Ramadan fasting alters food patterns, dietary diversity and body weight among Ghanaian adolescents.

BACKGROUND: Ramadan is a monthlong fast for healthy adolescents and adult Muslims. The quality of foods eaten and eating patterns in Ramadan may be different from other months of the year. Food intake of adolescents is a concern as energy and nutrient requirements are higher and needed to support the growth spurt of this stage. The objective of the present study was to describe the food patterns, dietary diversity and body weight changes among adolescents during Ramadan. METHODS: A prospective cohort study design with four measurement points (baseline, midline, endline and post endline) was conducted among 366 adolescents in Junior High Schools. Food pattern was assessed with a food frequency questionnaire, a 24-h dietary recall was used to assess dietary diversity and body weight was measured using an electronic scale. A repeated measures ANOVA was used to compare changes in dietary diversity scores (DDS) and weight of pupils. RESULTS: Half of the pupils (50.3%) were female and average age was 15.9 ± 1.8 years. Pupils fasted for an average of 28.3 ± 4.0 days and 14.3 ± 0.5 h a day (dawn to dusk) during Ramadan. The number and types of dishes taken at meal times differed substantially between Ramadan periods and outside Ramadan. Consumption of vitamin A-rich fruits, other fruits, and milk and milk products increased markedly during Ramadan. However, fasting came with a reduction in consumption of foods from roots and tubers, legumes and nuts, and dark green leafy vegetables while other food groups remained unchanged. Mean DDS increased significantly during Ramadan (F (2.933, 1070.573) = 7.152, p < 0.001) while mean daily meal frequency decreased (F (2.936, 1071.623) = 51.653, p < 0.001). There was significant body weight loss (-1.5 kg (95% CI: -1.1 kg to -1.6 kg)) among adolescents (F (2.656, 958.95) = 304.90, p < 0.001). Weight loss was short-lived; regained one month after Ramadan. CONCLUSION: In this prospective cohort study among schooling Ghanaian adolescents who fast during Ramadan, fasting was characterised by marked changes in usual food patterns, increased dietary diversity and significant body weight loss

Dietary patterns and associated factors of schooling Ghanaian adolescents

Background: Assessment of single nutrients or foods does not normally reflect the diet of population groups. Dietary pattern analyses are useful in understanding the overall diet and its relationship with disease conditions. The objective of the present study was to determine the dietary patterns and associated factors among schooling adolescents in Northern Ghana. Methods: A cross-sectional study involving 366 pupils in 10 junior high schools in the Tamale metropolis was conducted. A Food Frequency Questionnaire (FFQ) which consisted of 60 commonly consumed foods was used to assess pupils\u2019 7-day intake. Foods grouped (14) from FFQ data based on shared nutritional value were used to identify dietary patterns using principal component analysis (PCA). Bivariate and multivariate logistic regression analyses were used to determine the association between identified patterns and sociodemographic, anthropometric status, and household characteristics of pupils. Results: Half of the pupils were female (50.3%) and average age was 15.6 \ub1 2.0 years. PCA identified two dietary patterns which in total explained 49.7% of the variability of the diet of pupils. The patterns were sweet tooth pattern (STP) with high factor loadings for sugar sweetened snacks, energy and soft drinks, sweets, tea and coffee, and milk and milk products, and a traditional pattern (TP) which showed high factor loadings for cereals and grains, local beverages, nuts, seeds and legumes, vegetables, and fish and seafood. Logistic regression showed that pupils who lived with their parents [AOR = 1.95; 95% CI (1.1\u20133.4); p = 0.019], those who went to school with pocket money [AOR = 4.73; 95% CI (1.5\u201315.0); p = 0.008], and those who lived in the wealthiest homes [AOR = 3.4; 95% CI (1.6\u20137.5); p = 0.002)] had higher odds of following the STP. The TP was associated with high dietary diversity (p = 0.035) and household wealth [AOR = 3.518; 95% CI (1.763\u20137.017); p &lt; 0.001)]. None of the patterns was associated with anthropometric status of pupils. Conclusion: Adolescents in the present study followed a sweet tooth or a traditional diet pattern which associated more with household- and individual-level factors but not anthropometric status

Maternal daily work hours affect nutritional status of children in Northern Ghana.

BACKGROUND: Data on the effect of maternal daily work hours on child nutritional status is scarce in Ghana. Such data may be important in defining maternal employment policies for improved child nutrition. This study therefore sought to determine the effect of maternal daily work hours on the nutritional status of farmer and public service mothers in the northern region of Ghana. METHODS: An analytical cross-sectional survey was conducted among 320 mothers with children 6–59 months. Maternal daily work hours and dietary intake of children were assessed with a structured questionnaire. Anthropometric measurements of children were also taken to classify child nutritional status. The association between maternal daily work hours and child nutritional status was determined using both bivariate analysis and multivariate regression modelling. RESULTS: Majority of the children (45.1%) were aged between their second and third birthdays. The prevalence of stunting, wasting, and underweight were 17.8, 8.1, and 10.3% respectively. Only stunting (p = 0.031) associated significantly with maternal employment and was higher among children of farmers (22.1%) compared to public servants (12.8%). Even though maternal age (p = 0.035), minimum dietary diversity (p = 0.040), non-consumption of legumes (p = 0.031) and other vegetables (p = 0.006) associated with stunting at bivariate level, multivariate logistic regression analysis revealed that only maternal daily work hours had significant effect on stunting. Compared to mothers who worked above 6 h a day, those who worked only a maximum of 4 h were 5.4 times more likely to have stunted children [AOR = 5.375; 95% CI (1.751–16.502); p = 0.003]. CONCLUSION: Present study results show that maternal daily work hours could be an important determinant of child stunting in northern region of Ghana

Clinical learning environment of nursing and midwifery students in Ghana.

BACKGROUND: Data on student experience of the clinical learning environment in Ghana are scarce. We therefore aimed to assess students' evaluation of the clinical learning environment and the factors that influence their learning experience. METHODS: This was a cross-sectional survey of 225 undergraduate nursing and midwifery students. We used the Clinical Learning Environment and Supervision + Nurse Teacher (CLES +T) evaluation scale to assess students' experience of their clinical placement. The association between student demographic characteristics and clinical placement experience was determined using t-test or ANOVA. RESULTS: Most of the sampled students were Nurses (67%) and in the third year of training (81%). More students received supervision from a nurse (57%) during clinical placement and team supervision (67%) was the most common during clinical placement. Nursing students were more likely to rate their clinical experience better than midwifery students (p=0.002). Students who had increased contact with private supervisors were also more likely to rate their experience higher (p=0.002). Clinical experience was also rated higher by students who received successful supervision compared to those who had unsuccessful or team supervision (p=0.001). CONCLUSION: Team supervision is high in health facilities where students undertake clinical placement in Ghana. Frequent contact with private supervisor and successful supervision are associated with better rating of clinical experience among Ghanaian undergraduate nursing and midwifery students

Effect of cimetidine on some hematological indices of Wistar rats: modulatory role of vitamin c

Introduction: Cimetidine is a drug used in the treatment of dyspepsia, a clinical condition with widespread distribution. Many studies have reported cimetidine to cause many unwanted effects. However, in most of those studies cimetidine was administered at higher than therapeutic doses. Aim: The aim of this study was, therefore, to evaluate the effect of chronic cimetidine treatment at therapeutic dose on some hematological indices and the possible modulatory role of vitamin C on any such effect. Experimental design and Animal grouping: Forty adult male Wistar rats were divided into four groups (n = 10) and treated orally for 60 days with distilled water (control); cimetidine (30 mg kg-1); cimetidine (30 mg kg-1) + vitamin C (25 mg kg-1) and cimetidine (30 mg kg-1) + vitamin C (50 mg kg-1). At the end of the study blood was collected for analysis. Results: Total white blood cell (WBC) count (5.99 ± 0.20 x 103/mm3) of the cimetidine only-treated group was significantly lower than that of the control (7.95 ± 0.29 x 103/mm3).However, the valuesof red blood cell (RBC) count, packed cell volume (PCV), hemoglobin (Hb) concentration, mean corpuscular volume (MCV), mean corpuscular hemoglobin(MCH), mean corpuscular hemoglobin concentration (MCHC), and color index of the experimental groups were not significantly different from that of the control. Treatment with vitamin C modulated the cimetidine-induced decrease in total WBC count. Conclusion: It was concluded that chronic cimetidine administration at therapeutic dose caused a significant decrease in WBC count and this was modulated by vitamin C. Key words: Cimetidine; WBC count; RBC count; hemoglobin and vitamin C

Special foods and local herbs used to enhance breastmilk production in Ghana: rate of use and beliefs of efficacy.

BACKGROUND: Inadequate breastmilk production is one of the key factors associated with suboptimal breastfeeding. In most local African homes, special herbs and some food items are commonly used to promote breastmilk production (known as lactogogue/galactogogue). We describe the use and characterize the herbs and food items used to promote breastmilk production in two regions of Ghana. METHODS: We conducted a cross-sectional study in 2018 involving 402 lactating mothers. The range of foods used as lactogogues was obtained from 20 participants through focus group discussions. Quantitative data on demographics, lactogogue use and feeding practices were obtained through questionnaire administration. RESULTS: The mean age of women was 29.2 years and children were 10 months. Breastmilk production problems were low (22.4%) and the majority of lactating mothers felt they had adequate breastmilk (70.4%) but awareness about lactogogues was widespread in both regions (88.8%) and highest in the Brong-Ahafo region (90.0%). Information about lactogogues was mainly from grandparents (24.6%), parents (31.6), health facilities (16.5%) and friends (12.8%), while the media had little influence (< 1%). The majority of the mothers used lactogogues to enhance breastmilk production (67.7%), and a quarter of them used lactogogues because of their tradition (25.2%). Prevalence of lactogogue use was 83.8%, lactogogues were prepared separate from household meals (59.4%) and consumed one to three times a day (89.6%). Users felt the effectiveness within 24 h of use (98.5%). The most common lactogogues included; groundnut/peanut soup prepared with Bra leaves (Hibiscus sabdariffa), hot black tea, Werewere/Agushi (Citrulus colocynthis) prepared with Bra leaves, and Abemudro (a polyherbal formulation). Only 13.2% of lactating mothers also used lactogogues during pregnancy. CONCLUSIONS: Special foods and selected herbs are widely used to enhance breastmilk production in Ghana and constitute an important part of the diet of lactating mothers. These results could contribute to understanding breastfeeding behaviours and stimulate further research into evaluating the safety and scientific efficacy of these products in Ghana

Comparative study of stunting measurement in children using WHO procedure and Growth Length Mat in Ghana.

OBJECTIVE: Height data is not useful immediately without further processing. The Growth Length Mat (Stunting Mat) was designed to stunting directly. However, the Mat has not been validated for use in Ghana. This study compared stunting measured with the Mat and stunting measured following the WHO recommended procedure. We sampled 163 children aged 6-24 months in the Bono region of Ghana. We also explored the acceptability and interpretability of the two procedures among mothers and healthcare givers. RESULTS: The prevalence of stunting was 3.7% and 11.7% using the Mat and WHO procedures respectively. The Growth Length Mat had very low sensitivity (21.0%) but high specificity (98.6%) of detecting stunting in children. However, in younger aged children, the Mat was more accurate in detecting stunting. Both healthcare workers and caregivers found it easy to interpret the stunting status of children using the Mat. We conclude that the Growth Length Mat was less sensitive at detecting child stunting compared to the current gold standard of measuring stunting in younger children. There are possibilities to improve the accuracy and utility of the Mat for measuring stunting in low-resource settings by re-designing the mat to be more age appropriate

The effect of maternal and child factors on stunting, wasting and underweight among preschool children in Northern Ghana.

BACKGROUND: Undernutrition among preschool children in Northern region is the highest in Ghana. However, there is scarcity of data on the factors that determine undernutrition in these children. This study investigated the effect of maternal and child factors on undernutrition among preschool children in Northern Ghana. METHODS: This study was a community based analytical cross-sectional survey on a sample of 425 mother- child pairs drawn from 25 clusters. A semi- structured questionnaire was used to collect data on maternal and child socio-demographic characteristics, feeding practices and anthropometry. Anthropometric indices of Height-for-age Z-scores (HAZ), Weight-for-height Z-scores (WHZ) and Weight-for - age Z-scores (WAZ) were used to classify child stunting, wasting and underweight respectively. Bivariate and multivariate analyses were performed to determine associations between explanatory variables and undernutrition. RESULTS: The prevalence of stunting, wasting and underweight were 28.2, 9.9 and 19.3% respectively. Multiple logistic regression analysis showed that, the odds of stunting was higher among male children [AOR = 1.99; 95% CI (1.26-3.13); p = 0.003], children of mothers less than 150 cm in height [AOR = 3.87; 95% CI (1.34-11.20); p = 0.01], mothers 155-159 cm tall [AOR = 2.21; 95% CI (1.34-3.66); p = 0.002], and older children aged 12-23 months [AOR 9.81; 95% CI (2.85-33.76); p < 0.001]. Wasting was significantly higher among male children [AOR = 2.40; 95% CI (1.189-4.844); p = 0.015], consumption of less than four food groups [AOR = 3.733; 95% CI (1.889-7.376); p < 0.001] and among children of underweight mothers [AOR = 3.897; 95% CI (1.404-10.820); p = 0.009]. Male children [AOR = 2.685; 95% CI (1.205-5.98); p = 0.016] and having low birth weight [AOR = 3.778; 95% CI (1.440-9.911); p < 0.001] were associated with higher odds of underweight in children. CONCLUSION: Maternal height associated negatively with stunting but not wasting. Factors that affect low height -for-age z-score (HAZ) may not necessarily be the same as stunting. Infant and child feeding practices as measured by dietary diversity score associated positively with weight-for-height Z-scores than length-for-age Z-scores of young children. Surprisingly, consumption of some specific food groups including, animal source foods, legumes, staples and eggs were associated with lower HAZ but with increased likelihood of higher WHZ among children 6-59 months

Waterproof performance of concrete: a critical review on implemented approaches

Permeation of water and other fluids in concrete can result in degradation and other aesthetic problems which shorten concrete structures' life. Several studies have been undertaken to produce waterproofing additives that extend the service life of concrete elements. Consequently, a great deal of repair and maintenance costs could be avoided. This paper aims to review the studies which have used various agents and tests to evaluate the waterproofing efficiency of concrete. The study establishes the taxonomy and construct of research in concrete waterproofing research. Study established frequency aggregation of different additive used and tests applied. The technique adopted by majority of the researchers was the use of surface coating. Water absorption was found to be the most common test in this research area. Study delineated that most researchers focused on the use of polymer-based materials, silicates containing compound, silanes, siloxanes, cementing materials and some nano materials. Finally, study established three classification of additives based on material structure, method of application and additives functions