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Abstract Background The World Health Organization (WHO) has indicated that the absence of prison health poses a threat to public health, making it important to safeguard access to quality healthcare for incarcerated populations. Although several studies have explored the quality of care in prisons, there is a dearth of empirical evidence on the perspectives of incarcerated individuals. This study investigated incarcerated individuals’ perspectives and opinions on the general healthcare services in Ghanaian prisons. Methods Utilizing a qualitative approach, focus group discussions were conducted with 51 incarcerated individuals in five prisons sited in the Northern, Middle and Southern zones of Ghana. Thematic analysis following the tradition of Braun and Clarke was conducted. Four of the six constructs of the WHO Health Systems Framework – service delivery, health workforce, access to essential medicines, and leadership and guidance – were applied deductively to organise the data into themes and subthemes. Results Four themes were generated from the analysis: “Health service delivery”, “Health workforce in prisons”, “Access to essential medicines” and “Leadership; regulating healthcare services”. Participants rated health services in prisons as below average compared to those available to the general population. The use of nurses as prescribers in prison infirmaries, though consistent with Ghana Health Service policy, seems to negatively influence prisoners’ perceptions of the quality of the health workforce in prisons. Lack of basic equipment and essential medications at the infirmary for common endemic conditions such as malaria coupled with the bureaucratic processes required to access care outside of the prison also negatively affected incarcerated individuals’ perceptions of the quality of health care. Conclusions Incarcerated individuals perceived that the quality of health services provided in prisons was inferior to that provided in the general population. Addressing challenges associated with the unavailability of essential drugs and equipment, improving the number of health staff, and addressing bottlenecks in accessing urgent care will enhance the experiences of incarcerated populations on the quality of care given.

This art-based research explored the sculptural potential of using chrome tanned leather to merge plant forms with materials culture. Chrome tanned leather was selected as the medium for its flexible yet durable qualities that allow it to be manipulated into organic shapes reminiscent of botanicals. A series of sculptural works were created using varieties of chrome tanned leather offcuts that were either stitched, glued or tucked over metal pipes, wood or plastic tube armatures. These armatures were then curled, spiralled or formed into nodule shaped components evoking leaves, vines, roots and pods. The works aimed to blur boundaries between the natural and industrial by incorporating the distinctive patina and textures of chrome tanned leather, a material intrinsically tied to industry and manufacturing. Through an iterative process, techniques for shaping, assembling and finishing the leather components were developed. Finishing techniques such as tooling, staining and distressing were employed to enhance botanical details and accentuate the unique properties of the leather. The research found that chrome tanned leather lends itself well to organic sculptural forms and allowed an imaginative merging of plant inspirations with an industrially produced material. By flexing the material past its functional limits, a hybrid language was discovered that challenges perceptions of what leather can signify as an artistic medium. The research contributes to interrogating relationships between nature, culture and materials.

Este trabalho teve o objetivo de comparar os processos de fiscalização presencial e remota dos sistemas de abastecimento de água e de esgotamento sanitário de Minas Gerais, realizados pela Agência Reguladora de Serviços de Abastecimento de Água de Esgotamento Sanitário do Estado de Minas Gerais (Arsae-MG). A fiscalização remota começou a ser utilizada na Arsae-MG em 2019, devido às medidas de prevenção ao contágio da covid-19. No período analisado em 2019, foram fiscalizados 51 municípios e elaborados 91 relatórios, enquanto que em 2020 foram fiscalizados 52 municípios e elaborados 94 relatórios. Os dados apontam que a fiscalização remota apresentou maior produtividade na elaboração de relatórios e redução no tempo de atendimento às demandas recebidas. No entanto, os dados indicam complexidade da análise operacional e dificuldade na obtenção de informações. Dessa forma, o estudo observou potencialidades da fiscalização remota, indicando que as metodologias adotadas durante o período pandêmico podem ser utilizadas no contexto do fortalecimento da regulação em saneamento básico.

Abstract Building caring communities is fundamental to achieving a community-based approach to mental health. Understanding how communities perceive mental illness provides critical insight into fostering mental health awareness and care. We explored the perceptions of mental illness among members of two urban poor communities in Accra, Ghana. Qualitative data were collected from 77 participants through key informant interviews, focus group discussions, and situated conversations. Using theory-driven thematic analysis based on social representations theory, findings revealed cognitive-emotional representations of mental illness. The communities demonstrated high awareness of the multilevel factors contributing to mental illness risk and experiences, drawing on five sources of knowledge: embodied, common sense, medical, cultural, and religious. Mental illness representations informed the classification and legitimization of mental illness based on the severity of conditions and the identity of sufferers. These findings provide valuable insights for planning community mental health interventions that address both social and institutional care needs.

Abstract Background Although postgraduate studies have been shown to be associated with stressful experiences, students reading programmes through the distance and e-learning mode experience greater levels of stress due to several reasons. These stressful encounters might be heightened in female married postgraduates on distance education programmes due to other family-work-related engagements. This study investigated the stress-related experiences and intentions to quit studies among female married students on a distance education programme in Ghana. Methods Using a sequential explanatory mixed-methods design, 164 married postgraduate distance education students were sampled to participate by responding to a questionnaire. Follow-up interviews were conducted with 10 participants to offer insight into the quantitative findings. Quantitative data were analysed using descriptive statistics, including frequency and percentages, while the qualitative data were thematically analysed. Results Stress was prevalent among the female married distance education students, with the majority having intentions of quitting their studies. The stressors identified ranged from personal (i.e., work and family demands) to institutional ones (i.e., academic load, unresolved complaints and high financial demands from the programme). Conclusions Key findings suggest that female married postgraduate distance education students perform multiple roles as full-time employees with family and academic demands that can negatively impact their health and academic work. Implications and recommendations of the findings are discussed.

Background: Reference centiles describing gross motor function in children with cerebral palsy (CP) are used in clinical and research settings to guide treatments and evaluate interventions. However, it is unknown how existing references generalize to populations in novel settings. Aims: The aim of this study is to evaluate the cross-sectional and longitudinal performance of three reference centiles to describe the motor function of children with CP aged 2–12 years at a large urban US pediatric hospital through a retrospective observational study. Methods: and Procedures: We assessed cross-sectional performance by ranking our clinical population by quartile distributions described by the references. We assessed longitudinal performance by analyzing the distribution of prediction errors and correlations between predictions and observed scores. Outcomes and Results: For cross-sectional distribution, the reference centiles by Hanna more closely described our population than those by Duran. For longitudinal progression, prediction error was less than 6 GMFM points for most records at 24-, 12-, and 6-month time scales for all three sets of reference centiles, but higher at a 48-month time scale. Prediction errors increased at younger ages and higher motor ability. Conclusions and implications: Despite differences in cross-sectional performance, all three reference centiles achieved similar longitudinal performance and are sufficient for most clinical and research uses. Caution should be used when applying these curves to locations with different standards of care.

Introduction Early work-related experiences of newly hired employees can have important implications for their work performance over time and their future health and well-being trajectories. In health care work, such outcomes may hold implications for the services delivered and the patients whose lives depend on them. Objective(s) This study was conducted to explore the work-related experiences of newly hired hospital nurses in Ghana. Methods Using qualitative methods, thirty-six (36) newly hired nurses in three (3) hospitals in the Eastern Region of Ghana were purposively sampled and interviewed. Thematic network analyses were applied to the data collected. Results Five main themes emerged which summarized the experiences of the nurses. The themes indicated that newly hired nurses experienced the nursing profession as stressful and yet fulfilling, different from their preentry expectations with multiple sources of stressors and resources. Religion and faith, family support, and a perceived lack of suitable alternative sources of income emerged as the main motivators of the intention to stay. Conclusion The findings suggest a highly stressful and quite unpredictable work environment for newly hired nurses. Despite this, they are determined to stay on the job. Employee assistance programs that have specialized components targeted at providing emotional and psychosocial assistance to newly hired nurses are recommended.

Objectives: This study explored the prevalence and predictors of alcohol and cannabis co-use among 9263 Filipino adolescents, using data from the 2019 Global School-based Student Health Survey (GSHS). Methods: We conducted a cross-sectional secondary analysis of the GSHS, targeting adolescents aged 13-17 years and excluding cases with incomplete data on alcohol and cannabis use. Our analysis employed the bivariate chi-square test of independence and multivariable logistic regression using Stata version 18 to identify significant predictors of co-use, with a p-value threshold set at 0.05. Results: The weighted prevalence of co-users was 4.2% (95% confidence interval [CI], 3.4 to 5.3). Significant predictors included male sex (adjusted odds ratio [aOR], 4.50; 95% CI, 3.31 to 6.10; p

Abstract Introduction The empirical link between digital health literacy (DHL) and sense of coherence (SoC) has been extensively discussed in the literature. Yet, there seems to be limited evidence regarding the roles of age and depression status in the link between DHL and SoC of adolescents and young adults (AYAs), especially during the COVID-19 crises. This study investigated the interplay between age, DHL, SoC and psychological distress. Particularly, the study examined the following: (1) relationship between DHL and SoC, (2) moderating role of age in the relationship between DHL and SoC as well as (3) moderating role of depression in the relationship between DHL and SoC. Methods The study used a cross-sectional survey to select 998 AYAs in secondary schools in Northern Ghana through questionnaire administration using a stratified sampling procedure. Results Findings reveal that age was positively and significantly related to DHL and SoC. However, age failed to moderate the relationship between DHL and SoC. With the same level of DHL, students who exhibited depressive symptoms compared to those without, had lower levels of SoC regardless of their age. Conclusions Although AYAs’ DHL are likely to differ across different age brackets, this gap does not affect their rates of SoC and depression. Nonetheless, there is a need to improve DHL through regular standard training on internet search using basic audio-visual materials like laptops, smart phones, tablets, and lab computers for adolescent and young adult students. Additionally, school authorities, in collaboration with other stakeholders should develop student-centred cognitive-behavioural strategies aimed at reducing depressive symptoms in secondary school students who are at risk of depression in Northern Ghana.

Abstract Background Antimicrobial resistance poses a public health threat for the treatment of community-acquired urinary tract infections. This study determined the susceptibility patterns of uropathogens and associated risk factors among outpatients diagnosed with urinary tract infections at the Kanifing General Hospital in the Gambia. Methods A cross-sectional analytic study was conducted among patients with suspected urinary tract infections at Kanifing General Hospital from March to May 2021. Data on socio-demographic and other risk factors were collected from the study participants using a structured pre-tested questionnaire. Mid-stream urine samples were collected, and bacteria identification and antimicrobial susceptibility testing done using standard microbiological methods. Descriptive and inferential statistical analysis were done to determine factors associated with urinary tract infection at 95% confidence level and a p -value

IntroductionAlthough the relationship between subjective social status and depression in university students has been well-established, this association could be seen as a spurious one. Previous studies have shown that key variables like financial resources and age could play key roles in explaining the variances in social status and mental health outcomes. In this research, we assessed the complex interrelationships between subjective social status, financial resources at their disposal and depressive symptoms among university students within their young and middle adulthood stages.MethodsA cross-sectional survey was conducted in a university in Ghana to sample 1134 university students through accidental sampling. The McArthur Scale and WHO-5 Well-being measure were used for the data collection.ResultsThe results revealed that higher levels of subjective social status were associated with lower levels of depression. It was further found that the interaction between students’ pocket money and age played unique roles in the relationship between subjective social status and depression.ConclusionThe study findings call on stakeholders in education to explore funding opportunities and to examine ways of empowering parents (financially) to adequately support the students. Health educationists and promoters, including psychologists, school counsellors and parents could compliment these efforts by helping to train and empower students through self-regulation or management skills to help improve their well-being. Continuous efforts are required to improve the financial status and mental health of students.

BackgroundDiabetes mellitus is a growing public health emergency with prevalence in sub-Sahara Africa expected to experience the highest increase by 2045. Glycemic control is central to diabetes management, but it is influenced by various factors. This study determines the level of glycemic control and the associated individual factors among type 2 diabetes mellitus (T2DM) patients.MethodsA cross-sectional descriptive study was conducted at the Shai-Osudoku District Hospital from 9th November to 15th December 2022. A structured questionnaire was used to collect data on socio-demographic characteristics, lifestyle modifications, co-morbidities, adherence to medication and diet regimens and duration of diabetes. Anthropometric and glycated hemoglobin (HbA1c) measurements were taken. Chi-squared and multivariate logistic regression analyses were carried out to determine factors associated with glycemic control at 95% confidence levels.ResultsA total of 227 patients participated in this study. The majority of the participants were females (77.97%) and the mean (+SD) age was 60.76 + 12.12 years. Good glycemic control (HbA1c < 7%) among the participants was 38.77% (n = 88) and the median HbA1c was 7.5% (IQR: 6.5% to 9.4%). Significant factors associated with good glycemic control were eating healthy meals (AOR: 4.78, 95% CI: 1.65, 13.88: p = 0.004), oral hypoglycemic agents alone (AOR: 15.71, 95% CI: 1.90, 129.44: p = 0.010) and those with previously good glycemic control (AOR: 4.27, 95% CI: 2.16, 8.43: ConclusionThis study showed low levels of good glycemic control among T2DM patients at the primary care level in Ghana. Healthy eating, oral hypoglycemic agents and those with previously normal HbA1c were associated with glycemic control.

IntroductionLimited evidence compares short-course radiotherapy (SCRT) and long-course chemoradiotherapy (LCCRT), both of which are followed by consolidative chemotherapy before radical rectal surgery. We conducted a retrospective cohort study to assess treatment response, survival outcomes, and toxicity in patients with locally advanced rectal cancer.Materials and methodsPatients (cT3–4 and/or N+) treated with SCRT or LCCRT, consolidative chemotherapy, or total mesorectal excision between 2013 and 2021 were identified. the cause-specific cumulative incidence of disease-related treatment failure, locoregional recurrence, distant metastases, and overall survival were evaluated using flexible parametric competing risk analysis and Kaplan–Meier methods, adjusted for treatment regimens and clinicopathological factors. A pathological complete response (pCR), tumor downstaging, and toxicity have been reported.ResultsAmong the 144 patients, 115 (80%) underwent curative rectal surgery. The LCCRT and SCRT groups achieved pCR in 10 (18%) and seven (12%) patients, respectively (odds ratio, 1.68; 95% confidence interval [CI], 0.59–4.78). The adjusted cause-specific hazard ratio for disease-related treatment failure with LCCRT versus SCRT was 0.26 (95% CI, 0.08–0.87). Three-year cumulative probability of disease-related treatment failure was 10.0% and 25.6% for LCCRT and SCRT, respectively. No significant differences in T-downstaging, N-downstaging, significant pathologic downstaging (ypT0-2N0), locoregional failure, distant metastasis, or overall survival were found. Late rectal toxicity occurred in 10 (15%) LCCRT and two (3%) SCRT patients, respectively.ConclusionLCCRT with consolidative chemotherapy demonstrated improved disease-related treatment failure compared with SCRT, despite higher late rectal toxicity. Further research is needed to assess the long-term oncologic outcomes and toxicity.

Abstract Background With the growing concern and interest in the mental health and well-being of adolescents and young adults (AYAs) including those in schools, many studies have explored the bivariate relationship between subjective social status (SSS) and AYAs’ subjective well-being (SWB). Acknowledging the spurious nature of this relationship, we assessed the relationship between SSS and SWB of AYAs in schools within Northern Ghana, focusing on the conditional indirect effect of monetary resource (MR) and sense of coherence (SoC). Methods We utilised a cross-sectional descriptive design to survey 1096 senior high school students from two regions in Ghana’s Northern zone through a stratified sampling method. A questionnaire consisting of a number of calibrated standardized measures was used for the data collection. The data were processed using SPSS and PROCESS Macro and analysed using Hayes’ conditional process analysis. Results The results revealed that students’ MR significantly moderated the relationships between SSS and SoC as well as SSS and SWB. A significant moderated mediation effect of MR and SoC on the relationship between SSS and SWB was found. Particularly, AYAs who reported higher levels of MRl, SSS and SoC reported a better SWB. Conclusion The findings underscore the relevance of providing sufficient financial support for students in secondary schools in Ghana; thus, highlighting the sheer relevance of economic capital as a leading factor for better well-being. The findings also place much emphasis on building students’ personal coping mechanisms as a key variable in explaining how the students’ SSS and MR translate into having positive mental health outcomes.

Abstract Background Challenges such as stigma and loneliness may increase vulnerability to Human Immunodeficiency Virus (HIV) infection and negatively affect the quality of life of people living with HIV (PLHIV) despite the massive investment in access to antiretroviral therapy. This study aims to determine the level of loneliness and stigma and explore the coping resources employed by PLHIV in a resource-constrained setting. Methods This was a sequential mixed methods study conducted at the Cape Coast Teaching Hospital (CCTH) in Ghana between May and December 2021. A total of 395 adults were selected using a simple random sampling technique. HIV Stigma Scale and UCLA Loneliness Scale were used to collect quantitative data. A purposive sampling technique was applied to recruit 18 participants to saturation using a semi-structured interview guide. SPSS version 21 was used for the statistical analysis of the quantitative data. HIV-related loneliness and stigma levels were estimated, and bivariate and multivariable logistic regression were used to evaluate associated factors using a statistical significance of p-value (p

Introducción: el asesoramiento genético en espina bífida se centra en la identificación de los factores de riesgo y la probabilidad de tener un hijo con la enfermedad. A pesar de no ser hereditaria, en el sentido estricto de la palabra, existe un mayor riesgo de tener un segundo hijo afectado si se ha tenido anteriormente otro afectado de esta malformación. Objetivo: describir la patología y genética de las malformaciones combinadas en la medula espinal y la columna vertebral a causa de un defecto del cierre del tubo neural y sus cubiertas. Métodos: se realizó una revisión bibliográfica en donde se recolectó información de publicaciones, revistas científicas indexadas por medio del buscador en PubMed, Scielo y Google Scholar, usando las palabras claves de investigación. Desarrollo: la información recopilada evidencia que la enzima 5,10-Metil-tetrahidrofolato reductasa transforma el 5,10–Metil-tetrahidrofolato, en 5-Metil-tetrahidrofolato, el cual es un intermediario en la conversión del metabolismo de la homocisteína a metionina. Los polimorfismos en la MTHFR han sido relacionados con un aumento en el riesgo de padecer defectos del cierre del tubo neural, por lo que estos son una patología considerada herencia multifactorial. Conclusiones: en base a la información recopilada de las revistas científicas se determinó que es necesario para las mujeres embarazadas realizarse exámenes de rutina para lograr identificar temprano los defectos en el tubo neural, y así ayudar en la intervención terapéutica temprana y asesoramiento genético.

Available evidence suggests that managing the complexities of health information and the behaviours associated with information search call for adequate digital health literacy (DHL). Students’ ability to judge the relevance of health-related information largely affects their level of satisfaction with the information. The study assessed DHL, information searching behaviours, and the link between DHL and COVID-19 information. The cross-sectional study utilised the multi-stage sampling technique in the selection of 1392 secondary school students in the Northern Region of Ghana. A DHL questionnaire was used to survey the students. The students displayed inadequate level of DHL concerning the relevance of online information. Predictably, most of them had not searched for information in the past four weeks prior to the data collection. Search engine portals, websites of public bodies, and news portals were the predominant platforms used for information search. Majority of the participants reported not being satisfied with the information they found on the internet about coronavirus. A significant association between DHL levels and utilization of COVID-19 information platforms was identified, such that students who showed high levels of DHL used platforms which had reviewed/professional content compared to those with low levels of DHL. Advanced DHL may serve as a disincentive to the consumption of information from sources which are not credible. There is an urgent call for collaboration among the ministries/agencies responsible for education and health, telecommunication networks, and civil society organisations for interventions aimed at integrating DHL in schools..

Introduction: Adjuvant chemoradiation therapy (CRT) in gastric cancer inevitably results in an unintentional spleen radiation dose. We aimed to determine the association between the spleen radiation dose and the observed severity of lymphopenia which may affect the clinical outcomes (survival time and infection risk). Methods: Patients who received adjuvant CRT for gastric cancer between January 2015 and December 2020 were analyzed. The splenic dose-volume histogram (DVH) parameters were reported as mean splenic dose (MSD) and percentage of splenic volume receiving at least × Gray (Gy). Peripheral blood counts were recorded pre- and post-CRT. The development of severe (Common Terminology Criteria for Adverse Events, version 5.0, grade ≥ 3) post-CRT lymphopenia (absolute lymphocyte count [ALC] 40 Gy (odds ratio [OR], 1.13; 95 % confidence interval [CI], 1.01–1.26; P = 0.041), sex (OR for male to female, 0.25; 95 % CI, 0.09–0.70; P = 0.008), and baseline absolute neutrophil count (OR per 1 unit increase, 1.61; 95 % CI, 1.02–2.58; P = 0.040) were associated with the development of severe post-CRT lymphopenia, which was a risk factor for poorer OS (hazard ratio [HR] = 2.47; 95 % CI, 1.24–4.92; P = 0.010) and RFS (HR = 2.27; 95 % CI, 1.16–4.46; P = 0.017). The cumulative incidence of infections was higher among severe post-CRT lymphopenia patients (2.53, 95 % CI, 1.03–6.23, P = 0.043). Conclusion: High splenic radiation doses increase the odds of severe post-CRT lymphopenia, an independent predictor of lower OS and higher risks of recurrence and infections in gastric cancer patients receiving adjuvant CRT. Therefore, optimizing the splenic DVH parameters may decrease the risk of severe post-CRT lymphopenia.

A significant number of refugees and asylum seekers live in Kampala as opposed to the rural settlement areas. However, what is less known is the extent of destination substitution among these refugees and factors associated with changes in destination. Using a survey of 479 refugees from eight nationalities, this study examined the influences of social networks on destination substitution among refugees in Kampala. It was found that more than half of the refugees substituted their initially intended destination with Kampala. Refugees with social network ties in Kampala are likely to substitute their preferred destination for Kampala compared to those who do not have social network ties in Kampala. The study contributes to the literature on destination choices and social networks by showing that the refugees have destination preferences, but these preferences can be constrained by prevailing circumstances. Facilitated by social networks with alternative destinations, refugees may substitute their preferred destinations with a proxy destination in cities in neighboring countries.

Abstract The incidence of the COVID-19 pandemic heightened the levels of stress of not only students but for teachers, particularly physical education (PE) teachers. The reference to PE teachers is due to their role in engaging students in practical in-person lessons after the resumption of school. Previous literature has revealed that PE teachers exhibit significantly increased levels of anxiety, fear, tension and uncertainty that they could contract the virus during these lessons. Given this scenario, there is a growing need for identifying a suitable coping scale which can accurately measure coping strategies employed these teachers. This research assessed the psychometric properties of the 16-item coping inventory using a multidimensional item response theory approach. The study surveyed 484 PE teachers through the convenience sampling technique, after which the cultural mix coping instrument was administered to them. The findings of this study confirmed the 4-factor structure of the coping measure which is consistent with the original measure. Results further revealed that a modified 14-item compared to the original 16-item coping inventory was optimal in measuring coping strategies among PE teachers. The study concluded that the 14-item cultural mix coping inventory was appropriate, applicable and reproducible to the PE teachers’ population.

Though several studies have established the effect of gender and age on the sense of coherence (SoC) and subjective well-being (SWB) among diverse populations, findings have been varied and inconclusive. These inconsistencies have been attributed to the differences in sample characteristics, methodological and cultural disparities. Thus, the present study assessed the following: (1) gender and age effect on SoC, (2) gender and age effect on SWB, and (3) moderating roles of gender and age in the link between SoC and SWB. Through a stratified sampling technique, 724 selected high school students from secondary schools in Northern Ghana completed the World Health Organization-5 Well-Being and Sense of Coherence instruments. The results showed that female students exhibited higher levels of SoC compared to their male counterparts. Whereas younger male and female students showed no significant difference in SWB levels, older female students, compared to older males, exhibited high levels of SWB. Age significantly moderated the relationship between SoC and SWB. With the same level of SoC, younger students were more likely to exhibit higher SWB compared to older ones. The findings call for sustainable gender- and age-based interventions because students subjectively develop SoC mechanisms for improving their well-being.

Cognitive and behavioural coping strategies are relevant approaches for individuals such as university students as they attempt to manage stressful situations such as the COVID-19 pandemic and other academic-related pursuits within their social milieu. Although several instruments have been developed to measure the coping situations of such individuals, few studies have developed students’ specific coping inventories, with none in the African context. Of the few that exist, a culturally dominant code such as religion has been ignored by many scholars in the development of coping measures. In this study, a cultural-mix coping inventory was developed and validated using university students in Ghana. Two distinct interrelated objectives were addressed. First, the structure of the coping inventory was identified through principal component analysis. Further confirmatory factor as well as reliability analyses were then performed to provide evidence of construct validity of the scale. The outcome of the study revealed a sixteen-item psychometrically sound coping inventory with a four-dimensional structure, namely, active coping, religious coping, behaviour disengagement, and emotional support. The implications of the results are further discussed in detail.

The outbreak of COVID-19 led to the swift migration to alternate instructional delivery models and pedagogical practices in educational institutions. This study examined the perceived safety of the learning environment and associated anxiety factors among physical education students amidst COVID-19. Using a cross-sectional design, a sample of 638 students drawn purposively and conveniently from a public university in Ghana completed a self-developed questionnaire. Frequency counts, percentages, and ordered logistic regression were used to analyze the data. Findings of the study showed that students perceived the practical lesson environment as unsafe, with self-reported moderate to high levels of anxiety during their practical lessons. The ordered logistic regression results revealed that varied factors such as age, COVID-19 information platforms, certainty about personal safety, and adequacy of preparation to manage COVID-19 cases were associated with anxiety. The study concluded that an unsafe practical physical education learning environment increases the anxiety levels of students. Academic departments/units should provide periodic interventions (e.g., positive self-talk, mental rehearsal, cognitive restructuring) and counseling services for students amidst the ongoing pandemic to help moderate situational-specific anxiety. In addition, key to the management of students’ anxiety is the provision of a safe and supportive school environment, including the provision of adequate personal protective equipment for practical lessons by school authorities.

Abstract Background The World Health Organisation’s efforts to eliminate cervical cancer by 2030 with a target of 70% screening coverage using a high-performance test demand that women increase participation in screening. Factors that impact uptake of screening must therefore be identified and bottlenecks addressed, especially in lower- and middle-income countries where cervical cancer incidence remains high. This study investigated Muslim women, participation in, intention to engage in and self-efficacy about cervical cancer screening. Methods An analytical cross-sectional study was conducted among Muslim women aged 18 years and above in the Cape Coast Metropolis of Ghana using an interviewer-administered questionnaire. Data were analysed using appropriate descriptive statistics, Chi-square test, point biserial correlation and binary logistic regression analysis. Results The mean age of participants was approximately 31 years (M = 30.9, SD = 10.4). Out of the 431 women, 21 (4.9%) had ever participated in cervical cancer screening. Participants demonstrated very low knowledge about cervical cancer and screening, with a mean knowledge score of 3.68 out of 15. Knowledge about cervical cancer was associated with increased odds of participating in cervical cancer screening (aOR = 1.32, 95%CI 1.11, 1.56). Concerns about similarity with health provider in terms of gender and faith was associated with decreased odds of cervical cancer screening self-efficacy (aOR = 0.81, 95% CI 0.67). Islamic modesty (aOR = 0.88, 95%CI 0.81, 0.96) was associated with decreased self-efficacy about seeking cervical cancer screening, whereas attitude (aOR = 1.32, 95%CI 1.14, 1.53) was significantly associated with increased self-efficacy about seeking cervical cancer screening. Again, Islamic modesty (aOR = 0.88, 95%CI 0.80, 0.97) was associated with decreased intention to participate in screening, whereas attitude (aOR = 1.42, 95%CI 1.20, 1.68) was associated with increased intention to participate in screening. Conclusions There are gaps in knowledge of cervical cancer among Muslim women in this study as less than 5% had participated in screening. A positive attitude was found to influence intention to screen and actual participation in screening programmes. Islamic modesty and commitment to the Islamic faith decreased intention and self-efficacy regarding screening. Therefore, comprehensive and appropriate socio-cultural and religion-specific interventions aimed at addressing the barriers to screening are important in improving uptake among Muslim women.

IntroductionCapecitabine, irinotecan, and panitumumab (CAPIRI-P) is a controversial regimen for metastatic colorectal cancer, with concerns regarding the efficacy and toxicity. However, its toxicity profile has been improved with dose reduction, and concerns regarding efficacy have been extrapolated from other trials. This retrospective study reports the real-world effectiveness and safety of modified CAPIRI-P (mCAPIRI-P).Material and methodsAdvanced colorectal cancer patients receiving mCAPIPI-P in the first-line setting between July 2019 and December 2021 were analyzed. The progression-free survival on treatment (PFSOT) and overall survival (OS) were estimated using the Kaplan–Meier method, and the association with clinical and disease factors was analyzed using the Cox regression model. Serial changes in carcinoembryonic antigen (CEA) level and treatment toxicity were also evaluated.ResultsA total of 106 patients were included, of whom 97 (92%) and 31 (29%) had left-sided primary and unresectable liver-only disease, respectively. The median PFSOT and OS were 15.4 (95% CI 12.5–18.3) and 25.5 (95% CI 17.6–33.4) months, respectively. Sixteen (51.6%) and 10 (32.3%) liver-only disease patients underwent secondary liver treatment and R0 resection, respectively. In multivariable Cox regression, CEA responders (PFSOT: HR 0.53) and CEA normalization (PFSOT: HR 0.27; OS: HR 0.28) were independent favorable prognostic factors for PFSOT and OS. Grade ≥3 toxicity rate was 43%, mainly related to uncomplicated hematological toxicities.ConclusionThe real-world data show that mCAPIRI-P is safe and effective as the first-line treatment regimen for RAS wild-type advanced colorectal cancer and warrants further study.

Abstract Background Oral health surveys aid in estimating the oral health of a population and provide a projection for future oral health care needs. We report the procedures and rationale of a survey carried out to assess the oral health status and risk factors for oral disease among adults in the Greater Accra Region (GAR) of Ghana. The objective was to provide prevalence estimates on dental diseases, oral health behaviour and risk factors, and to establish baseline epidemiological data on the population’s oral health for further research. Methods This was a population-based cross-sectional study of adults aged 25 years and above. A random, stratified two-stage sampling method was used to select participants from rural and urban communities in three types of districts (Metropolitan, Municipal, Ordinary). A semi- structured questionnaire was used to collect data on socio-demographic characteristics, oral health behaviours and risk factors for oral disease. Anthropometric data and a full-mouth clinical examination was carried out including: soft tissue assessment, tooth count, prosthodontic status, dental caries assessment and periodontal assessment. Results A total of 729 participants were included in the study with a mean age of 43.9 years (SD 14.6). Majority 425 (61.0%) were females. Though the metropolitan districts had more dental clinics and personnel, along with better health insurance coverage, they had a higher prevalence of missing teeth, retained roots, severe periodontitis and poorer oral health coverage. The findings also show some significant differences in disease prevalence, within the different localities and districts. Conclusions Availability and access to oral health services is not the most important determinant of good oral health outcomes in this region. We recommend exploring socio-behavioral and cultural factors as well. This study provides district level data to inform policy and guide further research.