This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. It has been quite a challenge to diagnose Mild Cognitive Impairment due to Alzheimer's disease (MCI) and Alzheimer-type dementia (AD-type dementia) using the currently available clinical diagnostic criteria and neuropsychological examinations. As such we propose an automated diagnostic technique using a variant of deep neural networks language models (DNNLM) on the verbal utterances of affected individuals. Motivated by the success of DNNLM on natural language tasks, we propose a combination of deep neural network and deep language models (D2NNLM) for classifying the disease. Results on the DementiaBank language transcript clinical dataset show that D2NNLM sufficiently learned several linguistic biomarkers in the form of higher order n-grams to distinguish the affected group from the healthy group with reasonable accuracy on very sparse clinical datasets.

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Introduction Reducing maternal mortality remains a priority for global health. One in five maternal deaths, globally, are from Nigeria. Objective This study aimed to assess the sociocultural correlates of maternal mortality in Nigeria. Methods We conducted a retrospective analysis of nationally representative data from the 2013 Nigeria Demographic and Health Survey. The analysis was based on responses from the core women’s questionnaire. Maternal mortality was categorized as ‘yes’ for any death while pregnant, during delivery or two months after delivery (as reported by the sibling), and ‘no’ for deaths of other or unknown causes. Multilevel logistic regression analysis was conducted to test for association between maternal mortality and predictor variables of sociocultural status (educational attainment, community women’s education, region, type of residence, religion, and women’s empowerment). Results Region, Religion, and the level of community women’s education were independently associated with maternal mortality. Women in the North West were more than twice as likely to report maternal mortality (OR: 2.14; 95% CI: 1.42–3.23) compared to those in the North Central region. Muslim women were 52% more likely to report maternal deaths (OR: 1.52; 95% CI: 1.10–2.11) compared to Christian women. Respondents living in communities where a significant proportion of women have at least secondary schooling were 33% less likely to report that their sisters died of pregnancy-related causes (OR: 0.67; 95% CI: 0.48–0.95). Conclusion Efforts to reduce maternal mortality should implement tailored programs that address barriers to health-seeking behavior influenced by cultural beliefs and attitudes, and low educational attainment. Strategies to improve women’s agency should be at the core of these programs; they are essential for reducing maternal mortality and achieving sustainable development goals towards gender equality. Future studies should develop empirically evaluated measures which assess, and further investigate the association between women’s empowerment and maternal health status and outcomes.

This is an open access article distributedunder the terms of the Creative CommonsAttribution License, which permits unrestricted use, distribution, and reproductionin any medium,provided the original author and source are credited. There is a limited evaluation of an independent linguistic battery for early diagnosis of Mild Cognitive Impairment due to Alzheimer's disease (MCI-AD). We hypothesized that an independent linguistic battery comprising of only the language components or subtests of popular test batteries could give a better clinical diagnosis for MCI-AD compared to using an exhaustive battery of tests. As such, we combined multiple clinical datasets and performed Exploratory Factor Analysis (EFA) to extract the underlying linguistic constructs from a combination of the Consortium to Establish a Registry for Alzheimer's disease (CERAD), Wechsler Memory Scale (WMS) Logical Memory (LM) I and II, and the Boston Naming Test. Furthermore, we trained a machine-learning algorithm that validates the clinical relevance of the independent linguistic battery for differentiating between patients with MCI-AD and cognitive healthy control individuals. Our EFA identified ten linguistic variables with distinct underlying linguistic constructs that show Cronbach's alpha of 0.74 on the MCI-AD group and 0.87 on the healthy control group. Our machine learning evaluation showed a robust AUC of 0.97 when controlled for age, sex, race, and education, and a clinically reliable AUC of 0.88 without controlling for age, sex, race, and education. Overall, the linguistic battery showed a better diagnostic result compared to the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR), and a combination of MMSE and CDR.

To assess tobacco use among school-going adolescents and delineate determinants of their tobacco-use status. The study utilizes Global Youth Tobacco Survey data collected in 2006 (9,990 unweighted; 773,982 weighted). Univariate and bivariate analyses were performed to determine the relationship between the dependent (tobacco-use status) and independent variables. Logistic regression analyses were conducted to identify the key determinants of tobacco use among adolescents in Ghana. The gap in tobacco use between males and females was narrow (6.7% vs. 4.4% for ever cigarette smoker; 2.4% vs. 1.4% for current cigarette smoker; 6.8% vs. 5.2% for user of noncigarette tobacco products). Youth tobacco use was significantly associated with exposure to tobacco industry promotions and tobacco-use behavior of familial relations. Conversely, knowledge about the harmful effects of secondhand smoke was associated with decreased likelihood of tobacco use; however, it was significant only for users of noncigarette tobacco products. The narrow gap in tobacco use among school-going adolescents in a country where tobacco-use prevalence among adult males is more than 10 times that of females is a major policy concern. Additionally, the finding that about 15% of students have either acquired tobacco-branded merchandise or been offered a free cigarette suggest that tobacco marketing is reaching adolescents in the country, which demands urgent policy response. Dealing with such problems requires a comprehensive ban on tobacco industry advertising and promotion and marketing strategies, and policies that restrict youth access to and demand for tobacco products.

Tobacco use in Tennessee is higher than the national average and the decline in usage rate has stalled. The smokefree policy enacted to address this health issues contains several exemptions and does not repeal preemption that was introduced in 1994. In March 2013, the Governor unveiled Health and Wellness Initiatives, including reduction in the use of "tobacco products." To achieve this goal, two approaches should be considered and integrated into the initiative to facilitate the decline in tobacco use - policy and population. On the policy approach, the Governor should consider working for the repeal of state preemption of local tobacco control policymaking by the 1994 Prevention of Youth Access to Tobacco Act, and for removing exemption for certain venues from the Non-Smoker Protection Act. On the population approach, the Governor should consider focusing on young adults as an integral part of the target group and tobacco-free campuses as a strategy for addressing tobacco use among such group. All these conform to the Initiatives' strategy of "localized ownership."

To assess tobacco use among school-going adolescents and delineate determinants of their tobacco-use status. The study utilizes Global Youth Tobacco Survey data collected in 2006 (9,990 unweighted; 773,982 weighted). Univariate and bivariate analyses were performed to determine the relationship between the dependent (tobacco-use status) and independent variables. Logistic regression analyses were conducted to identify the key determinants of tobacco use among adolescents in Ghana. The gap in tobacco use between males and females was narrow (6.7% vs. 4.4% for ever cigarette smoker; 2.4% vs. 1.4% for current cigarette smoker; 6.8% vs. 5.2% for user of noncigarette tobacco products). Youth tobacco use was significantly associated with exposure to tobacco industry promotions and tobacco-use behavior of familial relations. Conversely, knowledge about the harmful effects of secondhand smoke was associated with decreased likelihood of tobacco use; however, it was significant only for users of noncigarette tobacco products. The narrow gap in tobacco use among school-going adolescents in a country where tobacco-use prevalence among adult males is more than 10 times that of females is a major policy concern. Additionally, the finding that about 15% of students have either acquired tobacco-branded merchandise or been offered a free cigarette suggest that tobacco marketing is reaching adolescents in the country, which demands urgent policy response. Dealing with such problems requires a comprehensive ban on tobacco industry advertising and promotion and marketing strategies, and policies that restrict youth access to and demand for tobacco products.

Tobacco use in Tennessee is higher than the national average and the decline in usage rate has stalled. The smokefree policy enacted to address this health issues contains several exemptions and does not repeal preemption that was introduced in 1994. In March 2013, the Governor unveiled Health and Wellness Initiatives, including reduction in the use of "tobacco products." To achieve this goal, two approaches should be considered and integrated into the initiative to facilitate the decline in tobacco use - policy and population. On the policy approach, the Governor should consider working for the repeal of state preemption of local tobacco control policymaking by the 1994 Prevention of Youth Access to Tobacco Act, and for removing exemption for certain venues from the Non-Smoker Protection Act. On the population approach, the Governor should consider focusing on young adults as an integral part of the target group and tobacco-free campuses as a strategy for addressing tobacco use among such group. All these conform to the Initiatives' strategy of "localized ownership."

Introduction Though Africa is in Stage 1 of the tobacco epidemic, lack of effective public smoking laws or political will implies that secondhand smoke (SHS) exposure may be high in youth. The study objective is to estimate prevalence and identify determinants of SHS exposure among never-smoker adolescents in Africa and make cross-country comparisons. Methods Pooled data from the Global Youth Tobacco Surveys conducted in 25 African countries during 2006–2011 were used. Based on the venue of exposure in past 7 days, SHS was categorized into exposure inside, outside, and overall exposure (either inside or outside of the home), respectively. Data were analyzed in 2015 using logistic regression models to identify factors related to SHS exposure in three venues. Results About 21% and 39% of adolescents were exposed to SHS inside or outside of the home, with overall exposure of 45%. In all 25 African countries, parental smoking was significantly associated with SHS exposure inside the home (ORs ranging from 3.02 [95% CI=2.0, 4.5] to 14.65 [95% CI=10.0, 21.5]). Peer smoking was associated with SHS exposure outside the home in 18 countries (ORs ranging from 1.45 [95% CI=1.0, 2.1] to 3.00 [95% CI=1.8, 5.1]). Parental smoking, peer smoking, and anti-smoking messages in media were identified as three major factors associated with SHS exposure. Conclusions A significant proportion of never-smoking adolescents in Africa are exposed to SHS, suggesting the need for countries to adopt policies to protect never smokers through the implementation of the WHO Framework Convention on Tobacco Control.

The World Health Organization has fostered a new global public policy - the Framework Convention for Tobacco Control (FCTC). Until the 1980s, tobacco control was the sole preserve of states. Now, most countries accept the transnational nature of policy. We explain this shift by identifying mutually reinforcing changes in key policy process elements: transnational actors became a source of policy learning; an international venue 'institutionalized' new policies; networks began to include tobacco control groups and exclude tobacco companies; socioeconomic shifts undermined public support, and the economic case, for tobacco; and the dissemination of scientific evidence helped actors reframe the image of tobacco, from an economic good to a health crisis. These elements combined to produce an environment conducive to 'comprehensive' tobacco control. Yet the implementation of the FCTC has been slow and uneven, reflecting the continued importance of domestic policy environments, most of which are not conducive to major policy change.

Objectives. Weestimated the prevalence and determinants of secondhand smoke (SHS) exposure among nonsmoking adolescents in 9 West African countries. Methods. We conducted a pooled analysis with nationally representative 2006 to 2009 Global Youth Tobacco Survey data. We used descriptive statistics to determine the prevalence of SHS exposure and inferential statistics using a multivariable logistic regression model to determine factors associated with SHS exposure. We investigated average marginal effect results that show the probability of SHS exposure, adjusting for all other attributes. Results. SHS exposure inside the home ranged from 13.0% to 45.0%; SHS exposure outside the home ranged from24.7%to 80.1%. Parental or peer smoking behaviorswere significantly associatedwith higher probability of SHS exposure in all 9 countries. Knowledge of smoking harm, support for smoking bans, exposure to antismoking media messages, and receptivity of school tobacco education were significantly associated with higher SHS exposure in most countries. Conclusions. West African policymakers should adopt policies consistent with Article 8 of the World Health Organization Framework Convention on Tobacco Control and its guidelines and public health education to promote smoke-free households.