Akinyinka O Omigbodun

Stressors and psychological symptoms in students of medicine and allied health professions in Nigeria

Studies suggest that high levels of stress and psychological morbidity occur in health care profession students. This study investigates stressors and psychological morbidity in students of medicine, dentistry, physiotherapy and nursing at the University of Ibadan. The students completed a questionnaire about their socio-demographic characteristics, perceived stressors and the 12-item General Health Questionnaire. Qualitative methods were used initially to categorise stressors. Data was then analysed using univariate and logistic regression to determine odds ratios and 95% confidence intervals. Medical and dental students were more likely to cite as stressors, overcrowding, strikes, excessive school work and lack of holidays while physiotherapy and nursing students focused on noisy environments, security and transportation. Medical and dental students (1.66; SD: 2.22) had significantly higher GHQ scores than the physiotherapy and nursing students (1.22; SD: 1.87) (t = 2.3; P = 0.022). Socio-demographic factors associated with psychological morbidity after logistic regression include being in a transition year of study, reporting financial distress and not being a ‘Pentecostal Christian’. Although males were more likely to perceive financial and lecturer problems as stressors and females to perceive faculty strikes and overcrowding as source of stress, gender did not have any significant effect on psychological morbidity. Stressors associated with psychological distress in the students include excessive school work, congested classrooms, strikes by faculty, lack of laboratory equipment, family problems, insecurity, financial and health problems. Several identified stressors such as financial problems, academic pressures and their consequent effect on social life have an adverse effect on the mental health of students in this environment especially for students of medicine and dentistry. While stressors outside the reach of the school authorities are difficult to control, academic support including providing a conducive learning environment, advice on means for sustenance, added support during periods of transition are key areas for interventions.

Building capacity for public and population health research in Africa: the consortium for advanced research training in Africa (CARTA) model.

Background: Globally, sub-Saharan Africa bears the greatest burden of disease. Strengthened research capacity to understand the social determinants of health among different African populations is key to addressing the drivers of poor health and developing interventions to improve health outcomes and health systems in the region. Yet, the continent clearly lacks centers of research excellence that can generate a strong evidence base to address the regions socio-economic and health problems. Objective and program overview: We describe the recently launched Consortium for Advanced Research Training in Africa (CARTA), which brings together a network of nine academic and four research institutions from West, East, Central, and Southern Africa, and select northern universities and training institutes. CARTAs program of activities comprises two primary, interrelated, and mutually reinforcing objectives: to strengthen research infrastructure and capacity at African universities; and to support doctoral training through the creation of a collaborative doctoral training program in population and public health. The ultimate goal of CARTA is to build local research capacity to understand the determinants of population health and effectively intervene to improve health outcomes and health systems. Conclusions: CARTAs focus on the local production of networked and high-skilled researchers committed to working in sub-Saharan Africa, and on the concomitant increase in local research and training capacity of African universities and research institutes addresses the inability of existing programs to create a critical mass of well-trained and networked researchers across the continent. The initiatives goal of strengthening human resources and university-wide systems critical to the success and sustainability of research productivity in public and population health will rejuvenate institutional teaching, research, and administrative systems.

Oral misoprostol for the prevention of primary post-partum hemorrhage during third stage of labor.

Aim:  To assess the effectiveness of oral misoprostol compared with methylergometrine in the prevention of primary post‐partum hemorrhage during the third stage of labor.

Stressors and Counseling Needs of Undergraduate Nursing Students in Ibadan, Nigeria

Existing evidence suggests that nursing students have high levels of stress and that counseling and other support services should be made available to them. However, the stressors and counseling needs of undergraduate nursing students in Nigeria have yet to be explored. This study used a questionnaire to investigate the stressors, counseling needs, and desired counseling facilities of undergraduate nursing students at the University of Ibadan. Common stressors included excessive schoolwork, financial problems, inadequate recreational facilities, and overcrowded accommodations. There was an association between reporting inconsiderate, insensitive lecturers as stressors and evidence of psychological distress. Nearly 60% of the respondents felt counseling would help them, and most desired counseling for academics, finances, and relationships. Most (78%) of the respondents preferred an independent facility with trained counselors. Desired characteristics for the services included accessibility, affordability, confidentiality, and a friendly atmosphere. Educators and administrators should use this information to design counseling facilities for students.

Medical students’ choices of specialty in The Gambia: the need for career counseling

BackgroundUnderstanding preferences for specialties by medical students and the factors driving choices assists policy makers in ensuring optimal spread of personnel across disciplines.MethodsThis cross-sectional survey using self-administered structured questionnaires was conducted on consenting students of the first medical school in The Gambia, established in 1999. Data collection was in June/July 2011. Questions were on sociodemographic characteristics of students, their parents, factors related to career preferences and opinions about counseling services. Data were analysed using JMP 8.0 software.ResultsRespondents were 52.4% of 202 eligible students. Mean age was 24.1 ± 5.0 years. Females constituted 54.7%. Muslims were 72.7% while Gambians formed 77.0%. Commonest specialties chosen by females were Obstetrics/Gynaecology, Paediatrics and Surgery in that order, while males preferred Internal Medicine, Surgery and Obstetrics/Gynaecology. Commonest factors influencing choices by females were ‘focus on urgent care’ (65.5%) and ‘intellectual content of specialty’ (56.9%). For males, these were ‘intellectual content of specialty’ (60.4%) and ‘focus on urgent care’ / ‘individual’s competence’ (50.0% each). More females (30.0%) than males (23.0%) had ever received career counseling, but all students desired it.ConclusionsSignificant gender differences exist in specialty choices and factors influencing these choices amongst these students. All want career counseling.

Influence of gender on undergraduate performance in psychiatry at Ibadan, Nigeria

Objective  This study examined the influence of gender on undergraduate performance in psychiatry among final year medical students at the University College Hospital, Ibadan, Nigeria.

Unmet Need for Sexuality Education among Adolescent Girls in Southwest Nigeria: A Qualitative Analysis

This study utilises a qualitative approach to elicit the reproductive health concerns of girls at a Christian summer camp with a view to making recommendations on how to improve the content and process of future sessions. The girls asked questions anonymously about various aspects of their sexuality, which were analysed to identify emergent themes. There were 75 participants with ages ranging from childhood to late adolescence (7-21 years). The different levels of cognitive development are clearly illustrated in the types of questions asked. The late adolescents focused on coping with relationships and demands for sex. The early and middle adolescents focused on their feelings, relationships, menstruation and breast size. Those in childhood (7-11 years) appeared totally ignorant about parts of their body. Myths and misconceptions were identified in all age groups. Future sessions should address the peculiar needs of these different age groups. Christian and other religious groups should work with health educators to develop realistic teaching guidelines that focus on the everyday concerns of the youth.

The influence of health-seeking behavior on the incidence and perinatal outcome of umbilical cord prolapse in Nigeria

Objectives: To determine the influence of health-seeking behavior of urban women in South-West Nigeria on the incidence and perinatal outcome of umbilical cord prolapse (UCP). Methods: A retrospective study comparing two groups of urban women using information extracted from medical records of patients who had UCP, and were managed at the University College Hospital Ibadan, Nigeria from January1st 1995 to December 31st 2005. The data was analyzed using SPSS software (version 15). Analysis included simple tabulation, proportion and comparison of incidence, perinatal morbidity, and mortality of UCP between the two groups of women using Chi-square or Fisher’s exact test. Odds ratio (OR) and 95% confidence intervals (CI) were calculated whenever necessary. P-value of 0.05 or less was statistically significant. Results: Women without prenatal care were more likely to have fetuses with UCP (54, 75%), than in women who had prenatal care (18, 25%). The risk of perinatal death from UCP was higher in women without prenatal care, as compared with those who received prenatal care (OR 3.02, 95% CI: 0.879 to 10.356; P-value = 0.061). The risk of perinatal morbidity and neonatal intensive care admission was also higher among women without prenatal care as compared with women who received prenatal care (OR 4.09, 95% CI: 1.03 to 16.30; P-value = 0.041). The overall perinatal mortality rate in the study population was 403 per 1000 total births, and this was five times more than that of the hospital perinatal mortality rate of 80 per 1000 total births during the study period. The perinatal mortality rate was higher among women without prenatal care, 463 per 1000 total births, as compared with 222 per 1000 total births in women who received prenatal care. Perinatal death before arrival at the hospital is less likely to occur in women with prenatal care when compared with women without prenatal care (OR 0.0635; 95% CI: 0.0052 to 0.776; P-value = 0.03). Conclusion: A high index of suspicion and an identification of risk factors, with early diagnosis, prompt intervention, and provision of health care facilities can reduce the incidence and poor outcome of UCP in developing countries.