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This study explored adolescents' perceptions and experiences with school counselling in Ibadan, Southwest Nigeria. A total of 48 students between the ages of 14 and 19 years from public and private secondary schools participated in eight focus groups. Using a phenomenological approach, data was analyzed using thematic analysis. Participants described the role of a school counsellor as an adult support system, and accessed counselling services mostly for academic purposes. Negative beliefs and experiences with the counselling process, and preference for significant others were some barriers to seeking school counselling services. Personal counsellor attributes which facilitate supportive interpersonal relationships were desired. Participants also wanted peer involvement in the counselling process. There is an urgent need for national policies guiding the training and practice of school counsellors to ensure high quality and effective services in schools.

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants, parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents.The study is aimed at comparing the presentations of children with ADHD in the rural area, across two different settings: home and school. Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state, south eastern, Nigeria completed the school version of ADHD rating scale-IV, and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale-IV. Results: Of the 18 symptoms of the condition, there were significant differences in the rate of identification in eight symptoms. These symptoms include ‘being easily distracted’ (p=0.0427), ‘difficulty following through on instruction’ (p=0.0026), ‘fails to give close attention to details (p=0.0001), ‘avoids tasks necessary for tasks’ (p=0.0013), ‘difficulty playing quietly (p=0.0059 ), ‘talks excessively’ (p=0.0023), ‘intrudes on others’ (p=0.0004), and ‘seems not to listen when spoken to directly’ (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Background Cervical cancer (CC) is a major health problem in Ethiopia. Integrated healthcare approaches have been suggested as a way to increase access to and utilisation of screening services. Limited data exists on integrated CC screening (CCS) uptake at the primary care facilities where most women access healthcare. This study aimed to determine integrated CCS uptake and associated factors among women attending primary care services at health centres (HCs) in Addis Ababa, Ethiopia.Methods A multicentred cross-sectional study design was conducted among 1366 women attending primary care services at HCs in Addis Ababa. A systematic random sampling method was used to reach the study participants. Sexually active women aged 30–49 years attending primary care services in HCs were included in the study. A multivariable logistic regression model, with Stata/MP V.17.0 software, was used to identify the factors associated with integrated CCS service utilisation at a p value

Accurate characterization of microcalcifications (MCs) in 2D digital mammography is a necessary step toward reducing the diagnostic uncertainty associated with the callback of indeterminate MCs. Quantitative analysis of MCs can better identify MCs with a higher likelihood of ductal carcinoma in situ or invasive cancer. However, automated identification and segmentation of MCs remain challenging with high false positive rates. We present a two-stage multiscale approach to MC segmentation in 2D full-field digital mammograms (FFDMs) and diagnostic magnification views. Candidate objects are first delineated using blob detection and Hessian analysis. A regression convolutional network, trained to output a function with a higher response near MCs, chooses the objects which constitute actual MCs. The method was trained and validated on 435 screening and diagnostic FFDMs from two separate datasets. We then used our approach to segment MCs on magnification views of 248 cases with amorphous MCs. We modeled the extracted features using gradient tree boosting to classify each case as benign or malignant. Compared to state-of-the-art comparison methods, our approach achieved superior mean intersection over the union (0.670 ± 0.121 per image versus 0.524 ± 0.034 per image), intersection over the union per MC object (0.607 ± 0.250 versus 0.363 ± 0.278) and true positive rate of 0.744 versus 0.581 at 0.4 false positive detections per square centimeter. Features generated using our approach outperformed the comparison method (0.763 versus 0.710 AUC) in distinguishing amorphous calcifications as benign or malignant.

Effective community entry processes influence community participation and acceptance of public health interventions. Though there is a growing body of literature on the importance of community partnerships, there is a lack of pragmatic and practical documentation of the experiences involved in the community entry process as it relates to culturally sensitive topics such as child marriage which can help to support researchers working in this field. This article highlights key themes related to knowledge of the community, effective communication, cultural sensitivity, coproduction and giving feedback which help to build trust between the community members and the research team. Institutional representation, not managing expectations, and lack of clarity, along with personal opinions of community gatekeepers can create challenges for the fostering of trustworthy relationships with the community. These realities must be actively addressed right at the onset of the process between the research team and community stakeholders. Researchers can develop trust, form connections and engage different communities by working with local groups and leaders, using culturally appropriate methods, and addressing community concerns. Future projects working with communities on child marriage in Nigeria and other countries would benefit from the reflections presented in this paper.

This paper describes a postgraduate training programme in child and adolescent mental health (CAMH) in Nigeria. It explains the background, curriculum development, teaching, evaluation and outcomes. By its 10th year the programme had trained 166 CAMH professionals from 14 African countries. Many of the graduates are running clinical CAMH services in their countries, mostly pioneered by them. They are also conducting CAMH training, including as faculty on the programme, and some are in international CAMH leadership roles. Key success elements of the programme that can be replicated in other low- and middle-income countries include international partnership, adopting a train-the-trainer approach, using a curriculum that covers clinical aspects of CAMH while also developing leadership and research skills, use of free-access training resources, and access to seed funding.

This research explores the enhancement of electrochemical performance in magnesium batteries by optimising magnesium alloy anodes, explicitly focusing on Mg-Al and Mg-Ag alloys. The study’s objective was to determine the impact of alloy composition on anode voltage stability and overall battery efficiency, particularly under extended cycling conditions. The research assessed the anodes’ voltage behaviour and internal resistance across magnesium bis(trifluoromethanesulfonyl)imide (Mg(TFSI)2) electrolyte formulations using a systematic setup involving cyclic voltammetry on the anode and electrochemical impedance spectroscopy. The Mg-Al alloy demonstrated superior performance, with minimal voltage drop and lower resistance increase than the Mg-Ag alloy. The results showed that the Mg-Al alloy maintained over 85% energy efficiency after 100 cycles, significantly outperforming the Mg-Ag alloy, which exhibited increased degradation and efficiency reduction to approximately 80%. These findings confirm that incorporating aluminium into magnesium anodes stabilises the anode voltage and enhances the overall battery efficiency by mitigating degradation mechanisms. Consequently, the Mg-Al alloy is identified as an up-and-coming candidate for use in advanced battery technologies, offering energy density and cycle life improvements. This study lays the groundwork for future research to refine magnesium alloy compositions further to boost battery performance.

This study explores the enhancement of poly(lactic acid) (PLA) matrix using calcium hydroxyapatite (cHAP) and reduced graphene oxide (rGO) for developing composite scaffolds aimed at bone regeneration applications. The PLA composites were fabricated through solvent evaporation and melt extrusion and characterized by various techniques, including thermogravimetric analysis (TGA), differential scanning calorimetry (DSC), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), and mechanical testing. The incorporation of cHAP and rGO significantly improved the thermal, mechanical, and morphological properties of the PLA matrix. Mechanical testing revealed that adding 10% cHAP and varying amounts of rGO (0.1%, 0.3%, 0.5%) enhanced tensile and compressive strengths, with the highest improvements observed at 0.5% rGO content. Thermal analysis showed increased thermal stability with higher degradation temperatures for the composites. Spectroscopic analyses confirmed the effective integration of cHAP and rGO into the PLA matrix with characteristic peaks of the fillers identified in the composite spectra. In vitro, degraded action tests in phosphate-buffered saline (PBS) at pH 7.4 over 12 months indicated that composites with higher rGO content exhibited lower mass loss and better mechanical stability. Furthermore, finite element analysis (FEA) simulations were performed to validate the experimental results, demonstrating a strong correlation between simulated and experimental compressive strengths. This novel approach demonstrates the potential of PLA/cHAP/rGO composites in creating effective and biocompatible scaffolds for tissue engineering, providing a comprehensive analysis of the synergistic effects of cHAP and rGO on the PLA matrix and offering a promising material for bone regeneration applications.

This research investigates the application of machine learning models to optimise renewable energy systems and contribute to achieving Net Zero emissions targets. The primary objective is to evaluate how machine learning can improve energy forecasting, grid management, and storage optimisation, thereby enhancing the reliability and efficiency of renewable energy sources. The methodology involved the application of various machine learning models, including Long Short-Term Memory (LSTM), Random Forest, Support Vector Machines (SVMs), and ARIMA, to predict energy generation and demand patterns. These models were evaluated using metrics such as Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). Key findings include a 15% improvement in grid efficiency after optimisation and a 10–20% increase in battery storage efficiency. Random Forest achieved the lowest MAE, reducing prediction error by approximately 8.5%. The study quantified CO2 emission reductions by energy source, with wind power accounting for a 15,000-ton annual reduction, followed by hydropower and solar reducing emissions by 10,000 and 7500 tons, respectively. The research concludes that machine learning can significantly enhance renewable energy system performance, with measurable reductions in errors and emissions. These improvements could help close the “ambition gap” by 20%, supporting global efforts to meet the 1.5 °C Paris Agreement targets.

This research aims to enhance the surface quality, mechanical properties, and biocompatibility of PEEK (polyether–ether–ketone) biomimetic dental implants through laser polishing. The objective is to improve osseointegration and implant durability by reducing surface roughness, increasing hydrophilicity, and enhancing mechanical strength. The methodology involved fabricating PEEK implants via FDM and applying laser polishing. The significant findings showed a 66.7% reduction in surface roughness, Ra reduced from 2.4 µm to 0.8 µm, and a 25.3% improvement in hydrophilicity, water contact angle decreased from 87° to 65°. Mechanical tests revealed a 6.3% increase in tensile strength (96 MPa to 102 MPa) and a 50% improvement in fatigue resistance (100,000 to 150,000 cycles). The strength analysis result showed a 10% increase in stiffness storage modulus from 1400 MPa to 1500 MPa. Error analysis showed a standard deviation of ±3% across all tests. In conclusion, laser polishing significantly improves the surface, mechanical, and biological performance of PEEK implants, making it a promising approach for advancing biomimetic dental implant technology.

Abstract Background Benign prostatic hyperplasia (BPH) is a major health concern associated with lower urinary tract symptoms and sexual dysfunction in men. Recurrent inflammation, decreased apoptotic rate and oxidative stress are some of the theories that explain the pathophysiology of BPH. Common salt, a food additive, is known to cause systemic inflammation and redox imbalance, and may serve as a potential risk factor for BPH development or progression. This study examined the effect of common salt intake on the pathology of testosterone-induced BPH. Methods Forty male Wistar rats were randomly divided into four equal groups of 10: a control and three salt diet groups-low-salt diet (LSD), standard-salt diet (SSD) and high-salt diet (HSD). The rats were castrated, allowed to recuperate and placed on salt-free diet (control), 0.25% salt diet (LSD), 0.5% salt diet (SSD) and 1.25% salt diet (HSD) for 60 days ad libitum. On day 33, BPH was induced in all the rats with daily injections of testosterone propionate-Testost® (3 mg/kg body weight) for 28 days. The rats had overnight fast (12 h) on day 60 and were euthanized the following day in order to collect blood and prostate samples for biochemical, molecular and immunohistochemistry (IHC) analyses. Mean ± SD values were calculated for each group and compared for significant difference with ANOVA followed by post hoc test (Tukey HSD) at p

Abstract Background HIV seroprevalence in Nigeria is increasing among men who have sex with men (MSM) from 14% to 2007 to 23% in 2014, threatening progress towards ending the epidemic in the country. Expanding access to HIV testing and linkage to care for key populations, like young MSM (YMSM), is critical to end the HIV epidemic in Nigeria. The Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents (iCARE Nigeria) pilot intervention successfully implemented a combination of evidence-based interventions utilizing peer navigators and popular social media apps and platforms to reach young men at risk for HIV exposure, including YMSM. We conducted sequential mixed methods explanatory implementation research to expand on the previously reported effectiveness and implementation outcomes and to explore the determinants and strategies which contributed to primary study results. Methods We conducted key informant interviews and focus group discussions with 2 peer navigators and 3 study staff at the end of the pilot. We used directed content analysis to understand the quantitative results from the pilot. Using the Implementation Research Logic Model, we were able to identify and map strategies through mechanisms of action from barriers addressed to the reported implementation outcomes including feasibility, acceptability fidelity and adoption. Results We found that iCARE Nigeria’s pilot intervention implementers reported high feasibility, acceptability fidelity and adoption were associated with implementation of strategies which addressed many challenging contextual factors, including social stigma, online social networking, legal barriers surrounding MSM behavior, and the COVID-19 pandemic. These strategies included integration of stakeholders’ interests, selection of experienced peer navigators including from the targeted population, training and supportive supervision using an implementation guide, ensuring safety (COVID and legal) and identification of clinics serving the targeted population. Conclusion Mixed methods using implementation research frameworks provided insights into the strategies and barriers and facilitators they addressed which may explain the success of the pilot. These results can inform strategies needed to scale-up the intervention to youth including YMSM in other areas in Nigeria and the region. Trial registration ISRCTN: ISRCTN94590823, https://doi.org/10.1186/ISRCTN94590823

This study explores the fabrication and characterisation of 3D-printed polylactic acid (PLA) scaffolds reinforced with calcium hydroxyapatite (cHAP) for bone tissue engineering applications. By varying the cHAP content, we aimed to enhance PLA scaffolds’ mechanical and thermal properties, making them suitable for load-bearing biomedical applications. The results indicate that increasing cHAP content improves the tensile and compressive strength of the scaffolds, although it also increases brittleness. Notably, incorporating cHAP at 7.5% and 10% significantly enhances thermal stability and mechanical performance, with properties comparable to or exceeding those of human cancellous bone. Furthermore, this study integrates machine learning techniques to predict the mechanical properties of these composites, employing algorithms such as XGBoost and AdaBoost. The models demonstrated high predictive accuracy, with R2 scores of 0.9173 and 0.8772 for compressive and tensile strength, respectively. These findings highlight the potential of using data-driven approaches to optimise material properties autonomously, offering significant implications for developing custom-tailored scaffolds in bone tissue engineering and regenerative medicine. The study underscores the promise of PLA/cHAP composites as viable candidates for advanced biomedical applications, particularly in creating patient-specific implants with improved mechanical and thermal characteristics.

This research investigates using Polyether ether ketone (PEEK) in dental prosthetics, focusing on enhancing the mechanical properties, adhesion capabilities, and environmental sustainability through AI-driven data analysis and advanced surface treatments. The objectives include improving PEEK’s adhesion to dental types of cement, assessing its biocompatibility, and evaluating its environmental impact compared to traditional materials. The methodologies employed involve surface treatments such as plasma treatment and chemical etching, mechanical testing under ASTM standards, biocompatibility assessments, and lifecycle analysis. AI models predict and optimize mechanical properties based on extensive data. Significant findings indicate that surface-treated PEEK exhibits superior adhesion properties, maintaining robust mechanical integrity with no cytotoxic effects and supporting its use in direct contact with human tissues. Lifecycle analysis suggests PEEK offers a reduced environmental footprint due to lower energy-intensive production processes and recyclability. AI-driven analysis further enhances the material’s performance prediction and optimization, ensuring better clinical outcomes. The study concludes that with improved surface treatments and AI optimization, PEEK is a promising alternative to conventional dental materials, combining enhanced performance with environmental sustainability, paving the way for broader acceptance in dental applications.

This review research aims to enhance the sustainability and functionality of shape-memory polymer composites (SMPCs) by integrating advanced 4D printing technologies and sustainable manufacturing practices. The primary objectives are to reduce environmental impact, improve material efficiency, and expand the design capabilities of SMPCs. The methodology involved incorporating recycled materials, bio-based additives, and smart materials into 4D printing processes, and conducting a comprehensive environmental impact and performance metrics analysis. Significant findings include a 30% reduction in material waste, a 25% decrease in energy consumption during production, and a 20% improvement in shape-memory recovery with a margin of error of ±3%. Notably, the study highlights the potential use of these SMPCs as biomimetic structural biomaterials and scaffolds, particularly in tissue engineering and regenerative medicine. The ability of SMPCs to undergo shape transformations in response to external stimuli makes them ideal for creating dynamic scaffolds that mimic the mechanical properties of natural tissues. This increased design flexibility, enabled by 4D printing, opens new avenues for developing complex, adaptive structures that support cell growth and tissue regeneration. In conclusion, the research demonstrates the potential of combining sustainable practices with 4D printing to achieve significant environmental, performance, and biomedical advancements in SMPC manufacturing.

This research investigates the environmental sustainability and biomedical applications of shape memory polymers (SMPs), focusing on their integration into 4D printing technologies. The objectives include comparing the carbon footprint, embodied energy, and water consumption of SMPs with traditional materials such as metals and conventional polymers and evaluating their potential in medical implants, drug delivery systems, and tissue engineering. The methodology involves a comprehensive literature review and AI-driven data analysis to provide robust, scalable insights into the environmental and functional performance of SMPs. Thermomechanical modeling, phase transformation kinetics, and heat transfer analyses are employed to understand the behavior of SMPs under various conditions. Significant findings reveal that SMPs exhibit considerably lower environmental impacts than traditional materials, reducing greenhouse gas emissions by approximately 40%, water consumption by 30%, and embodied energy by 25%. These polymers also demonstrate superior functionality and adaptability in biomedical applications due to their ability to change shape in response to external stimuli. The study concludes that SMPs are promising sustainable alternatives for biomedical applications, offering enhanced patient outcomes and reduced environmental footprints. Integrating SMPs into 4D printing technologies is poised to revolutionize healthcare manufacturing processes and product life cycles, promoting sustainable and efficient medical practices.

Abstract Background/introduction One of the key recommendations for the new WHO global strategy for oral health is inclusion of disadvantaged populations and their engagement in policy dialogues such that their needs and views are addressed in policy decisions. Objectives This study explored oral health perceptions, practices and care-seeking experiences of slum residents in Ibadan, Nigeria. Method Focus group discussions (FGD) were conducted with family health-decision makers in an urban slum site. Oral health perceptions, practices, and care-seeking experiences were discussed. FGDs were recorded, transcribed, and translated. ATLAS.ti qualitative research software was deployed for analysis using thematic analysis. Results Six FGD sessions, divided by gender and age, were conducted between September–October 2019, (N = total 58 participants, aged 25 to 59 years). Common dental ailments mentioned were dental pain, tooth sensitivity, bleeding gums, tooth decay, mouth odor, gum disease, and tooth fracture. Perceived causes of dental conditions included poor dental hygiene and habits, sugary diets, ignorance, and supernatural forces. Mouth cleaning was mostly done once daily using toothbrush and paste. Other cleaning tools were ground glass, wood ash, charcoal, “epa Ijebu” (a dentrifice), and “orin ata” (a type of chewing stick). Remedies for relieving dental pain included over-the-counter medicines, warm salted water, gin, tobacco (snuff/powdered), cow urine/dung, battery fluid, and various mixtures/ concoctions. Visits to the dentists were mentioned by a few but this was usually as last resort. Main barriers to accessing care from dental care facilities were unaffordability of service charges and fear of extreme treatment measures (extraction). Suggested measures to improve timely access to dental health care included reducing/subsidizing costs of treatments and medications, offering non-extraction treatment options, and oral health education programmes. Conclusion The slum residents experience various forms of dental ailments mostly pain-related. The residents perceived formal dental clinics as unaffordable, thereby engaging in self‐care remedies and harmful oral health practices before seeking professional help. Policymakers and decision-makers may leverage this empirical evidence for the people’s education on early dental care and address challenges to affordable, available, and acceptable oral healthcare services among slum residents to improve access to care facilities.

Abstract BackgroundLeprosy leads to nerve damage and slow-healing ulcers, which are treatable with routine therapy. There has been a recent resurgence of interest in the use of honey for the treatment of different kinds of wounds. ObjectiveThe aim of this study, Honey Experiment on Leprosy Ulcer (HELP), is to evaluate the healing properties of raw, unadulterated African honey in comparison with normal saline dressing for the treatment leprosy ulcers. MethodsThis is a multicenter, comparative, prospective, single-blinded, parallel-group, and 1:1 individually randomized controlled trial to be conducted at The Leprosy Referral Hospital, Chanchaga in Minna, Niger State, North Central Nigeria, and St. Benedict Tuberculosis and Leprosy Rehabilitation Hospital in Ogoja, Cross River State, South-South Nigeria. Raw, unadulterated honey will be used in the ulcer dressing of eligible, consenting participants in the intervention group, whereas those in the control group will be treated by dressing with normal saline. The main outcomes will be the proportion of complete healing and the rate of healing up to 84 days after randomization. Follow-up will be conducted 6 months after randomization. We aim to enroll 90‐130 participants into the study. Blinded observers will examine photographs of ulcers to determine the outcomes. ResultsThe recruitment of trial participants began on March 14, 2022, and has been continuing for approximately 24 months. ConclusionsOur study will provide an unbiased estimate of the effect of honey on the healing of neuropathic ulcers.

BackgroundA comprehensive summary of evidence about oral health in slum settings that could inform policy directions is lacking.ObjectiveTo summarise the latest evidence regarding oral disease burden and their determinants, perceptions, practices, and service utilization in the slums and non-slum urban settings of LMICs.DesignSystematic review.Data sourcesEmbase and MEDLINE (Ovid); PubMed; Scopus, Web of Science, CRD DARE Database; ELDIS; Essential Health Links; HINARI; African Index Medicus (AIM); and Bioline International, all searched from January 2000 to June 2023 using slum-related terms.Eligibility criteriaEmpirical studies of all designs were eligible. Studies published in English with full-text available and reporting disease burden, perceptions, behaviours and service utilisation related to oral health of residents of slums or broader settings including slums in low and middle-income countries were included.Data extraction, quality assessment, synthesis and reportingStudies were categorised and data were extracted and charted according to a preliminary conceptual framework refined by emerging findings. The Mixed Methods Assessment Tool (MMAT) was used to appraise the quality of empirical studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and (where applicable) the Synthesis Without Meta-analysis (SWiM) guideline were adopted for guiding synthesis and reporting. Results were tabulated and narratively summarised.ResultsFull-text articles for 56 records were assessed for eligibility and 23 of the articles were included in this review. The majority (13 studies, 57%) were conducted in Asia, and nine studies (39%) in Africa. Six focused on slums (two examined slum and urban non-slum and four examined purely slum settings), two examined general urban settings, eight included both rural and urban areas in their settings, two examined disadvantaged/low socioeconomic, one assessed rural/urban/metropolis/municipal/district, three covered the national population or whole country, and one looked at high versus low socioeconomic regions. The commonest oral diseases reported were dental caries (prevalence: 13% - 76%), and periodontal diseases (prevalence: 23% - 99%). These were higher in slum settings and showed differences across age groups, gender, and socioeconomic classes. Most participants in the studies perceived their oral health status as satisfactory, a belief commoner among younger people, males, those in higher socio-economic classes, and employed. Mouth cleaning was mostly once daily, usually in the mornings. The use of toothpaste and brush was commonest. Other oral hygiene implements included toothpowder, chewing-stick, neem, charcoal, sand, snuff, salt, and the fingers. There was widespread engagement in home remedies for oral disease cure or prevention, while the use of professional dental care facilities was generally low and problem-driven.ConclusionThe systematic review identified a sparse body of literature on oral health surveys in slums and other urban settings in LMICs. Available data suggest a high oral disease burden, worse in slums, use of inappropriate mouth cleaning tools, self-care practices for pain relief, and few visits to care facilities.Systematic review registrationSystematic review registration with PROSPERO in February 2020, number CRD42020123613.

BackgroundLow birth weight (LBW) is a major public health problem in Ethiopia. Dietary diversity is a key indicator of maternal dietary adequacy that may affect birth weight but little is known about their relationship. Hence, this study aimed to assess the association of suboptimal maternal dietary diversity during pregnancy and low birth weight in Gurage Zone, Ethiopia.MethodsThe prospective study was conducted among 1062 pregnant women enrolled consecutively in between 16 to 20 gestational weeks and followed until delivery. The baseline data were collected at recruitment and dietary diversity was assessed using the minimum dietary diversity score for women (MDD-W) tool in three different rounds. The average of three scores was considered to categorize women into optimal (consumed ≥ 5 food groups) and suboptimal (consumed < 5 food groups) dietary diversity groups. The risk of low birth weight among suboptimal dietary diversity was assessed using modified Poisson regression with robust standard error.ResultsOf the 1062 pregnant women recruited, 959 (90.4%) women completed follow-up. Among them, 302 (31.5%) women are having optimal and the rest, 657 (68.5%) women are having suboptimal dietary diversity. The risk of low birth weight was significantly higher among women with sub-optimal dietary diversity than among those with optimal diversity (ARR = 1.89, 95% CI: 1.25, 2.84). Other factors such as rural residence (ARR = 1.61, 95% CI: 1.43, 1.87), age > = 35 years (AAR = 3.94, 95% CI: 2.41, 6.46), being underweight (ARR = 1.81, 95% CI: 1.14, 2.86), height < 150cm (ARR = 4.65, 95% CI: 2.52, 8.59), unwanted pregnancy (ARR = 3.35, 95% CI: 2.23, 5.02), preterm delivery (3.65, 95% CI: 2.27, 5.84) and lack of nutritional counseling (ARR = 1.69, 95% CI: 1.08, 2.67) significantly increased the risk of low birth weight.ConclusionSuboptimal dietary diversity associated low birth weight. Promoting dietary diversity by strengthening nutritional education and avoiding unwanted pregnancy particularly among rural residents may help to reduce the incidence of low birth weight.

Background Cervical cancer is the fourth most common malignancy in women, with 90% of deaths in low- and middle-income countries. Integrating cervical cancer screening services into healthcare facilities is crucial for overcoming the disease. Thus, this review aims to map existing evidence and identify barriers and facilitators in low- and middle-income countries.Methods The scoping review will employ a five-step framework as proposed by Arksey and O’Malley. These are (1) formulating the research questions, (2) identifying relevant studies, (3) selecting eligible studies, (4) charting the data, and (5) collating, summarising and reporting the results. Five databases (MEDLINE, Maternity and Infant Care, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science) will be systematically searched. Grey literature will also be searched. Data will be extracted, charted, synthesised and summarised.Ethics and dissemination This review does not require ethics approval. Findings will be disseminated through peer-reviewed publications, policy briefs and conference presentations.

BackgroundMisconceptions about ADHD stigmatize affected people, reduce credibility of providers, and prevent/delay treatment. To challenge misconceptions, we curated findings with strong evidence base.MethodsWe reviewed studies with more than 2000 participants or meta-analyses from five or more studies or 2000 or more participants. We excluded meta-analyses that did not assess publication bias, except for meta-analyses of prevalence. For network meta-analyses we required comparison adjusted funnel plots. We excluded treatment studies with waiting-list or treatment as usual controls. From this literature, we extracted evidence-based assertions about the disorder.ResultsWe generated 208 empirically supported statements about ADHD. The status of the included statements as empirically supported is approved by 80 authors from 27 countries and 6 continents. The contents of the manuscript are endorsed by 366 people who have read this document and agree with its contents.ConclusionsMany findings in ADHD are supported by meta-analysis. These allow for firm statements about the nature, course, outcome causes, and treatments for disorders that are useful for reducing misconceptions and stigma.

Sickle cell disorder (SCD) is a serious blood disorder that affects millions of people worldwide. It is particularly prevalent in Africa. The condition can be associated with physical and psychological difficulties. There are no studies of psychological interventions for people affected by SCD in Africa where the majority of affected persons live. Eighteen students with SCD aged 16-24 years at University of Ibadan, Nigeria received five sessions of manualised group-based CBT. The sessions included psycho-education about SCD, strategies for managing negative thoughts and feelings, activity scheduling, relaxation techniques, and attention diversion. The outcome measures: Hospital Anxiety and Depression Scale (HADS), Coping Skills Questionnaire modified for sickle cell disease-adult version (CSQ-SCD), and Short-Form health survey (SF-36), were administered at baseline and repeated 1 week after the intervention. Post-intervention, there were significant reductions in anxiety and depressive symptoms (p = 0.001 and 0.02, respectively), increase in active and passive coping skills (p = 0.04 for both), and increase in social functioning (p = 0.001). Students' satisfaction with the intervention was very high. The study suggests that group-based CBT intervention is feasible, acceptable and appears helpful in reducing anxiety and depressive symptoms, improving adaptive coping skills, and social functioning of Nigerian University students affected by SCD.

Abstract Arthur Kleinman’s 2009 Lancet commentary described global mental health as a “moral failure of humanity”, asserting that priorities should be based not on the epidemiological and utilitarian economic arguments that tend to favour common mental health conditions like mild to moderate depression and anxiety, but rather on the human rights of those in the most vulnerable situations and the suffering that they experience. Yet more than a decade later, people with severe mental health conditions like psychoses are still being left behind. Here, we add to Kleinman’s appeal a critical review of the literature on psychoses in sub-Saharan Africa, highlighting contradictions between local evidence and global narratives surrounding the burden of disease, the outcomes of schizophrenia, and the economic costs of mental health conditions. We identify numerous instances where the lack of regionally representative data and other methodological shortcomings undermine the conclusions of international research carried out to inform decision-making. Our findings point to the need not only for more research on psychoses in sub-Saharan Africa, but also for more representation and leadership in the conduct of research and in international priority-setting more broadly—especially by people with lived experience from diverse backgrounds. This paper aims to encourage debate about how this chronically under-resourced field, as part of wider conversations in global mental health, can be reprioritised.

Aim: Given the male infertility’s pluri-etiological nature, thorough examinations are needed for its evaluation. Fructose and citric acid are simple biomolecules, easy to assay, which provide reliable information on the seminal vesicles and prostate, respectively. This study aimed to compare the seminal fructose and citric acid levels in men undergoing fertility evaluation and determine the relation between these markers and sperm parameters. Methods: A prospective cross-sectional study was conducted on consenting male participants. Following 2010 seminal fluid analysis (SFA) manual of World Health Organization (WHO), semen samples were analyzed for several sperm parameters, seminal fructose and citric acid. Statistical analyses were performed using IBM SPSS 24.0 software. Significant statistical difference was considered at P < 0.05. Results: There is no significant difference between seminal fructose and citric acid levels amongst men with normal and abnormal sperm parameters as median seminal fructose and citric acid levels were 11.1 (7.4–17.1) mg/mL and 11.4 (7.3–15.2) mg/mL respectively (P ≥ 0.05). However, a high level of fructose was observed in the two groups according to the reference value. The study revealed a significant positive correlation between seminal fructose levels and semen volume (coefficient rho = 0.663; P = 0.001) and between seminal citric acid levels and semen volume (coefficient rho = 0.319; P = 0.004). Conclusions: These biomarkers secretions can serve as markers of the state of their respective secreting glands and hence play a vital role in the investigation of male infertility.