Social and Spill-Over Benefits as Motivating Factors to Investment in Formal Education in Africa: A Reflection around Ghanaian, Kenyan And Rwandan Contexts.

This study examined the social and spill-over benefits as motivating factors to investment in formal education in selected countries in Africa. The paper had three objectives, namely) to profile the key statistics of formal schooling; ii) examine the formal education and iii) link national goals of education with expectations in Ghana, Kenya and Rwanda. The major contention of the paper is that investment in education is not a matter of random choice but rather an imperative led by the fact that education holds returns and externalities to the largest society.  Authors reviewed theory of human capital, local and international publications on social and spill over benefits of education focusing on Ghana, Kenya and Rwanda. The analysis of government policies and other publications from these three African nations have shown that education is considered as a key sector in these developing nations. Nevertheless, the researchers found out that mostly only primary and secondary education are distinctively accorded considerable public financial resources which might be associated with the countries limited financial ability, competitive needs, national and global trends. However, the fact that Ghana, Kenya and Rwanda strive to become democratic, self-reliant and middle income nations by conquering long terms set visions in which caliber manpower, welfare, self-employment, reduced social inequalities, increase in average income, knowledge based society, ICT driven and sustainable economy are key characteristics; it is imperative to invest substantially in TVET and higher education. It is also recommended that Ghana, Kenya and Rwanda put in place strong institutions that objectively, effectively and rationally ensure the efficient use of all available resources towards maximum educational outputs (265 words). Key words: Social Benefits, Spill-over Benefits, Private Cost, Social Cost, Private Rate of Returns, Education, Cost- Best Analysis in Education, Africa, Ghana, Kenya, Rwanda

Capability in the digital: institutional media management and its dis/contents

This paper explores how social media spaces are occupied, utilized and negotiated by the British Military in relation to the Ministry of Defence’s concerns and conceptualizations of risk. It draws on data from the DUN Project to investigate the content and form of social media about defence through the lens of ‘capability’, a term that captures and describes the meaning behind multiple representations of the military institution. But ‘capability’ is also a term that we hijack and extend here, not only in relation to the dominant presence of ‘capability’ as a representational trope and the extent to which it is revealing of a particular management of social media spaces, but also in relation to what our research reveals for the wider digital media landscape and ‘capable’ digital methods. What emerges from our analysis is the existence of powerful, successful and critically long-standing media and reputation management strategies occurring within the techno-economic online structures where the exercising of ‘control’ over the individual – as opposed to the technology – is highly effective. These findings raise critical questions regarding the extent to which ‘control’ and management of social media – both within and beyond the defence sector – may be determined as much by cultural, social, institutional and political influence and infrastructure as the technological economies. At a key moment in social media analysis, then, when attention is turning to the affordances, criticisms and possibilities of data, our research is a pertinent reminder that we should not forget the active management of content that is being similarly, if not equally, effective

Cardiopulmonary ultrasound for critically ill adults improves diagnostic accuracy in a resourceâ limited setting: the AFRICA trial

ObjectiveTo assess the effects of a cardiopulmonary ultrasound (CPUS) examination on diagnostic accuracy for critically ill patients in a resourceâ limited setting.MethodsApproximately half of the emergency medicine resident physicians at the Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, were trained in a CPUS protocol. Adult patients triaged to the resuscitation area of the emergency department (ED) were enrolled if they exhibited signs or symptoms of shock or respiratory distress. Patients were assigned to the intervention group if their treating physician had completed the CPUS training. The physician’s initial diagnostic impression was recorded immediately after the history and physical examination in the control group, and after an added CPUS examination in the intervention group. This was compared to a standardised final diagnosis derived from post hoc chart review of the patient’s care at 24 h by two blinded, independent reviewers using a clearly defined and systematic process. Secondary outcomes were 24â h mortality and use of IV fluids, diuretics, vasopressors and bronchodilators.ResultsOf 890 patients presenting during the study period, 502 were assessed for eligibility, and 180 patients were enrolled. Diagnostic accuracy was higher for patients who received the CPUS examination (71.9% vs. 57.1%, Î 14.8% [CI 0.5%, 28.4%]). This effect was particularly pronounced for patients with a â cardiacâ diagnosis, such as cardiogenic shock, congestive heart failure or acute valvular disease (94.7% vs. 40.0%, Î 54.7% [CI 8.9%, 86.4%]). Secondary outcomes were not different between groups.ConclusionsIn an urban ED in Ghana, a CPUS examination improved the accuracy of the treating physician’s initial diagnostic impression. There were no differences in 24â h mortality and a number of patient care interventions.ObjectifEvaluer les effets de l’examen échographique cardioâ pulmonaire (CPUS) sur la précision du diagnostic chez les patients gravement malades dans un cadre à ressource limitée.MéthodesEnviron la moitié des médecins résidents en médecine d’urgence à la Komfo Anokye Teaching Hôpital (KATH) à Kumasi, au Ghana ont été formés pour un protocole de CPUS. Les patients adultes triés dans l’unité de ressuscitation des soins intensifs ont été inscrits s’ils présentaient des signes ou des symptômes de choc ou d’une détresse respiratoire. Les patients ont été assignés au groupe d’intervention si leur médecin traitant avait suivi la formation CPUS. Le diagnostic initial du médecin a été enregistré immédiatement après l’anamnèse et l’examen physique dans le groupe témoin, et après un examen CPUS ultérieur dans le groupe d’intervention. Cela a été comparé à un diagnostic final standard dérivé de l’analyse postâ hoc en aveugle des dossiers de soins du patient à 24 heures par deux examinateurs indépendants, au moyen d’un processus clairement défini et systématique. Les résultats secondaires étaient la mortalité de 24 heures et l’utilisation de fluides en IV, de diurétiques, de vasopresseurs et de bronchodilatateurs.RésultatsSur 890 patients présentés au cours de la période dâ étude, 502 ont été évalués pour lâ éligibilité et 180 patients ont été inscrits. La précision du diagnostic était plus élevée chez les patients ayant reçu l’examen CPUS (71,9% contre 57,1%, Î 14,8% [IC: 0,5% à 28.4%]). Cet effet était particulièrement marquée pour les patients avec un diagnostic «cardiaque», tel que le choc cardiogénique, l’insuffisance cardiaque congestive ou une maladie aiguë valvulaire (94,7% contre 40,0%, Î 54,7% [IC: 8,9% à 86,4%]). Les résultats secondaires nâ étaient pas différents entre les groupes.ConclusionsDans un service de soins intensifs urbain au Ghana, un examen CPUS améliorait la précision du diagnostic initial du médecin traitant. Il n’y avait aucune différence dans la mortalité de 24 heures et dans le nombre des interventions de soins.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/1/tmi12992.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/141626/2/tmi12992_am.pd

Police views of suicidal persons and the law criminalizing attempted suicide in Ghana: A qualitative study with policy implications

The penal code of Ghana condemns suicide attempt. The present study sought to explore the views of the police on persons who attempt suicide and the law criminalizing the act. Qualitative in-depth interviews were used to explore the views of 18 officers of the Ghana Police Service. Data were analyzed using thematic analysis technique. Findings showed that the police officers profiled suicide attempters as needy, enigmatic, ignorant, and blameworthy. Majority (n = 14) of them disagreed with the law and suggested a repeal, whereas only four of them agreed with the law. Regardless of their positions on criminalization, they showed an inclination to help, rather than arrest, when confronted with such persons in line of their duty. Educating the police on suicidal behavior may help to deepen their understanding and help improve the way they handle suicidal persons. This may also strengthen police suicide prevention gatekeeping obligations

Recalibration of the limiting antigen avidity EIA to determine mean duration of recent infection in divergent HIV-1 subtypes.

ArticleBackground: Mean duration of recent infection (MDRI) and misclassification of long-term HIV-1 infections, as proportion false recent (PFR), are critical parameters for laboratory-based assays for estimating HIV-1 incidence. Recent review of the data by us and others indicated that MDRI of LAg-Avidity EIA estimated previously required recalibration. We present here results of recalibration efforts using >250 seroconversion panels and multiple statistical methods to ensure accuracy and consensus. Methods: A total of 2737 longitudinal specimens collected from 259 seroconverting individuals infected with diverse HIV-1 subtypes were tested with the LAg-Avidity EIA as previously described. Data were analyzed for determination of MDRI at ODn cutoffs of 1.0 to 2.0 using 7 statistical approaches and sub-analyzed by HIV-1 subtypes. In addition, 3740 specimens from individuals with infection >1 year, including 488 from patients with AIDS, were tested for PFR at varying cutoffs. Results: Using different statistical methods,MDRI values ranged from 88-94 days at cutoff ODn = 1.0 to 177-183 days at ODn = 2.0. The MDRI values were similar by different methods suggesting coherence of different approaches. Testing formisclassification among long-terminfections indicated that overall PFRs were 0.6%to 2.5%at increasing cutoffs of 1.0 to 2.0, respectively. Balancing the need for a longer MDRI and smaller PFR (<2.0%) suggests that a cutoff ODn = 1.5, corresponding to an MDRI of 130 days should be used for cross-sectional application. The MDRI varied among subtypes from 109 days (subtype A&D) to 152 days (subtype C). Conclusions: Based on the new data and revised analysis, we recommend an ODn cutoff = 1.5 to classify recent and long-term infections, corresponding to an MDRI of 130 days (118-142). Determination of revised parameters for estimation of HIV-1 incidence should facilitate application of the LAg-Avidity EIA for worldwide use.This research has been supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the Centers for Disease Control and Prevention (CDC)

Improving influenza vaccine virus selectionReport of a WHO informal consultation held at WHO headquarters, Geneva, Switzerland, 14–16 June 2010

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90035/1/j.1750-2659.2011.00277.x.pd

Health Services Utilization, Work Absenteeism and Costs of Pandemic Influenza A (H1N1) 2009 in Spain: A Multicenter-Longitudinal Study

Background: The aim of this study was to estimate healthcare resource utilization, work absenteeism and cost per patient with pandemic influenza (H1N1)2009, from its beginning to March 2010, in Spain. We also estimated the economic impact on healthcare services. Methods and Findings: Longitudinal, descriptive,multicenter study of in- and outpatients with confirmed diagnosis of influenza A (H1N1) in Spain. Temporal distribution of cases was comparable to that in Spain. Information of healthcare and social resources used from one week before admission (inpatient) or index-medical visit (outpatient) until recovery was gathered. Unit cost was imputed to utilization frequency for the monetary valuation of use. Mean cost per patient was calculated. A sensitivity analysis was conducted, and variables correlated with cost per patient were identified. Economic impact on the healthcare system was estimated using healthcare costs per patient and both, the reported number of confirmed and clinical cases in Spain. 172 inpatients and 224 outpatients were included. Less than 10% were over 65 years old and more than 50% had previous comorbidities. 12.8% of inpatients were admitted to the Intensive Care Unit. Mean length of hospital stay of patients not requiring critical care was 5 days (SD =4.4). All working-inpatients and 91.7% working-outpatients went on sick leave. On average, work absenteeism was 30.5 days (SD=20.7) for the first ones and 9 days (SD= 6.3) for the latest. Caregivers of 21.7% of inpatients and 8.5% of outpatients also had work absenteeism during 10.7 and 4.1 days on average respectively. Mean cost was J6,236/inpatient (CI95%=1,384-14,623) and J940/outpatient (CI95% =66-3,064). The healthcare economic burden of patients with confirmed influenza was J144,773,577 (IC95% 13,753,043-383,467,535). More than 86% of expenditures were a result of outpatients" utilization. Conclusion: Cost per H1N1-patient did not defer much from seasonal influenza estimates. Hospitalizations and work absenteeism represented the highest cost per patient

A Research and Development (R&D) roadmap for influenza vaccines: Looking toward the future

Improved influenza vaccines are urgently needed to reduce the burden of seasonal influenza and to ensure a rapid and effective public-health response to future influenza pandemics. The Influenza Vaccines Research and Development (R&D) Roadmap (IVR) was created, through an extensive international stakeholder engagement process, to promote influenza vaccine R&D. The roadmap covers a 10-year timeframe and is organized into six sections: virology; immunology; vaccinology for seasonal influenza vaccines; vaccinology for universal influenza vaccines; animal and human influenza virus infection models; and policy, finance, and regulation. Each section identifies barriers, gaps, strategic goals, milestones, and additional R&D priorities germane to that area. The roadmap includes 113 specific R&D milestones, 37 of which have been designated high priority by the IVR expert taskforce. This report summarizes the major issues and priority areas of research outlined in the IVR. By identifying the key issues and steps to address them, the roadmap not only encourages research aimed at new solutions, but also provides guidance on the use of innovative tools to drive breakthroughs in influenza vaccine R&D.publishedVersio

Rubber and plantain intercropping: Effects of different planting densities on soil characteristics

Two field experiments were conducted at Ellembelle and Jomoro districts in the Western region of Ghana where rubber cultivation is a predominant farming activity. The objective of the study was to assess the effect of rubber and plantain intercropping systems on selected soil properties. The experiment was arranged in a randomized complete block design (RCBD) with 3 replications. The treatments were the sole crop rubber (R), sole crop plantain (P) and three intercrop systems comprising an additive series of plantain: one row of plantain to one row of rubber (PR), two rows of plantain to one row of rubber (PPR) and three rows of plantain to one row of rubber (PPPR). Generally, agroforestry systems improved the soil hydraulic properties considerably, with the highest cumulative infiltration rates of 5.16 and 8.68 cm/min observed under the PPPR systems at the Ellembelle and Jomoro sites, respectively. Microbial biomass C (Cmic), N (Nmic) and P (Pmic) was significantly improved (P < 0.05) under the agroforestry than the monocrop systems. The Cmic, Nmic and Pmic values were highest under the PPPR system at both Ellembelle (Cmic, = 139.9 mg/kg; Nmic = 36.26 mg/kg and Pmic = 87.6 mg/kg) and Jomoro (Cmic = 78.7 mg/kg; Nmic = 80.3 mg/kg and Pmic = 3.45 mg/kg) sites

Genetic Characterization of Human T-Cell Lymphotropic Virus Type 1 in Mozambique: Transcontinental Lineages Drive the HTLV-1 Endemic

Human T-cell lymphotropic virus type 1 (HTLV-1) is the causative agent of Adult T-Cell Leukemia/Lymphoma (ATL), the Tropical Spastic Paraparesis/HTLV-1-associated Myelopathy (TSP/HAM) and other inflammatory diseases, including dermatitis, uveitis, and myositis. It is estimated that 2–8% of the infected persons will develop a HTLV-1-associated disease during their lifetimes, frequently TSP/HAM. Thus far, there is not a specific treatment to this progressive and chronic disease. HTLV-1 has means of three transmission: (i) from mother to child during prolonged breastfeeding, (ii) between sexual partners and (iii) through blood transfusion. HTLV-1 has been characterized in 7 subtypes and the geographical distribution and the clinical impact of this infection is not well known, mainly in African population. HTLV-1 is endemic in sub-Saharan Africa. Mozambique is a country of southeastern Africa where TSP/HAM cases were reported. Recently, our group estimated the HTLV prevalence among Mozambican blood donors as 0.9%. In this work we performed a genetic analysis of HTLV-1 in blood donors and HIV/HTLV co-infected patients from Maputo, Mozambique. Our results showed the presence of three HTLV-1 clusters within the Cosmopolitan/Transcontinental subtype/subgroup. The differential rates of HIV-1/HTLV-1 co-infection in the three HTLV-1 clusters demonstrated the dynamic of the two viruses and the need for implementation of control measures focusing on both retroviruses