Combining work and child care: The experiences of mothers in Accra, Ghana

Work-family research has focused predominantly on Western women. Yet the forms of economic labour in which women are typically involved and the meaning of motherhood are context-specific. This paper aims to explore the experience of combining economic activity and child care of mothers with young children using urban Ghana as a case study. Semi-structured interviews (n=24) were conducted in three locations in the Accra Metropolitan Area. Transcripts were analysed using the general inductive approach. The results found women’s experience of role conflict to be bi-directional. With regard to role enhancement, economic activity allowed women to provide materially for their children. The combination of work and child care had negative consequences for women’s wellbeing. This research questions policy makers’ strategy of frequently targeting women in their roles either as generators of income, or as the primary care-takers of children by highlighting the reality of women’s simultaneous performance of these roles

Targeted Selection of Stimulation Parameters for Restoration of Motor and Autonomic Function in Individuals With Spinal Cord Injury

Study Design: This is a report of methods and tools for selection of task and individual configurations targeted for voluntary movement, standing, stepping, blood pressure stabilization, and facilitation of bladder storage and emptying using tonic-interleaved excitation of the lumbosacral spinal cord. Objectives: This study aimed to present strategies used for selection of stimulation parameters for various motor and autonomic functions. Conclusions: Tonic-interleaved functionally focused neuromodulation targets a myriad of consequences from spinal cord injury with surgical implantation of the epidural electrode at a single location. This approach indicates the sophistication of the human spinal cord circuitry and its important role in the regulation of motor and autonomic functions in humans

Resistance of diamondback moth to insecticides in selected cabbage farms in southern Ghana

Resistance of diamondback moth (DBM), Plutella xylostella (L.) to insecticides applied for its control on cabbage was evaluated. DBM populations were tested for susceptibility to three pyrethroids (delatamethrin, lambdacyhalothrin, cypermethrin) and an organophosphate (chlorpyrifos-methyl) insecticide using larvaeimmersion dose-response technique. Non-specific carboxylesterase activity was used as a measure of DBM resistance. Partial characterization of carboxylesterase by zymogram studies was also undertaken usingpolyacrylamide gel electrophoresis (PAGE). Susceptibility studies revealed that DBM was resistant to the four insecticides assayed. DBM was least susceptible to chlorpyrifos-methyl, but most susceptible to deltamethrin.Esterase zymogram studies revealed between 2 to 7 bands, each with different characteristics. Higher frequency of the slow-moving esterases associated with high resistance was recorded in Mampong DBMpopulation than the Accra suburbs. This finding confirmed results for carboxylesterase activity. Deltamethrin and cypermethrin demonstrated high negative correlation between fold resistance and carboxylesterase activity for â-isozyme. Chlorpyrifos-methyl, on the other hand showed positive correlation between fold resistance and á-carboxylesterase activity. The high carboxylesterase activities recorded for Mampong DBM, however, did not correlate with results of susceptibility studies. It is suggested that farmers should adopt an integrated approach using the IPM principles coupled with judicious use of biopesticides such as Bacillus thuringiensis.© 2010 International Formulae Group. All rights reserved

Spinal Cord Imaging Markers and Recovery of Volitional Leg Movement With Spinal Cord Epidural Stimulation in Individuals With Clinically Motor Complete Spinal Cord Injury

Previous studies have shown that epidural stimulation of the lumbosacral spinal cord (scES) can re-enable lower limb volitional motor control in individuals with chronic, clinically motor complete spinal cord injury (SCI). This observation entails that residual supraspinal connectivity to the lumbosacral spinal circuitry still persisted after SCI, although it was non-detectable when scES was not provided. In the present study, we aimed at exploring further the mechanisms underlying scES-promoted recovery of volitional lower limb motor control by investigating neuroimaging markers at the spinal cord lesion site via magnetic resonance imaging (MRI). Spinal cord MRI was collected prior to epidural stimulator implantation in 13 individuals with chronic, clinically motor complete SCI, and the spared tissue of specific regions of the spinal cord (anterior, posterior, right, left, and total cord) was assessed. After epidural stimulator implantation, and prior to any training, volitional motor control was evaluated during left and right lower limb flexion and ankle dorsiflexion attempts. The ability to generate force exertion and movement was not correlated to any neuroimaging marker. On the other hand, spared tissue of specific cord regions significantly and importantly correlated with some aspects of motor control that include activation amplitude of antagonist (negative correlation) muscles during left ankle dorsiflexion, and electromyographic coordination patterns during right lower limb flexion. The fact that amount and location of spared spinal cord tissue at the lesion site were not related to the ability to generate volitional lower limb movements may suggest that supraspinal inputs through spared spinal cord regions that differ across individuals can result in the generation of lower limb volitional motor output prior to any training when epidural stimulation is provided

Association between Sexual Activity and Human Papillomavirus (HPV) Vaccine Initiation and Completion among College Students

HPV vaccination is most effective if received before initiation of sexual activity. Previous studies suggested that young adult women who were not sexually active were not interested in receiving the vaccine because they did not think it was necessary. Whether this misperception is still prevalent today-and also shared by men-is unknown. This study examined whether sexual activity was associated with HPV vaccine uptake (initiation and completion) among university students. A cross-sectional study was conducted between February and May 2021 among students (n = 951) at a public Midwestern University. Sexual activity was categorized as never or ever had oral and/or vaginal sex. Outcome variables were HPV vaccine initiation, defined as receipt of ≥1 dose, and completion, defined as receipt of ≥3 doses. Multivariable logistic regression models estimated the association between sexual activity and HPV vaccine uptake, adjusting for sociodemographic factors. Approximately 18% of students reported never engaging in sexual activity. Overall, 45.5% initiated the HPV vaccine, and 16.5% completed the vaccine series. After adjusting for covariates, compared to students that reported never engaging in sexual activity, those that had ever engaged in sexual activity were more likely to have initiated the vaccine series (aOR = 2.06, 95% CI: 1.34-3.17); however, no difference was observed for completion. HPV vaccination was low; sexually naïve students were less likely to initiate the HPV vaccine. Since sexually naïve students may benefit from receiving the HPV vaccination, targeted interventions should be implemented towards this population to help increase vaccination rates and prevent HPV-associated diseases

Peace in Guatemala and Immigrant Health in the United States

Background: The civil war between the indigenous Mayans and other Guatemalans lasted for 36 years, killed civilians, decimated villages, and resulted in many refugees. The Guatemalan Peace Agreement of 1996 aimed to alleviate the ongoing conflict. Studies of peace agreements more typically evaluate local political outcomes while neglecting global health outcomes. Objective: Our research quantified associations between pre-migration exposure to the peace agreement in Guatemala and the post-migration health status of Guatemalan immigrants in the United States. Methods: We used chi-square tests to compare the distribution of health status before and after peace. We used ordered probit regressions to estimate associations between peace in Guatemala and health in the United States, conditional on the observed distributions of age, age squared, age cubed, and linear time trends before and after peace. Findings: The study sample included 4,115 female and 5,282 male Guatemalan immigrants between the ages of 15 and 85. The mean age was 38.8 years for females (standard deviation, 14.2) and 35.4 years for males (standard deviation, 12.6). Chi-square tests found statistically significant differences in the distribution of health status before and after the peace agreement, for females (P < .001) and males (P < .001). In unadjusted results, the peace agreement was associated with a 7.3 percentage point increase in excellent post-migration health for females (95% confidence interval, 4.9 to 9.8) and a 6.0 percentage point increase for males (95% confidence interval, 3.8 to 8.2). In adjusted results, we found that the peace agreement was associated with a 6.1 percentage point increase in excellent post-migration health for females (95% confidence interval, 0.8 to 11.4) and a 5.5-percentage point increase for males (95% confidence interval, 1.0 to 10.0). Conclusions: The peace agreement in Guatemala was associated with statistically significant improvements in the health status of Guatemalan immigrants to the United States

Tobacco exposure and sleep disturbance in 498 208 UK Biobank participants

Background: The prevalence of sleep disturbance is high and increasing. The study investigated whether active, former and passive smoking were associated with sleep disturbance. Methods: This cross-sectional study used data from the UK Biobank: a cohort study of 502 655 participants, of whom 498 208 provided self-reported data on smoking and sleep characteristics. Multivariable multinomial and logistic regression models were used to examine the associations between smoking and sleep disturbance. Results: Long-sleep duration (&gt;9 h) was more common among current smokers [odds ratio (OR): 1.47; 95% confidence interval (CI): 1.17–1.85; probability value (P) = 0.001] than never smokers, especially heavy (&gt;20/day) smokers (OR: 2.85; 95% CI: 1.66–4.89; P &lt; 0.001). Former heavy (&gt;20/day) smokers were also more likely to report short (&lt;6 h) sleep duration (OR: 1.41; 95% CI: 1.25–1.60; P &lt; 0.001), long-sleep duration (OR: 1.99; 95% CI: 1.47–2.71; P &lt; 0.001) and sleeplessness (OR: 1.47; 95% CI: 1.38–1.57; P &lt; 0.001) than never smokers. Among never smokers, those who lived with more than one smoker had higher odds of long-sleep duration than those not cohabitating with a smoker (OR: 2.71; 95% CI: 1.26–5.82; P = 0.011). Conclusions: Active and passive exposure to high levels of tobacco smoke are associated with sleep disturbance. Existing global tobacco control interventions need to be enforced

Armed Conflict in Central America and Immigrant Health in the United States

Background: While many researchers document the immediate and localized health effects of armed conflicts on combatants are well documented in the literature, less is known about the effects of armed conflict on individuals who have subsequently migrated elsewhere. Objective: This study aims to estimate associations between pre-migration armed conflict in Central America and post-migration health in the United States. Methods: We created a new dataset that combines information on armed conflicts in Central America and immigrant health in the United States. We used ordered probit regressions to estimate age-adjusted associations between pre-migration armed conflict and post-migration health. Findings: The study sample of Central American immigrants included 15,563 females and 16,236 males between the ages 15 and 69. The mean age was 37.2 years (standard deviation, 11.6 years) for females and 35.5 years (standard deviation, 11.2 years) for males. After adjusting for age, pre-migration armed conflict was associated with a 8.6 percentage point decrease in excellent health for females (95% confidence interval, 6.0 to 11.1), and a 7.3 percentage point decrease for males (95% confidence interval, 4.0 to 10.7). Each decade of pre-migration armed conflict was associated a 2.9-percentage point decrease in excellent health for females (95% confidence interval, 2.0 to 3.8) and a 1.6-percentage point decrease for males (95% confidence interval, 0.6 to 2.6). For those individuals exposed to armed conflict, each decade since the most recent armed conflict was associated with a 1.5 percentage point increase in excellent health for females (95% confidence interval, 0.4 to 2.5). For males, the average marginal effect of decades since last conflict was not statistically significant (95% confidence interval, –0.001 to 0.002). Conclusions: Pre-migration armed conflict in Central America is associated with decreases in excellent post-migration health in the United States. The effects of armed conflict are cumulative and fade over time for females

An outbreak of suspected cutaneous leishmaniasis in Ghana: lessons learnt and preparation for future outbreaks

Human cutaneous leishmaniasis (CL) has previously been reported in West Africa, but more recently, sporadic reports of CL have increased. Leishmania major has been identified from Mauritania, Senegal, Mali, and Burkina Faso. Three zymodemes (MON-26, MON-117, and MON-74, the most frequent) have been found. The geographic range of leishmaniasis is limited by the sand fly vector, its feeding preferences, and its capacity to support internal development of specific species of Leishmania. The risk of acquiring CL has been reported to increase considerably with human activity and epidemics of CL have been associated with deforestation, road construction, wars, or other activities where humans intrude the habitat of the vector. In the Ho Municipality in the Volta Region of Ghana, a localised outbreak of skin ulcers, possibly CL, was noted in 2003 without any such documented activity. This outbreak was consistent with CL as evidenced using various methods including parasite identification, albeit, in a small number of patients with ulcers

Medical students\u27 knowledge of HPV, HPV vaccine, and HPV-associated head and neck cancer

On the basis of their training, medical students are considered the best case scenario among university students in knowledge of the human papillomavirus (HPV). We evaluated differences in knowledge of HPV, HPV vaccine, and head and neck cancer (HNC) among medical students. A previously validated questionnaire was completed by 247 medical students at a Midwestern university. Outcomes of interest were knowledge score for HPV and HPV vaccine, and HNC, derived from combining questionnaire items to form HPV knowledge and HNC scores, and analyzed using multivariate linear regression. Mean scores for HPV knowledge were 19.4 out of 26, and 7.2 out of 12 for HNC knowledge. In the final multivariate linear regression model, sex, race, and year of study were independently associated with HPV and HPV vaccine knowledge. Males had significantly lower HPV vaccine knowledge than females (β = -1.53; 95% CI: -2.53, -0.52), as did nonwhite students (β = -1.05; 95% CI: -2.07, -0.03). There was a gradient in HPV vaccine knowledge based on the year of study, highest among fourth year students (β = 6.75; 95% CI: 5.17, 8.33). Results were similar for factors associated with HNC knowledge, except for sex. HNC knowledge similarly increased based on year of study, highest for fourth year students (β = 2.50; 95% CI: 1.72, 3.29). Among medical students, gaps remain in knowledge of HPV, HPV vaccine, and HPV-linked HNC. Male medical students have significantly lower knowledge of HPV. This highlights the need to increase medical student knowledge of HPV and HPV-linked HNC