Exploring Factors That Influence Sustainable Marriage In St. Francis College Of Education And St. Francis Demonstration Basic School Community, Hohoe

This study investigates measures that ensure sustainability of marriages and to find out the extent to which these measures contribute to stable marriages. The research is undertaken in St. Francis College of Education Community, Hohoe. A sample of 140 respondents made up of teaching and non-teaching staff was randomly selected to complete questionnaire asking them to indicate the extent to which identified indicators contribute to stability of their marriages. The raw data of 21 original factors were subjected to factor analysis to identify the factors that contribute most to marriage stability. The result of the study shows that Love, understanding, acceptance and respect for each other, commitment to the marriage are factors that ensure sustainable marriage. Keywords: Marriage, stability, divorce, husband, wife

An Epidemiological Model of Malaria at Techiman Municipality, Ghana

The study examined the prevalence of Malaria in the Techiman Municipality of Ghana. We used  model to analyze, model and predict the prevalence of Malaria disease in the municipality. The study is made up of two sections. An  model without the vital dynamics and an  with vital dynamics were used to explain the spread of the Malaria in the Techiman Municipality followed by the Fred Brauer simple treatment model ( ) to determine whether the treatment of malaria in the municipality is beneficial. The model has two equilibrium states: the disease-free equilibrium and the endemic equilibrium states respectively. The stability condition of each equilibrium point is discussed. The basic reproductive number  of Malaria without the vital dynamics is estimated to be  and the basic reproductive number  of Malaria with the vital dynamics is estimated to be in the Techiman Municipality. The basic reproductive numbers of the  model and the modified malaria model were also estimated to be  and  respectively. Our work shows that the reproductive number () of Malaria infection at Techiman Municipality is less than 1(). Our work also shows that malaria treatment is beneficial in the municipality. According to the results of this study whenever the transmission rate coefficient in any of the models is increased, , but when the transmission rate coefficient is reduced, . We recommend that Malaria control measures should be intensified in the municipality so as to decrease the rate of transmission. Keywords: SIRS model, Stability analysis, Equilibrium points, Mathematical model, Epidemiological model

Assisting Basic Six Pupils of Presbyterian Women’s College of Education Demonstration School, Aburi-Akuapem, To Discover the Product of Two Multi-Digit Multiplicands Using the Lattice

An action research was performed with the aim of solving problems involving two multi-digit multiplicands using the lattice to give pupils’ conceptual understanding of multiplication in basic six at the Presbyterian Women’s College of Education Demonstration School. Twenty-five pupils out of fifty (50) were selected using The simple random sampling technique from a combined class of Six ‘A’ and Six ‘B’ who have difficulties in answering questions under multiplication involving two multi-digit numbers, after writing a teacher made test (Pre-Test). The Pre- Test produced 16% pass mark as compared to the post-test which gave 88% pass mark after the intervention. The discovery method of teaching was used in the intervention procedure to find the multiplication of multi-digit numbers. Pupils were directed to use the lattice to perform activities which had the potential of developing their conceptual understanding of the topic. The data collected indicated that some pupils improved their understanding but some pupils needed more time to re-learn the subject. This research only presents some practical solutions proposed within the time available. Keywords: Action Research, Pre- Test, post-test, Multi-Digit Number

Application of Max-min Ant System in Modelling the Inspectional Tour of Main Sales Points of Ghacem In Ghana.

Ant colony optimization (ACO) has widely been applied to solve combinatorial optimization problems in recent years. There are few studies, however, on its convergence time, which re?ects how many iteration times ACO algorithms spend in converging to the optimal solution. This study aims at using a Max-Min Ant System (MMAS), which belongs to Ants Algorithm to obtain optimal tour of the Travelling Salesman Problem of Ghacem. The study considered a twelve city node graph (major sales point of Ghacem) with the nodes representing the twelve cities, and the edges representing the major roads linking the cities. Secondary data of the inter-city driving distances was obtained from the Ghana Highway Authority. The results showed that the objective of finding the minimum tour from the Symmetric Travelling Salesman Problem (STSP) model by using Max-Min Ants System (MMAS) Algorithm was successfully achieved. The optimal route of total cost distance was found to be 1873Km. Therefore, Ghacem could minimize the cost of transportation  as the  Directors of Ghacem Ghana go on a tour to check on the sales performance  of the twelve key Distributors in the  major sales points in Ghana, starting from Tema where the company’s Head office is sited. It is very prudent for the company to rely on MMAS model to reduce fuel cost in order to maximize profit. In doing so it go along way to increase the tax revenue of the state. Keywords: Max-Min Ants System (MMAS), Ant Colony Optimization (ACO), Algorithm, Travelling Salesman (TSP), Ghace

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A fractal–fractional model of Ebola with reinfection

In this article, we have studied the dynamics of the Ebola virus disease by means of fractional differentiation combined with a fractal dimension. It has been shown explicitly that the Ebola model is positively invariant. The fixed point theorem procedures check the solution’s existence and uniqueness to the model using the Mittag-Leffler kernel. The stability of the Ebola fractal–fractional model is studied using the Hyers–Ulam stable analysis. The numerical simulation for the trajectories of the proposed model is obtained using Lagrangian interpolation. Also, the numerical sensitivity analysis of the model is presented. For instance, a reduction in the rate of human-to-human contact results in a decline in the rate of infection, implying that the disease at a point will die out. Again, an increase in the loss of immunity rate to unity leads to a massive spread of the Ebola disease in the population. The findings in our work depict that we can achieve an Ebola-free state should the health sector give more education on maintaining a strong immune system and reducing human-to-human contact, especially during outbreaks of the Ebola disease, using measures like isolation and quarantine. Finally, using the fractal–fractional operator, we observed that any amount of memory variation and repetition in the outbreak of the disease influences the spread of the Ebola disease

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Management and Outcomes Following Surgery for Gastrointestinal Typhoid: An International, Prospective, Multicentre Cohort Study

Background: Gastrointestinal perforation is the most serious complication of typhoid fever, with a high disease burden in low-income countries. Reliable, prospective, contemporary surgical outcome data are scarce in these settings. This study aimed to investigate surgical outcomes following surgery for intestinal typhoid. Methods: Two multicentre, international prospective cohort studies of consecutive patients undergoing surgery for gastrointestinal typhoid perforation were conducted. Outcomes were measured at 30 days and included mortality, surgical site infection, organ space infection and reintervention rate. Multilevel logistic regression models were used to adjust for clinically plausible explanatory variables. Effect estimates are expressed as odds ratios (ORs) alongside their corresponding 95% confidence intervals. Results: A total of 88 patients across the GlobalSurg 1 and GlobalSurg 2 studies were included, from 11 countries. Children comprised 38.6% (34/88) of included patients. Most patients (87/88) had intestinal perforation. The 30-day mortality rate was 9.1% (8/88), which was higher in children (14.7 vs. 5.6%). Surgical site infection was common, at 67.0% (59/88). Organ site infection was common, with 10.2% of patients affected. An ASA grade of III and above was a strong predictor of 30-day post-operative mortality, at the univariable level and following adjustment for explanatory variables (OR 15.82, 95% CI 1.53–163.57, p = 0.021). Conclusions: With high mortality and complication rates, outcomes from surgery for intestinal typhoid remain poor. Future studies in this area should focus on sustainable interventions which can reduce perioperative morbidity. At a policy level, improving these outcomes will require both surgical and public health system advances