional status Questionnaire (FSQ) and Geriatric Depression Scale (GDS) were used to measure quality of life, functional disability and depression respectively. Data was analysed using frequency counts and percentages and Spearman rank-order correlation coefficient, at 0.05 alpha level., Results: 45.5% of participants had depression, and at least 30% had functional disability in at least one domain, but their quality of life was fairly good (>60.0%) across all domains. Significant correlation existed between depression scores and individual quality of life and functional disability domains and between overall QoL and each functional disability domain (p<0.001)., Conclusions: Depression and functional disability were quite prevalent among sampled older adults but their QOL was not too severely affected. Since the constructs were interrelated, it seems interventions targeted at depression and functional status may invariably enhance the quality of life of the older adults., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Objectives: This study was designed to determine the caregiver-proxy reliability of the Igbo-culture adapted urban version of the Maleka Stroke Community Reintegration Measure (I-MSCRIM)., Methods: This was a validation study involving 74 consenting stroke survivors and their 74 primary informal caregivers consecutively recruited from selected tertiary hospitals in South-East Nigeria (Igboland). The I-MSCRIM was researcher-administered to the participants. Obtained data was analyzed using frequency counts, percentages, range, mean, standard deviation, Spearman rank order correlation, Mann-Whitney U test, Kruskal-Wallis test and Intra-class Correlation Coefficient. Alpha level was set at 0.05., Results: The mean ages of the stroke survivors (55.4% males) and their primary informal caregivers (41.9% males) were 50.14 ± 12.24 and 31.93 ± 10.9 years respectively. There was no significant difference in the community reintegration (CR) scores as rated by stroke survivors and their primary informal caregivers (p > 0.05). The correlations between stroke survivors' and primary informal caregivers' rated CR scores were all adequate and acceptable (ICC = 0.602-0.917). The discrepancy in the total CR scores between the two ratings was significantly influenced by primary informal caregivers' educational attainment (k = 13.15; p < 0.01)., Conclusion: The I-MSCRIM has acceptable caregiver-proxy reliability among Igbo stroke survivors in South-East Nigeria. This suggests that primary informal caregivers of stroke survivors can reliably estimate the CR of their care recipients when I-MSCRIM is administered to them. This will be useful when a stroke survivor cannot respond to I-MSCRIM.

Aim: Reports on social risk factors for falls are scarce. This study explored the associations of selected sociodemographic and health variables with falls among rural Nigerian community-dwelling older adults., Methods: The present cross-sectional study involved 131 community-dwelling older adults (84 women and 47 men) recruited at an outreach center. Demographic (age, sex and marital status), social (frequency of visiting relations and friends, and number of consistent informal carers) and health (number of comorbid conditions) variables were recorded., Results: Having fewer than two informal carers (0.26, 95% CI 0.10-0.68) was independently associated with reduced risk for falls. Visiting relations and friends less than twice per week was independently associated with greater risks for falls (3.85, 95% CI 1.42-10.46) and recurrent falls (4.86, 95% CI 1.25-18.85)., Conclusions: The number of informal carers and frequency of social visits are risk factors for falls in older adults, and need to be taken into consideration in any strategy for fall prevention in older adults. Geriatr Gerontol Int 2015; ●●: ●●-●●., (© 2015 Japan Geriatrics Society.)

There is a dearth of reports on possible additive blood pressure (BP)-reducing effect of aerobic exercise on antihypertensive drug in humans. This study investigated the additive BP-reducing effect of aerobic exercise on BP in individuals with uncontrolled hypertension. In this 12-week double-blind study, 120 new-diagnosed individuals with mild-to-moderate hypertension were randomized to receive coamilozide + 5/10 mg of amlodipine + aerobic dance or coamilozide + 5/10 mg of amlodipine alone. Forty-five and 43 participants in exercise and control groups, respectively, completed the 12-week intervention. Addition of aerobic exercise to antihypertensive drug therapy significantly reduced systolic BP (7.1 mm Hg [95% confidence interval: 5.0, 9.3]; P < .001) and diastolic BP (1.7 mm Hg [95% confidence interval: 0.4, 3.0]; P = .009) at 12 weeks. BP control rate differed significantly between exercise (53.9%) and control (35.3%) groups, P < .001. Postintervention, proportion of participants in exercise group who had their number of antihypertensive drug reduced to one (20.3%) differed from that in control group (11.1%); (χ(2) = 11.0; P = .001). Combination of aerobic dance and antihypertensive drugs reduces number of antihypertensive drugs needed to achieve BP control and enhances BP control in individuals with hypertension on two antihypertensive drugs., (Copyright © 2016 American Society of Hypertension. Published by Elsevier Inc. All rights reserved.)

Objective: This survey explored prevalence of overweight and obesity and their associations with socio-demographic variables in a Nigerian population., Methods: This cross-sectional survey involved 1521 adults in Nnewi. Age, sex, educational and occupational status, and BMI were recorded., Results: Prevalence of overweight was higher in males (32.3%; 95% CI, 29.5%-35.2%) than in females (29.8%; 95% CI, 26.8%-33.0%); the reverse was the case for prevalence of obesity (19.6%; 95% CI, 17.3%-22.2% in males and 36.0%; 95% CI, 32.8%-39.4% in females). Higher odds ratios (ORs) for overweight and obesity were observed in participants aged 41-60 years (OR 2.03; 95% CI, 1.57-2.61 for overweight and OR 4.29; 95% CI, 3.25-5.67 for obesity) and those >60 years (OR 1.72; 95% CI, 1.21-2.43 for overweight and OR 4.21; 95% CI, 2.86-6.19 for obesity) compared to those aged 18-40 years. Female sex was associated with higher ORs for overweight (OR 1.20; 95% CI, 0.96-1.51) and obesity (OR 2.21; 95% CI, 1.73-2.83). Participants with secondary education had marginally higher ORs for overweight (OR 1.15; 95% CI, 0.88-1.51) and obesity (OR 1.17; 95% CI, 0.86-1.59) than those with tertiary education, and so were those with primary education for obesity (OR 1.19; 95% CI, 0.74-1.89) but higher OR for overweight (OR 1.44; 95% CI, 0.98-2.13). Unskilled participants had about the same OR for overweight and obesity as professionals, and while skilled participants had about the same OR for overweight as professionals, their OR for obesity (OR 1.27; 95% CI, 0.67-2.43) was fairly higher than that for professionals., Conclusions: Prevalence of overweight is higher in males than in females, but the reverse is the case for prevalence of obesity. Older age and female sex are associated with increased risk of overweight and obesity, while working at a skilled occupation is associated with obesity, and tertiary educational attainment is associated with overweight.

Purpose: Hypertension is associated with dyslipidemia. Thiazides adversely affect serum lipid levels in hypertensives. There is currently a dearth of information on benefits of aerobic exercise training on serum lipid levels in individuals on thiazides and this study aimed at bridging this gap in knowledge., Methods: This randomized-controlled trial involved 120 newly-diagnosed adults with essential hypertension (≥65 years). They were treated with 50 mg of hydrochlorothiazide + 5 mg of hydrochloride amiloride and 5 or 10 mg of amlodipine for 4-6 weeks before they were randomly assigned into exercise group (EG) and control croup (CG). Only EG underwent 12-week aerobic dance training at 50-70 % of heart rate reserve three times per week. Low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglyceride and total cholesterol were measured and recorded at baseline and post-study., Results: Eighty-eight (45 in EG and 43 in CG) of 120 participants randomly assigned to groups completed the study. Systolic (p = 0.370) and diastolic (p = 0.771) blood pressures (BP) were similar between the two groups at baseline. Systolic (p < 0.001) and diastolic (p < 0.001) BPs reduced significantly in exercise and control groups. LDL-C (from 120.10 ± 33.41 to 110.50 ± 31.68 mg/dl; p = 0.037) and triglyceride (from 117.49 ± 45.12 to 100.63 ± 35.42 mg/dl; p = 0.002) decreased in EG post-study but no significant between-group differences were observed., Conclusions: Although, LDL-C and triglyceride are reduced after aerobic dance training, they were not any more than without it. Aerobic dance training has favorable effects on LDL-C, triglyceride, and systolic and diastolic BP in individuals with hypertension on a thiazide.

Achieving adequate blood pressure (BP) control with antihypertensive medication remains an elusive goal for many patients. The advances in knowledge of hypertension and the increasingly improved upon therapeutic strategies seem not to guarantee even sustainable control rates at the population level. In addition, patients who either discontinue their medications or are non-adherent to drug therapy run the risk of developing uncontrolled BP. Number of daily tablets more than two and number of daily drug administration at least three have been associated with poor adherence with drug therapy. However, BP control seems to go beyond adherence with drug therapy as there are other associated factors. Studies have demonstrated beneficial effect of aerobic exercise in the prevention and management of hypertension. It appears, however, that the majority of these studies failed to explore the possible additive or synergistic effect of aerobic exercise on antihypertensive drugs such that fewer drugs would be required to achieve BP control or that the BP control rate would be increased with the same number of drugs. This review presents the evidence for poor BP control in the general population, and the possible means and process of aerobic exercise complementing antihypertensive drug therapy in order to achieve higher BP control rates.

Purpose: This study explored decisional balance, self-efficacy, and physical activity (PA) level in relation to stages of change (SoC) for PA among Nigerian vendors. The study explored associations among decisional balance, self-efficacy, and PA level, and examined differences, by stage, in decisional balance, self-efficacy, and PA level., Design: Cross-sectional survey., Setting: Outdoor markets located in Eke Amobi, Nkwo, and Okpuno Egbu in Nnewi, southeastern Nigeria., Subjects: Participants were 499 market vendors (98 males and 401 females)., Measures: Self-efficacy, perceived barrier and benefit, PA level, and SoC for PA., Analysis: Spearman rank-order and partial correlations; analysis of variance by gender with Bonferroni post hoc adjustment., Results: Self-efficacy (r = 0.69; p = 0.000), perceived benefit (r = .12; p = .007), and perceived barrier (r = -.11; p = .017) for PA were related to the SoC. Adjusting for age, gender, and marital status, only self-efficacy (r = .48; p = .000) remained correlated with the SoC. In males, significant differences in perceived barrier (p = .003) and benefit (p = .003) lay between stages of contemplation and preparation and between stages of precontemplation and contemplation for self-efficacy (p = .006). In females, there were significance differences in self-efficacy across stages of precontemplation and contemplation (p = .000) and preparation and action (p = .007)., Conclusion: When designing PA interventions, age, gender, and marital status should be considered in explaining the relationships between outcome constructs of transtheoretical model (TTM) and SoC in vendors. It is also important to note that the stages at which outcome constructs of TTM change during PA interventions vary in males and females.

This study explored the association of socioeconomic status with individuals' perception of their body image (BI) and body weight (BW) among adults in a sub-urban Nigerian population. The cross-sectional sample comprised 1521 residents (775 males and 746 females) of the town of Nnewi. Perceived BI was assessed using figural representations of different sizes for males and females. Perceived BW was determined by presenting participants with BW category options to choose from. Body mass index (BMI) was calculated from objectively measured BW and height using standardized procedures. Actual BW categories were derived from participants' BMIs using WHO criteria. Perceived BI and BW differed from actual BW among unskilled and non-tertiary males (p<0.001) and female (p<0.001 to p<0.04) in all BW categories whereas these variables differed (p<0.001) among skilled and tertiary males and females in normal weight, overweight and obese categories. Perceived BW differed (p<0.001) from actual BW among unskilled and non-tertiary males in underweight, overweight and obese categories whereas these variables differed (p<0.001) among unskilled and non-tertiary females, skilled and tertiary males and females in overweight and obese categories. Underweight 'unskilled' and 'non-tertiary' males perceived their BI to be different from their actual BW (p<0.001). Overweight and obese 'skilled' and 'unskilled', and 'tertiary' and 'non-tertiary', males and females perceived their BI and BW to be different from their actual BW (p<0.001). Significant differences in perceived BI existed between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.005), overweight males, and between 'skilled' and 'unskilled' (p<0.001), and 'tertiary' and 'non-tertiary' (p=0.008), normal-weight females. The 'skilled' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.41-0.64; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.96; p=0.03) than the 'unskilled' participants. The 'tertiary' participants had a lower risk of perceiving a larger BI (OR 0.51, 95% CI 0.40-0.63; p<0.001) and larger BW (OR 0.71, 95% CI 0.53-0.95; p=0.02) than the 'non-tertiary' participants. After adjusting for possible confounders, all the risks became insignificant except for perception of BI by the 'skilled' participants (OR 0.70, 95% CI 0.50-0.99; p=0.04). Individuals in the different occupational and educational categories perceived their BI differently but their BW similarly. Given the same BMI, age, perceived ideal BI and sex, only occupation is found to be associated with perception of BI.

Information on self-reported physical activity (PA) level in association with primary dysmenorrhea (PD) is not readily available on African populations, and there is a dearth of information on the association of adiposity with PD. This study explored the association of PA and adiposity indices with PD and associated menstrual pain. This cross-sectional study involved 1383 female adolescents from 12 randomly selected secondary schools (9 private and 3 public schools). They were categorized into <1 hour/day or > or = 1 hour/day of PA based on their reported average duration of PA per day. The adiposity [body mass index (BMI) and waist circumference (WC)] was assessed using standardized procedures. Majority of participants (85.4%) in this study sample reported experiencing PD. More participants without PD engaged in PA for more than one hour daily than those with PD (Chi(2) = 11.49; p = 0.001). The participants with PD experienced menstrual pain mostly (55.1%) during menstruation and the mostly reported pain intensity was moderate (38.7%). Majority of those (80.5%) who had menstrual pain did not report using medication for the pain. 77.0% of those who used medication reported having pain relief. Waist circumference, BMI and PA level showed no independent association (p > 0.05) with either PD or its pain intensity experienced among the adolescents. PA level and adiposity are not associated with PD in school adolescents.

Overweight and obesity are serious health concerns for children. However, only a few studies have investigated the influence of gender on prevalence of overweight and obesity in children and adolescents in Nigeria. The objective of this study was to investigate gender influence on prevalence of overweight and obesity among Nigerian school children and adolescents. Information on age and gender of the participants was collected from the school register. Data on height, weight and BMI was collected using standard techniques. A total of 9,014 children and adolescents (male = 4392; female = 4622), aged 2-18 years, from 28 randomly selected schools were analyzed. Overweight and obesity were determined using the International Obesity Task Force cut-off points by age and gender. Males had higher BMI than females at age group 2-6 years, whereas females had higher BMI than males at age groups 11-14 years and 15-18 years. Females had significantly higher prevalence of overweight (P < 0.05) than males at age group 11-14 and 15-18 years. However, there was no gender difference in the prevalence of obesity from childhood through adolescence. In conclusion, BMI is larger in males in early childhood but larger in females in during adolescence. More female adolescents are at risk of obesity than males.

Background: The Effects of Aerobic Exercise Training (AET) on self-reported Quality of Life (QoL) in people with hypertension have been previously documented. However, data on black populations, especially from Africa, seem not to be available. This study investigated the effects of AET on QoL and exercise capacity in Nigerians on treatment for essential hypertension., Method: This randomised-controlled trial involved newly diagnosed individuals, with mild-to-moderate essential hypertension randomly assigned to antihypertensive drugs (ADs) alone (control: n = 60) and AET+ADs (exercise: n = 60) groups. The study lasted for 12 weeks. QoL was measured using the World Health Organization QoL Short Form (WHOQoL-BREF) and exercise capacity was assessed using the Rockport Fitness Walk Test pre- and post-study., Results: Physical health, psychological health, and social relationships domains of QoL improved significantly in the exercise and control groups post-intervention. The environment domain of QoL and exercise capacity improved significantly in only the exercise group. There were larger improvements in the physical health, psychological health, and environment domains of QoL, and exercise capacity in the exercise group., Conclusion: Aerobic exercise improves QoL and exercise capacity in individuals with essential hypertension., (© 2013 The Authors. Applied Psychology: Health and Well-Being © 2013 The International Association of Applied Psychology.)

Background: Body image (BI) is a multidimensional construct that includes perceptual, attitudinal, behavioural components, and feedback from other people's perception of oneself. The feedback from others and the degree to which one accepts or rejects it can determine self evaluation and perception. Body weight perception is a strong determinant of nutritional habits and weight management among adolescents. One of the barriers to reducing rise in obesity prevalence could be its cultural acceptability in some developing countries., Objective: To explore the gender influences on perception of self- and opposite-sex body images (BI), perceived body weight and the actual body weight categories at which discrepancies occur among the perceived BIs in undergraduates., Methods: This was a survey of perceptual dimension of BI, perceived body weight and actual body weight carried out in 121 undergraduates aged 21-29 years., Results: Discrepancies occurred between self-perceived BI and each of actual body weight (p= 0.00 at 0.00-0.02 confidence interval (CI)), perceived body weight (p= 0.01 at 0.000-0.02 CI) and self-ideal BI (p= 0.03 at 0.000-0.05 CI) of normal-weight males. Self-perceived BI and perceived body weight also differed in normal-weight females (p= 0.02 at 0.000-0.04 CI). Discrepancies (p= 0.02 at 0.00-0.04 CI) occurred between self-perceived BI and self-ideal BI, and between self-perceived BI and desired BI (p= 0.02 at 0.00-0.04 CI) in overweight females. Gender differences occurred for self-ideal BI (p= 0.00 at 0.00-0.02 CI), ideal image for the opposite sex (IBIOS) (p= 0.02 at 0.00-0.04 CI) and desired BI (p= 0.00 at 0.00-0.02 CI)., Conclusion: Normal-weight males perceived their BI differently from their actual body weight, perceived body weight and self-ideal BI whereas normal-weight females perceived their BI differently from only their perceived body weight. Discrepancies occur between self-ideal BI and self-perceived BI, and between self-perceived BI and desired BI in overweight females. There are differential perceptions of self-ideal BI, IBIOS and desired BI between males and females.

The influence of sex on systolic blood pressure (SBP) and heart rate (HR) responses associated with cardiovascular morbidity, in healthy young adults was determined in ninety healthy young adults (47 females and 43 males) exercised using Bruce protocol. SBP and HR were measured pre- and post-exercise, and during recovery. SBPresponse (peak minus pre-exercise SBP), %SBPresponse [(peak minus pre-exercise SBP)÷pre-exercise SBP]x100, SBP3 (SBP 3 minutes into recovery), SBP4 (SBP 4 minutes into recovery), SBP3:peak (SBP3÷peak SBP), %SBPd3 [(peak SBP minus SBP 3 minutes into recovery)x peak SBP]x100, %SBPd4 [(peak SBP minus SBP 4 minutes into recovery)x peak SBP]X100, HRresponse (Peak HR minus pre-exercise HR), %HRresponse [(peak HR minus pre-exercise HR)÷pre-exercise HR]x 100, HR3 (HR 3 minutes into recovery), HR4 (HR 4 minutes into recovery), %HRd3 [(peak HR minus HR 3 minutes into recovery)÷peak HR]x100, %HRd4 [(peak HR minus HR 4 minutes into recovery)÷peak HR]X100, and HR50-70 (HR between 50th and 70th seconds into recovery) were derived from SBP and HR measurements. SBPpeak, HRresponse and %HRresponse were higher in males than in females whereas, SBPresponse, %SBPresponse and HRpeak were not different. There were no significant differences in the post-exercise SBP and HR responses of males and females except for SBP3, SBP4, HR3 and HR4. After adjusting for exercise duration, body mass index (BMI), and resting SBP and HR, these variables became similar. Sex differences in some SBP and HR responses to exercise, become nonexistent after adjusting for BMI, exercise duration, and resting SBP and HR.

The World Health Organization's quality of life scale - short form (WHOQOL-BREF) is a well-validated, cross-cultural tool for measuring quality of life (QOL) of patients with chronic diseases. It has been translated into over 20 languages, none of which is an indigenous Nigerianlanguage. The aim of this study was to investigate the validity of a Yoruba translated version of the WHOQOL-BREF Yoruba is the indigenous language of southwestern Nigeria. The English version of the WHOQOL-BREF was translated into Yoruba and it went through two rounds of back-translation. The English and Yoruba versions of WHOQOL-BREF were completed by 41 stroke survivors, literate in both languages. Participants were recruited through purposive sampling method from physiotherapy clinics of all tertiary health institutions in southwestern Nigeria between April and August, 2004. Data was analyzed using Spearman rank order correlation and paired t- test with the alpha level set at 0.05. Participants (24 males, 14 females) were aged 55 +/- 10.7 years and have had stroke for 28.4 +/- 6.7 months. Participants' domain scores on the Yoruba translated version of WHOQOL-BREF correlated significantly with those on its English version (r = 0.695-0.859; p = 0.000). This Yoruba version is a valid translation of the English WHOQOL-BREF and may be used for assessing QOL of stroke survivors in southwestern Nigeria.