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Abstract Background Viruses are the leading etiology of acute respiratory infections (ARI) in children. However, there is limited knowledge on drivers of severe acute respiratory infection (SARI) cases involving viruses. We aimed to identify factors associated with severity and prolonged hospitalization of viral SARI among children 7 days). Conclusion Younger age, malnutrition, codetection of Klebsiella pneumoniae, and illness during the rainy season were associated with very severe cases and prolonged hospitalization of SARI involving viruses in children under five years. These findings emphasize the need for preventive actions targeting these factors in young children.

BackgroundLittle is known about the cocirculation of influenza and SARS-CoV-2 viruses during the COVID-19 pandemic and the use of respiratory disease sentinel surveillance platforms for monitoring SARS-CoV-2 activity in sub-Saharan Africa. ObjectiveWe aimed to describe influenza and SARS-CoV-2 cocirculation in Kenya and how the SARS-CoV-2 data from influenza sentinel surveillance correlated with that of universal national surveillance. MethodsFrom April 2020 to March 2022, we enrolled 7349 patients with severe acute respiratory illness or influenza-like illness at 8 sentinel influenza surveillance sites in Kenya and collected demographic, clinical, underlying medical condition, vaccination, and exposure information, as well as respiratory specimens, from them. Respiratory specimens were tested for influenza and SARS-CoV-2 by real-time reverse transcription polymerase chain reaction. The universal national-level SARS-CoV-2 data were also obtained from the Kenya Ministry of Health. The universal national-level SARS-CoV-2 data were collected from all health facilities nationally, border entry points, and contact tracing in Kenya. Epidemic curves and Pearson r were used to describe the correlation between SARS-CoV-2 positivity in data from the 8 influenza sentinel sites in Kenya and that of the universal national SARS-CoV-2 surveillance data. A logistic regression model was used to assess the association between influenza and SARS-CoV-2 coinfection with severe clinical illness. We defined severe clinical illness as any of oxygen saturation

Background There has been a notable rise in the number of African nurses and midwives migrating to high-income countries despite varying policies and restrictions to promote retention. The need to comprehensively evaluate existing policies addressing the exodus is crucial to future policy formulation and steps in addressing drivers of nurses and midwives brain drain in Africa.Aim To explore the existence of migration policies that address the drivers of nurse and midwives’ migration outside Africa and determine the characteristics and implementation of these policies.Methods The review would be guided by the JBI methodology for systematic reviews of text and non-research evidence. Databases including CINAHL, PubMed, Academic Search Complete via Ebscohost and ISI Web of Science will be searched using a PICOS selection criteria framework. Grey literature would be gathered from Google Scholar, government and organisational websites. Two independent reviewers would be involved in searching, study selection, data extraction and data analysis. A third reviewer would provide an arbitrary judgement during conflicts when disagreements persist after discussion. A meta-synthesis would be used to identify and report emerging themes in the literature.Ethics and dissemination The study does not require ethical approval. The findings would be published in peer-review journals and presented at research conferences.PROSPERO registration number CRD42023395013.

Introduction International students make significant contributions to their host institutions and countries. Yet research shows that not all international students have the financial means to fend for themselves and meet their financial obligations for the entire study programme. Such students are at significant risk of food insecurity. The objective of this scoping review is to synthesise available information on the factors related to food insecurity among international students studying at postsecondary educational institutions and identify the types of food insecurity interventions that have been implemented to address this issue.Methods and analysis The Joanna Briggs Institute scoping review methodology will be used to guide this scoping review, and we will search the following databases: MEDLINE (through Ovid), CINAHL (EBSCO), PubMed, ERIC (via Ovid), PROSPERO and ProQuest. The titles, abstracts, and subsequently full texts of the selected papers will then be screened against the inclusion criteria. Data from articles included in the review will be extracted using a data charting form and will be summarised in a tabular form. Thematic analysis will be used to identify common themes that thread through the selected studies and will be guided by the steps developed by Terry et al.Ethics and dissemination Since this project entails a review of available literature, ethical approval is not required. The findings will be presented at academic conferences and published in a peer-reviewed journal. To make the findings more accessible, they will also be distributed via digital communication platforms.

This study was carried out to identify which factors are most relevant to managers of SMEs in maintenance decision making, and to investigate how these factors influence the realization of business goals satisfactorily, using structural equation modelling, partial least square design (PLS-SEM) to establish significant relationships between manifest and latent variables. A study of maintenance cost vis a vis the number of maintenance works carried out and profits realized was conducted to ascertain correlations and identify which factors played key roles in profit maximization. Results showed that with increasing level of maintenance for SMEs, profit margins reduced significantly. Also, an R2 value of 0.83 showed that the latent variable, business goal satisfaction was explained to a high degree (83%) by the manifest variables. Rentals of equipment from third parties (0.27), halting production (0.11) and outsourcing (0.39) were less considered for business sustainability per correlation coefficients than funds (0.79), and the possibilities to carry out both corrective (0.64) and preventive (0.58) maintenance works. F-square value greater than zero was realized (0.387) and this showed reliability of the both inner and outer models. These findings can be used in building a decision tool or framework that will best suit SMEs with high financial budget constraints.

The SARS-CoV-2 Delta variant emerged shortly after COVID-19 vaccines became available in 2021. We describe SARS-CoV-2 breakthrough infections in a highly vaccinated, well-monitored US Embassy community in Kampala, Uganda. Defining breakthrough infection rates in highly vaccinated populations can help determine public health messaging, guidance, and policy globally.

INTRODUCTION: E-cigarettes have emerged as the most commonly used tobacco or nicotine products among youth in the United States (US), and usage with other products (dual use) is not well understood. This study assessed dual use and identified associated factors of usage in school-going youth in the high tobacco burdened region of rural Appalachian Tennessee. METHODS: Two waves of data for the same cohort of students were collected in 2014 (Wave 1) and 2016 (Wave 2). Dual use of e-cigarettes with any other tobacco product was the dependent variable. The independent variables consisted of exposure to tobacco use at home, home smoking rules, smoking inside the vehicle, attitudes toward smoking, exposure to tobacco industry marketing/promotion, and peer/family pressure. Descriptive statistics and multivariate logistic regression analyses were conducted to determine the prevalence of dual use and delineate factors associated with usage. RESULTS: Dual use increased from 13.3% in Wave 1 to 18.6% in Wave 2. Results of logistic regression show that exposure to tobacco industry marketing/promotion was significantly associated with dual use in the two waves, odds ratio (OR) = 4.18 (confidence interval [CI] = 1.69–10.38) and OR = 4.43 (CI = 2.03–9.67), respectively. While allowing smoking inside the vehicles, sometimes, significantly increased dual use in Wave 1 (OR = 3.18 [CI = 1.19–8.48]), exposure to tobacco use at home (OR = 2.94 [1.24–6.97]), and peer/family pressure (OR = 2.92 [1.87–7.19]) increased usage in Wave 2. CONCLUSION: The increasing trend in dual use of e-cigarettes and other tobacco products among youth in Appalachia Tennessee suggests a critical need for comprehensive tobacco control programs to avert exacerbating disparities in tobacco use and tobacco-related diseases in the US.

Serologic assays developed for SARS-CoV-2 detect different antibody subtypes and are based on different target antigens. Comparison of the performance of a SARS-CoV-2 Spike-Protein ELISA and the nucleocapsid-based Abbott ArchitectTM SARS-CoV-2 IgG assay indicated that the assays had high concordance, with rare paired discordant tests results.

There has been an upsurge of e-cigarette use in the United States in recent years. While e-cigarettes may contain lower levels of toxic chemicals than combusted cigarettes, they still pose serious health hazards, including increased risk for heart and respiratory disease. Despite these risks, public awareness of the health harms of e-cigarettes remains low. Thus, it is important to educate the public about the potential harms of e-cigarettes. This study took themes commonly found in antismoking messages and used them to develop messages about harms of e-cigarettes. A national sample of 2801 current smokers and nonsmokers (aged 18+ years) were randomized to view one of four e-cigarette messages (harmful effect of chemicals, uncertainty about ingredients, distrust of big tobacco, or cost of vaping) or a control message (bottled water ad). Participants' reactions to the messages and behavioral intentions were assessed immediately following the exposure. MANOVA examined effects of the messages on blocks of the outcome variables and univariate analyses estimated adjusted means for each experimental condition for each outcome. The message about harmful chemicals was perceived as the most informative and effective and elicited the highest levels of negative emotions (Ps

Abstract Background Tobacco companies argue that the decision to smoke is made by well-informed rational adults who have considered all the risks and benefits of smoking. Yet in promoting their products, the tobacco industry frequently relies on affect, portraying their products as part of a desirable lifestyle. Research examining the roles of affect and perceived risks in smoking has been scant and non-existent for novel tobacco products, such as electronic cigarettes (e-cigarettes). Methods We examined the relationship between affect, perceived risk, and current use for cigarettes and e-cigarettes in 2015 in a nationally representative sample of 5398 U.S. adults who were aware of e-cigarettes. Results Participants held various affective associations with tobacco products, and affect towards cigarettes was more negative than affect towards e-cigarettes. Using structural equation modeling (SEM), affect towards cigarettes and e-cigarettes was associated with cigarette smoking and e-cigarette use respectively, and these associations were both direct and partially mediated by risk perceptions towards smoking and e-cigarette use. More positive affect towards cigarettes or e-cigarettes was associated with lower perceived risks, which in turn was associated with higher odds of being a current cigarette or e-cigarette user. Conclusions In developing models explaining tobacco use behavior, or in creating public communication campaigns aimed at curbing tobacco use, it is useful to focus not only on the reason based predictors, such as perceptions of risks and benefits, but also on affective predictors. Educational efforts aimed at further smoking reductions should highlight and reinforce negative images and associations with cigarettes.

This article examines the factors affecting the inclusion of migrant students and how they exercise agency in response to the challenges that impede their inclusion within the Ghanaian education system. We draw on agency and inclusion theories in the analysis of interviews and observation data from 68 migrant students across 30 schools. The findings show the negative impact of language, exploitation, labeling, and teasing on migrant students in the absence of inclusive structures. This article brings to the fore the lack of inclusion for migrant students at the basic school level in Ghana and its negative ramifications on the academic achievement of not just migrant students but all students. The study highlights how migrant students demonstrate relational agency in their preference for friendships with people from similar backgrounds in overcoming challenges in school. Our findings contribute to studies on migration and education by addressing some of the challenges and possibilities of comparative and international education in "postcolonial" Africa.

Background Tobacco use and tobacco-induced diseases are rapidly increasing in Sub-Saharan Africa (SSA). Addressing this problem requires both tobacco use prevention and cessation. This study examined the rate of smoking cessation and assessed effects of tobacco control policies (TCPs) on cessation among adults in SSA. Methods During 2012 and 2014, Global Adult Tobacco Survey data were collected in Cameroon, Kenya, Nigeria, and Uganda and analyzed, with smoking cessation as the outcome. The exposure variable consisted of a composite index of the number of TCPs that participants have been exposed to. Covariates included participants' characteristic, knowledge of tobacco harm, exposure to anti-smoking messages, and tobacco industry promotions. Descriptive analyses were conducted for prevalence of smokers who had quit in the past year (i.e., ex-smokers) for each country and pooled data. A multivariable logistic regression was used to examine whether the number of TCPs a participant has been exposed to increase the likelihood of cessation. The odds ratios and associated 95% confidence intervals were ascertained. Results Of 27,952 participants, 48%, 32.1%, 17.5%, 81.2% had been exposed to anti-smoking media messages, health warning labels, smoke-free workplace, and smoke-free homes, respectively. Approximately 14.1% of the participants were ex-smokers, of which 7.1%, 6.1%, 5.0%, and 10.6% had been exposed to anti-smoking media messages, health warning labels, and smoke-free workplace, and smoke-free homes, respectively. Preliminary logistic regression analyses suggest that likelihood of smoking cessation increases with increase in exposure to TCPs. Conclusions As of 2014, only 41 countries had comprehensive tobacco control programs, with < 10 of the 47 SSA countries having national tobacco control laws. This study suggests that the number of TCPs in a country facilitates smoking cessation, suggesting that achieving the WHO FCTC goal of reduced tobacco use requires adoption of many TCPs, even in absence of a national law.

Background Secondhand smoke (SHS) exposure continues to be a major problem across Sub-Saharan Africa (SSA). Studies have called for immediate steps to address SHS exposure in SSA. Although several SSA countries are implementing smoke-free policies (SFPs), public support of these policies can affect their success. While support for SFPs has been studied in other countries, there is limited literature on SFPs in SSA. This study estimated the prevalence and factors associated with support for SPFs in four SSA countries. Methods Data from 27,952 participants of the Global Adult Tobacco Survey conducted in Nigeria (2012), Cameroon (2013), Uganda (2013) and Kenya (2014) were analyzed. Supports for smoking ban in eight public places were assessed. Descriptive analysis was conducted to estimate prevalence of support for SPF for the eight places and any support (defined as a support for SFP in at least one public place) for each country and pooled data. A multivariable logistic regression was used to examine factors associated with any support for SFPs. We report odds ratios and 95% confidence intervals (CI). Results Support for any SFP was 99.3% ,99.4%, 99.8%, and 99.8% in Kenya, Uganda, Cameroon and Nigeria, respectively. In the pooled data, support for SFPs ranged from 64.4% in restaurants to 98.8% in worship places. Adjusting for covariates, support for SFPs was significantly increased in participants who were aware of SHS harm, believed smoking causes serious illness, lived in homes where smoking is restricted, lived in smoke-free homes, resided in countries where three to five public places were completely smoke-free, and those aged 15-44 years. Conclusions The results suggest that support for SFPs increases as the number of smoke-free public places in a country increases. Implementing complete SFPs as described in the WHO FCTC in the SSA countries will likely succeed due to the prevailing high support for these policies.

Background Smoke-free policy is associated with smoking reduction; however, it is unknown if the reduction in smoking intensity occurs across the stages of smoking cessation, and there is paucity of literature on the relationship between home smoking rule and smoking intensity in low- and middle-income countries (LMICs). The aim of this study was to conduct a cross-country evaluation of the relationship between home smoking rule and smoking intensity among smokers in different stages of smoking cessation. Methods Data from 39,204 current smokers from the Global Adult Survey (GATS), 2009-2012 from 17 LMICs were analyzed. Weighted multiple linear regression analyses were conducted using the log of smoking intensity as the outcome variable with home smoking rule as the main independent variable. Adjusted regression coefficients (β) with associated 95% confidence intervals (CI) were estimated. Results Overall, the average smoking intensity was approximately 15, 14, and 13 for home smoking allowed, smoking restriction and smoke-free rules, respectively. There was a 12.7% (95% CI=7.6%-17.8%) and a 22.5% (95% CI=17.1%-28.0%) reduction in smoking intensity among adults in precontemplation from homes with smoking restriction and smoke-free rules, respectively. Among adults in contemplation, smoking restriction and smoke-free rules were associated with a 21.5% (95% CI=6.0%-36.9%) and an 18.6% (95% CI=9.0%-28.2%) reduction in smoking intensity, respectively. For adults in preparation, smoke-free rule was associated with a 19.4% (95% CI=3.9%-34.9%) reduction in smoking intensity. Conclusions Smoke-free homes are associated with a significant reduction in smoking intensity across the first three stages of the transtheoretical model. This suggests that, banning public smoking may have added benefit by reducing smoking intensity, since evidence suggests that people who work in smoke-free environments are more likely to live in smoke-free homes.

Background The psychological and physiological addictive nature of tobacco smoking makes it difficult for some smokers to quit without assistance. Tobacco cessation and utilization of cessation assistance rates are low in low-and-middle income countries (LMICs). It is not clear if health care provider tobacco screening and quit advice promote utilization of assistance to quit tobacco.This study examined the relationship between health care provider intervention and utilization of cessation assistance in 12 LMICs. Methods Data from 13967 participants of the Global Adults Tobacco Survey (GATS) in 12 LMICs were analyzed. Outcome variables were utilization of counseling/cessation clinic, prescription medication, quit line and any cessation assistance. Health care provider intervention ('no intervention', 'tobacco screening', 'quit advice') was the independent variable. Four multiple logistic regression models were fit to evaluate the relationship between the independent variable and each outcome, adjusting for covariates. All analyses were conducted using SAS version 9.4. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated. Results Approximately 52%, 8%, and 40% of participants received no intervention, tobacco screening, and advice to quit, respectively. Overall, 0.4%, 1.9%, 3.0% and 4.5% used quit line, counseling/cessation clinic, prescription medication, and any cessation assistance, respectively. Compared to no intervention, quit advice was associated with increased utilization of counseling/cessation clinic (OR=4.41, 95% CI=3.2-6.1), prescription medication (OR=1.67, 95% CI=1.2-2.3) and any assistance (OR=2.80, 95% CI=2.2-3.6). Conclusions A comprehensive tobacco control program, with frequent tobacco screening and quit advice by health care providers may improve utilization of cessation assistance in LMICs.

Obesity and type 2 diabetes (T2D) are comorbidities with cancer which may be partially due to shared genetic variants. Genetic variants in the ankyrin repeat and sterile alpha motif domain containing 1B (ANKS1B) gene may play a role in cancer, adiposity, body mass index (BMI), and body weight. However, few studies focused on the associations of ANKS1B with obesity and T2D. We examined genetic associations of 272 single nucleotide polymorphisms (SNPs) within the ANKS1B with the cancer (any diagnosed cancer omitting minor skin cancer), obesity and T2D using the Marshfield sample (716 individuals with cancers, 1442 individuals with obesity, and 878 individuals with T2D). The Health Aging and Body Composition (Health ABC) sample (305 obese and 1336 controls) was used for replication. Multiple logistic regression analysis was performed using the PLINK software. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. We identified 25 SNPs within the ANKS1B gene associated with cancer, 34 SNPs associated with obesity, and 12 SNPs associated with T2D (p < 0.05). The most significant SNPs associated with cancer, T2D, and obesity were rs2373013 (p = 2.21 × 10-4), rs10860548 (p = 1.92 × 10-3), and rs7139028 (p = 1.94 × 10-6), respectively. Interestingly, rs3759214 was identified for both cancer and T2D (p = 0.0161 and 0.044, respectively). Furthermore, seven SNPs were associated with both cancer and obesity (top SNP rs2372719 with p = 0.0161 and 0.0206, respectively); six SNPs were associated with both T2D and obesity (top SNP rs7139028 with p = 0.0231 and 1.94 × 10-6, respectively). In the Health ABC sample, 18 SNPs were associated with obesity, 5 of which were associated with cancer in the Marshfield sample. In addition, three SNPs (rs616804, rs7295102, and rs201421) were associated with obesity in meta-analysis using both samples. These findings provide evidence of common genetic variants in the ANKS1B gene influencing the risk of cancer, obesity, and T2D and will serve as a resource for replication in other populations.

This article focuses on deepening the understanding of the factors affecting migrant students' integration in Ghana's educational system. Research on migrant education has primarily centred on northern destination countries. Using the case of West African migrant children in a multiethnic and multilingual Ghanaian setting, the article examines the complex and interplaying factors affecting migrant students' integration into Ghanaian schools. Analysis from 40 semi-structured interviews with teachers and principals drawn from 30 schools offers insights into the challenges faced by schools in trying to help migrant students succeed. The study offers practical insights into the advantages of having teachers with a migrant background, especially the extent to which they use their intercultural competencies in helping migrant students overcome school-related challenges. While the fieldwork was carried out in Ghana, the implications are also of interest to other jurisdictions where schools are faced with migration-related diversity.

This article examines the factors affecting the inclusion of migrant students and how they exercise agency in response to the challenges that impede their inclusion within the Ghanaian education system. We draw on agency and inclusion theories in the analysis of interviews and observation data from 68 migrant students across 30 schools. The findings show the negative impact of language, exploitation, labeling, and teasing on migrant students in the absence of inclusive structures. This article brings to the fore the lack of inclusion for migrant students at the basic school level in Ghana and its negative ramifications on the academic achievement of not just migrant students but all students. The study highlights how migrant students demonstrate relational agency in their preference for friendships with people from similar backgrounds in overcoming challenges in school. Our findings contribute to studies on migration and education by addressing some of the challenges and possibilities of comparative and international education in "postcolonial" Africa. [ABSTRACT FROM AUTHOR]