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Background: Genetic factors play an important role in prostate cancer (PCa) susceptibility.Objective: To discover common genetic variants contributing to the risk of PCa in men of African ancestry.Design, setting, and participants: We conducted a meta-analysis of ten genome-wide association studies consisting of 19378 cases and 61620 controls of African ancestry.Outcome measurements and statistical analysis: Common genotyped and imputed variants were tested for their association with PCa risk. Novel susceptibility loci were identified and incorporated into a multiancestry polygenic risk score (PRS). The PRS was evaluated for associations with PCa risk and disease aggressiveness.Results and limitations: Nine novel susceptibility loci for PCa were identified, of which seven were only found or substantially more common in men of African ancestry, including an African-specific stop-gain variant in the prostate-specific gene anoctamin 7 (ANO7). A multiancestry PRS of 278 risk variants conferred strong associations with PCa risk in African ancestry studies (odds ratios [ORs] >3 and >5 for men in the top PRS decile and percentile, respectively). More importantly, compared with men in the 40-60% PRS category, men in the top PRS decile had a significantly higher risk of aggressive PCa (OR = 1.23, 95% confidence interval = 1.10-1.38, p = 4.4 × 10-4).Conclusions: This study demonstrates the importance of large-scale genetic studies in men of African ancestry for a better understanding of PCa susceptibility in this high-risk population and suggests a potential clinical utility of PRS in differentiating between the risks of developing aggressive and nonaggressive disease in men of African ancestry.Patient summary: In this large genetic study in men of African ancestry, we discovered nine novel prostate cancer (PCa) risk variants. We also showed that a multiancestry polygenic risk score was effective in stratifying PCa risk, and was able to differentiate risk of aggressive and nonaggressive disease.

Purpose Cancer of the prostate (CaP) is the leading cancer among men in sub-Saharan Africa (SSA). A substantial proportion of these men with CaP are diagnosed at late (usually incurable) stages, yet little is known about the etiology of CaP in SSA. Methods We established the Men of African Descent and Carcinoma of the Prostate Network, which includes seven SSA centers partnering with five US centers to study the genetics and epidemiology of CaP in SSA. We developed common data elements and instruments, regulatory infrastructure, and biosample collection, processing, and shipping protocols. We tested this infrastructure by collecting epidemiologic, medical record, and genomic data from a total of 311 patients with CaP and 218 matched controls recruited at the seven SSA centers. We extracted genomic DNA from whole blood, buffy coat, or buccal swabs from 265 participants and shipped it to the Center for Inherited Disease Research (Baltimore, MD) and the Centre for Proteomics and Genomics Research (Cape Town, South Africa), where genotypes were generated using the UK Biobank Axiom Array. Results We used common instruments for data collection and entered data into the shared database. Double-entered data from pilot participants showed a 95% to 98% concordance rate, suggesting that data can be collected, entered, and stored with a high degree of accuracy. Genotypes were obtained from 95% of tested DNA samples (100% from blood-derived DNA samples) with high concordance across laboratories. Conclusion We provide approaches that can produce high-quality epidemiologic and genomic data in multicenter studies of cancer in SSA.

Purpose Health research in low- and middle-income countries can generate novel scientific knowledge and improve clinical care, fostering population health improvements to prevent premature death. Project management is a critical part of the success of this research, applying knowledge, skills, tools, and techniques to accomplish required goals. Here, we describe the development and implementation of tools to support a multifaceted study of prostate cancer in Africa, focusing on building strategic and operational capacity. Methods Applying a learning organizational framework, we developed and implemented a project management toolkit (PMT) that includes a management process flowchart, a cyclical center-specific schedule of activities, periodic reporting and communication, and center-specific monitoring and evaluation metrics. Results The PMT was successfully deployed during year one of the project with effective component implementation occurring through periodic cycles of dissemination and feedback to local center project managers. A specific evaluation was conducted 1 year after study initiation to obtain enrollment data, evaluate individual quality control management plans, and undertake risk log assessments and follow-up. Pilot data obtained identified areas in which centers required mentoring, strengthening, and capacity development. Strategies were implemented to improve project goals and operational capacity through local problem solving, conducting quality control checks and following compliancy with study aims. Moving forward, centers will perform quarterly evaluations and initiate strengthening measures as required. Conclusion The PMT has fostered the development of both strategic and operational capacity across project centers. Investment in project management resources is essential to ensuring high-quality, impactful health research in low- and middle-income countries.

The study applies the counting approach to explain the deprivation concept among children under 5 years of age using the 2008 DHS data. Five dimensions of deprivation were used: safe drinking water, sanitation, housing, health, and nutrition largely recognized in the SDGs. In all, a total of 13561 children were sampled. About half of the children were males with a mean age of 28.27 months old. The assessment of dimensional deprivation showed that children are most deprived in sanitation, health, and access to safe drinking water while they were least deprived in nutrition. The situation is also marked with regional disparities with northern regions reporting higher deprivation rates than the southern regions but this rate was significantly higher in the sanitation dimension across regions. Considering deprivation counts, 33.9% of children suffer from more than three deprivations and approximately 85.2% from at least two deprivations. Child deprivation should be tackled using a holistic approach through social protection programmes to resolve children’s problems in an integrated manner which would in this case be more efficient and effective in safeguarding children’s rights to survival and development. Identifying the children suffering from single and multiple deprivations can help to target the interventions.

OBJECTIVES To examine Texas health educators' practice of providing family health history (FHH)-based services, alongside factors shaping their practice. METHODS A theoretical model of factors influencing health educators' FHH-based practice was developed and tested through structural equation modeling. (Master) Certified Health Education Specialists (N = 228; 40.93%) in Texas completed a baseline survey immediately before online or workshop FHH training. RESULTS Participants incorporated FHH into their practice at low rates (on average=37.10%). Our model fit the data adequately based on the overall model chi-square test and model-fit-indices (ie, χ(2) [df = 21]=27.20; p = .16; RMSEA=0.04; SRMR=0.05; CFI=0.97). Intention, self-efficacy, attitudes, and knowledge were associated with practice. CONCLUSIONS Training health educators to incorporate FHH into their practice is needed. Our theoretical model suggests intervention points for future training.

Market liberalization is a major provision of the structural adjustment programme .This paper examined the nature of maize price fluctuations following the introduction of the reform .Secondary data on average monthly prices of maize covering the period 1983-2000 were sourced from various publications. Data on monthly prices were deflated by consumer price index of food items to construct real price series for maize. The econometric model, Autoregressive Conditional Heteroskedastic in Mean (ARCH-M) was employed to determine the effect of the policy reform on the mean and volatility of maize prices. The results of the ARCH-M model show that a sharp increase was observed in the first-order autocorrelation between the pre- liberalization and post- liberalization periods for both the mean (0.02 to 0.10) and variance (0.49 to 3.96). This implies that the long term changes in the price of maize due to free marketing are different from periods of administrative pricing. The variation was lowest in the pre- liberalization period relative to the post- liberalization period while the highest variability was experienced in the short term period immediately after the reform. The price of its close substitute, sorghum, and the border parity price affects the price of maize thus allowing for informal cross border trade in the post- liberalization period. The lagged prices of maize and seasonal changes reduce volatility in the price of maize between the pre and post liberalization periods. There are also differences in the volatility of maize price across regions. Regional differences show that volatility increased in Adamawa and Niger and decreased in Akwa Ibom in the post- liberalization period. Prices became more stable in the southern agro- climatic zones in the long run but were high in the northern savannahs. Policy makers can stabilize maize prices by disseminating information on price movements and keeping stock of maize for the dry season. Present efforts to increase productivity through improved access to inputs should be strengthened and effectively monitored to ensure increased output so as to increase maize stock. The conclusion is that the reform has increased the mean prices of maize and its volatility over the years, however, other factors have also contributed to price increase since Nigeria’s maize are only traded across close borders and the country is yet to be integrated into the world’s maize market.