Proposing a second life - (adaptive reuse) for underutilized condemned masonry buildings in Cuba

From 2000 to 2013 nearly 3,856 partial or total buildings collapsed in Havana, Cuba with a 206,000-home deficit thus adding to its severe housing shortage, reported by officials. Officials have also estimate 28,000 people live in buildings that could collapse at any moment and yet some residents refuse to leave structures that authorities have declared unsafe. Locals have described the deaths witnessed from structures collapsing however Cuban officials do not release figures on those killed or injured in building collapses in attempt to minimize the severity of the situation. This thesis aims to investigate an adaptive reuse strategy needed for collapsing and condemned masonry systems in Havana, Cuba. Upgrading their performance to make them safe for inhabitation and to give the community a center for collective wellbeing. Masonry doesn’t support long span conditions or open floor plates that’s conducive to collective engagement needed in Havana neighborhoods, leading to the underutilization of these structures and the further deterioration of the neighborhoods. This thesis approach revives underutilized and potentially dangerous masonry structures in Cuba to no longer be seen as a loss of culture and purpose but as a new community hub generating a micro economy to serve the locals

Papanicolaou Test Status Among Inner-City Adolescent Girls in Accra, Ghana

Cervical cancer is an emerging public health problem in developing countries. Globally, it is the 3rd most common malignancy in women after breast and colorectal cancers and 4th most frequent cancer in women, with an estimated 570,000 new cases and 311,000 deaths in 2018. Cervical cancer screening in the developed countries is credited with the reductions in cervical cancer morbidity and mortality during the last 50 years. However, nearly 90% of cervical cancer deaths occur in less developed countries. Ghana has a cervical cancer rate of 26.4%. Further, it is the highest cancer incidence faced among women 25 to 44 years and has a mortality rate of 17.4% in this age group. Knowledge, culture, attitude, and beliefs are known to limit women\u27s participation in Pap test screening programs. Guided by the health belief model, the purpose of this quantitative study was to examine how knowledge, attitude, culture, and religious beliefs affected intent to seek Pap test screening among adolescent girls in Accra, Ghana. A total of 155 participants ages 16 to 20 years completed a 30-item questionnaire. Descriptive frequencies were calculated. Correlation and Chi-square tests were also performed to assess associations with intent to screen with Pap test. Most girls (92%) had never heard about Pap test screening. There were statistically significant correlations between cervical cancer knowledge (p=0.032) and attitude (p=0.001) with intent to participate in Pap test screening. However, culture (p=0.049) and religious beliefs (p=0.529) were not significantly associated with screening intent. The implications for social change include informing practice and research on how cervical cancer prevention programs can be tailored to girls living in countries where different cultural and religious values are practiced

Walking Two Worlds: Healing from Trauma in the American Indian Community

American Indian populations are known to be affected by high rates of trauma, including the impact and perpetuating effects of historical trauma. In an effort to better understand effective ways of healing from trauma, this study explores the methods utilized by American Indian people to facilitate healing, specifically from symptoms of post-traumatic stress. Qualitative interviews were used to collect the stories and experiences of eight practitioners working with American Indian clients as they relate to the use of traditional healing practices and use of Western mental health services. Findings revealed four themes that are consistent with prior research, and yet build understanding of healing practices among American Indian people. These themes are the widespread rates of trauma, the importance of community, the spiritual realm as the context for healing, and a lack of appropriate mental health services in the American Indian community. These themes also point to the unique position of American Indian people as bridging two worlds and two routes to healing: traditional tribal beliefs and mainstream health services. Implications from this study for social work practice, policy, and research are also discussed

Walking Two Worlds: Healing from Trauma in the American Indian Community

American Indian populations are known to be affected by high rates of trauma, including the impact and perpetuating effects of historical trauma. In an effort to better understand effective ways of healing from trauma, this study explores the methods utilized by American Indian people to facilitate healing, specifically from symptoms of post-traumatic stress. Qualitative interviews were used to collect the stories and experiences of eight practitioners working with American Indian clients as they relate to the use of traditional healing practices and use of Western mental health services. Findings revealed four themes that are consistent with prior research, and yet build understanding of healing practices among American Indian people. These themes are the widespread rates of trauma, the importance of community, the spiritual realm as the context for healing, and a lack of appropriate mental health services in the American Indian community. These themes also point to the unique position of American Indian people as bridging two worlds and two routes to healing: traditional tribal beliefs and mainstream health services. Implications from this study for social work practice, policy, and research are also discussed

Buruli Ulcer in Ghana: Results of a National Case Search

A national search for cases of Buruli ulcer in Ghana identified 5,619 patients, with 6,332 clinical lesions at various stages. The overall crude national prevalence rate of active lesions was 20.7 per 100,000, but the rate was 150.8 per 100,000 in the most disease-endemic district. The case search demonstrated widespread disease and gross underreporting compared with the routine reporting system. The epidemiologic information gathered will contribute to the design of control programs for Buruli ulcer

Learning the Fundamentals from Hands-on Learning

The projects featured in this piece represent the notion of design as an act of thinking-through-making. Through studies in design principles, craftsmanship, exercises, and projects, students engaged in hands-on learning, which included drawings, model-making, and producing artifacts. Fundamentals of Design Thinking: Architecture Majors Learning Community, Prof. Bronne Dytoc, Prof. Mine H. Hashas-Degertekin, Prof. Zamila Karimi, Prof. Marietta Monaghan, Prof. Willie Pittman, and Prof. Arief Setiawa

Complicated left isolated internal iliac artery aneurysm (IIIAA) in a young man - An unusual presentation in a Tertiary Hospital in Ghana: Case report

Generally, an aneurysm is a disease of the elderly due to the degenerative aetiological factor. Isolated internal iliac artery aneurysm (IIIAA) is rare, representing 0.3–0.5 % of all intra-abdominal aneurysms. It is a focal dilatation of the internal iliac artery alone with a threshold for surgical intervention set at 8 mm. Herein, we present an unusual presentation of a rare condition of a huge left internal iliac artery aneurysm in a young man with no identifiable risk factor complicated by left ilio-femoral deep vein thrombosis. Even though this is an interesting case study, the lack of facilities to do anaerobic cultures remains a major limitation in our setting

The history of the neglected tropical disease movement

The history of the neglected tropical disease movement is seen through the lens of authors who worked during the last 4 decades in different roles and in different settings, from Western-based laboratories to clinical roles in endemic countries and in critical policy roles in the World Health Organization (WHO). The authors seek to identify key players from the introduction of the word ‘neglected’ by the late Kenneth Warren in his Rockefeller Foundation–supported Great Neglected Diseases of Mankind movement through to the more recent developments after the London Declaration of 2012. The role of the various actors—endemic countries, major pharmaceutical companies, the WHO, non-government development organizations, bilateral donors and academia—are discussed. The critical events and decisions are highlighted that were essential enabling factors in creating a viable and successful movement and with a resultant massive global public health and antipoverty impact. The importance of advocacy is emphasized in creating the momentum to establish a globally recognized public health ‘brand’ as a target in the United Nations Sustainable Development Goals

Preliminary findings from stimulated spontaneous reporting of adverse drug reactions during COVID-19 pandemic: an experience from Ghana

Background: The novel coronavirus disease 2019 (COVID-19) is an ongoing pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is limited information on the safety of drugs used for the treatment of COVID-19.Objective: Objective of this study is to describe the pattern of stimulated spontaneous adverse drug reaction (ADR) reports received from healthcare professionals for SARS-CoV-2 positive patients in Ghana and lessons learnt particularly for low- and middle-income countries.Methods: This is a study of individual case safety reports (ICSRs) received from healthcare professionals between 1st April 2020 to 31st July 2020 in SARS-CoV-2 positive patients in Ghana. The ICSRs were retrieved from the SafetyWatch System and descriptive statistics used to describe the ADRs by System Organ Classification and Preferred Term.Results: Information was received from 40 COVID-19 Treatment Centres across the country with 9 centres submitting a total of 53 ICSRs containing 101 ADRs; approximately two ADRs per ICSR. Females accounted for 29(54.7%) of the ICSRs and males 24(45.3%). Newly reported ADRs of interest were one report each of tremor for doxycycline; scrotal pain, dyspnoea, gait disturbances and dysgeusia for chloroquine; and dry throat, hyperhidrosis, restlessness and micturition frequency increased for hydroxychloroquine. A strong spontaneous system with the availability of focal persons at the Treatment Centres played a key role in reporting ADRs during the pandemic.Conclusion: This is the first experience with spontaneous reporting during COVID-19 pandemic in Ghana. The profile of most of the ADRs reported appears consistent with what is expected from the summary of product characteristics. A study with a larger sample size with well-defined denominator in future studies is paramount in determining the relative risk of these medications in SARS-CoV-2 positive patients

Risk factors for Buruli ulcer disease (Mycobacterium ulcerans infection):Results from a case-control study in Ghana

Background. Morbidity due to Buruli ulcer disease (BUD), a cutaneous infection caused by Mycobacterium ulcerans, has been increasingly recognized in rural West Africa. The source and mode of transmission remain unknown. Methods. To identify BUD risk factors, we conducted a case-control study in 3 BUD-endemic districts in Ghana. We enrolled case patients with clinically diagnosed BUD and obtained skin biopsy specimens. M. ulcerans infection was confirmed by at least I of the following diagnostic methods: histopathologic analysis, culture, polymerase chain reaction, and Ziehl-Neelsen staining of a lesion smear. We compared characteristics of case patients with confirmed BUD with those of age- and community-matched control subjects using conditional logistic regression analysis. Results. Among 121 case patients with confirmed BUD, leg lesions (49%) or arm lesions (36%) were common. Male case patients were significantly more likely than female case patients to have lesions on the trunk (25% vs. 6%; P = .009). Multivariable modeling among 116 matched case-control pairs identified wading in a river as a risk factor for BUD (odds ratio [OR], 2.69; 95% confidence interval [Cl], 1.27-5.68; P = .0096). Wearing a shirt while farming (OR, 0.27; 95% Cl, 0.11-0.70; P = .0071), sharing indoor living space with livestock (OR, 0.36; 95% Cl, 0.15-0.86; P = .022), and bathing with toilet soap (OR, 0.41; 95% Cl, 0.19-0.90; P = .026) appeared to be protective. BUD was not significantly associated with penetrating injuries (P = .14), insect bites near water bodies (P = .84), bacille Calmette-Guerin vaccination (P = .33), or human immunodeficiency virus infection (P = .99). Conclusions. BUD is an environmentally acquired infection strongly associated with exposure to river areas. Exposed skin may facilitate transmission. Until transmission is better defined, control strategies in BUD-endemic areas could include covering exposed skin