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This historical narrative examines the early life of Dr. James Franklin Osman Adewale Ishola Mustaffah and his pivotal role in laying the foundations and advancing the field of neurosurgery in Ghana. The creation of this project was driven by the exploration of original scientific and bibliographical works concerning Dr. Mustaffah. It details his initial endeavors to shape the landscape of neurosurgery in Ghana and Africa. This historical account follows the remarkable journey of Dr. Mustaffah, spanning from his early education in Ghana, through his college years and medical training in London, to his distinguished career in neurosurgery. It explores his groundbreaking position as the first Ghanaian neurosurgeon and his contributions to establishing neurosurgery as a recognized practice in Ghana. We commemorate the life and legacy of Dr. Mustaffah, a visionary neurosurgeon whose profound influence has motivated numerous medical professionals in Africa and beyond. This article illuminates the extraordinary life and lasting legacy of Dr. Mustaffah, a pioneering neurosurgeon whose contributions have significantly shaped the trajectory of neurosurgical practice in Ghana and throughout Africa. [ABSTRACT FROM AUTHOR]

Emergency medical services (EMS) are minimally developed in many African countries. We sought to document the achievements and challenges faced by the National Ambulance Service (NAS) of Ghana during its 20-year nationwide expansion, and to understand how well it is providing access to previously unserved, remoter areas. Data routinely collected by NAS from 2004 to 2023 were analyzed, including structure and capacity (number of stations, ambulances, employees) and utilization and process of care (number of patients served, demographics, medical conditions, response site). Per population indicators of capacity and utilization were compared across Ghana's 16 regions. From 64 emergency medical technicians (EMTs) and nine ambulances in 2004, NAS has grown to 3,473 EMTs and 356 ambulances. From covering three cities in 2004, NAS now has at least one station in each of Ghana's 261 districts. From transporting 205 patients in 2004, NAS transported 38,393 patients in 2022. There have been interruptions due to financial restrictions, with numbers of patients transported per year in 2017–2019 decreasing by over 50% from the prior peak (n = 20,236 in 2014). In 2022, there were 1.13 ambulances per 100,000 people and 0.33 transports/100,000/day. Most (81.3%) transports are inter-facility transfers. Among Ghana's 16 regions, there is moderate variation in utilization from 0.16 to 0.50 transports/100,000/day. However, the three lowest-income, remoter regions currently have utilizations of 0.16, 0.30, and 0.37 transports/100,000/day, mostly near the National average of 0.33. Despite periodic limitations due to finances, the NAS has expanded to cover all of Ghana's 261 districts and has largely achieved geographic equity. Sustainability has been aided by having a training school directly under NAS's control, assuring a steady supply of EMTs. Challenges include assuring financial stability and increasing utilization for emergencies at the scene, in addition to the current high utilization for inter-facility transfer. [ABSTRACT FROM AUTHOR]

The channels and content of communication play an integral role in creating breast cancer screening awareness. Although breast cancer screening awareness campaigns are increasing in Ghana, no study has been conducted to investigate the communication channels used by these campaigns. This study aimed to identify the most effective source of breast cancer screening awareness information among women presenting for mammography in Ghana. Ethical approval was sought before data collection. A cross-sectional quantitative approach was adopted for the study and involved 192 women who visited two mammography centers in October 2020 for mammography screening. A self-administered closed-ended questionnaire was used for data collection. Descriptive and inferential statistics were carried out using SPSS version 26. A total of 192 responses were obtained. Of them, 72 (37.5%) participants had diploma/Higher National Diploma/degree education, with 105 (54.7%) of them being traders or nonprofessionals. All participants had heard of mammography screening and examination before this study. Mass media was the most common source of information on mammography screening (86 [44.8%]), of which radio was the highest subcategory (34 [39.5%]). Moreover, women presenting for mammography in Ghana demonstrated a high level of knowledge of breast cancer screening. Mass media is the most common source of information on breast cancer screening awareness in Ghana and has the potential to positively impact sensitization programs by reaching out to more women. There is a need to engage the Ghanaian population using mass media and health facilities to maximize the impact of breast cancer screening awareness campaigns. [Display omitted] [ABSTRACT FROM AUTHOR]

• Distinct classes of parental stimulation in peri-urban Ghana were identified. • Cultural and family factors predict latent class membership. • Latent class membership was not predictive of children's school readiness. • All combinations of parental stimulation promote school-related skills. Across geographically diverse samples, engagement in stimulating activities with young children is considered an important element of parenting that promotes cognitive, behavioral, and social-emotional development. Indicators of stimulation activities are often summed, based on the assumption that more stimulation is better and that different stimulating activities are equivalent. Instead, this study takes a household-centered analytic approach, applying latent class analysis to detect patterns of parental stimulation practices across six activities. We then examine predictors of the resultant latent classes and their implications for children's school readiness among a sample of Ghanaian kindergarteners (N = 2,117; M age = 5.2 years; 51% male). Results support a 4-class solution that represents (i) Highly Stimulating; (ii) Social-emotionally Stimulating; (iii) Playful; and (iv) Playful and Academically Stimulating households. Multiple child and family characteristics differentially predict latent class membership, although class membership did not differentially predict children's literacy, numeracy, executive function, or social-emotional skills. Findings suggest that all combinations of parental stimulation are equivalently promotive of children's school-related skills and help reify a strengths-based perspective. The results deepen our understanding of the different configurations of parental stimulation and suggest that a tailored approach to parenting programs may be beneficial. Programs can build on activities that parents already do (e.g., social-emotional) to encourage increased stimulation in other areas (e.g., academic). [ABSTRACT FROM AUTHOR]

[Display omitted] • A structural equation model for understanding how negative encounters influence the satisfaction of shared auto-rickshaw usage as public transport. • Availability is the most significant factor in predicting the adoption of shared auto-rickshaws. • Negative encounters in shared auto-rickshaws substantially negatively influence users' satisfaction. • Provide interventions and policy proposals on transparent fare structures and digital payment options to address concerns about unapproved fares. Emerging research has highlighted the significant role auto-rickshaws play in travel services, and yet, compared to other transport modes, they have received relatively less attention in research. No study has investigated travel behaviour and negative encounters in shared auto-rickshaws. The assumption that negative encounters deter users from utilising shared auto-rickshaws has not yet been validated. Moreover, previous studies have focused on adopting auto-rickshaws and travel behaviour, neglecting the specific dynamics of shared services within the public transport landscape. Here, we investigate the determinants influencing shared auto-rickshaw usage as a distinct mode in Ghana. We also identify negative attributes by drawing the link between negative user encounters and their impact on satisfaction, loyalty, and openness to policy propositions. The study deployed structural equation modelling, which is generally preferred in transport research. We discovered that 'Availability' is the most significant factor in predicting the adoption of shared auto-rickshaws. The estimated model established that negative encounters substantially impact users' satisfaction, and users' satisfaction was impacted by discomfort with seating arrangement, driver conduct, fleecing of users, and long travel time, among others. Older commuters reported higher levels of satisfaction than younger commuters, whereas commuters with higher levels of education tend to report lower levels of satisfaction. This research expands the limited understanding of shared auto-rickshaw usage by advancing our theoretical grasp of how negative encounters influence satisfaction and loyalty from a user-centric perspective. These insights can aid policymakers, service providers, and transport authorities in crafting legislation that prioritises user needs, enhances service quality, and creates a positive commuting experience. Furthermore, this study discusses managerial implications for transport authorities and policymakers. [ABSTRACT FROM AUTHOR]

• Analysis of the importance of the social impact of e-waste in African countries. • Presentation of the S-LCA methodology. • Presentation of the Social Hotspot Analysis of e-waste in Ghana and Nigeria. • Definition of a possible setoff indicators for assessing the Social impact of e-waste with site specific data. The transition towards a circular economy, which has emerged as a promising approach to achieving sustainable development and which involves the reuse of e-waste, may cause significant social impacts on vulnerable groups if it is not addressed in a proper manner. The European Union has established a clear circular economy plan with particular attention on e-waste treatment. However, a considerable amount of e-waste still ends up outside Europe, mainly in African Countries. Social Life Cycle Assessment (S-LCA) has been recognized as a valid methodology to assess the social impacts caused by products or services to stakeholders involved along the life cycle perspective. Most S-LCA studies are conducted in the formal sector; however, informal sectors constitute a crucial element of the economy in emerging and developing countries. In particular, formal waste management practices are complemented by the informal sector in Indonesia, African and Latin American countries. The informal sector represents an important support element. Few studies have been conducted on the social impacts of the e-waste sector and even fewer have been implemented following the guidelines of Social Life Cycle Assessment for Products and Organizations. However, we are still far from a complete overview of the social impacts in the e-waste sector, in particular for developing countries. Knowing that most e-waste through illegal exportation ends up in African countries, a social hotspot analysis has been conducted on the electronic sector in African countries, focusing on Nigeria and Ghana, which are the most affected. The study also identifies a set of indicators needed to assess the social performance of e-waste in Nigeria and Ghana. [ABSTRACT FROM AUTHOR]

Initial Anopheles stephensi detections have used different methods to confirm its presence in the past. We propose a standardized method of detection to be used in initial identification of invasive populations. Utilizing multiple genes and phylogenetic analysis can eliminate ambiguity in identification. Using cytochrome c oxidase subunit I (COI) can be critical for future genomic analysis and understanding An. stephensi spread. Anopheles stephensi is an invasive malaria vector in Africa that has been implicated in malaria outbreaks in the Horn of Africa. In 10 years, it has been detected as far east as Djibouti and as far west as Ghana. Early detections were mostly incidental, but now active surveillance in Africa has been updated to include An. stephensi. Morphological identification of An. stephensi from native vectors can be challenging, thus, sequence-based assays have been used to confirm identification during initial detections. Methods of sequence-based identification of An. stephensi have varied across initial detections to date. Here, we summarize initial detections, make suggestions that could provide a standardized approach, and discuss how sequences can inform additional genomic studies beyond species identification. [ABSTRACT FROM AUTHOR]

The experiences of trauma patients referred from Ghanaian non-tertiary hospitals for definitive care at higher levels is not well-known. Understanding the motivations of injured patients who do not attend their referral for definitive management may inform interventions to improve injury outcomes. This study is a follow-up survey of participants of a larger study involving initial management of injured patients presenting to 8 non-tertiary hospitals in Ghana from October 2020 to March 2022. Injured patients referred to higher levels of care were surveyed by phone using a structured questionnaire and patients who could not be reached were excluded. The main outcome was referral non-attendance and differences between patients who attended the referral and those who did not were determined with chi squared tests. Variables with intergroup differences were included in a multivariable logistic regression. Open-ended survey responses were analyzed using thematic content analysis. Of 335 referred patients surveyed, 17 % did not attend the referral. Factors associated with referral non-attendance included being male (Adjusted odds ratio (AOR)=2.70, p = 0.013), sustaining a fracture (AOR=2.83, p = 0.003), and having less severe injury (AOR 2.84, p = 0.017). Primary drivers of referral non-attendance included financial problems (59 %), family influence (45 %), and lack of transportation (20 %). The majority of patients (77 %) not attending the referral sought treatment from traditional healers, citing lower cost, faster service, and a perception of equivalent outcomes. Reported facilitators of referral attendance included positive hospital staff experiences and treatment while barriers included higher hospital costs, lack of bed space, and poor interhospital communication. An important proportion of injured patients in Ghana do not attend referrals for definitive management, with many seeking care from traditional healers. Our study identified possible targets for interventions aimed at maintaining the continuum of hospital-based care for injured patients in order to improve outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to determine the effectiveness of a standardized trauma intake form (TIF) to improve achievement of key performance indicators (KPIs) of initial trauma care among injured children, compared to adults, at non-tertiary hospitals in Ghana. A stepped-wedge cluster randomized trial was performed with research assistants directly observing the management of injured patients before and after introducing the TIF at emergency units of 8 non-tertiary hospitals for 17.5 months. Differences in outcomes between children and adults in periods before and after TIF introduction were determined with multivariable logistic regression. Differences in outcomes among children after TIF introduction were determined using generalized linear mixed regression. Management of 3889 injured patients was observed; 757 (19%) were children <18 years. Trauma care KPIs at baseline were lower for children compared to adults. Improvements in primary survey KPIs were observed among children after TIF introduction. Examples include airway assessment [279 (71%) to 359 (98%); adjusted odds ratio (AOR): 74.42, p = 0.005)] and chest examination [225 (58%) to 349 (95%); AOR 53.80, p = 0.002)]. However, despite these improvements, achievement of KPIs was still lower compared to adults. Examples are pelvic fracture evaluation [children: 295 (80%) vs adults: 1416 (88%), AOR: 0.56, p = 0.001] and respiratory rate assessment (children: 310 (84%) vs adults: 1458 (91%), AOR: 058, p = 0.030). While the TIF was effective in improving most KPIs of pediatric trauma care, more targeted education is needed to bridge the gap in quality between pediatric and adult trauma care at non-tertiary hospitals in Ghana and other low- and middle-income countries. Stepped-wedged cluster randomized controlled trial. I. • What is currently known about this topic? Incidence of pediatric trauma is disproportionately high in low- and middle-income countries (LMICs). Differences may exist in quality of care provided for injured children compared to adults. • What new information is contained in this article? At non-tertiary Ghanaian hospitals, quality of trauma care for children is lower compared to adults. While pediatric trauma care key performance indicators were improved with a standardized trauma intake form at these hospitals, the improvements were still lower compared to adults. [ABSTRACT FROM AUTHOR]

Community college libraries and writing centers are natural partners due to their shared goals regarding academic support and student success, as well as their joint focus on the interrelated processes of writing and research. Research has shown that libraries at four-year institutions and writing centers collaborate in many ways, but little research has been conducted on collaborations at community colleges and whether these collaborations have moved to a virtual setting. Given the rise in online education at community colleges and students' need for developmental education in writing, this study used a qualitative survey approach to gain a better understanding of virtual and in-person collaborative efforts between writing centers and community college libraries. The survey was distributed via listservs and direct emails, with participation limited to those working at two-year institutions with writing centers. Survey findings demonstrated that library and writing center staff are implementing a variety of virtual and in-person collaborative efforts, such as student trainings, individual student appointments, the joint creation of online resources, and campus outreach. Practical implications for academic libraries and future directions for research are also discussed. [ABSTRACT FROM AUTHOR]

Predatory publishing poses significant challenges to academic integrity and progress. It requires the involvement of academic institutions, funding bodies, and policymakers to establish robust evaluation mechanisms and promote ethical publishing practices. This study examines the effectiveness of implementing promotion policies to discourage unethical academic publishing, focusing on Kwame Nkrumah University of Science and Technology (KNUST) in Ghana. This study analyses 273 promotion applications submitted from January 2022 to November 2023, regardless of approval. The results show that researchers at KNUST submit relatively more publications to recommended outlets after the implementation of the new promotion guidelines. Moreover, with nine out of ten non-verified publications found to be from predatory journals, the verification process effectively discourages publication such outlets. Our study therefore confirms that the verification process can identify predatory publication outlets. Consequently, it is recommended that research institutions eliminate incentives for publishing in questionable outlets through publication criteria as part of promotion standards. [ABSTRACT FROM AUTHOR]

• Innovax bivalent HPV vaccine (Cecolin), and Gardasil have similar safety profiles. • Two Cecolin doses six months apart are immunologically non-inferior to Gardasil. • Six months after one dose, Cecolin is highly immunogenic. • Cecolin expands the options for HPV vaccination in low- and middle-income countries. World Health Organization human papillomavirus (HPV) vaccination recommendations include a single- or two-dose schedule in individuals 9–20 years old and advice for generating data on single-dose efficacy or immunobridging. The ongoing Phase 3 trial of Innovax's bivalent (types 16 and 18) HPV vaccine (Cecolin®) assesses in low- and middle-income countries alternative dosing schedules and generates data following one dose in girls 9–14 years old. Interim data for the 6-month dosing groups are presented. In Bangladesh and Ghana, 1,025 girls were randomized to receive either two doses of Cecolin at 6-, 12-, or 24-month intervals; one dose of Gardasil® followed by one dose of Cecolin at month 24; or two doses of Gardasil 6 months apart (referent). Serology was measured by enzyme-linked immunosorbent assay (ELISA) and, in a subset, by neutralization assays. Primary objectives include immunological non-inferiority of the Cecolin schedules to referent one month after the second dose. Safety endpoints include reactogenicity and unsolicited adverse events for 7 and 30 days post-vaccination, respectively, as well as serious adverse events throughout the study. Interim analyses included data from the two groups on a 0, 6-month schedule with 205 participants per group. One month after Dose 2, 100% of participants were seropositive by ELISA and had seroconverted for both antigens. Non-inferiority of Cecolin to Gardasil was demonstrated. Six months following one dose, over 96% of participants were seropositive by ELISA for both HPV antigens, with a trend for higher geometric mean concentration following Cecolin administration. Reactogenicity and safety were comparable between both vaccines. Cecolin in a 0, 6-month schedule elicits robust immunogenicity. Non-inferiority to Gardasil was demonstrated one month after a 0, 6-month schedule. Immunogenicity following one dose was comparable to Gardasil up to six months. Both vaccines were safe and well tolerated (ClinicalTrials.gov No. 04508309). [ABSTRACT FROM AUTHOR]

Ghana witnessed an outbreak of measles in 2022 following the COVID-19 pandemic, and Savannah Region was among the regions severely impacted. The objective of this study was to conduct trend analysis of measles case incidence and measles-rubella (MR) vaccination coverage in the Savannah Region to identify gaps and propose remedial actions to mitigate future outbreaks of vaccine preventable diseases (VPDs). Analysis of measles surveillance and measles-rubella vaccination data for 2018–2022 was conducted to assess relationship between immunization coverage and measles case incidence. Data were extracted from the District Health Information Management System (DHIMS) platform and loaded into Microsoft Excel 16.0 spreadsheet for analysis. Coverages for first (MR1) and second (MR2) doses of measles-rubella vaccination, dropout rates, and measles incidence (per 100,000) were calculated. The coverage trend for both vaccine doses followed similar trajectories, increasing from 2018 to a peak in 2019, and declining sequentially thereafter to the lowest (for the study period) in 2022. Generally, MR1/MR2 dropout rate was high across all districts during the entire study period. The regional incidence of confirmed measles rose sharply from less than 1/1,000,000 in 2018–2021 to 94 in 2022. Wide variations in vaccination coverage and dropout rates were observed among the districts. There was moderate to fairly strong negative correlation between MR vaccination coverage and measles case incidence. The MR vaccination coverage in the Savannah Region declined probably due to pre-existing weaknesses in the immunization programme accentuated by impact of the COVID-19 pandemic. The lowered population immunity likely contributed to occurrence of the measles outbreak in 2022. Pragmatic actions are needed to catch-up on missed children, restore coverage to pre-pandemic levels, and strengthen the immunization programme as part of global efforts towards achieving the Immunization Agenda 2030 (IA2030) trajectory. [ABSTRACT FROM AUTHOR]

[Display omitted] • The neglected tropical disease onchocerciasis is targeted for elimination of transmission. • Transmission zones could be identified using parasite genetic similarities and differences. • Onchocerca volvulus parasites are similar across a central transect of Ghana. • This transect is a single transmission zone throughout which interventions should be coordinated. National programs in Africa have expanded their objectives from control of onchocerciasis (river blindness) as a public health problem to elimination of parasite transmission, motivated by the reduction of Onchocerca volvulus infection prevalence in many African meso- and hyperendemic areas due to mass drug administration of ivermectin (MDAi). Given the large, contiguous hypo-, meso-, and hyperendemic areas, sustainable elimination of onchocerciasis in sub-Saharan Africa requires delineation of geographic boundaries for parasite transmission zones, so that programs can consider the risk of parasite re-introduction through vector or human migration from areas with ongoing transmission when making decisions to stop MDAi. We propose that transmission zone boundaries can be delineated by characterising the parasite genetic population structure within and between potential zones. We analysed whole mitochondrial genome sequences of 189 O. volvulus adults to determine the pattern of genetic similarity across three West African countries: Ghana, Mali, and Côte d'Ivoire. Population genetic structure indicates that parasites from villages near the Pru, Daka, and Black Volta rivers in central Ghana belong to one parasite population, indicating that the assumption that river basins constitute individual transmission zones is not supported by the data. Parasites from Mali and Côte d'Ivoire are genetically distinct from those from Ghana. This research provides the basis for developing tools for elimination programs to delineate transmission zones, to estimate the risk of parasite re-introduction via vector or human movement when intervention is stopped in one area while transmission is ongoing in others, to identify the origin of infections detected post-treatment cessation, and to investigate whether persisting prevalence despite ongoing interventions in one area is due to parasites imported from others. [ABSTRACT FROM AUTHOR]

• The changing structure of households in Africa is challenging the design of micro-level pro-poor policies. • Divorce/separation and widowhood have increased compared to data from 1987/88. • Lower incomes in female-headed households do not lower children's educational investment. • The gender mix of children plays a key role in aggregate household investments for male-headed households, with the financial inclusion of female household heads under 40 years being important for investments in children's education. • Structural changes in female leadership in communities interact with structural changes at the household level. Female headship of households has increased significantly around the world. This paper establishes a link between gender, income, and children's educational investments in an imperfect credit market. We show using a representative household survey from Ghana that, even though there is a positive correlation between income and educational investments, there are expected and unexpected heterogeneities in income and children's educational investments. We find that, whereas income levels for male-headed households with children 6 to 18 years are over 20% higher, female-headed households tend to invest 31% to 38% more on children's education than male-headed households. In imperfect credit markets, higher educational investments could be taking place at the expense of other household outcomes such as food/leisure. Our empirical results show the need for different interventions for different households. We also show how institutional changes that recognize affirmative action can interact with household-level structural changes. [ABSTRACT FROM AUTHOR]

Background: Information on salt consumption patterns is needed to inform the need for and design of salt reduction strategies. Objectives: In northern Ghana, this study aimed to estimate household consumption of salt, including salt from bouillon, and compare (estimated) women and children's salt intake to global recommendations; to estimate the proportion of salt consumed from bouillon; and to identify factors, including knowledge, attitudes, and practices, associated with household salt consumption. Methods: Employing mixed-methods methodology, we conducted a pilot survey (n = 369 households enrolled) and focus group discussions (FGDs; n = 20) in Tolon and Kumbungu districts (14 urban, 14 rural clusters) (clinicaltrials.gov registry: NCT04632771). Households reported purchases of discretionary salt (DS, "table salt") and bouillon cubes. DS and total salt (TS; DSþsalt from bouillon) consumption for women (15-49 y) and children (2-5 y) were estimated using the Adult Male Equivalent method and compared with global recommendations (<5 g/d women; <3.75 g/d children). Women's salt intake was also predicted from urinary sodium excretion (INTERSALT equation). Associations between DS and TS consumption, as well as household and women's characteristics, were tested with minimally adjusted and multivariable linear mixed-effects models. Qualitative FGD themes were generated using the Framework Method. Results: From household purchase data, estimated TS consumption exceeded global recommendations for 44% of children [median: 2.9 (IQR: 1.9, 5.2) g/d] and 60% of women [6.0 (4.0, 10.2) g/d]; 35% of children and 50% of women exceeded recommendations from DS alone. Bouillon contributed <25% of households' TS consumption. Few characteristics were associated with DS or TS consumption. Salient qualitative themes that shaped salt consumption behaviors included salt's ubiquity as a seasoning, key household members' influence on food procurement and preparation, and perceptions about health. Conclusions: Purchase data suggest salt consumption among women and children exceeds recommendations, even when excluding salt from bouillon; food prepared outside the home likely further contributes. Salt reduction interventions may be warranted in this context. [ABSTRACT FROM AUTHOR]

Innovative tools and software programs that can be utilised at different stages of a construction project, from inception to completion, are collectively called digital technologies (DTs). Drones are invaluable for construction projects since they substantially increase productivity, safety, and data collection. During the construction stage of a project, drones can provide accurate and comprehensive data. The study aims to investigate strategies for enhancing the sustainability of building construction in the Greater Accra Region of Ghana through drones. After a thorough literature analysis, ten key indicators were established to guarantee the sustainability of building construction. The indicators were then confirmed using a questionnaire survey. Professionals in building construction, including architects, quantity surveyors, site engineers, and supervisors, were chosen for the studies using the snowball sampling technique. One-way ANOVA, frequency, percentage, mean value, and other statistical methods were used to analyze the collected data. According to the report, regular maintenance, risk assessment, data security and privacy, training and skill development, and extended battery life are the main building sustainability strategies. Following the supply of standards for drone operation, construction organizations, professional bodies, and the government would benefit from assessing the critical strategies for building construction sustainability. This study adds significantly to the body of knowledge by describing how developing economies like Ghana, where drone use is uncommon, could operationalize drones effectively and efficiently using the outlined strategies. [ABSTRACT FROM AUTHOR]

The demand for urban delivery services (UDS) in low- and middle-income countries (LMICs) has been growing due to the spike in e-commerce activities. This phenomenon has led to the search for more innovative UDS modes, such as drones, as they provide fast, safer, and eco-friendly services. Although researchers have examined the perceptions regarding the adoption of drone delivery, there are many unknowns about the intentions to use this futuristic delivery mode. By employing survey data obtained through an online survey conducted in Ghana, this study aims to gain a deeper understanding of the current UDS user profiles and investigate their intentions to adopt drone deliveries in the future, considering the lived experiences of traditional UDS usage pre/post the COVID-19 pandemic. Regarding UDS user profiling, the study applied an advanced unsupervised machine learning method known as cluster correspondence analysis to simultaneously identify critical clusters in the data as well as key factor associations for each group. The findings demonstrated that most people in Ghana who seldom used the traditional UDS usually experienced poor service levels. Females living in the capital of Ghana who are frequent users of UDS mainly experienced acceptable service levels. Using an ordered probit regression model, the study identified that variables such as males, people who desired contactless UDS, and frequent UDS users at work or school during the COVID-19 pandemic were more inclined to embrace drone deliveries when introduced. Conversely, individuals who frequently used UDS services at home, those living in large cities, and those with lower income levels expressed reluctance toward drone delivery services. This study augments the urban logistics literature in LMICs by offering insightful suggestions in the areas of education, enhanced marketing strategies, and delivery optimization, which are instrumental for informing policy decisions. Government-related transportation bodies, private logistics firms, and trade unions can collaborate and adopt the recommendations provided to improve urban delivery services and to pave the way for integrating drone delivery services in the near future. • Delivery service user profiles and drone delivery adoption influence factors are explored. • Both advanced machine learning and econometric modelling are applied. • Users of current urban delivery services mostly experience poor levels of service. • People who prefer contactless delivery services are willing to accept drone delivery. • Low income earners are less likely to adopt drone delivery services. [ABSTRACT FROM AUTHOR]

Background: Bouillon is a promising large-scale food fortification vehicle, but there is uncertainty regarding the types and concentrations of micronutrients that are feasible to add without compromising consumer acceptability. Objective: The objective of this study was to evaluate the acceptability of 2 different multiple micronutrient-fortified bouillon cube formulations, compared with a bouillon cube fortified with iodine only. Methods: We conducted a double-blind, randomized, controlled acceptability study in 2 districts in northern Ghana. Two nonproprietary, noncommercialized formulations of multiple micronutrient-fortified bouillon cubes containing iron, zinc, folic acid, vitamins A and B12, and iodine at "upper-level" (45-125% CODEX NRV/2.5g) or "lower-level" (15-50% CODEX NRV/2.5g) concentrations, and a control cube that contained iodine only (50% CODEX NRV/2.5g) were evaluated. Eligible women (n = 84) were invited to participate in 1) center-based sensory evaluations designed to permit within-individual comparisons among the different study products; and 2) in-home evaluation of bouillon acceptability and use, in which participants were randomized to receive 1 of the 3 study products to use in household cooking for a 2-wk period. Acceptance test ratings were based on a 5-point Likert scale (1 = dislike very much, 5 = like very much). Results: In the center-based evaluations, overall liking of the 3 bouillon cube formulations both dry and in prepared dishes ranged from 4.3 to 4.6 on the 5-point Likert scale and did not differ among formulations (P > 0.05). After the 2-wk in-home trial, 93.8% of index participants (n = 75/80) rated their overall liking of the bouillon product formulation to which they were randomly assigned as "like" or "like very much" (4-5 on the 5-point Likert scale) and median apparent intake of study-provided bouillon over 2 wk was 3.6 g/capita/d; neither value differed by study group (P = 0.91 for both). Conclusions: All 3 formulations of bouillon cubes assessed were acceptable to women and their households in 2 districts in northern Ghana. [ABSTRACT FROM AUTHOR]

• 23 synoptic stations network is used to evaluate five temperature datasets in Ghana. • The assessment is carried out from multiple perspectives, including climatology. • Multiple performance metrics are used to assess the robustness of the datasets. • Using CRU, CPC, and TerraClimate in Ghana is most recommended. Global temperature datasets have become increasingly accessible in recent years, yet their performance in regions with sparse data remains a subject that requires thorough investigation, especially in areas where validation is essential. This study addresses this urgency, given the significant impact of the increase in global temperature, as highlighted in the IPCC's 6th Assessment Report, on regional and local levels. In this research, we evaluated air temperature datasets from Climatic Research Unit (CRU TS4.05), Modern-Era Retrospective Analysis for Research and Applications, version 2 (MERRA-2), Climate Prediction Centre (CPC), European Centre for Medium-Range Weather Forecasts (ECMWF) Reanalysis (ERA-5), and TerraClimate (hereinafter referred to as Gridded Temperature Datasets - GTDs). Our assessment involved comparing and validating these datasets against reference ground observation data from 23 synoptic stations, spanning 40 years from 1981 to 2020, to ensure robustness in regions with sparse data. We conducted a spatio-temporal investigation to explore temperature patterns, and evaluated their capacity to reproduce inter-annual and intra-seasonal variability. To assess dataset performance, we employed a group of statistical metrics, including root-mean-square error (RMSE), mean absolute error (MAE), percentage bias (PBIAS), and correlation coefficient (R). The GTDs consistently captured the annual climatological cycle distribution over Ghana. The correlation coefficient values significantly varied across the 23 synoptic stations and three climatic zones. At the annual level, CPC exhibited R values ranging from 0.53 to 0.93, while CRU ranged from 0.48 to 0.88. The bias for CPC and CRU spanned from 2.40 to −0.35 °C and 2.07 to −0.91 °C, respectively. Overall, CRU, CPC, and TerraClimate demonstrated the most consistent near-surface temperature patterns over Ghana, outperforming other datasets. Based on our findings, we recommend these datasets for model evaluation and assessment in Ghana, given their strong performance in capturing temperature variations. [ABSTRACT FROM AUTHOR]

Background: Small-quantity lipid-based nutrient supplements (SQ-LNS) during pregnancy and postnatally were previously shown to improve high-density lipoprotein (HDL) cholesterol efflux capacity (CEC) and length in the children of supplemented mothers at 18 mo of age in the International Lipid-Based Nutrient Supplements (iLiNS) DYAD trial in Ghana. However, the effects of SQ-LNS on maternal HDL functionality during pregnancy are unknown. Objective: The goal of this cross-sectional, secondary outcome analysis was to compare HDL function in mothers supplemented with SQLNS vs. iron and folic acid (IFA) during gestation. Methods: HDL CEC and the activities of 3 HDL-associated enzymes were analyzed in archived plasma samples (N = 197) from a subsample of females at 36 weeks of gestation enrolled in the iLiNS-DYAD trial in Ghana. Correlations between HDL function and birth outcomes, inflammatory markers C-reactive protein (CRP) and alpha-1-acid glycoprotein (AGP), and the effects of season were explored to determine the influence of these factors on HDL function in this cohort of pregnant females. Results: There were no statistically significant differences in HDL CEC, plasma lecithin-cholesterol acyltransferase (LCAT) activity, cholesteryl ester transfer protein (CETP) activity, or phospholipid transfer protein (PLTP) activity between mothers supplemented with SQ-LNS compared with IFA control, and no statistically significant relationships between maternal HDL function and childbirth outcomes. LCAT activity was negatively correlated with plasma AGP (R = -0.19, P = 0.007) and CRP (R = -0.28, P < 0.001), CETP and LCAT activity were higher during the dry season compared to the wet season, and PLTP activity was higher in the wet season compared to the dry season. Conclusions: Mothers in Ghana supplemented with SQ-LNS compared with IFA during gestation did not have measurable differences in HDL functionality, and maternal HDL function was not associated with childbirth outcomes. However, seasonal factors and markers of inflammation were associated with HDL function, indicating that these factors had a stronger influence on HDL functionality than SQ-LNS supplementation during pregnancy. [ABSTRACT FROM AUTHOR]

Laboratory research in Ghana demonstrated the effectiveness of an isolate of Beauveria bassiana (IMI 389521) from the United Kingdom against the larger grain borer Prostephanus truncatus (Horn) (Coleoptera: Bostrichidae), a major pest of stored maize. The minimum effective concentration, following artificial infestation trials on maize, was between 109 and 1010 cfu/kg maize. Before moving out to village-level control, a major requirement was to determine if the product could effect control in artificially infested maize held under real environmental conditions in several locations in Ghana. Therefore, this study investigated the efficacy of formulated conidia of B. bassiana , IMI 389521, at two concentrations (1 × 109 and 3.16 × 109 cfu/kg maize) to control P. truncatus on stored maize kernels under semi-field conditions in Ghana. Maize ('Obatanpa' cultivar) kernels were treated with the formulated B. bassiana product and stored in polypropylene woven bags in cribs in Southern Ghana. After 24 h, one hundred adults of P. truncatus were placed into each bag containing the treated maize. Mortality and the percent of weight loss of kernels were assessed every two weeks for three months. The semi-field trials revealed the possibility of successfully controlling adult P. truncatus on maize kernels treated with B. bassiana at 3.16 × 109 cfu/kg maize. However, due to the minimal protection of kernels after four weeks, re-treating maize kernels after this period is recommended to ensure maximum protection during prolonged storage. • B. bassiana kills P. truncatus in maize kernels under semifield conditions in Ghana. • >90 % mortality of P. truncatus in 2 weeks with B. bassiana at 3.16 × 109 cfu/kg maize. • Re-treating of maize kernels after 4 weeks is required for prolonged storage. [ABSTRACT FROM AUTHOR]

• What is the primary question addressed by this study? To what extent do generalized anxiety and depressive symptoms serially mediate the association between sleep problems and happiness levels in later life? • What is the main finding of this study? Sleep problems are an independent risk factor for lower happiness levels among older adults in the sub-Saharan African context, where research is exclusively lacking. The association is serially explained by generalized anxiety and depressive symptoms with a total mediating effect of 54.42%. • What is the meaning of the finding? Tailored interventions to promote happiness and subjective well-being through quality sleep should holistically include screening and management for generalized anxiety and depressive symptoms in old age. Sleep problems (SP) are highly prevalent and seriously affect health and well-being in old age. The aim of this study was to examine the association between SP and happiness in an urban-dwelling older sample. The authors further explore the effects of generalized anxiety and depressive symptoms in the SP-happiness link using serial mediating modeling. Data came from the 2016 to 2018 Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (n = 661). The authors measured happiness with the cross-culturally validated item on a five-point scale. The GAD-7 and the CESD-8, respectively, assessed generalized anxiety and depressive symptoms. Participants reported nighttime and daytime SP in the last 30 days. The SPSS-based Hayes' PROCESS macro program (Model 6) was constructed to quantify the hypothesized mediation effect. The analysis included 661 adults aged greater than or equal to 50 years (mean age = 65.53 [SD] = 11.89 years; 65.20% women). After full adjustment, path models showed that SP was negatively associated with happiness (β = −0.1277, 95%CI = −0.15950 to −0.096). Bootstrapping estimates revealed that the SP-happiness link was serially mediated via generalized anxiety representing 8.77%, depressive symptoms yielding 18.95%, and anxiety symptoms→depressive symptoms accounting for 26.70% of the total effect. Generalized anxiety and depressive symptoms may explain the negative association between SP and happiness in urban-dwelling older adults in the sub-Saharan African (SSA) context. Interventions, social and clinical, to improve happiness through sleep quality should include ways to improve mental health. Longitudinal and cross-cultural data are warranted to assess the bi-directionality of this relationship. [ABSTRACT FROM AUTHOR]

In Ghana, little is known about fathers' experiences caring for children with cerebral palsy. The purpose of this study is to explore a. the caregiving demand and burden on fathers of children with cerebral palsy and b. describe the caregiving consequences and coping strategies of fathers of children with cerebral palsy. The study utilized an exploratory, descriptive qualitative approach with a sample size of fifteen fathers purposively selected. The study used a semi-structured interview guide to conduct a one-on-one interview with participants. The analysis performed was thematic and content analysis. The results revealed complexities of care demand and burden; thus, meeting the child's needs resulted in physical and mental exhaustion, frequent hospital visits, and substantial financial implications for fathers. We conclude that t he family, particularly fathers, need support to embrace the challenging care roles as parents to children with cerebral palsy. It is evident that caring for children is mainly reserved for mothers in the African context. However, the demanding nature of care for a child with a developmental disability requires the involvement of both parents to meet the child's care needs and reduce the caregiver's care burden. Health professionals, particularly nurses must initiate and advocate for fathers' active participation in daily childcare. Tailored supportive care for families with children with disabilities in sub-Saharan Africa is required. • In Ghana, parenting a child with cerebral palsy has enormous implications for families. • Inadequate support systems constitute a significant challenge in caring for children with disabilities. • As a caregiver to a child with cerebral palsy, the father's involvement is necessary. • Fathers of children with cerebral palsy experience physical, emotional, social, and financial burdens. • Caring for children with cerebral palsy negatively impacts fathers' health. [ABSTRACT FROM AUTHOR]

Immunopathology in human tuberculosis affects T-cell phenotype and functions. Previous studies identified impaired T-cell sensitivity to Interleukin (IL)-7 accompanied by lower IL-7 receptor α-chain (IL-7Rα) expression in patients with acute tuberculosis. In the present study, we characterized affected T-cell subsets and determined the influence of tuberculosis disease severity and treatment response. Tuberculosis patients (n = 89) as well as age- and gender-matched asymptomatic contacts (controls, n = 47) were recruited in Ghana. Mycobacterium (M.) tuberculosis sputum burden was monitored prior to and during treatment. Blood samples from all patients and controls were analyzed for IL-7Rα expression and T-cell markers by multi-colour flow cytometry. CD4+ and CD8+ T-cells of tuberculosis patients showed generally lower IL-7Rα expression as compared to controls. Concomitantly, tuberculosis patients had higher proportions of naïve and lower proportions of memory CD4+ T-cells. Notably, a subset of CD27 positive central memory T-cells (T cm), which lacked IL-7Rα expression was enriched in tuberculosis patients as compared to controls. M. tuberculosis sputum burden was not associated with differences in IL-7Rα expression. Treatment duration and response showed no clear effects although IL-7Rα expression patterns were highly variable. These results suggested generally impaired generation of memory CD4+ T-cells and enrichment of a T cm subset without IL-7Rα expression in patients with tuberculosis. [ABSTRACT FROM AUTHOR]

The majority of literature on cervical cancer (CC) and cervical cancer screening (CCS) focused on women all over the world. However, research has indicated that men's involvement in CCS can lead to improved health outcomes for women. Despite this, there is limited information available in the literature regarding men's attitudes toward CCS. This highlights the need for further study on the subject to increase understanding and improve outcomes. The purpose of this study was therefore to explore the perceptions and attitudes toward partners' support for CCS among married men from the Adentan Municipality. An exploratory descriptive qualitative approach was used in the study to explore the perceptions of married men about male involvement in CCS. Thirty-four married men were purposively selected to be part of the interviews. A semistructured interview guide was used to collect data, which were recorded. The tape-recorded data were reproduced verbatim, and content analysis was carried out to generate the themes and subthemes. Three themes and nine subthemes were constructed from the data analysis. The study revealed that the perceptions of males about cervical cancer had a positive or a negative influence on women's behaviors toward CCS. It was interesting that some men constantly reminded their wives to participate in CCS. However, some barriers to men's support included fear of trauma to the wife's vagina during screening and concerns about exposure to the wife's nakedness. It was therefore recommended that healthcare facilities should roll out sustainable programs and policies to involve men in CC prevention. In addition, health workers should devise innovative ways to make male involvement in CCS more attractive to men. [ABSTRACT FROM AUTHOR]

This study aimed to evaluate the impact of Ghana's free maternal health care policy on stillbirth and perinatal death since its implementation a decade ago. The study used the propensity score matching method, a quasi-experimental design technique and secondary data to construct two groups of mothers with a history of perinatal deaths who subscribed to the 'free' maternal health care policy versus mothers who did not. The study merged two rounds of repeated cross-sectional data sets obtained from the Ghana Demographic and Health Survey (GDHS), 2008 and 2014, and generated exposure variables; pregnant women policy holding status and outcome variables; stillbirth and perinatal death by constructing binary outcomes from the under-five mortality variables of the DHS data sets. Fetal and early neonatal deaths within the data set were categorized into two groups: those exposed to the free maternal health care policy and those who did not. The propensity scores of the two groups were then generated and analyzed after checking for bias and common support. The analysis applied sample weighting to account for clustering and stratification due to the complex design of the DHS. All analyses were done with STATA 15 and adjusted for confounding using independent covariates. Stillbirth (43.3%) and perinatal death (60.2%) were high in the intervention group compared to the comparison group, and the differences were statistically significant (stillbirth, 0.0156, and perinatal death, 0.0012). Stillbirth and perinatal deaths were 12 and 13 percentage points higher in the intervention group, and these were statistically significant: adj. coef. = 0.12; 95% CI: [0.03–0.19]; P = 0.005 and adj. coef. = 0.13; 95% CI: [0.03–0.22]; P = 0.005. The results show that stillbirth and perinatal death were high in the maternal health care policy group, poorly reflecting as outcomes. However, the percentage point difference between stillbirth and perinatal death suggests a decline in early neonatal mortality and a positive impact of the 'free' maternal health care policy on perinatal death over stillbirth. [ABSTRACT FROM AUTHOR]

Coastal erosion as a threat to Ghana's coastline is being exacerbated by natural and anthropogenic processes. Adaptation to coastal erosion helps in managing the impacts and the levels of destruction to livelihoods, properties and investments along the coastline. Government intervention in adaptation to coastal erosion has always focused on the development of coastal sea defences without the integration of Indigenous knowledge and initiatives of coastal dwellers. This paper contributes to this gap by examining the Indigenous adaptation responses to coastal erosion in selected coastal communities of Ghana, factors influencing the choice of adaptation responses and the extent to which these Indigenous adaptation responses are addressing coastal erosion. Findings from the explorative qualitative study revealed that coastal dwellers are engaged in different forms of planned and reactive adaptation responses to coastal erosion. It was also found out that most of the Indigenous adaptation responses to coastal erosion were unsustainable in addressing coastal erosion and the choice of Indigenous adaptation response to coastal erosion was shaped by socio-economic and ecological factors or perception. Maladaptation responses by coastal dwellers were contributing to the phenomenon of coastal erosion. Coastal dwellers have survived the impacts of coastal erosion in the absence of support from central and local governments and their unsustainable adaptation responses have become a cyclical ritual over a period of time. The paper contributes to the debates on adaptation to climate change and the consideration of Indigenous knowledge into climate change mitigation and adaptation strategies in coastal zone planning and management. • Indigenous adaptation responses to coastal erosion are autonomous and reactive. • There is no collective community action towards addressing coastal erosion. • Adaptation responses are shaped by socio-economic and ecological considerations. • Maladaptation responses are counterproductive to addressing coastal erosion. • Hard Indigenous adaptation responses are a physical limitation to coastal resilience. [ABSTRACT FROM AUTHOR]

Environmental challenges associated with stormwater management, including flooding, droughts and depleting water quality, are exacerbated in urban areas. Despite growing expertise and policy advocacy for alternatives to conventional stormwater management approaches, Ghanaian cities, like many cities in developing countries, have not adopted governance principles to mainstream green stormwater infrastructure (GSI). There is very limited research which examines the governance barriers to mainstreaming GSI and their nuances within the Ghanaian context. Based on document analysis and interviews, this article explores the governance factors influencing GSI implementation and their associated barriers in Ghana's most populated water catchment. It analyses the governance dimensions comprising actors, rules of the game, discourse, and resources and power that could influence stormwater management. The article highlights that governance dimensions are currently not framed to facilitate GSI implementation. This shortfall reflects 11 specific barriers, including poverty, unresponsive culture, lack of knowledge, and lack of collaboration. The barriers transcend multiple governance components, particularly the actors. Yet, several governance components, including the specific actors and existing policies, are not currently integrated into stormwater management despite having strong potential to overcome the barriers and facilitate GSI implementation. The article proposes a good green governance framework, which accounts for the holistic nature of the identified barriers and envisages active inclusion and collaboration between diverse actors, including a basin authority as an intermediary, communities, local governments and national-level agencies. • Governance dimensions involve actors, rules of the game, discourse and resources. • Barriers to mainstream green stormwater infrastructure transcend multiple dimensions. • Governance potentials for addressing barriers are often overlooked. • Good green governance in policy, strategic and operational domains is required. [ABSTRACT FROM AUTHOR]

Prevention of infectious diseases among children is crucial to improve child health and survival. However, many countries in Sub-Saharan Africa struggle to achieve vaccination targets due to supply chain challenges, which lead to vaccine shortages, stockouts, and increased costs. We evaluated the effects of aerial logistics (centralized storage and delivery by drones) on vaccine stock, stockouts, vaccination coverage and vaccine preventable outcomes in the Western North Region of Ghana. The study combined retrospective quasi-experimental and cross-sectional designs to evaluate supply chain, programmatic, and clinical outcomes. Surveys to health providers were used to collect information from a random sample of 156 facilities, and secondary data on vaccination coverage and clinical outcomes was analyzed at the district level for the years 2017–2021. Facilities served by aerial logistics reported significant reductions in the duration of vaccine stockouts (30 %, p-value < 0.05), as well as in the frequency of missed opportunities for vaccination (44 %, p-value < 0.05). Being served by aerial logistics was associated with increased satisfaction with access to vaccines. Significant differences in vaccination coverage were found for most vaccines, in a range between 13.1 and 37.5 percentage points in vaccination coverage for served districts. Infectious diarrhea cases in children between 5 and 9 years old were reduced by 41.6 % (p-value < 0.05). End-to-end aerial logistics appears as an effective tool to improve the performance of the supply chain for vaccines. The strategy potentially increases the resilience of the health system and contributes to increased vaccination coverage and higher levels of satisfaction among providers in the Western North Region of Ghana. [ABSTRACT FROM AUTHOR]

Radiology equipment requires routine maintenance to prevent equipment breakdown. Equipment breakdown can lead to adverse patient outcomes and lost revenue to hospitals. In Ghana, there is a mismatch between the available radiology equipment and requests which may result in frequent breakdown. Several studies have been conducted to investigate equipment downtime across radiology departments. However, there is none for Ghana. This study therefore investigated the downtimes of radiology equipment across three hospitals in Ghana. The study covered the period January–December 2020. An inventory sheet was used to collect data on equipment specifications, frequency of breakdown, downtimes, average daily patient throughput, the average cost of common examinations, the availability of post-installation training and maintenance contracts/agreements. The study reviewed 32 items of radiology equipment. Radiology equipment across the hospitals broke down frequently and downtimes were very high. Radiographers/radiologists across the hospitals were provided with poor/inadequate post-installation training, and maintenance contracts/agreements were unavailable. The radiology equipment downtimes resulted in significant lost revenue of GH₵ 16,279,803 (US$ 1,968,537). Radiology equipment across the hospitals broke down frequently and downtimes were lengthy leading to significant lost revenue for the hospitals. Post-installation trainings were poor/inadequate, spanning a few hours. Also, maintenance contracts/agreements were non-existent across the three hospitals. A nationwide study is needed to determine equipment downtimes and lost revenue across all radiology departments in Ghanaian hospitals, to better inform policy-making. This study may help hospital managers and other stakeholders involved in policy formulation and strategic planning, put measures in place to minimise radiology equipment breakdown in Ghana. The study may also help optimise radiology services and enable radiology departments to render uninterrupted clinical services to patients in Ghana. [ABSTRACT FROM AUTHOR]

Plastics in freshwaters are a major problem for socio-ecological systems, calling upon smart policies for its solution. At the same time, there is a lack of relevant monitoring data on plastics in freshwaters to design such policies, specifically in the so-called Global South. This study, therefore, aims to analyze the complex barriers to mo-nitoring plastics in freshwaters in example cases of the Global South, as a starting point for more tailored monitoring, and targeted policies to reduce plastics in the environment. Based on a survey amongst 45 stakeholders in Ghana and Cambodia, we systematically analyze general barriers as well as specific technical, human, financial, and knowledge barriers identified through literature analysis and based on eight expert interviews. Results show that barriers to plastic monitoring are in general rather high, with survey respondents indicating rather high challenges with regard to the indicated barriers in both cases. Further, only slight variations between cases exist, with some barriers being slightly higher in Ghana than in Cambodia. Based on these results we call for both specific capacity development activities and less capacity-intense monitoring goals such as macro plastic monitoring to identify hotspots for policy interventions. • We analyse barriers to plastics monitoring in Ghana and Cambodia. • We combine qualitative interviews with a survey amongst 45 stakeholders. • There exists a rather complex set of barriers to plastics monitoring. • The level of barriers are similar in the two case studies of the Global South. • Implications for plastics monitoring methodologies are provided. [ABSTRACT FROM AUTHOR]

In this study, four analytical techniques for the detection of Sc, La, Ce, Nd, Sm, Eu, Tb and Lu in volcanic rock specimens from Ghana have been compared. These rock samples were examined using inductively coupled plasma mass spectrometry, X-ray fluorescence spectrometry, and instrumental neutron activation analysis. The Am-241 excitation-based X-ray fluorescence accuracies were good for Y, La, Ce, Nd, Eu, and the results were comparable to inductively coupled plasma mass spectrometry and instrumental neutron activation analysis except Silver-anode X-ray tube X-ray fluorescence. This demonstrates the limitations of the tube-based X-ray fluorescence excitation system for rare earth elements analysis, primarily caused by interference between the K-series X-ray emission from the transition metals and the relatively low intensities of L-series lines of the rare earth elements. Data on the precision and accuracy of these methods were based on IAEA SOIL-7 reference material. [ABSTRACT FROM AUTHOR]

Despite numerous studies on motorcycle safety, especially the compliance of helmet use laws in both developed and developing countries across the globe, little is known about the mediating role of traffic law enforcement and road safety education specifically on the relationship between helmet use influencing factors and helmet usage in general. The aim of this study was to examine the mediating role of traffic law enforcement and road safety education on the relationship between helmet usage influencing factors and motorcycle helmet usage. A total of 358 respondents from a university community that uses a motorcycle on daily bases to and from the community and for other important trip purposes completed a self-reported questionnaire in the Upper West Region of Ghana where motorcycles are predominantly used as a transportation mode. To test for the various hypotheses of this study, we developed a hypothesized single multiple mediated structural equation model and several sub-mediated models using AMOS 26.0. The results showed that the perceived safety of the helmet, weather conditions, and convenience of helmet use have positive significant impacts on helmet use. The study also found a full mediation role of the combined effect of traffic law enforcement and road safety education on the relationship of helmet use influencing factors investigated and helmet use. The study concludes that new traffic law enforcement and road safety education strategies need to be adopted to help improve upon the low prevalence of helmet use within the study area. • The combined effect of traffic law enforcement and road safety education on motorcycle helmet usage was explored • A hypothesized mediated structural equation models were developed. • Helmet use influencing factors investigated have positive significant impacts on helmet usage. • The study found a full mediation role of the combined effect of traffic law enforcement and road safety education. • New traffic law enforcement and road safety education strategies are needed. [ABSTRACT FROM AUTHOR]

Vaccine procurement costs comprise a significant share of immunization program costs in low- and middle-income countries, yet not all procured vaccines are administered. Vaccine wastage occurs due to vial breakage, excessive heat or freezing, expiration, or when not all doses in a multidose vial are used. Better estimates of vaccine wastage rates and their causes could support improved management of vaccine stocks and reduce procurement costs. This study examined aspects of wastage for four vaccines at service delivery points in Ghana (n = 48), Mozambique (n = 36), and Pakistan (n = 46). We used prospective data from daily and monthly vaccine usage data entry forms, along with cross-sectional surveys, and in-depth interviews. The analysis found that estimated monthly proportional open-vial wastage rates for vaccines in single-dose vials (SDV) or in multi-dose vials (MDV) that can be kept refrigerated up to four weeks after opening ranged from 0.08 % to 3 %. For MDV where remaining doses are discarded within six hours after opening, the mean wastage rates ranged from 5 % to 33 %, with rates being highest for measles containing vaccine. Despite national-level guidance to open a vaccine vial even when only one child is present, vaccines in MDV that are discarded within six hours of opening are sometimes offered less frequently than vaccines in SDV or in MDV where remaining doses can be used for up to 4 weeks. This practice can lead to missed opportunities for vaccination. While closed-vial wastage at service delivery points (SDPs) was relatively rare, individual instances can result in large losses, suggesting that monitoring closed-vial wastage should not be neglected. Health workers reported insufficient knowledge of vaccine wastage tracking and reporting methods. Improving reporting forms would facilitate more accurate reporting of all causes of wastage, as would additional training and supportive supervision. Globally, decreasing doses per vial could reduce open-vial wastage. [ABSTRACT FROM AUTHOR]

The formulation of signal-to-noise ratio (SNR) does not take into account the number of parameters used in the model, which can result in capturing intense noise when the number of predictor variables increases. Additionally, there is currently no probabilistic mechanism for comparing the model goodness measure values (in this case, adjusted SNR) of two candidate models used to select the best model. The research objective is to construct an adjusted SNR that accounts for the effect of the number of parameters used in the functional form of a model and establish a Lorenz function selection procedure using the adjusted SNR. The adjusted SNR is constructed by combining SNR and adjusted R2 (R2 adj), while the Lorenz function selection procedure is formed through a bootstrap mechanism. The proposed methods are applied to household consumption expenditure in Banten Province in 2020, the total income of employment per household in Ghana in 1998, and household income in South Africa in 2015, sourced from BPS-Statistics Banten Province of Indonesia, the Ghana Statistical Service, and Statistics South Africa, respectively. The adjusted SNR developed in this research can be used in empirical practice and addresses the weakness of SNR in not accounting for the number of parameters in the model. Selecting the Lorenz function through bootstrap using the adjusted SNR to measure model goodness-of-fit is a fundamentally new way of analyzing income inequality. [ABSTRACT FROM AUTHOR]

• Physicochemical properties are essential for assessing the quality of crude drugs. • Characteristic UV fingerprint and Thin layer chromatography reveal the differences in constituent for different plant parts. • Suppression of Carrageenan-induced foot oedema establishes the anti-inflammatory potential of plant extracts. • Microscopic examination of powdered plant parts reveal various cells plant cells. • Pharmacognostic standards are important for correct identification, authentication and quality control purposes. Loeseneriella africana (Willd.) R. Wilczek ex N. Hallé (Celastraceae) is a medicinal plant used by some traditional healers to treat microbial infections and inflammatory diseases in Ghana. This research was done to establish pharmacognostic standards and investigate the anti-inflammatory and antioxidant activities of Loeseneriella africana. Pharmacognostic studies were done on the stem and leaf whereas the biological investigations were done on the stem extracts of L. africana. The result of the pharmacognostic studies established organoleptic, macroscopic, and microscopic parameters for identification of the whole and powdered plant samples as well as physicochemical parameters such as solvent soluble extractives, pH and elemental content for quality control. UV, IR and TLC fingerprint as well as fluorescent characteristics of the stem and leaf of the plants were established. Preliminary phytochemical screening showed the presence of alkaloids, triterpenoids, phytosterols, flavonoids, tannins and coumarins which could be responsible for the medicinal uses of the plants. The extracts of L. africana demonstrated anti-inflammatory activities with percentage inhibition of oedema (18.80±5.00 - 36.70±4.60) at 300 mg/kg (p <0.0001). The extracts of L. africana exhibited DPPH scavenging activities at IC 50 (21.70 - 139.8 µg/mL). The whole extract of L. africana exhibited considerable total antioxidant capacity 477.7 mg/g of ascorbic acid equivalent. The results provide scientific evidence to support the traditional uses of Loeseneriella africana in treating inflammatory conditions, as well as standardization parameters for authentic sourcing of the plant for consistent use. [ABSTRACT FROM AUTHOR]

Enterally based resuscitation for major burn injuries has been suggested as a simple, operationally superior, and effective resuscitation strategy for use in austere contexts. However, key information to support its implementation is lacking, including palatability and acceptability of widely available rehydration drinks. We performed a single-blinded, cross-sectional survey of 60 healthy children (5–14 years), adults (15–54 years) and older adults (≥55 years) to determine palatability and overall acceptability of five oral rehydration solutions (ORS) and a positive control drink (Sprite Zero®) in Ghana. Quantitative data were described and differences between our control drink and the others across age groups were visually examined with Likert plots. Qualitative responses were analyzed using a content analysis framework. Twenty participants in each age group completed the study. Participants were as young as 5 years and as old as 84 years. Nearly two thirds of the sample identified as male (n = 38, 63% of all participants). The positive control was reported to taste 'good or 'very good' by the majority of participants (89%) followed by lemon-flavored ORS (78%) and orange-flavored ORS (78%). Conversely, homemade and low-osmolarity ORS were reported to taste 'good' or 'very good' by only 20% and 15% of participants, respectively. There were no major taste differences across the age groups. However, children more frequently reported positively (i.e., tastes 'good' or 'very good') about flavored and sweet drinks than did adults and older adults. When faced with the hypothetical situation of being critically injured and needing resuscitation, participants tended to be more agreeable to consuming all the drinks, even low-osmolarity and homemade ORS. These findings can be used to support the development of protocols that may be more acceptable among patients undergoing enterally based resuscitation, thus improving the effectiveness of the treatment. Specifically, enterally based resuscitation should likely include citrus-flavored ORS when available, given superior palatability and the fact that different flavor additives for patients of different ages do not seem necessary. • Citrus-flavored oral rehydration solutions (ORS) were preferred. • Different flavor additives for patients of different ages are not necessary. • Participants were agreeable to ORS if they were, hypothetically, critically injured. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Medical Imaging & Radiation Sciences is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This study examines the spillovers and connectedness between oil and the African stock markets under bearish, normal, and bullish market conditions. Using the quantile connectedness method, we find higher spillovers under bearish market conditions than in both tranquil and bullish market conditions. Oil is a net transmitter of spillovers in the African markets. Furthermore, Ghana, Kenya, Nigeria, and South Africa are net receivers of spillovers, and Tunisia, Egypt, Morocco, and Mauritius are net transmitters of spillovers in the lower quantile. In the median quantile, Ghana shifts to being a net transmitter of spillovers, whereas Egypt becomes a net receiver of spillovers. In the upper quantiles, all markets are net transmitters of spillovers, except for Mauritius and Egypt. We find a strong connectedness between oil and the Nigerian market during bearish and tranquil market conditions which alleviates the bullish market scenario. Moreover, spillovers reached the maximum level in early 2020, corresponding to the first wave of the COVID-19 pandemic. The portfolio analysis shows that an optimally weighted portfolio offers the best downside risk for all markets. The hedged portfolio offers the best risk reduction for all economies. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between urban form, residential rooftop solar PV potential, and levelized cost of electricity (LCOE) in high-income, middle-class, and low-income neighborhoods in Accra, Ghana. Using building footprint data, ArcGIS Pro, and linear regression analysis, we find a statistically significant association between urban form parameters (building density, neighborhood compactness, building footprint area, suitable rooftop area, and near distance between buildings) and the rooftop solar PV potential in all the three types of neighborhoods. However, the well-planned high-income neighborhood exhibited the highest rooftop solar PV potential with low LCOE values for most houses, while the lowest rooftop PV potential and highest LCOE values were found in the largely unplanned low-income neighborhood. The low-income neighborhood exhibited higher density with clustered building patterns and, consequently, lower rooftop PV potential. The LCOE ranged between $0.02/kWh-$0.19/kWh for most buildings, with 92 %, 74 %, and 51 % of houses in the high-income, middle-class, and low-income neighborhoods falling within this range, respectively. We conclude that while capital subsidies for residential solar PV can boost their uptake by urbanites, their effectiveness could be limited in low-income neighborhoods due to the limitations imposed by their urban form. It may be more appropriate for policy interventions to target such neighborhoods with community solar schemes while targeting high-income neighborhoods with building integrated solar photovoltaics. [Display omitted] • Rooftop solar PV potential is higher in high-income neighborhoods than in low-income ones. • Neighborhoods with low building density and dispersed layouts have higher solar PV potential. • Urban form could impede the diffusion of solar PV in cities. • Solar energy considerations need to be mainstreamed into urban planning and design. • Urban energy transition theories need to incorporate socio-spatial dimensions. [ABSTRACT FROM AUTHOR]

Every profession is guided by ethical conduct to help maintain the status quo of the profession. This study focused on assessing the ethical misconduct among librarians in selected nursing and midwifery training colleges in Ghana. The study adopted a qualitative research technique. Four head librarians were chosen using a purposive sampling approach each, from the three sectors demarcated by the researchers for the study. The findings from this study indicate that plagiarism is the most ethical misconduct librarians engage in, followed by violation of intellectual property rights and lack of access to information. The study also reveals that quick turnaround for searches, inadequate funds, ignorance of the code of ethics, and lack of education are the main causes of information ethical misconduct in librarianship. The study recommends that enough funding must be given to Nursing and Midwifery Training College (NMTC) libraries by management in order to equip them with the acquisition of legitimate materials to help curtail the violation of intellectual property rights and all other forms of ethical misconduct and dilemmas as a whole. Furthermore, the researchers propose that the Ghana Library Association which is the body responsible for librarians' interests should revise the 2014 Library Code of Ethics and urgently hold a seminar/workshop to refresh members' knowledge of the Code of Ethics. [ABSTRACT FROM AUTHOR]

We know little about the epidemiology of suicide among middle school students in Ghana, including the years preceding high school. This study explores the onset, characteristics, and recent patterns of suicide among Ghanaian middle and high school students. This study used the World Health Organization Global School-based Student Health Survey (GSHS, 2012), which has self-reported measures on suicide ideation, plan, and attempt of middle and high school students in Ghana. Correlation and logistic regression analyses were performed using Statistical Package for the Social Sciences (SPSS version 25). The study found prevalence of suicidal behaviors among the population as follows: ideation (19%), plan (22%), and attempt (25%). Suicide ideation significantly increased the risk for suicide plan (odds ratio [OR] = 9.14; 95% confidence interval [CI] = 7.57–11.02) and attempt (OR = 11.89; 95% CI = 9.82–14.38), whereas suicide plan significantly increased the odds of suicide attempt (OR = 12.64; 95% CI = 10.50–15.19). There was a higher prevalence of suicide ideation, plan, and attempts among middle school students than high school students although only suicide attempt differences were significant (28.4% > 22.3%; χ2 = 17.1, p <.001). The onset of suicide among Ghanaian students occurs at younger ages than previously thought, and there were increasing trends in suicide behaviors as age increases. This finding highlights a potential suicide crisis among preteens, which warrants attention. Additional studies are needed to observe these increasing trends, identify risk, protective, and precipitating factors to help prevent suicide among these children. [ABSTRACT FROM AUTHOR]

• There was observed COVID-19 vaccine hesitancy of 30.6% among unvaccinated respondents in the rural community of Nkwanta South, Ghana. • Key predictors of hesitancy included high levels of mistrust, being female, greater years of education, and being Christian. • These predictors are inconsistent among other published studies; thus tailored health promotion strategies that understands local social dynamics are crucial. In Ghana, as of 30 July 2022, around one-third of the eligible population are considered fully-vaccinated against COVID-19, and efforts are being made to increase coverage. Vaccine hesitancy is defined by the World Health Organization (WHO) as the delay in the acceptance, or blunt refusal of, vaccines. This study assesses vaccine hesitancy and confidence in Nkwanta South, a rural municipal in Oti region, Ghana. Data collection within Nkwanta South took place in sub-municipalities of Alokpatsa (11,028 population), Brewaniase (14,483), and Tutukpene (15,453). Data was collected by 47 local residents, known as Community-Based Surveillance Volunteers (CBSVs), using Kobo Toolbox forms on electronic devices (tablets). Information collected included numerous demographic variables, including age, gender, relationship status, and religion. Further questions covered reasons for vaccine hesitancy and COVID-19 vaccine status. Descriptive and inferential statistics assessed the association between variables to identify predictors of hesitancy. Across 1500 respondents, 700 (46.7%) reported having received at least one COVID-19 vaccine dose, and 800 (53.3%) reported being unvaccinated against COVID-19. Among unvaccinated respondents, 556 (69.4%) reported willingness to receive the vaccine once available, 190 (23.7%) said they would not be willing to be vaccinated, and 55 (6.9%) said they were unsure. Overall, this represented 30.6% hesitancy within the currently-unvaccinated group. Common reasons for hesitancy included believing that they did not need the vaccine (33.8%), believing the vaccine to be dangerous (30.6%), concerns about side effects (25.3%), and not having enough information (20.1%). Key predictors of hesitancy among our participants included high levels of mistrust, being female, greater years of education, and being Christian. The information gathered here can inform how best to target national and local health promotion strategies. Locally-tailored efforts, that understand local context and social dynamics, must remain a core component of public health activity to achieve a high vaccine uptake. [ABSTRACT FROM AUTHOR]

• The gap in the access to tuberculosis testing was equally large over the pre-/COVID-19 periods. • Less than half the severely ill admitted patients with HIV had an Xpert MTB/RIF result. • The tuberculosis prevalence rate and 8-week all-cause mortality rate were unacceptably high. • Missed or delayed tuberculosis diagnosis among people with HIV may be critical. The COVID-19 pandemic had a disruptive impact on tuberculosis (TB) and HIV services. We assessed the in-hospital TB diagnostic care among people with HIV (PWH) overall and before and during the pandemic. In this prospective study, adult PWH admitted at three hospitals in Ghana were recruited if they had a positive World Health Organization four-symptom screen or one or more World Health Organization danger signs or advanced HIV. We collected data on patient characteristics, TB assessment, and clinical outcomes after 8 weeks and used descriptive statistics and survival analysis. We enrolled 248 PWH with a median clusters of differentiation 4 count of 80.5 cells/mm3 (interquartile range 24-193). Of those, 246 (99.2%) patients had a positive World Health Organization four-symptom screen. Overall, 112 (45.2%) patients obtained a sputum Xpert result, 66 (46.5%) in the prepandemic and 46 (43.4%) in the pandemic period; P -value = 0.629. The TB prevalence of 46/246 (18.7%) was similar in the prepandemic 28/140 (20.0%) and pandemic 18/106 (17.0%) population; P -value = 0.548. The 8-week all-cause mortality was 62/246 (25.2%), with no difference in cumulative survival when stratifying for the pandemic period; log-rank P -value = 0.412. The study highlighted a large gap in the access to TB investigation and high early mortality among hospitalized PWH, irrespective of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The global prevalence of intestinal extended-spectrum β-lactamase–producing Enterobacterales (ESBL-PE) is approximately 17% in communities, with significant variations among regions. This longitudinal study aimed to assess the impact of antibiotic intake on the incidence of intestinal ESBL-PE in Ghanaian pharmacy customers outside of hospitals. Screening for ESBL-PE was performed in four independent pharmacies in Kumasi, Ghana, using rectal swabs and an ESBL-PE–selective medium. Pharmacy customers purchasing antibiotics were recruited, and those buying non-antibiotic drugs served as controls. Participants who were negative for ESBL-PE provided follow-up swabs for up to 28 days. At baseline, 302 (75%) of 404 participants were colonized with ESBL-PE. Sixty-three participants who were negative for ESBL-PE at baseline received per-protocol follow-up, including 28 individuals who took antibiotics and 35 controls. The cumulative proportions of ESBL-PE in the antibiotics and control groups were 71% (20/28) and 54% (19/35) at the first follow-up (p 0.258), 86% (24/28) and 80% (28/35) at the second follow-up (p 0.741) and 86% (24/28) and 94% (33/35) at the third follow-up (p 0.393), respectively. The rate of intestinal ESBL-PE carriage among pharmacy customers outside of hospitals was higher than expected at baseline and further increased during the 28 days of follow-up, irrespective of antibiotic intake. This alarming finding needs to be considered in the antibiotic treatment of outpatients and emphasizes the urgent need for improved prevention strategies, development of new antibiotic drugs and potential future elimination strategies. Further longitudinal studies on ESBL-PE in African communities, also outside of pharmacy settings, are required. [Display omitted] [ABSTRACT FROM AUTHOR]

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Discourses on climate change often characterise African cities as homogenous, experiencing the same climate events and requiring the same planning solutions. However, African cities are diverse and different across regions, scales, and contexts, despite some resemblance of urban problems. This paper addresses the generalisation of climate change issues and urban planning responses in African cities by: (i) exploring how climate impact, specifically flooding is different in one African city in terms of shaping the urban space; and (ii) examining the usefulness of city-focused and driven urban planning responses in addressing these risks. Using Accra, Ghana's capital, as a case study and mixed methods approach, findings indicate that despite the commonality of flood events across African cities, Accra's case is caused by a complex web of locally induced factors such as limited understanding of the geography and hydrology of the city by urban planning authorities, poor practice of informality, and changing weather patterns. Yet, the limited understanding of local driving causes of flooding in Accra has contributed to the use of unworkable top-down general responses (e.g., evictions and demolitions). The case of Accra demonstrates that increased preparedness (involving individuals, households, and institutions) is required to enhance adaptation to flood events rather than the current top-down response approach. In this case, we argue that a general approach to urban planning to address flood events across African cities may not work in all situations. Areas requiring further research are proffered, notably ways for capturing, integrating, and disseminating local knowledge in internationally funded flood planning and management initiatives. • This paper questions the overgeneralisation of climate impacts across African cities. • It discusses the importance of context-specific analysis in climate change debate. • Findings show significant differences in climate socio-geographical processes at the city level. • Bottom-up responses that are sensitive to local factors are recommended. [ABSTRACT FROM AUTHOR]